The Psychiatric Interview in Clinical Practice

In this meticulously revised and expanded edition of The Psychiatric Interview in Clinical Practice, the authors continue to address the challenges inherent in clinical interviewing -- the complexities of defense mechanisms, conflicts, wishes, and fantasies -- as they did in their original 1971 edition, while also undertaking the daunting task of adapting their interviewing strategies to a new era of psychiatry, one that has witnessed revolutionary breakthroughs in neuroscience, genetics, psychopharmacology, and brain-imaging research.

In 20 new and updated chapters, the authors comprehensively examine the strategy and conduct of psychodynamically informed clinical interviewing, accommodating the DSM-IV-TR diagnostic nomenclature but also being forthright in critiquing its limitations. Included are new chapters on traumatic, narcissistic, masochistic, anxiety, and borderline conditions and a contemporary perspective on interviewing "the patient of different background" (i.e., the patient whose race, ethnicity, culture, age, or sexual orientation is different from that of the interviewer). Updated chapters discuss modern psychodynamic theories; interviewing in the context of psychosis, schizophrenia, and cognitive impairment; strategies with hospitalized, psychosomatic, and emergency patients; and approaches with depressed, obsessive-compulsive, and histrionic patients. Incorporated throughout are compelling vignettes of interviewer-patient interchanges garnered from the authors' extensive clinical experience.

The Psychiatric Interview in Clinical Practice offers a wealth of clinical wisdom useful for trainees in all of the mental health professions, from medical students and psychiatric residents to psychologists, social workers, and nurses.

American Psychiatric Publishing

In this extensively revised and expanded new edition of the classic, The Psychiatric Interview in Clinical Practice, the authors continue to address the challenges inherent in clinical interviewing—the complexities of defense mechanisms, conflicts, wishes, and fantasies—as they did in their original 1971 edition while also acknowledging the task of adapting their interview strategies to a new era of psychiatry.

New perspectives on psychopathology often emphasize descriptive phenomenological approaches and encourage psychiatric interviewing that is overly focused on describing symptoms and establishing diagnoses. The Psychiatric Interview in Clinical Practice stresses that the clinician needs to learn about patients, their problems, their illness, and their lives. From this readers will understand the universal presence of personality types and the importance of the personality as a determining factor in the unfolding of the psychiatric interview.

Students learning psychiatry often ask, "But what do I say to the patient?" In 20 new and updated chapters, The Psychiatric Interview answers that question by using clinical vignettes from the authors' everyday work, what they said in a wide variety of clinical situations and what they felt and thought that led them to say it. Specifically this new edition includes,

• New chapter sections addressing the process of eliciting a patient's psychodynamic history and the role of information technology in the psychiatric interview.
• New chapters on narcissistic, masochistic, anxious, traumatized, and borderline patients, emphasizing the importance of personality type in determining the evolution of psychiatric disorders and providing copious clinical detail illustrating both what to do and what not to do when interviewing these patients.
• A new chapter presenting a contemporary perspective on "the patient of different background," in which the authors offer valuable guidance on how to approach racial, ethnic, cultural, age, and sexual-orientation differences between interviewer and patient.
• Updated chapters on psychotic patients, patients with schizophrenia, and cognitively impaired patients, and on depressed, obsessive-compulsive, and histrionic patients, incorporating new, emotionally moving vignettes of interviewer-patient interchanges garnered from the authors' extensive clinical experience.
• Updated chapters on hospitalized, psychosomatic, and emergency patients, which are not only psychotherapeutically instructive but also brimming with practical advice for medical students, house staff, doctors, nurses, and social workers.

Although The Psychiatric Interview in Clinical Practice is about psychiatric interviewing, many readers will likely recognize aspects of themselves in some of the clinical descriptions. The hope is that this self-recognition will lead to greater self-understanding and self-acceptance as well as to greater understanding and acceptance of others. The clinical examples are about real people, including the authors themselves, their friends, students, and patients. The authors selected situations or traits that are so common and typical that nearly all readers would be able to relate to them.

The Psychiatric Interview in Clinical Practice promises to be an enjoyable read as well as a tremendous learning experience for trainees in all of the mental health professions, from medical students and psychiatric residents to psychologists, social workers, and nurses.

Doody Review Services

Reviewer:Steven T. Herron, MD(University of Arizona Health Sciences Center)
Description:The second edition of a book first published in 1971, this book addresses and updates changes in the practice, understanding, and diagnosis of psychiatric illness over the past 35 years.
Purpose:With the vast shift in both the understanding of the etiology of psychiatric illness, and the advances in the treatments offered to alleviate many of the symptoms associated with these disorders, this text attempts to combine solid psychoanalytical theory with fundamentals of biologic psychiatry.
Audience:Given its depth and substantial length, this book is more appropriate for individuals with advanced training, significant clinical experience, or a combination of both; including psychiatrists, psychiatry residents, psychologists, and (potentially master's level) therapists.
Features:About one sixth of this book is dedicated to the general principles of interviewing psychiatric patients, leaving the remainder to address concepts in the evaluation of individuals with various complicated clinical syndromes and special populations. Case examples are present to illustrate particularly important points, and there are a few tables and charts, though these mostly list the DSM-IV-TR diagnostic criteria for various psychiatric disorders.
Assessment:While comprehensive and insightful, this book may overwhelm the casual or less experienced reader, especially with its use of complex psychoanalytic concepts and terminology. This book is best left to individuals, practicing in or planning to practice in, the area of psychodynamic or psychoanalytical psychotherapy, as those who are relatively naive to these ideas are likely to be further confused by terms and concepts presented here. That said, this book is a valuable tool for individuals with a keen and specialized interest in practicing psychotherapy and should be referenced when working with patients having various forms of psychopathology.

Roger A. MacKinnon, M.D., is Professor Emeritus of Clinical Psychiatry at the College of Physicians and Surgeons of Columbia University in New York, New York.

Robert Michels, M.D., is Walsh McDermott University Professor of Medicine and Psychiatry at Weill Medical College of Cornell University in New York, New York.

Peter J. Buckley, M.D., is Professor of Psychiatry at Albert Einstein College of Medicine of Yeshiva University in Bronx, New York.