Three-way interviews and psychiatric training

The three-way interview is a helpful and sometimes necessary adjunct to the supervision of psychiatric residents who are treating disturbed inpatients. Direct bedside observation of the interaction between therapist and patient can reveal evidence of previously unrecognized countertransference difficulties in the beginning therapist. It also maximizes patient care by allowing detection and correction of diagnostic errors that have resulted from either underlying medical illnesses or drug toxicity. This supervision model resembles that used in teaching internal medicine, in which the house staff and the consultant share their observations.