ArticleLiterature Review

La manipulation dans la pratique de l’entretien psychiatrique

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Abstract

Introduction The term “manipulation” is defined as “getting someone to behave otherwise than he spontaneously would”. Unlike cognitive therapies, it does not involve cognitive functioning and may increase psychotherapies’ efficiency. Method In the absence of data in the scientific literature (Medline and Web of Science), we propose a synthesis of theoretical data from social psychology with a reflection on its applications in the daily practice of psychiatry. Results Firstly we present auto-manipulation: the “chilling effect” is the fact that people tend to keep to a decision and to duplicate it, even if it does not work. The commitment of the patient, i.e., the degree to which he/she identifies with his/her act, will be even stronger if the patient's sense of freedom is high. The rationalization process is the ability for individuals to revisit their beliefs after being forced to issue a behavior (that he/she did not adhere to) to justify it a posteriori. In the second part, we present techniques for hetero-manipulation. Priming is to ask about a low effort to “initiate” the behavior. The lure technique is to hide convenience or invent fictitious benefits of a product, but is not ethical. The labeling technique is to assign an individual to a positive value regardless of his or her behavior, which increases the probability of emission of positive behaviors. The touch technique, whatever the cultural context, encourages a patient to have more confidence in his/her therapist and to make them friendly towards the person involved by creating a positive mood, reduces stress in patients before surgery, and improve the academic performance of students. Discussion and conclusion We propose reflections on the application of these concepts in daily practice in the psychiatric interview. These techniques seem fundamental in improving therapeutic alliance and the likelihood of good compliance in our patients, and should be known to all practitioners.

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... For example, anesthesiologists working in ICU may be more prone to report having chosen medicine a posteriori to save lives and may have reported other MMS if they could not have chosen anesthesiology at the National Exam in the 6th year of medical studies. This phenomenon called rationalization has been well described in social psychology [7]. However, how MDs justify their past choice for their specialty may also impact their behavior at work. ...
L'entretien motivationnel : aider la personne à engager le changement
  • W R Miller
  • S Rollnick
Miller WR, Rollnick S. L'entretien motivationnel : aider la personne à engager le changement. Paris: Broché; 1991.