Communication Skills and Focused Listening Module

Communication Skills

and Focused Listening Module

What is this?!

What is this?!

What is this?!

Constellation of Needs

Individual experience

Spiritual: meaning and purpose in life, religious or other

views

Emotional: reactions & feelings, i.e.

anxiety, fear, sadness

Practical: financial, home support, childcare,

transportation

Social: family & community

network

Physical: pain, nutrition, help with

daily living

Information: about cancer & related services, to inform

decisions, reduce anxiety

Psychological: coping with cancer, changes &

consequences

COMMUNICATION SKILLS

When connecting with patients/ family members you will be talking in a specialized way. You are following the individuals agenda.

Good Communication Starts with Empathy

• Intellectual and emotional awareness and understanding of another person’s thoughts, feelings and behavior, including emotions that are distressing

• “As little as 40 seconds of empathic language results in significant changes in

patient’s anxiety level”.

HOW TO BE A GOOD LISTENER

• EMPATHIZE: Put yourself in the other person’s shoes, this is different then sympathy.

• STAY IN THE MOMENT: Focus on listening vs. formulating your response.

• MAKE UNDERSTANDING YOUR GOAL: Allow people to elaborate and explain themselves as needed. Focus on understanding what the patient/family is saying, meaning and feeling and why it is important to them. Really make understanding your primary goal.

HOW TO BE A GOOD LISTENER

• LISTEN ACTIVELY: Check your understanding by repeating back the main points as you’ve heard them.

• BE AWARE of ASSUMPTIONS: Avoid assuming, check it out.

• LISTEN FOR WHAT IS MISSING: What information or emotion has been left out that could give you a clearer picture?

• DON’T RUSH IN TO: soothe, fix, and advise.

HOW TO BE A GOOD LISTENER

• BE AWARE OF YOUR IMPACT: Notice patient’s responses to your interactions and feedback and adapt accordingly.

• DON’T offer false reassurance (everything will be all right…), defend (but Dr./Nurse/Social Worker X is very skilled).

• DON’T tell people what to do or how to feel i.e. “Think positive”; “Don’t worry”.

ACTIVE LISTENING SKILLS

• Encourage – “Tell me more about that.”

– Face the speaker, make eye contact.

– Body language, nod your head.

• Clarify

– “And what does that mean?”

– “When did this happen?”

– “That is your key concern?”

ACTIVE LISTENING SKILLS

• Restate

– “What you are saying is…”

– “Your understanding is…”

• Reflect

– “You looked very angry when you said…”

– “You seem sad about that.”

ACTIVE LISTENING SKILLS

• Summarize

• “You’re upset with me because…”

• “You’d like me to…”

• Validate

• “Sounds like you have a great deal on your plate right now.”

• “You have been having many stressful things happen all at once.”

Techniques that Facilitate Communication

• Body Language: be relaxed and confident• Start where the patient is: Allow the patient to

take the lead• Clarify- restate, paraphrase and translate feelings• Use open ended questions that cannot be

answered by YES or NO• Validating• Using silence with non verbal body language

Techniques that block communication

• Offering false reassurance• Making promises you can’t keep• Expressing judgment• Disagreeing• Making stereotype comments “Just listen to

your doctor, he/she knows”• Changing the subject to something unrelated

Expressing Empathy

The key to responding to the PERSON

is responding to their EMOTIONS

Scenario

• “I have gone from the body of an active 18 year old doing pretty much whatever I wanted, to a much weaker and more fragile one. [I had a] seemingly never ending list of complications ranging from routine fevers to pancreatitis, which caused severe pain attacks and further complications which I am still dealing with. This may have been the most trying period mentally as well, because it seemed like I got a never ending stream of bad news.

• I did not really want to make my issues public, especially at first... I find that I have to make an effort to will myself to go out and be with my friends.

• [Cancer] has forced me to sit back and take a look at life and what it means, who I am and where I am going... as well as seeing the value of just living day to day, for the moment.”

[Young man, diagnosed with Leukemia]

Practicing Communication Guidelines: Active Listening Skills based on Scenario

1. Provide an example of how you could express empathy and validate their experience.

2. Provide an example of assumptions that you might make and how you might check them out.

3. What is something supportive that you can say that is not “false reassurance” nor providing information?

4. Provide an example of strengths you are hearing from the patient and how you might reflect them back.

5. Provide an example of how can you wrap up the conversation.

Role Plays