Why the therapist needs to be familiar with the story interview

In my training as an MD, my doctor learned to ask questions about signs and symptoms, make a diagnosis, and evaluate the prognosis. I first began to question this traditional medical approach to patients when I faced suicide patients. I was interested in the history of dying wishes. Without this information, it was impossible to understand what was an existing crisis. Obviously, the patient had to tell me about how things had evolved. This means that you need to switch roles. Here, the patient was an expert in his story.

After learning the basics of the story approach, I immediately found the huge value of the story interview. suicide。 The first patient’s contact was an attractive experience. I learned that the patient has an amazing story ability to convey a consistent story of health problems to the open mind dristener. With the story approach, my occupation life has become more worthwhile. After all, human biography is very attractive, diverse and unique.

The story is a way for therapists and patients to find a joint understanding and allow changes.

In an interview with the story, the listener enters the world built by the narrator, is useful for speaking, and thus the story is achieved. Medical experts, which are non -judgment, support trust, become patients, and support patients with disadvantaged experience and suffering.

I had to stop asking questions and learn to trust the patient’s abilities who gave a consistent story about how the problem developed. Surprisingly, most patients spontaneously entered the suicide crisis into the biographical context. “As you know, I think it will return to me ChildhoodWhen my parents broke up, and I thought it was my fault. “ In other words, they were not just talking about the actual emotional crisis, but they brought me back in the early years of childhood, and taught me painful experience, refusal, and problems. Self -esteemSelf -blame, Feeling of guiltAnd many other unsupported needs.

The alliance of story and treatment

When you start consulting with the history of patient illness, you will be involved in the interaction between doctors and patients as an aggressive participant. What is particularly interesting here is the early research on the relationship between the doctor’s interview style and the patient’s satisfaction. For example, Bertakis et al. (1) I found it “Patients are most satisfied in interviews that encourage talking about the psychological and social issues in the atmosphere, which is characterized by the lack of doctors.” in Psychotherapy The relationship between patient research -therapists was a major focus in the 1980s and 1990s, including the author, such as Luborsky (1992), Crits -Christoph (1993), and HORVATH (1994). Important conclusions are still valid today: (1) quality Treatment This is an important factor in the treatment results for various types of treatment, and (2) the early stage of psychotherapy predicts the results of the treatment. This is why it is important to start contacting new patients in the story interview.

In our department, we have decided to test a hypothesis that the story approach is related to the high degree of satisfaction of patients with treatment. Immediately after an interview with a patient who attempted suicide, the patient completed the aid alliance association (2) (2) as a means to measure patient satisfaction with the therapist. The results showed that the interview was highly high when the interviewer used the word “story” or “Tell me”. The second discovery was that the interview was highly evaluated when the interviewer recognized the patient’s important life. the goal For example, such needs: “”As you know, separation was always a big problem in my life. “ (3).

Trust, empathy, and understand -based treatment alliance is a prerequisite required for effective treatment, and patients can change their abilities. In cooperation with suicide patients, it has been shown that a powerful alliance formed early in the treatment process is related to suicide mind and a decrease in trials (4).

Guidelines for story interviews

• Take the position of a relaxed seat and convey the attitude of an interesting and attentive listener that you always have around the world (even if it is 20-30 minutes!).
• In the following standard sentence, invite patients with a history related to health issues seeking medical consultation. “I want you to tell me the story behind the problem that came to see me …. To contact Crisis Center … consider suicide as a solution.”
• Do not interrupt unnecessary questions. Relieve the ability of the patient’s story.
• Don’t ask “why”. The reason is that, except for the personal stories related to this, assuming that this is a simple cause.
• If necessary, use open -end questions, or, n, or no questions, to help patients continue the story. for example: “Can you tell me more? “I’m trying to understand -Can you help me understand?”
• The patient will pause, but when the brain looks like he is working: “What is happening in your head now? “
• I will go with the patient’s subjective explanation about what happened. This is important to establish a working alliance. Medical experts, which are specialists, need to ask specific questions for diagnostic evaluation, and take a comprehensive understanding of health issues and further measures in accordance with the story interview.

total

“Treatment occurs between the two, not the doctor, not the doctor.” (5). active collaboration The interaction between the doctor and the patient is made interesting and rewarding between the patient and the therapist. Treatment is not about diagnosis or patient treatment, “Patient person“