Offering patients opportunities to reveal their subjective experiences in psychiatric assessment interviews

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Objective: With the intention of understanding the dynamics of psychiatric interviews, we investigated the usual (DSM/ICD-based) psychiatric assessment process and an alternative assessment process based on a case formulation method. We compared the two different approaches in terms of the clinicians’ practices for offering patients opportunities to reveal their subjective experiences.
Methods: Using qualitative and quantitative applications of conversation analysis, we compared patient–clinician interaction in five usual psychiatric assessments (AAU) with five assessment interviews based on dialogical sequence analysis (DSA).
Results: The frequency of conversational sequences where the patient described his/her problematic experiences was higher in the DSA interviews than in the AAU interviews. In DSA, the clinicians typically facilitated the patient’s subjective experience talk by experience-focused questions and formulations, whereas in AAU, such talk typically occurred in environments where the clinicians’ questions and formulations focused on non-experiential, medical matters.
Conclusion: Interaction in DSA was organized to provide for the patient’s experience-focused talk, whereas in AAU, the patient needed to go against the conversational grain to produce such talk.
Practice implications: By facilitating patients’ opportunities to uncover subjective experiences, it is possible to promote their individualized care planning in psychiatry.
Original languageEnglish
JournalPatient Education and Counseling
Volume102
Issue number7
Pages (from-to)1296-1303
Number of pages8
ISSN0738-3991
DOIs
Publication statusPublished - 2019
MoE publication typeA1 Journal article-refereed

Fields of Science

  • 5141 Sociology
  • 515 Psychology

Cite this

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title = "Offering patients opportunities to reveal their subjective experiences in psychiatric assessment interviews",
abstract = "Objective: With the intention of understanding the dynamics of psychiatric interviews, we investigated the usual (DSM/ICD-based) psychiatric assessment process and an alternative assessment process based on a case formulation method. We compared the two different approaches in terms of the clinicians’ practices for offering patients opportunities to reveal their subjective experiences.Methods: Using qualitative and quantitative applications of conversation analysis, we compared patient–clinician interaction in five usual psychiatric assessments (AAU) with five assessment interviews based on dialogical sequence analysis (DSA).Results: The frequency of conversational sequences where the patient described his/her problematic experiences was higher in the DSA interviews than in the AAU interviews. In DSA, the clinicians typically facilitated the patient’s subjective experience talk by experience-focused questions and formulations, whereas in AAU, such talk typically occurred in environments where the clinicians’ questions and formulations focused on non-experiential, medical matters.Conclusion: Interaction in DSA was organized to provide for the patient’s experience-focused talk, whereas in AAU, the patient needed to go against the conversational grain to produce such talk.Practice implications: By facilitating patients’ opportunities to uncover subjective experiences, it is possible to promote their individualized care planning in psychiatry.",
keywords = "5141 Sociology, 515 Psychology",
author = "Enik{\"o} Savander and Elina Weiste and Jukka Hintikka and Mikael Leiman and Valkeap{\"a}{\"a}, {Taina Jenni Marika} and Heinonen, {Erkki Olavi} and Per{\"a}kyl{\"a}, {Anssi Matti}",
year = "2019",
doi = "10.1016/j.pec.2019.02.021",
language = "English",
volume = "102",
pages = "1296--1303",
journal = "Patient Education and Counseling",
issn = "0738-3991",
publisher = "ELSEVIER IRELAND LTD",
number = "7",

}

Offering patients opportunities to reveal their subjective experiences in psychiatric assessment interviews. / Savander, Enikö; Weiste, Elina; Hintikka, Jukka; Leiman, Mikael; Valkeapää, Taina Jenni Marika; Heinonen, Erkki Olavi; Peräkylä, Anssi Matti.

In: Patient Education and Counseling, Vol. 102, No. 7, 2019, p. 1296-1303.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Offering patients opportunities to reveal their subjective experiences in psychiatric assessment interviews

AU - Savander, Enikö

AU - Weiste, Elina

AU - Hintikka, Jukka

AU - Leiman, Mikael

AU - Valkeapää, Taina Jenni Marika

AU - Heinonen, Erkki Olavi

AU - Peräkylä, Anssi Matti

PY - 2019

Y1 - 2019

N2 - Objective: With the intention of understanding the dynamics of psychiatric interviews, we investigated the usual (DSM/ICD-based) psychiatric assessment process and an alternative assessment process based on a case formulation method. We compared the two different approaches in terms of the clinicians’ practices for offering patients opportunities to reveal their subjective experiences.Methods: Using qualitative and quantitative applications of conversation analysis, we compared patient–clinician interaction in five usual psychiatric assessments (AAU) with five assessment interviews based on dialogical sequence analysis (DSA).Results: The frequency of conversational sequences where the patient described his/her problematic experiences was higher in the DSA interviews than in the AAU interviews. In DSA, the clinicians typically facilitated the patient’s subjective experience talk by experience-focused questions and formulations, whereas in AAU, such talk typically occurred in environments where the clinicians’ questions and formulations focused on non-experiential, medical matters.Conclusion: Interaction in DSA was organized to provide for the patient’s experience-focused talk, whereas in AAU, the patient needed to go against the conversational grain to produce such talk.Practice implications: By facilitating patients’ opportunities to uncover subjective experiences, it is possible to promote their individualized care planning in psychiatry.

AB - Objective: With the intention of understanding the dynamics of psychiatric interviews, we investigated the usual (DSM/ICD-based) psychiatric assessment process and an alternative assessment process based on a case formulation method. We compared the two different approaches in terms of the clinicians’ practices for offering patients opportunities to reveal their subjective experiences.Methods: Using qualitative and quantitative applications of conversation analysis, we compared patient–clinician interaction in five usual psychiatric assessments (AAU) with five assessment interviews based on dialogical sequence analysis (DSA).Results: The frequency of conversational sequences where the patient described his/her problematic experiences was higher in the DSA interviews than in the AAU interviews. In DSA, the clinicians typically facilitated the patient’s subjective experience talk by experience-focused questions and formulations, whereas in AAU, such talk typically occurred in environments where the clinicians’ questions and formulations focused on non-experiential, medical matters.Conclusion: Interaction in DSA was organized to provide for the patient’s experience-focused talk, whereas in AAU, the patient needed to go against the conversational grain to produce such talk.Practice implications: By facilitating patients’ opportunities to uncover subjective experiences, it is possible to promote their individualized care planning in psychiatry.

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KW - 515 Psychology

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