Psychiatric Interview
- professional relationship
- with sense of purpose
- unfeeling and undirected convo is avoided
- compassion & curiosity
- organized and structured gathering of data
Objectives of Psych Interview
- nature of problem
- therapeutic relationship (empathy, competence, respect, trust, & interest
- info about problem and treatment plan
Theapeutic Alliance
- doctor-patient relationship
- patient's conscious and unconscious desire to cooperate
Process of Psych Interview
- emotional reactions to questioning
- matters to be discussed
- sensitivity and sensibility of actual verbal exchange
- patient's feelings at that time
- patient's reactions to what is happening during the interview
1)Process Communication
- not all patients express their feelings
- unacknowledge feelings may be present
a. Characteristics
- fear may be expressed by anger or irritation
- speak about present by recalling past
- important messages hide in trivial remarks r jokes
- shifts of topics
- may speak through body language
- if same concern is repeated, note it
- physician's emotion-reaction to patient and reflection on patient's feelings
b. Resistance
- conscious and unconscious forces that oppose the therapeutic process
- e.g. tardiness, staring at the floor, no eye contact, hiding hands, sitting stiffly, not moving or too much moving, nothing to say
Phases of Psych Interview
1)Initial
a. Proper Introduction - patient's name, physician's name, patient's companion
b. Comfortable Seating-explain the purpose, open-ended/non-directive questions
2)Middle
- discovers what is troubling the patient (emotional responses and psychosocial factors within)
- examine the physician to understand thoughts, feelings and reactions
- note patient's responses (verbal & nonverbal)
a. Interview Techniques
- fit on interviewer's style and comfort (friendly convo or interrogation)
- eye contact
- body posture (arms not folded on chest)
- facilitation (encourage patient to elaborate)
- open-ended questions
- support (willingness to help)
- clarification
- confrontation (if inconsistent and contradictory)
- silence (give chance to explore deeper concerns)
- reflection (explore and organize ideas and emotions
- effects of reflection (opportunity for patient to change interviewer's perception or bring new topics)
b. Levels of Reflection (factual, surface feeling, underlying feeling)
c. Jargon and Humor (counterproductive, dehumanizing, confusing form of resistance)
d. Transference
e. Countertransference
f. Effective Listening
3)Terminal
- give patient chance to ask questions
- summarize the interview
- plans for the future
- thank patient for sharing
a. Interviewing Children
- may respond to nurturing doctor
- play and fantasy may help in rapport
b. Interviewing Adolescents
- respond best to direct and simple questions
- warm and respectful manner
c. Interviewing Elderly
- respond to those who have sincere interest, patient, and gentle
- direct questions about sensitive issues (if rapport was established)
