TEACHING CLINICAL OBSERVATION AND DIAGNOSIC INTERVIEW
In France, possession of a B.A. and Master degree in Psychology gives the right to use the professional label "psychologist", a general label without specification, and thus to lawfully practice in any field of psychology. It therefore is the task of the university to offer a special training for those who wish to work in the clinical field. Among the specific skills needed in clinical practice, diagnostic skills can only be acquired through a long process of integrating clinical experience, assessment tools and sound knowledge of psychopathology. While theories and models can easily be taught through university courses, the challenge is to train the students in clinical observation, and diagnostic interviews.
After a brief presentation of the structure and contents of the French university teaching in clinical psychology, we will focus on the technical and ethical aspects of case presentations. Traditionally, the clinical aspect of the teaching was performed in hospital settings through "live" presentations, i.e. a real patient was interviewed by a psychiatrist or a psychologist in front of a group of students. As the number of students kept growing, interviews were transmitted by a video system to an adjacent room. The next step naturally was to record the interview, opening the path to performing clinical presentations at the university through videos. On one hand, this type of video presentations poses ethical issues such as: is it legitimate to keep trace and track of people who have been once patients, can it be considered that the patient is being used, as opposed to cared for, how to guarantee confidentiality etc. On another hand, clinical skills can only be acquired through a contact with real patients and by observing the interactions between a consultant and a consultee. Video presentations also offer the opportunity to analyse short sequences of the interaction and discuss with the students both the clinical signs presented by the patient and the interviewing methods of the consultant.
Psychopathology has two sides: one is the necessary knowledge acquired through books and lectures; the other is the clinical training which should be acquired through residency periods in psychiatric settings. In some European countries and elsewhere – but not in France –, a one-year residency is compulsory for becoming a clinical psychologist. Whereas video presentations of patients in the USA are a current practice, it is not so in France and the author of this paper is unaware of the methods used in other European countries. This presentation could introduce to a fruitful debate between colleagues of different countries.
© 2008 Victor Karandashev