History taking skills

Question 1

Concepts for approaching threatening topics

Answer 1

Normalising questions
Approach with expectation of the symptom to defuse guilt
Use symptom exaggeration to determine true frequency
Use familiar language

Question 2

Stage of the interview to use open ended questions

Answer 2

Opening stage

Question 3

Situations to avoid open ended questions

Answer 3

Over-talkative

Extremely poor historian

Question 4

Purpose of repetition or restatement of what the patient has said during interviews

Answer 4

Allow the patient feel you are actively listening

Question 5

Purposes of summation during an interview

Answer 5

Allows patient to check if they have said everything they have intended to
Allow you to give structure to the information gained so far

Question 6

Interview technique that includes leaning forward, nodding, ‘uh-huh’, ‘go on…’

Answer 6

Facilitation

Question 7

Interview techniques used without focussing on a particular answer

Answer 7

Non-directive techniques

Question 8

Interview techniques used when seeking a particular answer

Answer 8

Directed techniques

Question 9

Stage of the interview to use closed questions

Answer 9

Towards the end

Question 10

Patients to avoid closed questions with

Answer 10

Highly suggestible patients

Question 11

Interview technique where the patient is gently reoriented towards the question

Answer 11

Redirection

Question 12

Interview technique used to move from one topic to another

Answer 12

Transition

Question 13

Three types of transition in interviews

Answer 13

Smooth transition
Referred transition
Introduced transition

Question 14

Type of transition where a cue is taken from something a patient has just said

Answer 14

Smooth transition

Question 15

Type of transition where a cue is taken from something a patient said earlier in the interview

Answer 15

Referred transition

Question 16

Type of transition where a totally new topic is started

Answer 16

Introduced transition

Question 17

Purpose of limit setting in an interview

Answer 17

To use time effectively

Question 18

Interview technique where you point out to the patient something you think they are not telling you, or not being honest about

Answer 18

Confrontation

Question 19

Interview technique where you suggest an association or relationship the patient might not be aware of e.g. ‘you seem anxious when talking about your partner. Are there any relationship difficulties?’

Answer 19

Interpretation

Question 20

Type of interview technique where you purposefully disclose something about your own life

Answer 20

Self-revelation

Question 21

Purposes of using silence during an interview

Answer 21

Indicate disapproval or disinterest
Allow the patient to feel they do not need to spend every moment talking
Facilitate further information from the patient

Question 22

Interview technique where you ask a question based on the assumption a patient exhibits a behaviour without them having told you this e.g. ‘what’s your usual drink’

Answer 22

Symptom expectation

Question 23

Purpose of using symptom expectation in interviews

Answer 23

Reduce the guilt or embarrassment of admitting a behaviour

Question 24

Interview technique where you purposefully guess too high a frequency of a behaviour in order to elicit the true frequency e.g. ‘how many do you smoke a day? Fifty or sixty?’

Answer 24

Symptom exaggeration

Question 25

Purpose of reassurance in interview

Answer 25

Instil hope and avoid despair for the patient

Question 26

Possible drawback to using reassurance in interview

Answer 26

Instilling false hope

Question 27

Interview technique where certain topics are deliberately left for later

Answer 27

Postponement

Question 28

Interview technique where you suggest a certain behaviour or feeling is common/normal to reduce a patient's embarrassment

Answer 28

Validation/normalisation

Question 29

Interview technique where you provide realistic praise to a patient to encourage good self-esteem

Answer 29

Positive reinforcement

Question 30

Interview technique where you use affirmative statements towards a patient e.g. 'you have been through a tough time'

Answer 30

Statement of respect

Question 31

Interview technique where you encourage the patient to ask questions

Answer 31

Partnering

Question 32

Poor interview technique where possible answers are contained in the question

Answer 32

Suggestive questions

Question 33

Poor interview technique where you ask multiple questions within one

Answer 33

Compound questions

Question 34

Issues with asking compound questions in interview

Answer 34

Confuses the patient | Leads to a vague response

Question 35

Non-verbal interview behaviour such as yawning, checking your watch etc. that indicates a lack of attention or interest

Answer 35

Negative nonverbal gestures

Question 36

Interview technique where a patient's own words are used to negate their answers e.g. 'you said you can't form relationships but you've told me about how close you are with your cousin'

Answer 36

Setting traps

Question 37

Advantages to open questions

Answer 37

More informative

Question 38

Disadvantages to open questions

Answer 38

Not time efficient Low precision - do not focus on particular symptoms Low reproducibility at another date

Question 39

Advantages to closed questions

Answer 39

Time efficient Reproducible Allows focus on precise symptoms

Question 40

Disadvantages of closed questions

Answer 40

Low yield in amount of information gained

Question 41

Behavioural observation method where every nth event is described in detail E.g. every fifth time the patient appears to be openly responding is recorded in depth

Answer 41

Event sampling

Question 42

Behavioural observation method where observations are made after a certain amount of time e.g. every fifteen minutes

Answer 42

Time sampling

Question 43

Behavioural observation method where an attempt is made to explain the function of a certain behaviour made by a patient

Answer 43

Functional analysis/ABC analysis

Question 44

Sequence that is recorded in functional analysis/ABC analysis

Answer 44

Antecedent Behaviour Consequences

Question 45

Population groups functional analysis/ABC analysis is used with

Answer 45

LD setting Dementia care Challenging behaviour services

Question 46

Communication to have with an interpreter, if using

Answer 46

Explain the goals of the interview Explain the structure and content of the interview Explain the need for literal translation Ask for feedback if something is hard to translate Ask about the patient's degree of openness Offer to debrief the interpreter afterwards

Question 47

Substance traditionally used in narcoanalysis

Answer 47

Amobarbitol

Question 48

Types of conditions that improve with amobarbitol

Answer 48

Non-organic

Question 49

Type of doctor-patient relationship where the doctor decides the treatment and the patient is expected to comply

Answer 49

Paternalistic

Question 50

Type of doctor-patient relationship where the doctor provides information and the patient makes any decisions themselves

Answer 50

Informative

Question 51

Type of doctor-patient relationship where the doctor knows the patient, and helps them make a decision i.e. there is shared decision making

Answer 51

Interpretive

Question 52

Type of doctor-patient relationship where the doctor attempts to steer the patient in a certain direction but ultimately the patient makes decisions themselves

Answer 52

Deliberative

Question 53

Repeating what the patient has said exactly how they have said it

Answer 53

Repetition

Question 54

Repeating what the patient has said but rearranging the sentence

Answer 54

Restatement

Question 55

Apparent deterioration in a patient's symptoms after an observation of improvement by a healthcare professional

Answer 55

Negative therapeutic reaction

Question 56

Process by which a patient unconsciously attempts to mirror past relationships within a therapeutic relationship

Answer 56

Transference resistance

Question 57

Interview technique where you attempt to understand the feelings of the patient

Answer 57

Empathy

Question 58

Type of question that starts with 'how is...'

Answer 58

Qualitative question