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Patient Educ Couns. 2009 May;75(2):220-6. doi: 10.1016/j.pec.2008.10.010. Epub 2008 Dec 4.

Patient initiation of information: exploring its role during the mental health intake visit.

Author information

  • 1New School of Psychology, Interdisciplinary Center (IDC) Herzliya, P.O. Box 167, Herzliya 46150, Israel. onakash@idc.ac.il



Describe the role of patients' initiation of information in patient-provider communication during mental health intake visits.


One hundred and twenty-nine mental health intake visits of diverse racial/ethnic patients were videotaped. Semi-structured interviews were conducted with patients and providers following each intake visit. We qualitatively analyzed the interviews to identify themes related to patients' initiation of information. We quantitatively analyzed the videos of the intake visits utilizing a checklist that identified whether the patient or the provider initiated the information exchanged.


Patient initiation of information affected providers' evaluation of the credence of the information, assessment of rapport and appraisal of the success of the intake visit. Patients' initiation of information varied with patients' race, age and prior treatment experience; and provider's age, discipline and experience. Patients expressed a personal preference either to not be interrupted or to be asked questions by their providers.


Our findings illuminate the role of patient initiation of information in provider decision-making and highlight the importance of tailoring the communication style to patients' preferences.


Encouraging explicit communication with patients about expectations related to information exchange styles is recommended. Improving provider awareness of assumptions regarding their decision-making is also suggested.

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