There are many different theoretical perspectives that can form the basis for listening during a psychiatric interview. Each of the stands is based on certain attitudes and focuses of attention. The latter describes the role assigned to the therapist during the interview, as well as the main aspects that need to be scrutinized. The psychiatric picture of the patient given for analysis suggests many different strategies for the interview. The behavioral, existential, and cognitive perspectives were chosen to analyze the manifestations of symptoms and related problems.
From the cognitive perspective, the patient interview is based on exploring cognitive correspondences and examining the causes and mechanisms of the patient’s impairment. According to this perspective, the therapist needs to pay attention to the description of the patient’s roles in various social situations (Aboraya, 2022). The interviewer is a benign expert; in the case under study, a patient named Bob acts as a victim of police prosecution. The cognitive inconsistency manifests itself in the fact that the man attributes his involvement in the police and his desire to have many people around him, including the therapist, arrested. Because of his reluctance to compromise himself, Bob refuses to provide information about prior treatment experiences. Therein lies the main difficulty in working with the patient. From a cognitive perspective, the therapist should choose soft interaction tactics that are trusting and aimed at compensating for the role mismatch.
From the existential perspective, the therapist’s task is limited to examining the feelings of the patient that lead to a distortion of the perception of reality and the various types of traumatization that affect the patient’s motives and goals for behavior (Aboraya, 2022). In Bob’s case, the therapist needs to reach a maximum level of empathy for the patient’s experiences to understand the initial feelings that initiated his disorder. In this case, the patient’s symptoms, namely his mistrustful, false anxiety, are the result of a particular effect that needs to be uncovered. All aspects of Bob’s existential behavior have their origins in a biographical background filled with various emotional phenomena.
The behavioral perspective views the conversation with the patient as a search for abnormalities in the patient’s behavioral attitudes. The task of the therapist is to determine how the manifested symptoms indicate the person’s lack of adaptability to various life situations (Aboraya, 2022). In the case under study, the doctor acts as an expert. Ideas about police harassment and an unwillingness to share the patient’s medical history act for the therapist as a consequence of a traumatic experience. The latter became a motivating factor for the emergence of abnormalities and problems in adapting to reality.
The manifestations of Bob’s disorder can be studied from different theoretical perspectives and from different diagnostic manuals. Besides the DSM-5, a good guide for symptom analysis is the International Classification of Diseases in its 11th edition (ICD-11), which provides detailed descriptions not only of treatments for the disorders but also of possible causes. For this reason, using this manual may be helpful in choosing a patient interview perspective. Kaplan & Sadock’s Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry can also be recommended as a reliable handbook. It provides quite extensive historical information about the research on a disorder and, therefore, can be particularly helpful in choosing patient interview strategies and selecting appropriate methods of treatment.
References
Aboraya, A. S. (2022). Manual for the Standard for Clinicians’ Interview in Psychiatry (SCIP): A New Assessment Tool for Measurement-Based Care (MBC) and Personalized (1st ed.). Springer.