1500 HS MOD 2 ASSN

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HS1500MOD2CHECKLISTINFO.docx

Interview Checklist Sheet

Name of Practitioner: __________________________________

Initials of Volunteer: __________________________________

Date: __________________________________

Skill Set:

Building Relationships

Check if observed

Attending (Did you do/have the following?)

Open and accessible body posture

Congruent facial expression (matches body language and words)

Slightly inclined toward client (not leaning back)

Regular, appropriate eye contact

No distracting behaviors (fidgeting, tapping pencil, swinging legs, etc)

Minimal encouragement (nod head occasionally, mhmm, etc)

Notes:

Observing (Did you pay attention to the following in your client?)

**For this activity, if you complete a phone interview, some if these obviously can’t be observed visually. However, many can be observed through listening carefully.)

Check if observed

Client’s facial expressions

Eye contact

Body position and movement

Breathing Patterns

Muscle tone (relaxed, tense, shaky?)

Gestures

Skin tone changes (did they flush, grow pale, become sweaty?)

Notes:

Questioning: (Did you do the following?)

Used closed-ended questions when appropriate

Used open-ended questions when appropriate

Asked one question at a time

Avoided using leading questions or interrogating

Notes:

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Refer to Appendix A in text, page 223-224 & assess performance in the following:

Level 1,3,or 5

Listening: Content and Process Evaluation Scale

Empathy Evaluation Scale

Warmth Evaluation Scale

Respect Evaluation Scale

Genuineness Evaluation Scale

Notes: