Oral Interview Vignettes

1. PsyD CCE Oral Interview Clinical Vignette 1
Miss Jennifer Nguyen is a 38-year-old female of Asian and Caucasian descent. She is seeking
individual psychotherapy to help with her “relationships.” She noted, “I am having great difficulty
getting along with my partner.” She also noted she is very sad much of the time and cries “at all the
stupid commercials on TV.” She noted she has been feeling this way for a “very long time” but that
more recently “things have gone from bad to worse.” She noted she often wishes she “would just
not wake up one morning.”
During her intake she revealed the following history. Her father is an American of European
heritage and her mother is Vietnamese. She reported her father met her mother in the former South
Vietnam during the war. She indicated her father married her mother and returned to the states
after his tour of duty was completed. Miss Nguyen noted her mother was 18 years old when she
moved to America.
Miss Nguyen reported her father molested from the ages of 9 until 13. She noted the molestation
included sexual intercourse. She indicated she made an outcry at a slumber party to a friend who
then told her teacher at school. By all accounts, she was removed from her father’s custody and her
father was successfully prosecuted and incarcerated for 10 years.
Miss Nguyen noted when her mother divorced her father, she took her maiden name back. When
Miss Nguyen turned 18, she legally changed her name to Nguyen to “forget about that miserable
bastard and put it out of my mind.”
Miss Nguyen reported a history of unstable relationships with both peers and significant others. She
noted she has fights with her current significant other whom she has cohabitated with for about 6
months. She noted, “We met online and I was instantly drawn to her. It was like she understood
me like no one else.” Miss Nguyen reported the current relationship is rocky and unstable but she
“really loves” her partner and wants to work things out.
Miss Nguyen noted she has no children and is gainfully employed as an executive assistant to a civil
rights attorney. She noted she does her job well but is often in conflict with her peers and boss.

2. PsyD CCE Oral Interview Clinical Vignette 1
Interviewer Copy
Miss Jennifer Nguyen is a 38-year-old female of Asian and Caucasian descent. She is seeking
individual psychotherapy to help with her “relationships.” She noted, “I am having great difficulty
getting along with my partner.” She also noted she is very sad much of the time and cries “at all the
stupid commercials on TV.” She noted she has been feeling this way for a “very long time” but that
more recently “things have gone from bad to worse.”
During her intake she revealed the following history. Her father is an American of European
heritage and her mother is Vietnamese. She reported her father met her mother in the former South
Vietnam during the war. She indicated her father married her mother and returned to the states
after his tour of duty was completed. Miss Nguyen noted her mother was 18 years old when she
moved to America.
Miss Nguyen reported her father molested from the ages of 9 until 13. She noted the molestation
included sexual intercourse. She indicated she made an outcry at a slumber party to a friend who
then told her teacher at school. By all accounts, she was removed from her father’s custody and her
father was successfully prosecuted and incarcerated for 10 years.
Miss Nguyen noted when her mother divorced her father, she took her maiden name back. When
Miss Nguyen turned 18, she legally changed her name to Nguyen to “forget about that miserable
bastard and put it out of my mind.”
Miss Nguyen reported a history of unstable relationships with both peers and significant others. She
noted she has fights with her current significant other whom she has cohabitated with for about 6
months. She noted, “We met online and I was instantly drawn to her. It was like she understood
me like no one else.” Miss Nguyen reported the current relationship is rocky and unstable but she
“really loves” her partner and wants to work things out.
Miss Nguyen noted she has no children and is gainfully employed as an executive assistant to a civil
rights attorney. She noted she does her job well but is often in conflict with her peers and boss.
Possible diagnoses to keep in mind with information given
Axis I:
1. Major Depressive Disorder
2. Dysthymia with a Major Depressive Disorder superimposed
3. Posttraumatic Stress Disorder
4. Adjustment Disorder
Axis II:
1. Borderline Personality Disorder
2. Histrionic Personality Disorder
3. Personality Disorder NOS/Mixed Personality Disorder

