General Guidelines on Interview Technique
- As much as possible, try to employ the OPEN-ENDED question format. This provides the most freedom for the patient to structure the topic and content of his/her response. With practice, an open-ended questioning style can become second nature.
- Rely on LAUNDRY-LIST or DIRECT questions when more specific information is sought.
- In general, avoid questions which can be answered YES or NO, as these tend to restrict the information obtained.
- Eliminate from your repertoire:
- LEADING questions, which directly or subtly pull for a certain answer;
- MULTIPLE questions, which confuse the patient and are awkward to respond to;
- "WHY?" questions, which are inappropriate during the initial phases of clinical assessment.
- Encourage the patient to continue speaking through REINFORCING GESTURES, both VERBAL and NON-VERBAL, which convey the messages "I’m with you’ I hear you; keep going; you’re doing fine."
- A good interview involves a two-way exchange of information and impressions. This aspect of the interview can be enhanced by making statements which REFLECT, SUMMARIZE, AND CLARIFY, or INTERPRET what the patient has been saying. In general, statements which reflect or summarize have wider application, insofar as they involve only a restatement or feedback of what the patient has already said. In contrast, statements which clarify or interpret involve some active input from the interviewer, and should be employed sparingly – in situations where the interviewer feels that they will help the patient carry forward personal meaning.
- Additional types of statements, including REASSURANCES, CONFRONTATIONS, AND SELF-DISCLOSURES have their place in the interview process, but it is important not to OVERDO any of these lest they get in the way of the interview’s primary purposes: To build rapport and obtain information.
- Be sure to avoid statements which convey PREMATURE ADVICE or a PUT-DOWN. Such statements will shut down the information flow and destroy rapport.
- Develop a tolerance for SILENCE during an interview, but remain sensitive to how the patient is experiencing and reacting to it. Silence can offer a patient some helpful time to think, reflect, feel – but it can also be a source of increased anxiety.
- It is much better to use the time between interviewer responses to LISTEN TO WHAT THE PATIENT IS SAYING, rather than to be deliberating on what you will ask next.
Steve Herman, Ph.D.
Duke Dept. of Psychiatry ca. 1988