Person-Centered Interviewing and Diagnosis
One of the early steps of the clinical care process in Person Centered Medicine crucially involves person-centered interviewing and a personalized and contextualized diagnostic formulation to set the tone and provide the informational bases of clinical care and treatment.
Such interviewing and diagnostic formulation should in fact be based on the establishment of a common ground, a collaborative understanding and commitment among all protagonists of clinical care, i.e. health professionals, the patient and the family. Installing common ground is the subject of Chapter “Establishing Common Ground, Engagement, and Empathy” of the Person Centered Medicine book.
Clinical interviewing represents a fundamental opportunity to establish a warm and trusting inter-personal relationship between a health professional, the patient and his/her family. It should have a flexible structure, which typically includes a salutation phase, the main body of the interview, and a concluding phase.
The person-centered and contextualized diagnostic formulation may involve the presentation and articulation, first, of the concepts and procedures of a person-centered integrative diagnosis model that involves both a formulation and a collaborative process. It also involves three informational levels, i.e., health status covering illnesses and disabilities, on one hand, and positive health, such as adaptive functioning, resilience, supports and quality of life, on the other. It further involves the engagement of categories, dimensions and narratives to describe different aspects of the diagnostic content.
The above theoretical diagnostic model has found a highly visible practical application in the Latin American Guide of Psychiatric Diagnosis produced officially by the Diagnosis and Classification Section of the Latin American Psychiatric Association. Its first edition appeared in 2004, and its Revised Version in 2016, while a fully new Second Edition that will use ICD-11 codes is under preparation.
While the Person-centered Integrative Diagnosis model and the Latin American Guide of Psychiatric Diagnosis were produced collaboratively by the Section on Classification, Diagnostic Assessment and Nomenclature of the World Psychiatric Association, the Diagnosis and Classification Section of the Latin American Psychiatric Association, and the International College of Person Centered Medicine as a diagnostic guide for the use of mental health professionals conducting a broad-based diagnosis of health, the present chapter examines specially the bases for person-centered diagnosis for the broader field of general medicine. Thus, this goal is approached in this chapter through a review, analysis and discussion of the pertinent literature to facilitate the development of concepts and procedures for person-centered diagnosis in general medicine.
Mezzich, J.E., Salloum, I.M., Wong, M.T.H., Braš, M., Đorđević, V., Wilson, C.R. (2023). Person-Centered Interviewing and Diagnosis. In: Mezzich, J.E., Appleyard, W.J., Glare, P., Snaedal, J., Wilson, C.R. (eds) Person Centered Medicine. Springer, Cham. https://doi.org/10.1007/978-3-031-17650-0_11
Person Centered Medicine