A comparison of videotaped and live patient interview examinations and written examination in psychiatry.

The authors scored the examination performance of 28 psychiatrists who were tested after conducting an interview with a real patient and after seeing a videotaped interview with an actor playing the role of either a psychotic or a neurotic patient. The also scored the performance of 15 of the same examinees who completed a written examination. Eighty-five percent of the examinees reported that the videotaped interview examination was a useful learning experience, and 81% said that it was a useful testing experience. The examiners' feelings varied regarding the use of the standardized videotaped format for certification and recertification of psychiatrists.

Therapists' physiological activation and patient difficulty.

The differential effects of an easy and difficult-to-interview patient on therapist self-reported behavioral arousal and physiological activation were observed. Eighteen experienced white male psychiatrists each interviewed two patient simulators believing they were real patients. Each actress was programed to act the part of a difficult-to-interview patient and an easy-to-interview patient. Each randomly played either part as assigned and the order of patient and role was counterbalanced. Differences in patient roles were validated by the participating therapists and independent raters. Fifteen-minute rest periods with soft music preceded each therapy session such that a complete experimental session consisted of rest 1, therapy 1, rest 2, and therapy 2. Self-reported arousal was assessed during each of the four periods by Thayer's factors from the Nowlis Mood Adjective List. Physiological activation was measured by electromyogram, heart rate, blood pressure (systolic and diastolic), and skin conductance. Therapist self-reported behavioral arousal and measured physiological activation during therapy were significantly greater than during rest. The difficulty of the patient did not appear to affect either behavioral or physiological activation level of the therapists. Several explanations for this are explored.

Four therapeutic approaches to the same patient. A study of the Truax variables.

Interviewing behavior of psychiatrists representing the Gestalt, Psychoanalytic, Kleinian and Jungian schools of psychotherapy are rated using the Truax-Carkhuff measures of accurate empathy, nonpossessive warmth and genuineness. Although similarities of behavior were found, there were significant behavioral differences that coincide with the theoretical models.