The Neurobehavioral History and Behavioral Observations

INTERVIEWING TECHNIQUES

The opening and introduction must focus on putting the patient at ease and establishing rapport. The examiner is establishing a relationship. To this end he or she first addresses the patient, introducing him- or herself while looking and speaking directly to the patient. Although initial small talk can help put some patients at ease, it should be minimal, and the examiner should not talk about him- or herself. The introduction requires some preparation, not only in knowing the patient’s medical information but also how to pronounce the patient’s name and what the expectations might be. The examiner must briefly explain the purpose and nature of the examination, his or her role, and the goals of interview. Other aspects of the opening and introduction include attending to one’s own attitude and body language (i.e., conveying an empathic attitude), the environment (i.e., if in-person, sitting at the same level and about 2 feet from the patient), and the patient’s verbal and nonverbal cues (i.e., cooperative or hostile toward the interview) ( Box 6.1 ). Rapport is most facilitated if the examiner searches for the patient’s underlying emotions and areas of concern and adjusts his or her demeanor accordingly.