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Review Essays of Academic, Professional & Technical Books in the Humanities & Sciences


Clinical Interview

The Clinical Interview Using DSM-IV-TR Volume 1: Fundamentals edited by Ekkehard Othmer, Sieglinde C. Othmer (American Psychiatric Publishing). DSM‑IV provides text and criteria for currently recognized psychiatric disorders; this book provides interviewing techniques to determine, assess, and implement these criteria. The Othmers illustrate how to approach patients in a way that illuminates the diagnostic criteria and points the way toward treatment. With case examples drawn directly from their clinical work, the Othmers lead clini­cians through the steps that will help them to include or exclude appropriate DSM‑IV categories in their differential diagnoses, and engage the patient to help in this process.

This text will benefit even the experienced clinician, but it is most criti­cal reading for young psychiatrists, clinical psychologists, social workers, and other mental health professionals. It shows students the full complexity of the interview process. By the time the reader encounters the final chap­ters‑detailed interviews showing the interviewer's process of diagnostic in­clusion and exclusion‑the reader has a highly developed understanding of the four components advocated by the Othmers: rapport, techniques to gather information, mental status assessment, and diagnostic decision making.

This book helps teach DSM‑IV in a way that usefully illustrates the diag­nostic criteria. It sets the standard for clinical, diagnostic interviewing. Superb teachers and clinicians, the Othmers have established the classic book on how to conduct an interview.


Clinical Interview Using DSM-IV-TR Volume 2: The Difficult Patient edited by Ekkehard Othmer, Sieglinde C. Othmer (American Psychiatric Publishing) The success of The Clinical Interview Using DSM-IV-TR Volume 1: Fundamentals edited by Ekkehard Othmer and Sieglinde C. Othmer, indicated a significant need in the mental health field. The Othmers perceived that need and have now followed up with Clinical Interview Using DSM-IV-TR Volume 2: The Difficult Patient

From my perspective, before DSM‑III, interviewing by mental health workers in the United States depended significantly on the clinical and educational orientation of the leadership at various institutions. Those facilities with a psychodynamic orientation advocated one type of approach, whereas those with descriptive and cognitive emphases used quite different styles of interviewing. With the advent of DSM‑IV the Othmers recognized that an integrated approach to interviewing was vital for the entire field. They achieved this integration in Volume 1 and have now taken the more complex step of attempting an integrated approach to more "difficult" patients.

Beyond conceptualizing the need, the Othmers have accomplished several other tasks in making Volume 2 useful to a wide group of practitioners. Taking DSM‑IV as a base, they have classified "difficult" patients into a practical system, including 1) patients with disorders that are "medically inexplicable" (e.g., conversion, dissociation), 2) patients with impaired reality testing resulting from delusional and hallucinatory experiences, 3) patients with cognitive impairment, and 4) patients with self‑deceptive and dissimulating behavior. Given this classification, the Othmers illustrate how to conduct an interview with patients who have each of these types of problems. The interviews are provided in great detail, along with a logical rationale for the specific choice of words, methods, and sequences.

The DSM process has provided us with a base for developing rational options for treatment of those with specific disorders. Practice guidelines will be a central feature of this evolution of the mental health field. Clinical interviewing is a transitional process between diagnosis and treatment. The interviewing, of course, is a vital part of making the diagnosis. To recognize that variations in styles of interviewing may be necessary is very important, especially in difficult clinical encounters. The Othmers have helped to teach us that the successful diagnostic interview may also be a useful key for successful treatment.

I am particularly pleased that the Othmers have transcended old ideological schools (they call this "Old Think") and have come up with a "New Think" approach. In a practical way, they have shown that "difficult" patients with different clusters of symptoms may be best interviewed by specific combinations of methods. They have also once again organized their book and their chapters into clearly understandable interviewing segments. This superb organization will be most helpful for students, but also will help their teachers to integrate the clinical phenomena more rationally.

As a long‑time advocate of integration rather than ideological segmentation of our field, I am delighted that the Othmers have provided us with a thoroughly practical clinical approach to the interviewing of patients with problems that could easily puzzle the beginner. Their integrated approach is also a good model for us to utilize in many other clinical contexts. This book, like Volume 1, will become recognized as a fundamental text for our education and continuing leaming.

We welcome the opportunity to update our two interview books to make their content compatible with DSM‑IV‑TR. We hope the update will aid the reader in becoming current with the consensus judgment of the experts consulted for DSM‑IV‑TR.

Our update did not change the structure of the books or the interviews; we applied the changes in DSM‑IV‑TR to the comments on the interviews. Some case vignettes concerning assessment of patients with homicidal tendencies have been added.

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