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As you interview the patient, you should listen reflectively to what she's saying. This means repeating or paraphrasing what the patient said in your own words, and occasionally summarizing your understanding of the overall situation. Listening reflectively ensures accurate communication, develops rapport, and demonstrates empathy.

For example, if you asked why she decided to pierce her belly button, the patient may have said: "Because everyone at school has it pierced. I wanted to fit in but didn't have enough money to go get it done." A reflective listening response would be, "It sounds like it's important to you to fit in with other people at school." Even if you don't approve of or agree with the patient, reflecting what she's said in your own words would let her know you heard her and can understand how she felt.

Then, you could continue the interview and ask for more details about her social behaviors. Something like, "What are some other ways you've tried to fit in with your peers at school?"

Her response to fitting in at school may have revealed that she was being bullied and was thinking about suicide.