MANIFEST REACTIONS OF PATIENTS AND INTERVIEWERS TO THE USE OF SOUND RECORDING IN THE PSYCHIATRIC INTERVIEW
RICHARD LAMB M. D.1, and
GEORGE F. MAHL PH. D.1
1 Department of Psychiatry, Yale University Medical School.
Thirty-five psychiatric patients were interviewed under standard conditions and confronted for the first time in a standard way with the fact that the interview was being recorded. Thirty-one were intake interviews of applicants for outpatient treatment. In evaluating patient response and attitude, only their overt replies to being told of recording, and other comments relating directly to his cognizance of being recorded, were considered. Sixty percent of the patients showed no overt manifestations of disturbance about recording; another 20% manifested no disturbance after the initial moments of the interview. All but 2 patients recorded productive interviews.
Each patient was rated by 3 independent observers as to the general level of hostility and anxiety manifested during the interview—independently of the response to recording. Higher mean anxiety and hostility ratings were found in the groups manifesting more disturbance to recording, but these differences were not statistically significant.
Five of the 34 patients permitting the recording manifested overt hostility to the idea of recording, and all 5 were found to be above the median of the ratings of general level of hostility. There was no evidence to suggest that the patients' hostility to being recorded was suppressed and then displaced, resulting in a higher general level of hostility expressed throughout the interview.
A questionnaire of multiple choice questions was sent to 88 professional members of the Yale department of psychiatry in order to assemble some data on the verbalized attitudes of therapists toward recording. The replies of 40, who do therapy and have recorded, were analyzed. Fifty-five percent reported little or no disturbance while recording; 35% feel that they are self-conscious of techniques and more careful during every interview; 7.5% said that they are disturbed sufficiently to give less attention to the patient.
Fifty-two percent felt that they conduct their therapy differently while recording than while not recording. Of these, 76% felt that this influences the effects of their therapy.
Fifty-five percent felt that the knowledge that he is being recorded affects the patient in intake interviews and consultations, while 20% felt it does not, and 25% did not commit themselves. Forty-five percent felt that the patient was affected in long-term therapy, while 33% did not, and 22% did not comment. Forty percent felt that knowledge that he is being recorded increases patient resistance, and 38% felt that it does not, with 22% not commenting.
A positive correlation was found between the degree of disturbance felt by the therapist while recording and (1) whether the therapist feels he is conducting his therapy differently and (2) the judgment by the therapist as to whether knowledge of recording affects the patient in intake interviews or consultations. It was suggested that many therapists who are disturbed by recording may project some of their disturbance onto their patients.
