Which of the following is NOT a facilitative message?
A. Questions used in clinical interviews can be either facilitative or obstructive. Facilitative messages help the interview to fl ow, establish a rapport and gain the confi dence of the patient. For example, open-ended questions, facilitating statements, refl ections, silence, interpretations, positive reinforcements, etc. Run on or polythematic questioning refers to the process of asking the patient a number of questions at the same time. For example, ‘Have you felt high in spirits, gone on spending sprees and made foolish investments in the past week?’ These questions can be obstructive. Self disclosures are statements about oneself (the psychiatrist) that may help establish a rapport with the patient. I want messages are generally used when the interview fails to progress because the patient is stuck on the same topic. In this case, the psychiatrist could say politely that he or she wants to move on to other topics.
A psychiatrist at an early stage of his initial assessment interview asks the patient, ‘Can you tell me about your depression?’
Which of the following interview techniques is he utilizing?
B. Open-ended questions refl ect a topic that the psychiatrist may want to explore, but leaves it open to the patient to say what he/she thinks is important. These questions are used to start the interview and, later on, can lead to specifi c closed-ended questions. Put down questions are where the underlying message is a criticism. For example ‘How can you complain when you have got an A grade in your GCSE?’ Facilitation statements encourage the patient to continue along a particular line of thought. For example, statements such as ‘Go on’; ‘Proceed’; ‘What else’ are facilitation statements.
Which of the following is an open-ended question?
A. A question whose answer cannot be a simple yes or no, or a single factual answer that can be classifi ed as right or wrong, is an open-ended question, such as the question given in 3. A. (See also Question 2).
During a clinical interview the following statement is made by the clinician: ‘So you have been anxious since these changes occurred at your work place.’
Which of the following interview technique best describes the above statement?
E. Refl ections are statements where the psychiatrist repeats what the patient has just said. This gives an opportunity to correct one’s understanding of what the patient said and to let the patient know that the clinician is listening and trying to understand the situation the patient is in. Interpretations are inferences reached by examining patterns of behaviour or thoughts expressed at a clinical interview.
Which of the following interview techniques is least directive?
B. Directiveness in the interview ensures that a clinician has all the information needed from a patient. Highly directive intervention aims to focus and restrict the patient’s speech content and behaviour. These may include check lists or yes/no questions. Limit setting and redirection include situations where a clinician attempts to change the direction of the interview, especially when the interview is not progressing in the detail of information transferred.
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