The First Interview: Revised for DSM-IV / Edition 2

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Rewritten to incorporate the new DSM criteria, The First Interview updates a text that is rapidly becoming a standard in the field. This timely, accessible volume covers a broad range of personalities and problems typically encountered in the first interview, offering fresh insight on how to elicit key diagnostic details from even the most challenging patient. Completely up to date, all references to DSM-III-R have been revised, and outlines of the most common diagnoses have been rewritten in accordance with the new criteria. The First Interview specifies what you need to ask, and how best to frame your questions. Presented in a conversational, forthright style, these techniques are further brought to life by illustrative clinical vignettes. The author takes you through each stage of an interview, demonstrating how to derive maximum information while establishing and maintaining trust and rapport. Effective verbal and nonverbal communication skills are emphasized, with techniques provided to help draw out feelings and determine symptoms, mental status, family background, personal strengths, and vulnerabilities such as a history of violence or childhood abuse. The volume concludes with a detailed discussion of how clinicians can most effectively present findings and recommendations to patients and their families in a manner that offers information with a sense of trust and hope. Clinically useful appendices include a sample interview and written report, DSM-IV diagnoses in abbreviated form for easy reference, standards for scoring the initial interview, and a list of recommended readings. For the seasoned clinician, this new edition of The First Interview provides a refresher course on the initial interview, and alternative approaches for interviewing difficult patients. It is also an ideal introductory text for students in psychology, psychiatry, social work, pastoral counseling, medicine, and nursing.

Discusses interviewing about feelings/developing rapport/ history of the present illness/meeting resistance/etc.

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Editorial Reviews

From the Publisher

"An important how-to book on the diagnostic interview. Its elucidation of the medical model is particularly noteworthy. Comprehensive and eminently readable, the first edition of The First Interview has been at the top of my list of recommended readings to beginning psychiatry residents; senior medical students; psychology, social work and counseling students; and other trainees needing to sharpen their diagnostic interviewing skills. Dr. Morrison's years of experience as a crack interviewer and diagnostician come through in vivid colors. Thank you, Dr. Morrison, for making my job as an educator that much easier." --Sidney Zisook, MD, Professor of Psychiatry, UCSD School of Medicine

"Complely updated for DSM-IV, The First Interview is an important how-to book on the diagnostic interview. I plan to put it at top of my list of recommended readings for senior medical students and any other trainees needing to acquire diagnostic interviewing skills." --Sidney Zisook, University of California, San Diego School of Medicine

"Dr. Morrison has successfully sharpened the focus of the earlier edition of his important book, further enhancing the value and utility his work brings to all of us who are interested in the efficacy of the first interview and its relevancy to the DSM-IV." --Jule D. Moravec, Ph.D., Director, Western Region, Department of Veteran's Affairs, San Francisco

"The first contact with a patient, more often than not, sets the stage for a useful relationship as well as a sensible therapeutic plan. This book systematically presents a methodology for doing this. The new edition incorporates the latest in diagnostic criteria (DSM-IV) which have become a necessity for people to use in ordering their ideas about patients as well as interacting with their colleagues. This is true whether the clinician is a psychologist, psychiatrist, social worker, minister, nurse or, for that matter, a non-psychiatric physician. Dr. Morrison writes extremely well. One doesn't need a dictionary to understand the concepts and the suggestions. A decent educational experience in the discipline of one's practice is quite adequate for total understanding of the text. Finally, I want to say something about Dr. Morrison's common sense and insightfulness. In discussing a variety of stressors that may occur in the life of a patient or client, he points out that these could be independent events, possibly causing some part of the disorder or that the disorder itself might cause these events. This indicates both an open mindedness as to the cause of behavioral and emotional problems. I believe that Dr. Morrison's practical viewpoint and intelligence shines through every page of this book. No reader could help but derive considerable benefit and knowledge." --George Winokur, M.D., The Paul W. Penningroth Professor of Psychiatry, University of Iowa College of Medicine

