Psychiatrist-Patient Verbal and Nonverbal Communications During Split-Treatment Appointments

Abstract

Objective: This study characterized psychiatrist and patientcommunication behaviors and affective voice tones during pharmacotherapyappointments with depressed patients at four community-based mentalhealth clinics where psychiatrists provided medication management andother mental health professionals provided therapy ({''}splittreatment{''}). Methods: Audiorecordings of 84 unique pairs ofpsychiatrists and patients with a depressive disorder were analyzed withthe Roter Interaction Analysis System, which identifies 41 discretespeech categories that can be grouped into composites representing broadconceptual communication domains. Cluster analysis identifiedpsychiatrist communication patterns. T test and chi square analysescompared the clusters for verbal dominance, affective voice tone, andcharacteristics of psychiatrist and patients. Results: On average, 53%of psychiatrist talk was devoted to partnering and relationshipbuilding, and 67% of patient talk was about biomedical subjects, suchas depression symptoms, and psychosocial information giving.Psychiatrist communication patterns were Characterized by two clusters,a biomedical-centered cluster that emphasized biomedical questions(eta(2)=.22, df=82, p