3. PsyD CCE Oral Interview Clinical Vignette 2
Mr. Carl Wilson is a 43-year-old male of African American heritage. He is in an inpatient psychiatric
ward. His chart indicates he was brought into the emergency room “ranting and raving” about the
end of the world and than “all must repent to believe.” Documents from the attending physician
indicate, “Mr. Wilson kept repeating, ‘I am the way, the truth and the life, no one comes to the
father except through me.” Apparently, 30 mg of Haldol IM helped him calm down.
After being admitted to the psychiatric ward for “observation” and “stabilization,” Mr. Wilson
decided he wanted to leave and became agitated. His agitation accelerated to the point of requiring
physical restraints for 2 hours. After another does of Haldol, his behavior calmed and he was able
to return to his room but was under one-on-one observation for the next two days.
During his ER intake, blood work was positive for marijuana and amphetamines. During his
interview, his speech was pressured and his thoughts were tangential. The content of his
spontaneous responses frequently centered on religious material. For example, he noted, “God has
blessed me with the spiritual gift of discernment. I know where evil is and I have been commanded
to purge the world of evil as an intercessory prayer warrior.” By all accounts, Mr. Wilson attends a
local Pentecostal church. He noted he sees spirits and can hear the voice of God leading him to “do
the good works in the name of Jesus.”
His wife of 10 years reported Mr. Wilson has a history of “binging” on the “ice.” She noted he
recently relapsed from 4 years of clean time. She noted he was recently let go from his job of 5 years
and became increasingly despondent over the next few weeks and months. She reported his interest
in relations had diminished and that he had gained several pounds. She noted he often sat up late at
nights watching television and then not getting up out of the bed in the morning.
Mrs. Wilson noted, “His father was in the state hospital for a long time, I don’t know what he was
diagnosed with but he was always just a little bit off.”

4. PsyD CCE Oral Interview Clinical Vignette 2
Interviewer Copy
Mr. Carl Wilson is a 43-year-old male of African American heritage. He is in an inpatient psychiatric
ward. His chart indicates he was brought into the emergency room “ranting and raving” about the
end of the world and than “all must repent to believe.” Documents from the attending physician
indicate, “Mr. Wilson kept repeating, ‘I am the way, the truth and the life, no one comes to the
father except through me.” Apparently, 30 mg of Haldol IM helped him calm down.
After being admitted to the psychiatric ward for “observation” and “stabilization,” Mr. Wilson
decided he wanted to leave and became agitated. His agitation accelerated to the point of requiring
physical restraints for 2 hours. After another does of Haldol, his behavior calmed and he was able
to return to his room but was under one-on-one observation for the next two days.
During his ER intake, blood work was positive for marijuana and amphetamines. During his
interview, his speech was pressured and his thoughts were tangential. The content of his
spontaneous responses frequently centered on religious material. For example, he noted, “God has
blessed me with the spiritual gift of discernment. I know where evil is and I have been commanded
to purge the world of evil as an intercessory prayer warrior.” By all accounts, Mr. Wilson attends a
local Pentecostal church. He noted he sees spirits and can hear the voice of God leading him to “do
the good works in the name of Jesus.”
His wife of 10 years reported Mr. Wilson has a history of “binging” on the “ice.” She noted he
“came to the Lord” while in prison and then married her when he was paroled 10 years ago. She
noted he recently relapsed from “4 years of clean time.” She noted he was recently let go from his
job of 5 years and became increasingly despondent over the next few weeks and months. She
reported his interest in relations had diminished and that he had gained several pounds. She noted
he often sat up late at nights watching television and then not getting up out of the bed in the
morning.
Mrs. Wilson noted, “His father was in the state hospital for a long time, I don’t know what he was
diagnosed with but he was always just a little bit off.”
Possible diagnoses to keep in mind with information given
Axis I:
1. Bipolar I Disorder, Most Recent Episode Manic
2. Methamphetamine intoxication
3. Substance-Induced Psychotic Disorder
4. Schizophrenia, Paranoid type
5. Brief Psychotic Disorder
6. Delusional Disorder, Grandiose Type
7. Adjustment Disorder, With Mixed Mood and Conduct
Axis II:
1. Narcissistic Personality Disorder
2. Antisocial Personality Disorder
3. Personality Disorder NOS/Mixed Personality Disorder

