Confrontation

Confrontation is a response based on an observation by the interviewer that points out something striking about the patient's behavior or previous statement. This interviewing technique directs the patient's attention to something of which he or she may or may not be aware. The confrontation may be either a statement or a question;for example:

Is there any reason why you always look away when you talk to me?'' ''You're angry.''

''You sound uncomfortable about it.''

''What is the reason you are not answering my questions?''

''You look as though you are going to cry.''

Confrontation is particularly useful in encouraging the patient to continue the narrative when there are subtle clues given. By confronting the patient, the interviewer may enable the patient to explain the problem further. Confrontation is also useful to clarify discrepancies in the history.

Confrontation must be used with care; excessive use is considered impolite and overbearing. If correctly used, however, confrontation can be a powerful technique. Suppose a patient is describing a symptom of chest pain. By observing the patient, you notice that there are now tears in the patient's eyes. By saying sympathetically, ''You look very upset,'' you are encouraging the patient to express emotions.

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