Sensitive Inquiry

Clinical Skills for Interviewing Patients and Building the Clinician-Patient Partnership

As described in the best-selling book What Happened to You? (see RESOURCES below), with the recognition of the high prevalence of trauma and devastating impact of trauma, our conversations shift:

- from What is Wrong with You?
- to What Happened to You?

Building a safe and trusting Clinician-Patient Partnership is essential to promote deep conversations about painful topics.  Key principles*:
o   Universal Precautions:  Assume a history of trauma without asking
   o   Notice the IMPACTS of past Trauma - rather than asking directly about the trauma itself
   o   Open-ended questions:  
                 - Sleep is a fairly neutral way to open a conversation - and is often disturbed by current stress or past memories.  See Quick Questions about Sleep
                 - Any stress at school/work? 
                 - In the case of a severe or unusual illness:  What was going on in your life around that time? 

Reminder about Secondary Trauma

Everyone who talks to another person is at risk for Secondary Trauma.   Secondary Trauma is the emotional distress that happens when we hear about or witness another person's traumatic experience.  Hearing stories may be disturbing and dysregulating.  A prequisite for caring for others is investing in our own Brain-Body Regulation.  

We can't take staying healthy for granted.  We each need a specific plan for Self and Collective Care or burnout is inevitable.  


* Lewis-O'Connor (2019)  The state of the science of trauma inquiry.  Women's Health.

Machtinger (2019).  From Treatment to Healing:  Inquiry and Response to Recent and Past Trauma in Adult Health Care.  Women's Health Issues.

What Happened to You?

Joining forces with Dr. Bruce Perry, one of the world's leading experts on childhood trauma, Oprah Winfrey marries the power of storytelling with the science of trauma. 

Asking What Happened to You? is a subtle but profound shift in how we can each clear a path to open the door to healing - for ourselves and our patients.


Motivational Interviewing

Miller and Rollnick, 3rd edition 2012

The ideas behind "motivational interviewing" have significantly evolved over recent decades.  The original idea was to motivate people to change; honestly we often wanted others to change in the ways we thought would be best.

The new generation of Motivational Interviewing focuses on building safety and trust and partnering with our clients to understand their perspective and their goals.