SOC-449 Intake Form & Questions Worksheet

First, you will find a person to partner with for this mock interview. It can be a friend or family member or classmate.

Important Consideration: Make sure you make it very clear to your partner that they are simply playing a role. They should not add to the information in the intake form or use any experiences from their personal lives when acting out this role. They should also not choose a character situation that might remind them of any traumatic or difficult experiences they have had. This interview has nothing to do with them, it is just about acting out a role they have been provided in the case study.

Next, provide the selected person with all four of the “Intake Interview Forms.” This person is to select only one intake form “character” to play in your mock intake interview scenario. In other words, it’s a chance for them to perform a scene like in one of the videos you watched for this course. This person is NOT to discuss or disclose with you how they are planning to act in the mock interview. They are to simply tell you which client they are going to portray prior to the mock interview so you can prepare the corresponding Intake Interview Questions with the little info you do have on that character before you conduct interview. They may refer to the intake form information at any time during the mock interview.

Keep in mind the engagement strategies and the culture/subculture issues of the client when drafting your questions. Try to utilize these questioning techniques:

 

 

  • Empathy and compassion
  • Suggestions/solutions
  • Guiding the discussion
  • Affective words & phrases
  • Furthering responses
  • Reflective listening
  • Client expectations
  • Eliciting essential information
  • Emphatic communication techniques
  • Ending the interview

 

 

Part 1: Intake Form Client  Due Topic 2
In this section, briefly explain  the person in the selected intake form you will use to conduct your mock interview (50 words):
Describe possible culture/subculture influences on the client (50-75 words):

 

Describe the presenting problem (30-40 words):

 

Explain the possible identified problems. (30-40 words):

 

Intake Interview Questions:  Next, after reviewing the selected intake form, write 10 questions, based off the information presented in the selected intake form, for your client to answer. [Keep in mind Phase I in the Helping Process (in Chapter 3 in Direct Social Work Practice) and obvious adherence to the NASW Code of Ethics when analyzing and revising your questions.]

You will use these 10 questions to conduct your mock intake interview in the upcoming weeks. Write 10 questions that will lead you to the identified problem. Use the instructor feedback to revise your questions before you complete your mock interview later in the course.

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