Basic interviewing techniques

There are a number of basic interviewing techniques 4 that encourage communication. It is important to use the least controlling interview techniques, before embarking on direct questioning.

The open-ended question

The open-ended question is essential in initiating the interview. A question such as 'What kind of troubles have you been having?' says to the patient 'I'm interested in anything you may feel is important enough for you to tell me'.

The open-ended question gives the patient an opportunity to take temporary control of the consultation and to outline problems and concerns.

Listening and silence

Silence is a means of encouraging communication. While the patient is communicating freely, the doctor's behaviour of choice is an interested, attentive and relaxed silence. An attentive facial expression and posture tells the patient non-verbally that he or she has an interested listener. Silence can also encourage communication but one has to be careful that the person does not feel uncomfortable with the process. There is one time when it is mandatory for the doctor to use silence— this is when the patient has stopped speaking from being overwhelmed with emotion.

Facilitation

Facilitation encourages communication by using manner, gesture or words that do not specify the kind of information that is being sought. It suggests that the doctor is interested and encourages the patient to continue. Silence and facilitation go hand in hand.

A common mode of facilitation is the nod of the head, conveying 'I'm listening', 'I understand what you are saying' or 'Go on'. A similar message is conveyed to the patient with an occasional 'mmm-mmm' or by postural shifts towards the patient or into a position of greater alertness. The doctor may also interject short words or phrases, such as 'Yes' or 'I see', without interrupting the flow of the patient's narrative or following a pause saying: 'Yes, I understand— please continue'.

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