Free explainer4 min read
Interview techniques
Understand the model, recognise it in a stem, separate the look-alikes, then apply it.
Start with the mental model
Interview technique names describe HOW a clinician moves the conversation forward, not what is being discussed. A doctor saying 'you mentioned trouble sleeping earlier, can we return to that?' is making a specific move, linking back to something the patient already said, which is a referred transition, not just a topic change. Naming the technique correctly matters as much on the exam as recognising what the patient actually said.
Visual explanationUse the diagram to rebuild the concept from memory.
01Core model
Core facilitative techniques include open questions (inviting narrative), funnelling (open questions narrowing to closed ones to confirm specifics), facilitation (nods, 'go on'), reflection (mirroring the patient's stated feeling), clarification and summarising. Confrontation points out an inconsistency; interpretation offers an unconscious meaning, both differ from reflection, which only mirrors what the patient already said. Take a patient who denies feeling low despite crying throughout the interview: reflection stays close to the patient's own words, while interpretation adds the clinician's own hypothesis, such as suggesting the tears reveal an unacknowledged sadness. Normalising is a distinct named technique: a statement that validates a patient's emotional reaction as an understandable, expected response, such as telling a tearful patient that it is normal to cry when discussing something painful. Validation is a related but separate technique: it explicitly acknowledges that the patient's feeling or reaction makes sense given their particular circumstances, without necessarily framing the reaction as common or expected the way normalising does. Reinforcement is an operant-conditioning mechanism, and it is the underlying principle behind praising a patient's effort or courage in disclosing something difficult. That praise acts as a distinct technique that reinforces and encourages continued openness. More broadly, any clinician response, such as attention, reassurance, or visible concern, that reliably follows a patient's report can reinforce and increase how often that behaviour is reported, independent of the clinician's intent.
02Recognise it in an SBA
• As a patient describes a distressing event, the psychiatrist leans forward, nods and says 'go on, tell me more' to encourage continued disclosure. Which technique is this?
• At the start of an assessment the psychiatrist says, 'Today I'd like to cover your mood, sleep and any thoughts of harm - does that work for you?' Which technique is this?
03Separate the look-alikes
| Reflection | mirrors feeling, whereas interpretation adds meaning. |
|---|---|
| Clarification | checks meaning, unlike confrontation. |
| Referred transition | linked topic vs abrupt subject change. |
| Facilitation | opens disclosure, whereas reassurance closes it. |
| Normalising | validates an emotional reaction as expected (e.g. 'it's normal to cry'), unlike reflection, which mirrors the patient's own words without judging them as normal. |
| Validation | acknowledges that a feeling makes sense given the patient's circumstances, unlike normalising, which frames the reaction as a common or expected one. |
| Praise as reinforcement | rewards effort or courage in disclosing, distinct from normalising, which validates the emotional reaction itself. |
How the exam thinksRead the question the way the examiner wrote it.
What people get wrong here
• Summarising restates what has been said so far to check understanding, rather than prompting further disclosure.
• Confrontation gently highlights a discrepancy the patient has shown, which is not happening in this exchange.
• Closed questioning narrows answers to short fixed responses, which is the opposite of this open invitation to keep talking.
• Reflecting feelings mirrors back the patient's own words or feelings, which has not yet been said at this early stage.
• Facilitation encourages continued disclosure once talking has begun, rather than proposing the interview's topics upfront.