Box 3.

Negative impact

Emotional upheaval

“Maybe some of the questions were apt to churn up all the past, and when that happens the emotions tend to start ticking over as well . . . [later in interview] She was harping on about why don't you think you can work . . . because she couldn't understand . . . I found with the other students they were more apt for listening.” (patient 2: depression)

“Some find it very stressful and they need about 10 minutes of debriefing after the session. Most of the patients—and this is what I have learnt with time—that need debriefing [are] the ones that have not come to terms with their problem. And when their whole life history is sort of laid out in an hour—they find it quite traumatic.” (general practitioner 11)

Blurring of boundaries in doctor-patient relationship

“The problem is that these patients, obviously they want something in return, and the something in return is to see them whenever they want to be seen, squeezing in an appointment or whatever, and that's the trade-off.” (general practitioner 3)