5. PsyD CCE Oral Interview Clinical Vignette 3
Mr. and Mrs. Joe Smith are seeking marital therapy. Mr. Smith is a 40-year-old Caucasian male. He
is reportedly a very successful and prominent local business executive. Mrs. Smith is a 30-year-old
Caucasian female. She is currently enrolled in a community college and will graduate with her
associate’s degree in two months. They have been married approximately 6 years. This is Mr.
Smith’s second marriage and Mrs. Smith’s first marriage. They have a 5-year-old son, Brandon, their
only child. Joe has two children from his first marriage. They live out of state with their mother and
stepfather.
During the intake, Joe presents dressed in a handsome business suit. His salt-and-pepper gray hair is
slicked back and his fingernails are manicured. His wingtips are well polished. Mary is equally well
dressed in fashionable attire that flatters an attractive figure. Her nails too are manicured and across
her arm is an expensive brand-name handbag. They look like models from a fashion magazine.
Joe complains of Mary’s “extreme moodiness.” He noted he first experienced her “good days” as
exhilarating. He noted, “She had unlimited energy and was very exciting in bed.” He added, “Now,
there are days where she won’t get up until noon and the house is a wreck.”
She noted Joe has a volatile temper that can erupt over the littlest thing. She noted she walks on
eggshells around him. She denied he has ever hit her but noted he yells and has broken small items
by smashing them. She noted, “He’s like a volcano and I never know when he is going to erupt.”
She noted he is more likely to have an “outburst” after a “couple of cocktails.”
Over the course of five sessions, both appear to be making some degree of progress. Joe notes
Mary is managing to get up and out of bed on most days and Mary notes that Joe is learning to
manage his temper better.
Between the fifth and sixth session, Mary leaves a voicemail. She sounds almost desperate and her
speech is rapid. She says, “Hi, its me, Mary Smith. I need you to call me back immediately. Please,
as soon as you get this message, please call me back. You can reach me on my cell phone or at the
house.” She left the numbers so quickly, you had to rewind the message three times to write them
down.
When you get a hold of her, she is speaking very rapidly and jumping from subject to subject while
communicating the urgent information. She noted she feels very guilty and “needs to get something
off [her] chest.” In sum, she tells you that Joe has “spanked” Brandon on two occasions. She noted
that both spankings left noticeable but not life-threatening bruises on the child’s buttocks and upper
thigh. She noted the last event took place 6 months ago when Brandon accidentally spilled grape
juice on their new carpet in the living room. As she continues this story, she tearfully explains she
“desperately wants to save this marriage” and pleads with you not to bring this up to Joe in their
sessions, but “could no longer keep this secret.” She noted if you bring it up in session “Joe will
leave me immediately.” She added, “God wants me to stay in this marriage and I can’t afford to live
without him.” She concludes with, “If he were to leave me, I don’t know what I would do.”

