Contemporary Psychiatric Interviewing: New Directions for Training

Abstract

THERE has been an unheralded evolution in psychiatric interviewing, an evolution that is, nonetheless, of a critical nature. Over the past three decades the basic psychiatric interview has evolved into a collection of different psychiatric interviews. Each style of interview is determined by the immediate patient care tasks facing the clinician, whether in an emergency room or a private practice office. The acquisition of new skills, such as structuring techniques and diagnostic examinations using the DSM-III, has become a vital and challenging aspect of the education of contemporary psychiatrists. In this paper the influences that have created these new developments in psychiatric interviewing will be outlined and their implications for training discussed. We will describe a specific training approach that has evolved as a method of helping psychiatric residents develop the skills and confidence needed to handle any one of the numerous types of psychiatric interviews required of a contemporary clinician, ranging from a traditional psychodynamic assessment to a standard diagnostic interview.

The “Medication Interest Model”

“…His principles, as well as the introduction of several supervision languages for behaviorally tagging interviewing techniques, were subsequently adopted in the design of interviewing training programs for mental health care professionals Shea & Mezzich, 1988;Shea, Mezzich, Bohon, & Zeiders, 1989). His principles, as well as the introduction of several supervision languages for behaviorally tagging interviewing techniques, were subsequently adopted in the design of interviewing training programs for mental health care professionals Shea & Mezzich, 1988;Shea, Mezzich, Bohon, & Zeiders, 1989).…”

“…Facilic supervision provides clinical mentors with a concrete supervision language (as seen with response-mode systems) for teaching the art of transforming interviews into fluid conversations, including a shorthand visual schematic system for tracking the structuring of trainees as they interview and subsequently reviewing their transitional skills with them (Shea, 1998a;Shea & Barney, 2007b;Shea et al, 1989;Shea & Mezzich, 1988). Facilic supervision provides clinical mentors with a concrete supervision language (as seen with response-mode systems) for teaching the art of transforming interviews into fluid conversations, including a shorthand visual schematic system for tracking the structuring of trainees as they interview and subsequently reviewing their transitional skills with them (Shea, 1998a;Shea & Barney, 2007b;Shea et al, 1989;Shea & Mezzich, 1988).…”

Assessment and validation of diagnostic interviewing skills for the mental health professions

“…Many practitioners have documented how to conduct such an interview (e.g., Hersen & Turner, 1985;Shea, 1988). Although it is widely recognized that the development of diagnostic interviewing skill should be one of the main objectives of mental health education (Borus & Yager, 1986;Maguire, 1982;Pollock, Shanley, & Byrne, 1985), there has been little systematic study on the assessment of diagnostic interviewing competence (McCready & Waring, 1986;Rutter & Cox, 1981;Shea & Mezzich, 1988).…”

The Puzzle of the Psychiatric Interview

“…Studies concerned with the methodological problems of the psychiatric interview mirror a traditional dichotomy within the community of mental health professionals (Othmer & Othmer, 1994;Shea & Mezzich, 1988). The first approach asserts that the psychiatric interview is a technique designed to elicit signs and symptoms that allow nosographical diagnosis, emphasising the importance of their objective and reliable recording.…”