How to handle those tricky conversations...
Words by Sarah Yule
We only have to glance at the front page of many magazines as we are at the quick check out at Safeway, to see that advice regarding how we interact with another human is so sought after, it is a selling point for such magazines. 'How to tell him you love him without freaking him out!'; 'how to tell her she's the one'; 'how to let them go and stay friends'; 'what to say to a friend with a bad habit'... This seemingly ubiquitous advice often captures our attention because many of us share the desire to be able to accurately express what we are trying to say with the highest possible chances of the recipient of our conversation hearing and interpreting what we are trying to say as it was intended.
What about those seemingly challenging conversations with our patients?
The challenging conversation can often be easily actively avoided as often the alternative to the conversation is seen as conflict. Truth and conflict do not necessarily have to be in competition with one another. Although depending on the person, this may be perceived to be the case. The 'difficult conversations' being referred to in this instance can be any one of the following scenarios:
Your patient is insistent that the only way for your to fix their back is to 'click it' back in
The only way your patient is going to lose weight is if you help them with a quick fix smoothie diet
They are doing their exercises in the waiting room before they see you because they haven't done them at all since your last appointment
Firstly, the language we use ourselves can often project onto how we perceive the impending conversation. So, that being said, from this point onward, we shall replace 'difficult conversation' with the term 'solution focused conversation'. Sounds far more productive and far less emotive already doesn't it?
So, now that we have a new title for our conversation, what’s next? A few things to remember when entering said 'solution focused conversation':
Acknowledge their perspective: Promisingly, more often than not, us homo sapiens have reasons for doing what we do. Try to understand where your patients/clients mindset is at. What's their reason for doing what they do or how they formed the views they have on their health? Understanding this will help you design your next step because a one size fits all approach rarely works.
Things don't have to be black or white: Often health misconceptions have come from a filtered and watered down version of fact and laced with a bit of convenient icing on top that forms perhaps an unhealthy perspective. If possible, try to identify the positive or factual elements of their viewpoints (sometimes this is not always possible). Acknowledge these and use these as a conduit to rebuild or reframe the idea!
Be aware of body language: both yours and theirs. Be attuned to subtle cues they may be giving you to indicate they are either on board or perhaps not on board with what you are discussing. Similarly, be aware of your own body language in ensuring it is complementing the message you are conveying. For example, your arms being crossed whilst listening to your patient may not appear as open to hearing your patients views compared to you sitting with your hands in your lap.
Bring it back to the why: you both have the same shared goal (hopefully) which is addressing the element of their health that they are seeing you for. Returning to establish what each of your roles are in the practitioner-client context may help with reframing an action plan from there.
Remember we are all on the same team, so sometimes its about finding the best possible shared strategy during your solution focus conversation!
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