|INTERVIEWING TIP OF THE MONTH
# 99 May 2008
Raising the Topic of Physical Fighting
TISA Description of the Problem: As we continue moving through the year 2008, we have a very special series of "Tips of the Month." In 2007 our TISA website was honored by having the following article, "My Favorite Tips from the Interviewing Tip of the Month Archive" published in the Psychiatric Clinics of North America (Shea, SC: Psychiatric Clinics of North America, June 2007,Vol 30:#2, 219-225). The tips in this article all appeared on this website. During the first eight months of 2008 they will now be re-posted with some additional comments - exactly as they appeared in the journal. Congratulations to all of the contributors whose tips were chosen as the very best! Let us now look at our fifth tip from the article.
It can be difficult with adults, in an initial interview, to raise potentially shame or guilt producing topics with which they have been involved as adults, such as physical fighting, in a gentle and nonconfrontative fashion. Mustafa Soomro, M.D., has a nice method of smoothly raising such topics.
Tip: "When I find that if I want to approach the topic of physical fighting unobtrusively, I sometimes start by raising the topic in such a way that it does not necessarily imply that the client was involved in the altercation. Once raised, I can sensitively investigate what role the client himself or herself played in the violence. In this regard the following question is quite useful:
'Have you ever been in situations where fights occurred and you were affected?'
Using this approach I can then proceed to flesh out the role of the client in provoking the violence, escalating it, or perhaps merely being a victim of it."
TISA Follow-up: The above tip is a shrewd and effective one. I find it is very non-threatening, and it can allow one to uncover all sorts of violence from street fighting to domestic violence.
It reminds me of another interviewing technique for raising a difficult topic - participation in prostitution -in a way that makes it less shame producing to discuss by hinting that the prostitution may have been triggered by financial necessity as with, "You told me earlier that you desperately needed to get money for your kids, have you ever found that, out of necessity, you turned to stealing or prostitution?" To this non-offensive inquiry, I have had patients reply, "You know, I had to turn to prostitution for a couple of months, and I'll tell you one thing, no matter what happens to me, I will never do it again."
Tip provided by:
Mustafa Soomro, M.D.