Formulations in first encounters

The paper describes and compares the use and function of the formulation-decision pair in three types of diagnostic interviewing. The investigatory type of interviewing, which typically occurs in the medical interview, is characterized by the absence of formulations, In the exploratory type of interviewing, which typically occurs in the psychiatric interview, the interviewer uses the formulation-decision pair for exploring the patient's experiences. He does not, however, formulate his professional assessment in the interview. In the collaborative type, which typically is found in psychotherapy, the formulation-decision pair is the main interactional device used by the interviewer for translating the patient's troubles into a professional problem definition. It is suggested that the patient's protoprofessionalization, which is typical for psychotherapy, already begins in the initial interview and that it is an effect of the interviewer's specific use of the formulation-decision device in the interview.