Revisiting the Hypothesis-Driven Interview in a Contemporary Context

Abstract

Objective: The “hypothesis-driven interview” was articulated by George Engel as a method of raising and testing hypotheses in the process of building a biopsychosocial formulation and determining the most likely diagnosis. This interview was a forerunner of the modern medical interview as well as the contemporary psychiatric assessment. The objective of this article is to describe the hypothesis-driven interview and to explore its relationship with the contemporary medical interview. Method: The literature on the medical and hypothesis-driven interview was reviewed. Key features of each were identified. Results: The hypothesis-driven interview shares much with the contemporary medical interview. In addition, it enhances the application of communication skills and allows the interviewer to develop a formulation during the course of the assessment. Conclusion: The hypothesis-driven interview is well suited to the aims of a contemporary psychiatric assessment.