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Initial%20Interview%20Summary

Initial%20Interview%20Summary - Summary of the Initial...

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Summary of the Initial Interview Information Process Openings and Introductions Introduce yourself [1] Explain your role in patient’s care Outline time, goals of interview Your initial goals Teach respondent role to patient Help patient feel comfortable Chief Complaint Ask why patient came for evaluation/treatment Request for chief complaint is directive but open-ended [9] Free Speech [2] Allow several minutes for patient to amplify on reasons for coming Listen for areas of clinical interest [2] Difficulty thinking (cognitive disorders) Substance use Psychosis Mood disorders (depression and mania) Anxiety, avoidance behavior, and arousal Physical complaints Social and personality problems Summarize presenting problems before moving on Early part of interview is nondirective Establish rapport [2–3] Adjust your demeanor to patient’s needs Monitor your feelings Show your positive affect clearly Use language patient can comprehend Don’t criticize patient or others Maintain appropriate distance [4] Call patient by title and last name Don’t talk about yourself Promote flow with silent encouragements [5] Maintain eye contact Nod or smile when appropriate Verbal encouragements [5] “Yes” or “Mm-hmm” Repeat patient’s own word or words Ask for more information Re-request information if patient doesn’t respond at first Briefly summarize to be sure you understand Reassure patient when indicated [5] Must be factual, believable Use body language OK to correct misconceptions about physical, mental sx History of the Present Illness [6] Describe symptoms Type Onset and sequence [6] Severity Frequency Duration Context Stressors [7] Vegetative symptoms: sleep, appetite and weight, diurnal variation [6] Previous episodes [7] When? What were the symptoms? Recovery complete? Previous treatment Type (medications, psychotherapy, social) Compliance Side effects Hospitalizations Consequences of illness [7] Marital and sexual Social Legal Job (disability payments?) Interests Feelings about symptoms, behavior Negative and positive How does patient cope with feelings? Establish the need for truth It’s for patient’s benefit and for yours Reassure about confidentiality: “If you can’t discuss it, don’t lie; just ask to talk about something else” General interviewing principles [10] Restate what patient says to be sure you understand Don’t phrase questions in the negative Avoid asking double questions Encourage precision
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