6. PsyD CCE Oral Interview Clinical Vignette 3
Interviewer Copy
Mr. and Mrs. Joe Smith are seeking marital therapy. Mr. Smith is a 40-year-old Caucasian male. He
is reportedly a very successful and prominent local business executive. Mrs. Smith is a 30-year-old
Caucasian female. She is currently enrolled in a community college and will graduate with her
associate’s degree in two months. They have been married approximately 6 years. This is Mr.
Smith’s second marriage and Mrs. Smith’s first marriage. They have a 5-year-old son, Brandon, their
only child. Joe has two children from his first marriage. They live out of state with their mother and
stepfather.
During the intake, Joe presents dressed in a handsome business suit. His salt-and-pepper gray hair is
slicked back and his fingernails are manicured. His wingtips are well polished. Mary is equally well
dressed in fashionable attire that flatters an attractive figure. Her nails too are manicured and across
her arm is an expensive brand-name handbag. They look like models from a fashion magazine.
Joe complains of Mary’s “extreme moodiness.” He noted he first experienced her “good days” as
exhilarating. He noted, “She had unlimited energy and was very exciting in bed.” He added, “Now,
there are days where she won’t get up until noon and the house is a wreck.”
She noted Joe has a volatile temper that can erupt over the littlest thing. She noted she walks on
eggshells around him. She denied he has ever hit her but noted he yells and has broken small items
by smashing them. She noted, “He’s like a volcano and I never know when he is going to erupt.”
She noted he is more likely to have an “outburst” after a “couple of cocktails.”
Over the course of five sessions, both appear to be making some degree of progress. Joe notes
Mary is managing to get up and out of bed on most days and Mary notes that Joe is learning to
manage his temper better.
Between the fifth and sixth session, Mary leaves a voicemail. She sounds almost desperate and her
speech is rapid. She says, “Hi, its me, Mary Smith. I need you to call me back immediately. Please,
as soon as you get this message, please call me back. You can reach me on my cell phone or at the
house.” She recited the numbers quickly; you had to rewind the message three times to write them
down.
When you get a hold of her, she is speaking very rapidly and jumping from subject to subject while
communicating the urgent information. She noted she feels very guilty and “needs to get something
off [her] chest.” In sum, she tells you that Joe has “spanked” Brandon on two occasions. She noted
that both spankings left noticeable but not life-threatening bruises on the child’s buttocks and upper
thigh. She noted the last event took place 6 months ago when Brandon accidentally spilled grape
juice on their new carpet in the living room. As she continues this story, she tearfully explains she
“desperately wants to save this marriage” and pleads with you not to bring this up to Joe in their
sessions, but “could no longer keep this secret.” She noted if you bring it up in session “Joe will
leave me immediately.” She added, “God wants me to stay in this marriage and I can’t afford to live
without him.” She concludes with, “If he were to leave me, I don’t know what I would do.”
See possible diagnoses on next page

7. Possible diagnoses to keep in mind with information given
Joe Mary
Axis I
1. Alcohol Abuse
2. Alcohol Dependence
3. Intermittent Explosive Disorder
4. Physical Abuse of a Child
5. Adjustment Disorder
Axis I
1. Bipolar I Disorder
2. Bipolar II Disorder
3. Major Depressive Disorder
4. Substance Intoxication
5. Substance Abuse Disorder
Axis II
1. Narcissistic Personality Disorder
2. Antisocial Personality Disorder
Axis II
1. Borderline Personality Disorder
2. Narcissistic Personality Disorder
3. Histrionic Personality Disorder
4. Dependent Personality Disorder

8. PsyD CCE Oral Interview Clinical Vignette 4
Dr. Chandra Wilson is an attractive 40-year-old female of African American heritage. She bristled
when you called her by her first name and she only addresses you in a formal manner. She is petite
and shorter than average. She is of slender build but this is not immediately apparent as she is
wearing clothes that are too big for her. She is a pediatrician and has a successful private practice in
a middle-class neighborhood. She presented initially complaining of “worrying too much,” “trouble
sleeping,” and “difficulty in [her] marriage.” She noted she has been “down” and “blue” for “a
while.” She noted when she tries to sleep, thoughts race and keep her from sleeping unless she takes
an Ambien. She noted she wanted couples therapy, but indicated her husband believes “counseling
is for the crazy people.” She reported they have two children, ages 6 and 8 years.
Dr. Wilson noted she and her husband have met with their pastor “a couple of times” regarding
their marriage. She reported she has taken samples of Lexapro, 10 mg daily, for the last two weeks.
She reported little change in her mood. It was at this point she sought counseling with you.
She noted she has been married for “over 20 years.” She indicated they were “childhood
sweethearts.” She noted her husband is “emotionally abusive” and can be “physically intimidating.”
She denies any physical abuse of herself. Nevertheless, she is concerned about how his behavior is
affecting their children, especially their oldest child, a son, because “he is emotionally sensitive.”
You agreed to see her in weekly therapy. Dr. Wilson made marked improvements over nine
months. Toward the end of the nine months, she has decreased her session frequency to bi-weekly.
She terminated therapy by not rescheduling after a family vacation.
Eighteen months after she stopped attending therapy, she calls you and tells you she filed for
divorce from her husband. She indicated she is seeking to be the “primary” possessory and
managing conservator of both children. She indicates her attorney has asked her to have you write a
letter giving your opinion about her parenting ability and that of her husband, particularly with
regard to how his abusive behavior would affect their young children.

