Common Interview Techniques

Establish rapport as early in the interview as possible.
Determine the patient’s chief complaint.
Use the chief complaint to develop a provisional differential diagnosis.
Rule the various diagnostic possibilities out or in by using focused and detailed questions.
Follow up on vague or obscure replies with enough persistence to accurately determine the answer to the question.
Let the patient talk freely enough to observe how tightly the thoughts are connected.
Use a mixture of open-ended and closed-ended questions.
Don’t be afraid to ask about topics that you or the patient may find difficult or embarrassing.
Ask about suicidal thoughts.
Give the patient a chance to ask questions at the end of the interview.
Conclude the initial interview by conveying a sense of confidence and, if possible, of hope.

Facilitation: a basic technique to encourage the patient to elaborate on an answer, e.g., “Tell me more.”
Confrontation: Calling the patient’s attention to inconsistencies in his or her responses or body language; for example, “You say that you are not nervous, yet you seem to be quite upset.”
Silence: Waiting patiently for the patient to speak without interrupting him or her;
(the least controlling interviewing technique)
Recapitulation (Summing up)
Summing up the information obtained during the interview;
for example, “Let’s go over what happened last night: you felt very frightened and you called your sister. She came over and brought you…”
Reflection
Physician repeats the patient’s response to encourage elaboration of the answer;
for example, “You said that your heart began to beat rapidly as soon as you went outside?”

What is transference?
Unconscious emotional reactions of patients to their physicians, based in
- childhood parent-child relationships;
  they can interfere with the physician-patient relationship and with compliance with medical advice.
What is positive transference?
The patient views the physician as good and has a high level of confidence in his or her abilities, even without the physician doing anything to earn it.
What is negative transference?
Unjustified resentment or anger of patients toward the physician if their desires and expectations are not realized; this may result in noncompliance with medical advice.

Physicians’ idiosyncratic reactions to the patients;
He may feel guilty when they are unable to help a patient, or they may have particular feelings toward patients who remind them of a close relative or friend.

Family Interview

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