becoming a better interviewer

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I'm doing my psych rotation and I really want to become a better interviewer. The interview is so important and I don't think I'm very good at it. One thing that's frustrating is I always forget to ask important questions. Another thing is that I seem to word questions wrong. I was told not to use the word "why" when asking patients how the patient came in. Is there a book that goes over interview essentials like how to ask specific questions, what to say to difficult patients, how to redirect ect.? I feel like these things should be more natural especially since I came to medical school thinking I would do psych. Now I'm realizing I really need to master my interview skills (which I thought were good until I started this rotation). My attending has been pretty busy so I haven't had a chance to ask questions. I want to be a good psychiatrist and I know that comes with experience but I want to make the most of my time.
 
The psych interview's a bit different and I think getting better at it is mostly a function of time and experience. I think the first step is just getting comfortable sitting with a patient, asking questions, and active listening. Be yourself, be interested in what they have to say, and be compassionate. All of that goes a long way to establishing rapport. Also, it's helpful to have a good knowledge of the DSM-IV-TR criteria because that's where your screening questions come from.

When I was a junior resident, my chief recommended the book, The Psychiatric Interview by Daniel Carlat, which I still have and found to be helpful.
 
I would strongly second the advice of sunlioness. The most important thing when starting out is learning and practicing the art of how to relate to your patient. Without that, it doesn't matter what you do. I've seen many students get so worried about going through the checklist of what they think they need to ask that they forget there's a patient in front of them. You will have time to learn the details of what to ask and how to ask it later. Don't expect to learn how to do a great comprehensive interview in this rotation. That's what your residency is for.
 
Thanks for the replies. I probably will invest in one of the books suggested. If I don't have time to tackle it during this rotation, perhaps I will during my sub-i or another elective.
 
Cool, but keep in mind that the book that toothless recommended and I seconded is small. You could literally read the entire thing during the course of an episode of Family Guy.
 
I think a better start would be to figure out what area of interviewing are you looking to improve--

Patient rapport? Basic diagnostic interview? Advanced diagnostic interview such as when to challenge a patient? Therapeutic interventions?

I'm guessing you're considering basic diagnostic interview.

I like this basic MSE book -
http://www.amazon.com/Psychiatric-M...=sr_1_2?s=books&ie=UTF8&qid=1299811796&sr=1-2

I think of equal importance is watching good models.
 
Last edited:
nitemagi said:
I think a better start would be to figure out what area of interviewing are you looking to improve--

Patient rapport? Basic diagnostic interview? Advanced diagnostic interview such as when to challenge a patient? Therapeutic interventions?

I'm guessing you're considering basic diagnostic interview.

I like this basic MSE book -
http://www.amazon.com/Psychiatric-M...=sr_1_2?s=books&ie=UTF8&qid=1299811796&sr=1-2

I think of equal importance is watching good models.
Click to expand...

Good psychotherapists, especially those psychoanalytically trained ones can really provide good training. The problem with this is that your presence can create a problem. Seeing yourself interviewing by videotaping yourself and seeing others with a 2 way mirror are both excellent ways. The interview is both a skill and an art. Both can be learned however in different ways.

Yet another important reason to really have solid psychotherapy training as a resident.
 
notdeadyet said:
Cool, but keep in mind that the book that toothless recommended and I seconded is small. You could literally read the entire thing during the course of an episode of Family Guy.
Click to expand...

or during American Dad,
but not during South Park. That would be foolish.
And you should never read anything during The Simpsons. In fact, you should shut the blinds, turn off the heater and refrigerator and phone, and kick family members out of the house. As the longest running entertainment program in the history of television, it deserves that kind of respect.

If X Files was still on, I doubt I'd be married, or employed,
or even bathed.
 
sunshine1160 said:
I'm doing an audition rotation, how can I get a copy of the mental status exam explained for cheaper than the $500 price tag? thanks
Click to expand...
Wait until residency for that. Getting down the basics shouldn't require an expensive book.
 
nitemagi said:
I think a better start would be to figure out what area of interviewing are you looking to improve--

Patient rapport? Basic diagnostic interview? Advanced diagnostic interview such as when to challenge a patient? Therapeutic interventions?

I'm guessing you're considering basic diagnostic interview.

I like this basic MSE book -
Amazon product ASIN 0195062515
I think of equal importance is watching good models.
Click to expand...

Worth the $45 price tag?

I don't feel deficient in my interviewing skills, but I do feel like I could shore things up. Frankly I've had next to no formal teaching related to the MSE apart from picking things up clinically. I think it might be helpful to have a basic text that goes over the basics of everything.
 
sunshine1160 said:
Ummm.... I did that, and I saw the absurd price tag on Amazon. I thought this pocketbook was suppose to be around $17, not $400+
Click to expand...
Wow, I bought this exact book a couple of months ago for something like $15. It's a really nice little book but no way it's worth $400+. I suggest you wait for a price drop (the sellers must realize this is unreasonable).

I very enthusiastically second the Zimmerman (a tiny but very useful pocketbook; there is a DSM-5 edition available now http://www.amazon.com/gp/aw/d/096338211X/ref=pd_aw_ppdp_sim_14_2?ie=UTF8&refRID=0VMV5J4XFDEB4MEWEA60 ; a nice collection of screening questions covering DSM criteria for most common disorders), Carlat (also a pocketbook though a bigger one; very practical and insightful, gives some tips on how to approach certain kinds of patients - talkative, paranoid, angry etc), Shea (not a quick read but a worthy time investment) books mentioned above.
 
Amazon has an algorithm for determining prices based on some crazy array of factors. Once in a while, if you're looking at something obscure, the price will come out weird because the algorithm yielded a weird number for some reason. Just look at it on a different website and you'll find a more reasonable price.

That said, the point of posting the google link was that there are lots of online sources that do a great job of summarizing the mental status exam at an adequate level of detail for a med student.
 
im not sure one needs a book on the mental status exam there are so many free resources out there. you can pm me with your email address if you would like the resources I provide for our medical students and interns.
 
also kaplan and sadock has a decent section on the mental status exam that should be avaialable electronically through the medical school or hospital library
 
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