|INTERVIEWING TIP OF THE MONTH
# 160 June 2013
Listening to the Patient's Symptomatic Concerns: The List Technique
TISA Description of the Problem: People will be most motivated to try potentially helpful medications, the more they feel that the prescribing clinician is genuinely listening to their concerns and recommending medication based upon those concerns. The following excellent clinical interviewing tip by Amit Gupta, M.D. provides a useful technique in this regard:
Tip: I have found the following interviewing technique can help patients to better communicate - and even explore - the varying impacts of their symptoms, thus providing guidance on which target symptoms we can collaboratively focus upon first:
"If you can give me an idea of which of your symptoms are the most bothersome for you, you know, cause you the most problems, I think it might help us to choose the best medication for you. Let's see if we can list them in the order of most bothersome to least bothersome. And I'll try to figure out which medication or medications might help best with what is bothering you most."
I find this question communicates genuine interest on my part as well as helping us both to focus upon what might be best to focus upon, especially if there are a multitude of symptoms which is often the case.
TISA Follow-up: This excellent tip from Amit fits in beautifully with the Medication Interest Model (MIM). One of the questions in the MIM is called the "Target Symptoms Question" and goes like this, "What are some of the symptoms from your panic disorder (or whatever disorder the patient is coping with from major depression to congestive heart failure or asthma) that you would most want me to help you with today if I can?"
To learn more about the Medication Interest Model (MIM) you might enjoy the book Improving Medication Adherence: How to Talk with Patients About Their Medications, which has become popular in teaching medical, nursing, physician assistant, clinical pharmacy students (more information including reviews and a sample chapter are to be found by clicking on Book #4 on our TISA home page).
Tip provided by:
Amit Gupta, M. D., F-2 Child Psychiatry
TISA is a site dedicated to advancing the science and art of preventing suicide and teaching clinical interviewing