9. PsyD CCE Oral Interview Clinical Vignette 4
Interviewer Copy
Dr. Chandra Wilson is an attractive 40-year-old female of African American heritage. She bristled
when you called her by her first name and she only addresses you in a formal manner. She is petite
and shorter than average. She is of slender build but this is not immediately apparent as she is
wearing clothes that are too big for her. She is a pediatrician and has a successful private practice in
a middle-class neighborhood. She presented initially complaining of “worrying too much,” “trouble
sleeping,” and “difficulty in [her] marriage.” She noted she has been “down” and “blue” for “a
while.” She noted when she tries to sleep, thoughts race and keep her from sleeping unless she takes
an Ambien. She noted she wanted couples therapy, but indicated her husband believes “counseling
is for the crazy people.” She reported they have two children, ages 6 and 8 years.
Dr. Wilson noted she and her husband have met with their pastor “a couple of times” regarding
their marriage. She reported she has taken samples of Lexapro, 10 mg daily, for the last two weeks.
She reported little change in her mood. It was at this point she sought counseling with you.
She noted she has been married for “over 20 years.” She indicated they were “childhood
sweethearts.” She noted her husband is “emotionally abusive” and can be “physically intimidating.”
She denies any physical abuse of herself. Nevertheless, she is concerned about how his behavior is
affecting their children, especially their oldest child, a son, because “he is emotionally sensitive.”
You agreed to see her in weekly therapy. Dr. Wilson made marked improvements over nine
months. Toward the end of the nine months, she has decreased her session frequency to bi-weekly.
She terminated therapy by not rescheduling after a family vacation.
Eighteen months after she stopped attending therapy, she calls you and tells you she filed for
divorce from her husband. She indicated she is seeking to be the “primary” possessory and
managing conservator of both children. She indicates her attorney has asked her to have you write a
letter giving your opinion about her parenting ability and that of her husband, particularly with
regard to how his abusive behavior would affect their young children.
Possible diagnoses to keep in mind with information given
Axis I
1. Eating Disorder
2. Substance Abuse
3. Adjustment Disorder
4. Major Depressive Disorder
5. Anxiety Disorder
6. Malingering
7. Partner Relational Problem
Axis II
1. Narcissistic Personality Disorder

10. PsyD CCE Oral Interview Clinical Vignette 5
Geoffrey Alexander is a 12-year-old male of Caucasian heritage. Geoffrey arrived at his appointment on time with his
mother, Tiffany Alexander.
Ms. Alexander noted, “Geoffrey is having so many problems [sic].” She added, “Like learning and poor reading.” Ms.
Alexander noted the onset of his condition began to impact his education seriously at least two years ago. Ms.
Alexander reported the condition began to interfere with school on in the fourth grade when he began to earn “Fs” on
his report card. By all accounts, Geoffrey has received special education services since entering elementary school.
Geoffrey noted he is in the seventh grade. By all accounts he earns poor grades. He said, “I don’t like school.”
Geoffrey noted he was disciplined once for bringing a knife to school.
Geoffrey noted he has satisfactory peer relationships. Ms. Alexander noted he is a “home body” who isolates and stays
to himself. Ms. Alexander noted Geoffrey gets along well with the friends he has and has no problems with authority
figures. She noted sibling strife that appeared within expected limits.
By all accounts, Geoffrey has trouble paying attention and attending to tasks. Mother noted he does not “complete
tasks” on time and has “trouble focusing.” She gave examples of attempts to provide direction in the.
Geoffrey was born in Dallas, Texas, on July 19, 1992. There are no indications of a family history of serious mental
illness, substance abuse, or criminal activity. Geoffrey reported a satisfactory family history. Geoffrey noted he has one
sister. Ms. Alexander denied any unusual medical problems. Geoffrey denied a history of substance use.
His height was average and his build was judged average. He demonstrated adequate hygiene. He was dressed casually
for the evaluation. He looked his stated age. He did not utilize corrective lenses to help him read or perform tasks. He
typically demonstrated adequate eye contact and paid adequate attention during the interviews. His speech content was
depleted but his answers were goal-directed and articulation problems were minimal. While he might have
mispronounced some words, he did not make notable errors prohibiting the evaluator to understand his verbal
responses. Rate was within normal limits with volume on the soft-side of normal.
Geoffrey demonstrated an appropriate range of emotional expression. His mood was generally euthymic during the
interview. His affect was calm and mood congruent. Mom noted a history of anxiety and worry and anger outbursts at
home when he is frustrated. She noted he has a strong “stubborn streak” when he is asked to do things he does not
want to do something. He did not demonstrate any severe psychomotor agitation. He had no difficulty sitting still in his
chair and apparently focusing on the required tasks. Ms. Alexander noted his sleeping patterns are poor. He indicated
he has trouble falling asleep and does not sleep through the night. Mother noted he gets 7 hours of sleep a night. She
noted his appetite has been strong. He noted he is interested in “going” with girls but does not have a girlfriend.

