The Importance of Primacy and Recency Effects When Teaching Our Clients

Mar 05, 2017

“The trouble with being in the rat race is that even if you win, you’re still a rat.”

Lily Tomlin
Comedian and writer

The Importance of Primacy and Recency Effects When Teaching Our Clients

TISA Description of the Problem: One of our most important tasks as clinicians is providing information to our clients – the art of teaching. Unfortunately, precious little time is given in most graduate and psychiatric training programs to improving the educational skills of their students.

In actual clinical practice we frequently find that we are providing information to our clients from psychoeducation about their disorders and/or information about their medications to important information about homework assignments in CBT or details about therapeutic techniques such as relaxation therapy and guided visualization.

In such situations the question is, “Are their ways to improve our ability to convey information to our clients so that they will retain the information better?” A complicated and common situation occurs when we are describing a long list of items to a client, such as a series of homework instructions in CBT or a list of side-effects with medications. Often times client’s “space” such information. The following tip from Katherine Vestevich, Ph.D., provides some useful insights into optimizing client retention in such circumstances.

Tip: Any time I am providing a list of information for a client, I find the following principles from learning studies in cognitive psychology to be useful. “Primacy Effects” suggest that people will tend to remember best the first few items (a cluster) at the beginning of a series. “Recency Effects” occur at the opposite end of the list, where people will tend to remember the last few items mentioned the best. Thus, the first and last cluster of items tend to be retained the best in a long list.

This suggests that if you are giving a client some information, and some of the information is more critical to retain than other information, it is often wise for the clinician to consciously place this more critical information first and/or last. It is a slick trick that works well.

TISA Follow-up: This is a great tip! I have found it to be quite effective in my own clinical work. It also reminds me of another good educational tip, which is to always “test” to see if a client has retained any information that one feels it is particularly important to remember. Let us say that it was important that a patient not “double-up” on a medication dose if the patient accidentally missed a dose. After giving such information I might ask something like this: “Just to make sure that I was clear, Mrs. Jenkins, if you missed a dose of your digoxin, in your own words, what would you do?” If readers have any other tips on how to improve our teaching skills, please send them on, they will be greatly appreciated.

Tip provided by:

Katherine Vestevich, Ph.D.
Kaiser Permanente
Union City, California

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