therapeutic helping relationship

assess a patient

make appropriate clinical decisions

implement a plan

evaluate effectiveness of a plan

patient centered communication allows you to:

patient participates in their own healthcare

patient-centered care =

content

verbal cues

non-verbal cues

emotion

types of communication

5x more impactful

non-verbal cues are BLANK than spoken words

active listening

demonstrates understanding of the message's content; dynamic and interactive

repeating

paraphrasing

summarizing

3 techniques to active listening

repeating

simplest form of reflective listening, but can be especially poignant to acknowledge a key phrase to the patient or important to emphasize a critical point

paraphrasing

some interpretation involved. conveying what has been said in a slightly different way

summarizing

communicating their main points back to the patient. when skillfully done, can be useful for helping the patient identify discrepancies or contradictions in thinking that are barriers to meeting their health goals

attentive silence

giving the patient time to respond

facilitation

encourages continued sharing and moving the conversation along

universal response

avoid dismissing the patient's emotions and use cautiously in an emotional context; used in context to offer help

empathetic repsonse

demonstrate understanding of content + feeling in the message

-active listening with the emotion

judgmental

advising

placating

quizzing/probing

distracting

generalizing

sympathy/"I'm sorry"

common pitfalls when providing an emotional response

judgmental responses

placing the patient's feelings under evaluation

advising

offering a solution to the patient's emotions or personal problems

placating

offering false reassurance

quizzing or probing

focuses on the content of the patient's message, not the feelings

distracting

changing the subject

generalizing

minimizes the uniqueness of the patient's individual experience

when accepting responsibility

when can you say "I'm sorry"?

clinician

patient

healthcare setting

barriers to communication

clinician factors

-lack of training

-inattention, lack of focus, interruptions

-failure to ask for clarification (use of active listening)

-non-empathetic responses

patient factors

-literacy

-language

-culture

-misconception about visit purpose

-aging

-disabilities

health care setting

-lack of privacy

-may lack a space

-may lack an appropriate space to accommodate a given patient population

controlling behavior

not engaging in shared decision making

depersonalizing

should communicate with patient directly rather than caregiver (unless permission is given or medically necessary)

active listening leads to patients disclosing personal info that can explain a wide variety of health behaviors and attitudes. these can leave HCPs feeling awkward, uncomfortable, or not knowing what to say

how does HCP discomfort occur?