From The Critics
Reviewer: Aaron Plattner, MD(Rush University Medical Center)
Description: This book thoroughly covers the interview of a patient, with a focus on the mental health interview. It details how to ask specific questions, addresses different potential conflicts and/or issues that may arise, explains the different parts of the Mental Status Exam, describes how to communicate findings to others, and suggests how to improve interviewing skills through self-reflection and feedback.
Purpose: The purpose is to provide a baseline foundation and tools for becoming an efficient interviewer as well as providing the basic foundation of the different aspects of the field of mental health.
Audience: Medical, psychology, social work, physician assistant, and other students who are enrolled in classes focused on the mental health are the intended audience.
Features: The book provides detailed explanations and examples of all of the different aspects of interviewing a patient in the context of mental health, as well as explanations of why the different areas are important. Areas include the basic format of an interview, how to perform the interview, how to address different potential conflicts that may arise, different symptoms of various diseases, how to end an interview, how to gather all of the gathered information into a diagnosis, and how to present the information in an efficient way. The appendixes provide detailed examples of the interview process and various examples of types of questions that can be used in an interview.
Assessment: When I was starting my patient interviews, I simply read different books on interviews for all areas with specific instructions for each of the different areas of medicine, with the result that psychiatry was covered in one paragraph. With this book, I found it easy to identify with the examples and I appreciated the advice for the more complicated scenarios, including patients who are resistant to an interview. However, as a resident, I feel that this book is much too basic and not necessarily useful for someone trying to hone one's skill. Although this book is ideal for students going into mental health for the first time, this is also a very stressful time for young clinicians and they may find themselves hard pressed to be able to complete it before they are overwhelmed with all the other responsibilities in a rotation. This book could be used by students as they progress through their education.
This volume, revised to incorporate the new DSM-IV criteria, covers a broad range of personalities and problems typically encountered in the first psychiatric interview, offering insight on eliciting diagnostic details from even the most difficult patients. Clinical vignettes illustrate techniques for each stage of the interview and offer ways to establish rapport and determine symptoms. Appendices provide a summary of the initial interview, describe criteria for selected disorders, and include a sample interview and written report. Annotation c. Book News, Inc., Portland, OR (
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Product Details

  • ISBN-13: 9780898625691
  • Publisher: Guilford Publications, Inc.
  • Publication date: 11/18/1994
  • Edition description: Revised
  • Edition number: 2
  • Pages: 317
  • Product dimensions: 6.25 (w) x 9.26 (h) x 1.25 (d)

Meet the Author

bio revised for reprint, 9/02:
James Morrison, MD, was educated at Reed College and obtained his medical and psychiatric training at Washington University in St. Louis. He is currently Professor of Clinical Psychiatry at Oregon Health and Science University in Portland. He is the author or coauthor of such acclaimed professional resources as [i]DSM-IV Made Easy[/i], [i]When Psychological Problems Mask Medical Disorders[/i], and [i]Interviewing Children and Adolescents[/i], as well as [i]Straight Talk about Your Mental Health[/i], a guide for consumers considering mental health treatment.

James Morrison, MD, was educated at Reed College and obtained his medical and psychiatric training at Washington University in St. Louis. He is currently Clinical Professor of Psychiatry at Oregon Health Sciences University. He is the author of The First Interview, DSM-IV Made Easy, and When Psychological Problems Mask Medical Disorders, and coauthor (with Thomas F. Anders) of Interviewing Children and Adolescents.

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Table of Contents

Introduction. What Is Interviewing? 1
1 Openings and Introductions 7
2 Chief Complaint and Free Speech 14
3 Developing Rapport 23
4 Managing the Early Patient Interview 32
5 History of the Present Illness 37
6 Getting the Facts about the Present Illness 47
7 Interviewing about Feelings 55
8 Personal and Social History 65
9 Sensitive Subjects 83
10 Control of the Later Interview 99
11 Mental Status Exam I: Behavioral Aspects 105
12 Mental Status Exam II: Cognitive Aspects 117
13 Signs and Symptoms in Areas of Clinical Interest 135
14 Closure 161
15 Interviewing Informants 165
16 Meeting Resistance 172
17 Special and Difficult Patients 183
18 Evaluation 200
19 Making Recommendations 216
20 Communicating Your Findings 227
Appendix A. Summary of the Initial Interview 242
Appendix B. Description and Diagnostic Criteria for Selected Disorders 250
Appendix C. Sample Interview 272
Appendix D. Sample Written Report 293
Appendix E. Assessing Your Interview 298
Appendix F. Bibliography and Recommended Readings 303
Index 307
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