communication skills - breast cancer · love, hate please, sorry, i can't, try tones harsh,...
TRANSCRIPT
Communication Skills
Alison Dawkins
ABC Global Alliance
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What will we explore?
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Understanding the different elements that contribute to effective communication▪ Preparing your message - what is it that needs to be communicated? ▪ Setting an appropriate emotional temperature for the conversation▪ The role for language, body language and vocal tonality▪ Building rapport and influencing others
Breaking bad news, balancing transparency with empathy▪ Handling the impact of the bad news▪ Managing the responses and the emotions of others, balancing rapport but maintaining an outcome focus▪ Collaborating around decision making, presenting options, helping others to evaluate options▪ Gaining agreement - next steps and agreement
Building your influencing skills ▪ When influencing becomes persuasion - exploring resistance, remaining assertive, steering preferred outcomes▪ Adapting your approach to different situations and different personalities
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Your communication tool-kit
Your mind setYour energy
Your choice of languageThe clarity of your message
The tone of your voiceYour body language
Listening skillsRapport building skills
Your emotional intelligenceYour resilience
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Our resilience tank
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Your mind-set and energy
What should we be aiming for when communicating with others?
What sometimes happens?
What are the consequences?
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Transactional analysis
Parent Parent
Adult Adult
Child Child
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Transactional analysis explained
Clues from Controlling
Parent Nurturing
Parent Adult Free Child Adapted Child
Words
Should, must, don't, good, bad
Don't worry, let me help you, there there
How, when, where, I
understand
I wish, wow, love, hate
Please, sorry, I can't, try
TonesHarsh, abrupt, authoritative
Soothing, consoling, loving
Calm, clear, even
Joyful, noisy, energetic
Complaining, surly, monotone
Gestures/ mannerisms Finger pointing,
arms crossed
Pat on arm, nodding
encouragingly
Level eye contact, present
Exaggerated movements, uninhibited
Head tilted to one side, fidgeting, slouching
Facial expressions
Rolling eyes, furrowed brow,
scowling
Smiling, proud eyes
Open, thoughtful
Bright-eyed, smiling freely
Pouting, downcast, not
engaged
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The building blocks of rapport What are some of the things we can do that will build rapport with others?
How do we know when we have rapport?
What are some of the things we can do to break rapport?
What are the benefits of rapport?
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The power of the first impression
Our brains form first impressions by creating a composite of all the signals given off by a new experience
What do we noticewithin the first 30 seconds of meeting someone?
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Silent messages
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Words account for 7% of the overall message
Tone of voice accounts for 38% of the overall message
Body language accounts for 55% of the overall message
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Non verbal communication
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Body language that improves the experience
Eye contact, eye support
Tilted head
Facing forward, 90 degrees
Open and engaged posture
Active facial expressions
Contained frustration/nerves
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The power of posture
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The power of the voice
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Articulate Tone Pauses VolumePace
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The power of the voice
Interpreting emotional
states through
tone
Avoiding projecting
disharmony or
dissonance with tone
Supporting your
message with tone
Setting the emotional
temperature through
tone
Building rapport with
response tone
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Self reflection exercise
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What impact do I want to make as a communicator?
What changes might I need to make?
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What are the challenges faced when delivering bad news?
What are some of your
successful strategies?
Delivering bad news
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Structuring the conversation
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Preparing for the conversation• What’s the message?• What’s the second position?• Mental rehearsal
2Managing the conversation• Explore the patient’s current perception• Be clear with your message• Expect certain behaviours / responses• Allow for catharsis, protect rapport• Use empathy, validation statements• Steer towards understanding
Concluding the conversation• Agreement on next steps
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Preparing for the conversation
What is the purpose of the conversation?
What is your anchor message?
How will you structure and steer the conversation?
What will be the likely position of the other person?
What reaction/ behaviours might you expect?
How can you demonstrate rapport through out ?
How will you know if its been a successful conversation?
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The value of second positioning
Stepping into the other person’s shoes
What language will resonate?
Seeing things from an alternative perspective
How should you frame your approach?
What will their likely response be?
If I was in their shoes how would I feel/what would I think?
What message will resonate?
