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The psychiatric interview differs from the general clinical interview in a number of respects. As Sullivan pointed out, the psychiatrist is considered an expert in the field of interpersonal relations, and accordingly the patient expects to find more than a sympathetic listener. Any person seeking psychological help justifiably expects expert handling in the interview.
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Interviews in nonpsychiatric branches of medicine generally emphasize medical history taking, the purpose of which is to obtain facts that facilitate the establishment of a correct diagnosis and the institution of appropriate treatment. That interview is organized around the present illness, the past history, the family history, and the review of systems.
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The patient's fear of looking beneath his defenses is not the only basis for concealment in the interview. Every person is concerned with the impression he makes on others. If the patient suspects that some of less admirable aspects of his personality are involved in his illness, he may be unwilling to disclose such material until he is certain that he will not lose the interviewer's respect as he exposes himself.
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