A Brief History of the Clinical Interview

This is a short excerpt (pre-publication) from the forthcoming Encyclopedia of Clinical Psychology, edited by R. Cautin and S. Lilienfeld. My coauthors on this were Waganesh Zeleke and Meredith Hood. Waganesh is now at Duquesne University and Meredith is busy working on her dissertation.

This section is an interesting–albeit academically oriented–description of the history of the clinical interview.

A Brief History of the Clinical Interview

The term “interview” was first used in the 1500s to refer to a formal conference or face-to-face meeting. The term “clinical” has origins from around 1780 and is linked to an objective or coldly dispassionate approach to bedside observations and treatment of hospital patients. Although difficult to determine the precise origin of the joining of clinical and interview in modern use, it appears that Jean Piaget (1896 – 1980) was the first psychologist to use a variant of the term clinical interview.

In 1920, as Piaget was working to develop a standardized French version of an English reasoning test with Theodore Simon in the Binet laboratory in Paris, he became more interested in the fundamental nature of children’s thinking than in the ranking of children’s intellectual ability on a standardized test. Realizing that existing psychological research methods were inadequate for studying cognitive development, he began using an interviewing approach that had much in common with psychiatric diagnostic interviews. He referred to his process as the “semiclinical interview” (Elkind 1964). Piaget’s semiclinical interview combined standard and nonstandard questioning as a means for exploring the richness of children’s thought.

Similar to Piaget’s initial efforts to combine a rigorously standardized protocol with spontaneous or unplanned questioning, the definition and implementation of the clinical interview has historically and presently been characterized by tension between a highly structured or protocol-driven interaction versus an unstructured or free-response process. In a report on structured clinical interviews, Abt (1949) provided an early articulation of this dialectical tension inherent to the clinical interview, noting that researchers did not want to lose the rich, projective, and idiosyncratic material obtained in a clinical interview, but also needed reliable interviewing procedures that were quantifiable.

Abt’s comments captured the qualitative vs. quantitative nature of most historical and contemporary controversies concerning the clinical interview. On the one side, adherents to the medical model view the clinical interview as a scientific assessment endeavor, emphasizing its quantitative nature and psychometrics (e.g., reliability and validity). On the other side, many practitioners view the clinical interview as a means for obtaining qualitative and idiosyncratic data about patients, using both the process and the data obtained to strengthen the therapeutic relationship and move toward a culturally and individually tailored intervention. Since the 1940s the clinical interview has been considered as either a method for gathering facts about symptoms that align with a scientifically valid diagnosis or a relational experience designed to understand the subjective world of another. There are some who contend that the clinical interview can and should be both a scientific and relational process (Sommers-Flanagan and Sommers-Flanagan 2012).

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