Shea_Chapter 6

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PART TWO — Interviewing Techniques and Strategies

that I really need them and I feel that the benefits will outweigh the costs. I take the same approach with my patients. So, I don’t suggest a medication unless I really have a feeling it will help you. I would never recommend a medication that I myself would not take or give to one of my family. And I always try to fill my patients in on possible side effects and the pros and cons of using the med. How’s that sound to you? (Medication Interest Opening) Pt.: Sounds good. Clin.: I look at it that you and I are both experts. Hopefully, I know a lot about medications and how different medications can help in dif- ferent ways and I can call on years of experience, as well as other colleagues, to help. You are the expert on your own body. The medi- cation goes in you, not me. And outside of some diseases like your diabetes and high blood pressure where lab work and blood pressure readings can help guide us, I’m basically dependent on you to tell me if it’s helping or not and also if it’s causing any side effects. Make sense? (Introducing Shared Expertise) Pt.: Sounds good to me (pauses) I hope you know what you’re talking about (smiles with a joking tone of voice). Clin.: (smiles, pleasantly reflecting the patient’s use of humor) Yeah, let’s hope so. (smiles, pauses) I’m curious, how comfortable do you feel talking with your doctor about side effects and things like that because people vary on that point (interesting variation on the Call- Me-First Invitation , for the interviewer has decided to start the technique with a question). Pt.: Oh, I’ll tell you, you can count on that. I want to know what’s going on. I’m not a big one for surprises (smiles). Clin.: Neither am I (smiles). Which brings up another point. If for some reason you start getting a side effect, please give me a call before you do anything. I’ll let you know what I think is happening and you can decide what to do. But try not to stop any medication without talk- ing with me first, or if I’m not available one of my staff will be sure to talk with you, and they’re great. Sometimes it isn’t a side effect. And some side effects even go away shortly after appearing as your body adjusts to the medication. In any case, I really am your consultant. You get to call the final shots, but be sure to use me. (pause) I got some good ideas. (smiles) Deal? Pt.: Deal. ( Call-Me-First Invitation completed. Also note that the clini- cian has effectively used all three techniques comprising the strategy of Forging the Medication Alliance . And she is about to use this