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  • Initial Interview Notes

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    Klein Xavier Boiser
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    This document contains notes from an initial interview session with a client. It includes sections about the client's family history, academic experience, self-image, personal values, emotional maturity, sources of stress, coping skills, support systems, relationships, career choices, goals, and other pertinent data like history of abuse or medical conditions. The interview is meant to gather information across different life domains to help assess the client's situation and needs.

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    For Psychological Assessment

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    This document contains notes from an initial interview session with a client. It includes sections about the client's family history, academic experience, self-image, personal values, emotional maturity, sources of stress, coping skills, support systems, relationships, career choices, goals, and other pertinent data like history of abuse or medical conditions. The interview is meant to gather information across different life domains to help assess the client's situation and needs.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    5 views2 pages

    Initial Interview Notes

    Uploaded by

    Klein Xavier Boiser
    This document contains notes from an initial interview session with a client. It includes sections about the client's family history, academic experience, self-image, personal values, emotional maturity, sources of stress, coping skills, support systems, relationships, career choices, goals, and other pertinent data like history of abuse or medical conditions. The interview is meant to gather information across different life domains to help assess the client's situation and needs.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 2

    INITIAL INTERVIEW SESSION NOTES

    Name: _________________________________ Date & Time: __________________

    I.FAMILY HISTORY (more space at the back)

    a. Current Living Situation


    __________________________________________________________________________
    __________________________________________________________________________

    b. Relationship with Parents, Siblings and Extended Family


    __________________________________________________________________________
    __________________________________________________________________________

    c. Best and Worst Memory of growing up


    __________________________________________________________________________
    __________________________________________________________________________

    II. ACADEMIC EXPERIENCE


    __________________________________________________________________________
    __________________________________________________________________________

    III. SELF-IMAGE
    a. Strengths
    __________________________________________________________________________
    __________________________________________________________________________

    b.weaknesses
    __________________________________________________________________________
    __________________________________________________________________________

    IV. PERSONAL VALUES and ATTITUDES ______________________________________________

    V. EMOTIONAL MATURITY _________________________________________________________

    VI. SOURCES OF STRESS __________________________________________________________

    VII. COPING SKILLS ________________________________________________________________

    VIII. SUPPORT SYSTEMS ____________________________________________________________


    IX. RELATIONSHIP WITH PEERS _____________________________________________________

    X. CAREER CHOICES ______________________________________________________________

    XI. GOALS/DREAMS/AMBITIONS _____________________________________________________

    XII. OTHER PERTINENT DATA (History of Abuse, General Medical Conditions & Identified Risk
    Factors)
    _____________________________________________________________________________________
    _____________________________________________________________________________________

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