11. PsyD CCE Oral Interview Clinical Vignette 5
Interviewer Copy
Geoffrey Alexander is a 12-year-old male of Caucasian heritage. Geoffrey arrived at his appointment on time with his
mother, Tiffany Alexander.
Ms. Alexander noted, “Geoffrey is having so many problems [sic].” She added, “Like learning and poor reading.” Ms.
Alexander noted the onset of his condition began to impact his education seriously at least two years ago. Ms.
Alexander reported the condition began to interfere with school on in the fourth grade when he began to earn “Fs” on
his report card. By all accounts, Geoffrey has received special education services since entering elementary school.
Geoffrey noted he is in the seventh grade. By all accounts he earns poor grades. He said, “I don’t like school.”
Geoffrey noted he was disciplined once for bringing a knife to school.
Geoffrey noted he has satisfactory peer relationships. Ms. Alexander noted he is a “home body” who isolates and stays
to himself. Ms. Alexander noted Geoffrey gets along well with the friends he has and has no problems with authority
figures. She noted sibling strife that appeared within expected limits.
By all accounts, Geoffrey has trouble paying attention and attending to tasks. Mother noted he does not “complete
tasks” on time and has “trouble focusing.” She gave examples of attempts to provide direction in the.
Geoffrey was born in Dallas, Texas, on July 19, 1992. There are no indications of a family history of serious mental
illness, substance abuse, or criminal activity. Geoffrey reported a satisfactory family history. Geoffrey noted he has one
sister. Ms. Alexander denied any unusual medical problems. Geoffrey denied a history of substance use.
His height was average and his build was judged average. He demonstrated adequate hygiene. He was dressed casually
for the evaluation. He looked his stated age. He did not utilize corrective lenses to help him read or perform tasks. He
typically demonstrated adequate eye contact and paid adequate attention during the interviews. His speech content was
depleted but his answers were goal-directed and articulation problems were minimal. While he might have
mispronounced some words, he did not make notable errors prohibiting the evaluator to understand his verbal
responses. Rate was within normal limits with volume on the soft-side of normal.
Geoffrey demonstrated an appropriate range of emotional expression. His mood was generally euthymic during the
interview. His affect was calm and mood congruent. Mom noted a history of anxiety and worry and anger outbursts at
home when he is frustrated. She noted he has a strong “stubborn streak” when he is asked to do things he does not
want to do something. He did not demonstrate any severe psychomotor agitation. He had no difficulty sitting still in his
chair and apparently focusing on the required tasks. Ms. Alexander noted his sleeping patterns are poor. He indicated
he has trouble falling asleep and does not sleep through the night. Mother noted he gets 7 hours of sleep a night. She
noted his appetite has been strong. He noted he is interested in “going” with girls but does not have a girlfriend.
Possible diagnoses to keep in mind with information given
Axis I
1. Learning Disorder(s)
2. Adjustment Disorder
3. Attention Hyperactivity Deficit Disorder
4. Oppositional Defiant Disorder
5. Conduct Disorder
6. Major Depressive Disorder
7. Articulation Disorder
Axis II
1. Mild Mental Retardation
2. Borderline Intellectual Functioning