Extended psychiatric interview and medical students: a tool for teaching psychotherapeutic skills

There is difficulty in teaching medical students clinical psychiatric skills, specifically the clinical interview and general psychotherapeutic technique. We present a way to convey to students the ability to assess and make contact with patients while being aware of and utilizing their own presence as part of the therapeutic process. We describe a model for teaching these skills based on a prolonged clinical interview.

Medical students in their second clinical year interview new attenders at a public mental health clinic treating a range of neurotic and personality related disorders. Each student is assigned one patient whom he interviews independently at three weekly sessions lasting an hour. The students remain the sole therapeutic contact and are instructed to conduct an open interview with the purpose of maintaining therapeutic contact while gathering relevant information and assessing psychopathology. Supervision is conducted in a group session each week.

It is our impression that despite initial resistance, the students display a remarkable ability to conduct the prolonged interview in the form of a very brief therapeutic encounter. They show considerable appreciation of the basic issues involving transference and counter-transference. Over 20 years experience, there have been no reported adverse reactions in patients assessed in this process.

The supervised experience of an extended psychiatric interview, performed independently by medical students, facilitates the learning and acquisition of basic psychotherapeutic concepts and skills. We propose this model as an effective way of introducing medical students to the psychotherapeutic aspects of psychiatry.