10-14 Psych Interview

Question 1

content vs. process

Answer 1

• Content- refers to the factual information which is obtained from the patient - what is actually said.
• Process - the manner in which the interview is conducted and all other aspects of the communication, including non-verbal communication.

Question 2

defining empathy

Answer 2

The most essential emotional response to the patient, empathy goes beyond feeling sorry for the patient or expressing vague feelings of sympathy. It involves the understanding of a patient’s pain, distress, anxiety, sorrow, despair, embarrassment, etc. by putting yourself in his/her shoes and responding to the perceived feeling (“The pain must have been very distressing for you”).

Question 3

defining reassurance

Answer 3

It is not appropriate to provide false reassurance to patients with grave medical problems.

Question 4

defining support

Answer 4

Patients need to understand that you will see the problem through with them. In addition, it is helpful to reinforce healthy aspects of the patient’s efforts to cope with a given symptom or illness

Question 5

When to use open-ended vs close-ended questions

Answer 5

In general, the interview should begin with open-ended questions and proceed toward more closed-ended, specific inquiries.

Question 6

Confidentiality in the psych interview

Answer 6

—All of what you hear from the patient is to be held confidential and is communicated to others in the profession on a need-to-know basis for the purpose of advancing the patient’s care or for medical education.
—On occasion, it may be important for you to reassure the patient about confidentiality.
—Exceptions to the rule of confidentiality do exist, such as required reporting, medical emergencies, or dangerousness.

Question 7

Skeleton of a psych interview

Answer 7

1. Introductions/Assess CC
2. HPI (characterize problem)
3. Med/Surg Hx
4. Past Psych Hx
5. ROS: Both medical and psych
6. Personal Hx*
7. Social Hx
8. Family Hx
9. Mental Status Exam

*Unique to psych interview; includes:Child/adol devel, Family life, School hx, Occup. hx/finances, Relationship/ marital hx, Sexual history/ issues of sexual orientation

Question 8

precedence for duty”to”inform” legislation

Answer 8

Tarasoff ruling