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Being a communication chameleon
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Building resonance in the conversation
Non-verbal support
Reflection of feelingVerbal support
Paraphrasing
Reflection of meaning
Summarising
Active listening
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Explaining the complicated
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✓ Avoid technical language
✓ Explain context
✓ Definitions
✓ Anecdotes
✓ Insights
✓ Metaphors, analogies
✓ Visualisation
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In conversation check list
How clear is your message?
How well are you listening?
How aware are you of the different tones in the
conversation?
Are you attuned to the non verbal
communication in the conversation?
How ‘on board’ is the other person?
Are you on track? Headed in the right
direction?
When is the right time to conclude the conversation?
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Anticipating reactions and behaviours
What are some of the reactions / behaviours you have experienced?
Which ones do you find most challenging and why?
What have been some of your more successful strategies?
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A change in tone, pace, volume
Silence. PausesHuman, not technical or
scientific language
Empathic statements
Non verbal warmth and openness
Validating statements
Building rapport
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Connecting with your patients
Empathic statements Exploratory questions Validating responses
“I can see how upsetting this is to you.” “How do you mean?” “I can understand how you felt that way.”
“I can tell you weren't expecting to hear this.” “Tell me more about it.”
“I guess anyone might have that same reaction.”
“I know this is not good news for you.” “Could you explain what you mean?”“You were perfectly correct to think that way.”
“I'm sorry to have to tell you this.” “You said it frightened you?”“Yes, your understanding of the reason for the tests is very good.”
“This is very difficult for me also.”“Could you tell me what you're worried about?”
“It appears that you've thought things through very well.”
“I was also hoping for a better result.”“Now, you said you were concerned about your children. Tell me more.”
“Many other patients have had a similar experience.”
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Emotional Intelligence
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Self-Awareness
Relationship Management
Social Awareness
Self-Management
Personal Competence
Social Competence
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What happens next?
Check patient is ready for discussion – what does that sound like?
Present treatment options but share responsibility for treatment options – how do we
frame that?
Invite questions, determine specific treatment goals – what does that sound like?
How do we conclude the conversation in a meaningful way?
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Challenges around treatment conversations
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Resistance is expressed
There is another
option that is favoured
I have some concerns with your position
You don’t understand what I need
You have stopped listening
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Different types of challenge
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Resonant
Dissonant
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A framework for handling being challenged
Empathise, remain open
Explore, find out what the issue is, be present and listen actively
Reflect back to check your understanding
Respond to concerns
Assert your position, use the anchor message
Invite feedback
Prepare to repeat
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Neutralising dissonance
Use your tone of voice and body
language to signal rapport
Use empathic statements, model
rapport
Demonstrate willingness to listen
Do not check out, interrupt or talk over
Try to remain issue and outcome focused
Build breathing space into the conversation
Steer towards outcomes
Separate the emotional from the factual
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Handling challenging conversations
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Assertive
Aggressive Passive
Passive-Aggressive
DismissiveCritical and combative
Show frustration
Giving inAccepting what you
don’t wantNot speaking up
ColdDisengaged
Absent in the conversation
Clear with needs and thoughts, wantsListens to others
Explores resistance
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The assertiveness mindset
I am ok and you are ok
Everyone has the right to disagree, challenge, question
I need to be tactful when being truthful
It is ok to change my mind
It is ok to factor in my own needs when decisions are made
It is ok to express what I really want
I acknowledge those around me are not mind readers
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Assertive language
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I NEED TO SEE MOVING FORWARD CAN WE AGREE… I HAVE SOME CONCERNS ABOUT…
MY CONCERN IS… I NEED YOUR HELPMY PREFERENCE WOULD BE…
IT WOULD BE GREAT IF… LETS WORK TOGETHER TO…I’D LIKE TO FIND A WAY TO…
I WOULD VERY MUCH LIKE IT IF… WE HAVE TO FIND A WAY TO…MY FEAR WOULD BE…
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Action Planning
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Conclude every conversation with an action –what happens now
Summarise what’s been agreed
Agree timeframes
Agree next point of contact
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Insights & Actions
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Insights – outline the key points you have learned today
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Actions – how will you apply them?
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