Biopsychosocial Assessment: Personal Experience

The process of conducting a biopsychosocial interview can be seen as challenging if an interviewer lacks the required experience in performing such an assessment. Before starting an interview, it is important to determine certain points and features of this assessment to pay attention to, including the declaration of its purpose and the focus on minimal guidance. In this paper, I will discuss my experience in conducting a biopsychosocial interview with a focus on my strengths and areas for improvement.

During my conversation with a 68-year-old male client, I was able to address all the issues listed in protocols and templates for this type of interview. In order to start the conversation and motivate the client to speak, I mentioned the purpose of the interview referring to the client’s needs. He was able to answer my questions regarding demographic characteristics, the history of his present problem, social, economic, and cultural aspects of his life, and his mental status and memory. However, it was rather problematic to collect data regarding the client’s current difficulties because he was inclined to answer direct questions rather than tell his own story since childhood in spite of my stimulation and triggers. As a result, much guidance was required in order to learn the details of the client’s mental state (bipolar I disorder) and his problem with alcohol consumption and substance use observed in the past. Furthermore, the client did not provide information on his medical problems other than bipolar I disorder and addiction, as well as on any taken medications.

The flow of the interview was in corresponds to the protocol for conducting biopsychosocial interviews. The client answered my questions actively, clearly formulated the chief complaint associated with improving the quality of his life, increasing self-esteem, and becoming less anxious and dependent on the voices he heard (auditory hallucinations). Still, the client needed much guidance and asking probing questions when he was telling the history of his disease. It was important to collect information regarding the client’s current state (changes in mood, auditory hallucinations, anxiety, problems with self-esteem, aggression, problems with sleep, episodes of depression, and finding himself isolated) and understand how the past history of alcohol consumption and substance use could influence those symptoms. Therefore, in spite of recommendations for biopsychosocial interviews, the conversation was highly directed by me because the client was unwilling to present his history of the disease as a narrative. From that perspective, when the client finished answering my questions, he became silent, and it was necessary to provide the man with more probing questions to address.

The format of a biopsychosocial interview can be effectively used in a clinical setting because it provides a counselor with all the required information about a client’s history of the disease, his or her social and economic status, family, and cultural impacts. As a result, a counselor receives an opportunity to analyze a full picture related to the client’s problem, including the variety of biological, psychological, and specific sociocultural factors that could influence the development of the disease, and that will further impact the effectiveness of the treatment. This format of assessment also allows for identifying all possible risks and problems that are not recognized by a client but are mentioned in an interview. From that perspective, this type of assessment is holistic in its nature, and the information collected during the interview helps a counselor determine all possible problems and risks that should be taken into account while proposing a treatment plan.

After conducting a biopsychosocial interview, I can assess my professional qualities and skills in organizing such challenging interviews. I should state that I can be highly concentrated on a client’s speech as well as on important details from his or her life to make necessary notes in an interview protocol. In addition, I can follow the structure of an interview and understand when I need to guide a client or ask additional questions in order to clarify some points or collect additional information.

As an interviewer, I am too focused on a client’s words and making notes. This is the reason why I cannot feel relaxed and calm while asking questions as is recommended by Elder, Evans, Nizette, and Trenoweth (2014) and Perkinson (2017). Thus, I need to receive more experience in conducting biopsychosocial interviews in order to feel more comfortable while talking with a client. Still, I should state that I followed the key recommendations provided by Passchier and Busschbach (2015) and Brooks and McHenry (2015), and I did not try to give interventional comments before learning a client’s whole story and setting a diagnosis. Therefore, I can assess my skills in organizing this complex interview as basic ones and requiring further improvement even despite the fact that I did not make critical errors while speaking with the client.

It is important to pay attention to the fact that I should further develop my skills in guiding clients during biopsychosocial interviews without interrupting them, formulating effective probing questions, identifying problems and risk areas to focus on, and making efficient summaries to use while developing a treatment plan. In spite of the fact that I demonstrated high results in addressing the above-mentioned areas and issues, I understand that I need to develop these critical skills further in order to become a professional in conducting biopsychosocial interviews and actively using them in my practice. Thus, I will read more literature on how to guide clients when they participate in biopsychosocial interviews and how to formulate probing questions that can be discussed as most appropriate to help individuals organize their thoughts. I will also train in identifying health problems, social issues, and risky factors in clients’ speech to pay attention to these aspects while deciding on the most appropriate treatment. Furthermore, I will develop skills in summarizing the collected information because this step is essential to guarantee that nothing is missed before deciding on a diagnosis and designing a treatment plan.

I can state that my experience as an interviewer who had successfully conducted a biopsychosocial interview changed my conceptual understanding of this process. Referring to the literature and recommendations on planning and organizing biopsychosocial interviews, I was almost sure that the role of a counselor in this interview was rather passive (Chandler & Andrews, 2018; Perkinson, 2017). Thus, focusing on theoretical guidelines, I was prepared to allow a client to take a leading role in an interview while describing the current problem and presenting the history of his or her illness. However, the experience in conducting such an interview has demonstrated that a counselor should also take an active role during a conversation even if this role is not obvious.

The male client whom I was interviewing during an hour was not ready to present his history of the disease in the form that is described in the theoretical literature. It was rather problematic to organize effective communication with him and make him feel comfortable while speaking because he was rather anxious in spite of his readiness to receive assistance. Thus, I had to take an active position during the conversation and lead the client helping him present the details of his life to addressing all the points from the interview protocol. As a result, I was able to understand how it is possible to apply provided recommendations on conducting biopsychosocial interviews while working with different clients whose readiness or willingness to participate in this assessment can be different. I have realized that it can be a challenging task to develop a mutual understanding with a client and stimulate him or her to honestly answer questions and provide true information about one’s personal life.

My experience in conducting a biopsychosocial interview helped me identify my unique strengths as an interviewer, as well as the areas for development and improvement. I understand that further practice in using this assessment is the most effective approach for me to develop skills in this type of interview. In addition, I will concentrate on available research on the topic in order to determine the most efficient techniques that can be used by counselors to conduct biopsychosocial interviews if they have no experience in this area. As a result of these activities, I will be able to apply this assessment tool in my practice.

References

Brooks, F., & McHenry, B. (2015). A contemporary approach to substance use disorders and addiction counseling (2nd ed.). Alexandria, VA: John Wiley & Sons.

Chandler, C., & Andrews, A. (2018). Addiction: A biopsychosocial perspective. Thousand Oaks, CA: SAGE Publications.

Elder, R., Evans, K., Nizette, D., & Trenoweth, S. (Eds.). (2014). Mental health nursing: A manual for practice. London, UK: Elsevier Health Sciences.

Passchier, J., & Busschbach, J. (2015). Quality of Life. In F. Andrasik, J. L. Goodie, & A. L. Peterson (Eds.), Biopsychosocial Assessment in Clinical Health Psychology. (pp. 182-192). New York: The Guildford Press.

Perkinson, R. R. (2017). Chemical dependency counseling: A practical guide (5th ed.). Thousand Oaks, CA: SAGE Publications.