121provide feedback and legal information that reflects that the attorney was listen-
ing carefully...Studies of interviewers, including lawyers...police interview-
ers...and physicians, have found that interviewers are prone to interrupt early
and often. Research shows that interjecting a large number of specific questions
can make it difficult for the interviewer to listen to the answers provided by the
interviewee...Directing those limited mental resources to formulating many
questions—rather than listening intently to the witness’s narrative response to
open-ended questions—ought to increase the difficulty of understanding or
notating the witness’s responses....” Furthermore, psychological research has
documented the benefits to memory that come from listening to interviewees and
not interrupting their answers to questions...” (pp. 492–493).- Allow patients to interrupt you. Usually, what they have to say is important and
indicates they are engaged in the process and willing to share with you. - You can always back track. If the discussion shifts before you have gathered all the
information you need, remember you can always redirect your patient. For instance,
you could say, “Earlier, you were saying...Can I ask you more about that?” - Re-invite patients to share an experience. If your patient provides a minimal
response to your open question, ask the question again. It’s important to consider
that this may be the first time a patient has had the chance to share the whole
story with a health-care professional. - Be transparent. When you repeat questions, shift topics, or introduce new topics,
patients will be more open to answering your questions if you explain why you
are doing so. For example, “Part of my role is to ask you to talk about how you
made this decision. I’m doing this to be sure you have all the relevant informa-
tion I’m able to give you. I’m not trying to judge or change your decision.” - Use silence. Silences allow patients the time and space to consider your question
and to formulate thoughtful responses. As we mention in Chap. 4 , silence can be
difficult to gauge. Try counting silently to 10 or 15 in order to allow sufficient time. - Try other ways to obtain information. Remember that a good empathic reflection
can encourage patients to disclose a great deal of information (Martin 2015 ).
Their disclosure may not be as systematic as in response to a question, but
patients do have more autonomy and control over the discussion when you use a
less leading response such as empathy. Monitor your questioning behavior to see
if you’re resorting to questions because you don’t know what else to do, or you’re
trying to avoid patient feelings. If this is the case, try to use other types of
responses. - Follow up with primary empathy. Summarize your patient’s response to your
question (see Chap. 4 for a discussion of primary empathy). Primary empathy
not only shows you heard and understood the patient’s answer, it also allows the
patient to “hear” what she or he said.
Remember that not every response you give in a questioning tone is necessarily
a question. The primary goal of a question is to gather additional information.
Empathy responses often are stated in a questioning tone, but their intent is to reflect
the patient’s experience, not to gather new information.
5.1 Obtaining Information from Patients