With so many people w/ #COVID19 saying they don't know how they got it, as a psychologist, I tend to wonder if part of this is due to the shame of admitting to risky choices.

How we gather this info could the accuracy of responses. Some ideas! 1/x https://www.bostonglobe.com/2020/11/24/nation/what-does-it-mean-when-youve-got-covid-19-you-dont-know-where-or-how/

Allow patients to share this information anonymously, for example in an online survey. Make sure they understand it is anonymous. Anonymity often reduces the shame factor.

2/x

Provide a list of activities for them to check off rather than asking an open-ended question. People may not think an activity is risky and so never mention it.

3/x

People tend to focus on what they do all the time (I always wear a mask! I never leave the house!) rather than things they did once or infrequently. Praise their safety behaviors, but probe for infrequent behaviors. If using a list, make sure it is specific and exhaustive.

4/x

Emphasize how important getting accurate information from them is to saving lives. Thank them for doing their part to save lives. 5/x

Create a nonjudgmental, empathic atmosphere, using statements like, "Nobody is to blame, this virus is very infectious" "Everybody is doing the best they can" "Life is messy, it is very difficult to avoid all risks" "You were so smart to get tested." 6/x

Consider that appearing stressed or tired may convey blame to a patient who is feeling shameful (like they are contributing to this). A calm demeanor may produce more honesty. 7/x

Behavioral scientists: Other ideas for getting accurate information from patients when the topic is associated with much shame? 8/x