Mastering the Return Interview Technique: A Comprehensive Approach
The Return Interview Technique in Psychological Practice
The Return Interview: Information and Technique
Working with return interviews implies the need to manage a different approach than classically used in the preparation of psychological diagnoses. It involves the constant use of latent and transference dynamics.
A successful return interview begins with the acquisition of thorough knowledge of the case, which provides a firm basis for effective implementation.
Upon completion of the initial interviews with parents and the administration of tests and play sessions with the patient (if a child), we must study all the recorded material and develop explanatory hypotheses. Try to get a picture as complete as possible, including the nature of the ties that bind the patient with their family as a whole, with the parental couple, with each member of their household, and with the psychologist.
Within this scenario, it is useful to discriminate which are the most healthy and adaptive aspects of the patient, their parents, and their family group, and which are less adaptable and more problematic. Once that is established, we must make a second discrimination: what can we tell the patient and/or their parents regarding everything less adaptable and more problematic, that is, how far can we go, and what can we not tell the patient and/or parents. Since we know whether or not they will ultimately accept the recommended treatment, it is risky to mobilize them more than their ego can absorb or tolerate, based on data collected. We emphasize that it is very important to understand what is true and what is not, as elements that limit the scope within which the return interview may take place.
With these elements, we can tailor a plan to guide the return interview, elastic enough to edit on the fly, depending on the reaction of the recipients (more open or more closed than expected). Indeed, it cannot be pre-planned to follow to the letter. In most cases, new information or the emergence of new behaviors determine a detour.
Margin, healthy to the extent that it creates a better fit to the dynamics of the interview. Sometimes it is necessary to restrict the original plan; other times, zoom in.
We start the return by highlighting the adaptive aspects of the patient and continue with the less adaptive pathology, including the extent and pace at which each patient can tolerate it. We have found clear signs of tolerance or intolerance expressed verbally and preverbally. Here are some indicators of intolerance:
- There are verbal cues such as saying “I do not understand” or “it is very difficult for me.”
- Other verbalizations express feelings of estrangement: “That is not me, not me.”
- Or those feelings projected onto the psychologist: “You do not understand.”
Other indicators are expressed verbally, but the patient is not conscious of them. These are lapses and associations that show us the opposite of acceptance or a massive passive acceptance not to think. This makes for a submission to the superego projected in the psychologist, and the patient’s ego is almost nullified in their ability to question, to ask the psychologist, tolerate, and raise questions, etc. Other indicators belong to the preverbal level. Among them, we can mention:
- Breaking frame as to some of their patterns, such as coming late.
- Wanting to leave right away.
- Requesting a refund by phone.
- Not wanting to stop the psychologist.
- Showing nervousness.
- Turning pale.
- Coughing.
- Asking to go to the bathroom, etc.
In contrast to these, we find other indicators that express tolerance of what is given back to them, namely: the emergence of new partnerships related to repressed memories, new perspectives, expectations, fears, etc. Another important indicator is the acceptability of “pseudo identities” and manifest and latent aspects of their identity, through testing different materials.
Another technical problem is the choice of appropriate language. It is important to be clear, not to fall into the use of technical terminology, avoid ambiguous or equivocal terms, and where possible, use the same language used by the patient or parent.
Selecting a verb form to translate to the child what they transmitted to us in verbal form is very difficult. To further clarify what we want to communicate to the patient, whether child, adolescent, or adult, it is advisable to use the testing equipment available, which usually appears in condensed or plastically expressed what we mean. For example, we can use the father figure drawn on the test of the family and the history of plate 3 of the CAT.