How can you actively listen in complex cases with patients who have social issues?
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Active listening is a crucial skill for patient advocates, especially when dealing with complex cases that involve social issues such as poverty, discrimination, abuse, or trauma. Social issues can affect the health, well-being, and autonomy of patients, as well as their access to care and resources. As a patient advocate, you need to listen attentively, empathetically, and respectfully to understand the patient's situation, needs, and preferences. Here are some tips on how to practice active listening in complex cases with patients who have social issues.
The first step to active listening is to establish rapport with the patient. Rapport is a sense of trust, mutual understanding, and respect that facilitates communication and cooperation. To build rapport, you need to show genuine interest, compassion, and curiosity about the patient and their story. You can do this by using open-ended questions, acknowledging their emotions, and validating their experiences. Avoid judging, interrupting, or imposing your own opinions or solutions on the patient. Instead, let them express themselves freely and fully.
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Courtney Lawrence
Archaeologist and Heritage Professional, M.A.
I think it is important to remember that it is relatively easy to break what trust has been built. As a result, it's important to be consistent, be empathetic, practice cultural relativism as the individual may be from a different culture than your own, and let them know that you are listening. Don't be afraid to repeat what they said, though without judgment, to affirm that you are indeed listening. Make sure they know that you are there to respectfully listen and not to judge or harm.
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Arshia Bhandari
Patient Safety Advocate | Pharmacovigilance Expert | Business Storyteller | Keynote Speaker | Founder @ PhVFIT | NLP Business Practitioner
The first step to establishing rapport is to give a non-judgemental “patient” listening. To the patient or the family, its important that you let them talk and show genuine interest in what they say. Its only possible, if the patient advocate has a genuine desire and intention to help the patient find solutions. If you can not help, don’t leave it there, direct the patient to someone who can!
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The second step to active listening is to reflect and clarify what the patient is saying. Reflection is a technique that involves repeating or paraphrasing the patient's words or feelings to show that you are listening and that you understand them. Clarification is a technique that involves asking questions or requesting more information to avoid confusion or misunderstanding. You can use reflection and clarification to confirm the accuracy of your interpretation, to show empathy and support, and to encourage the patient to elaborate or explore their thoughts and feelings.
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Judy Lane Boyer
Ghostwriter. Building an audience for YOUR practice, story, or expertise.
Sometimes you may also need to ask questions for clarification: "So, you're saying . . . ?" or "Do you mean . . . ?" Always ask these questions with sensitivity and humility; you're genuinely trying to understand.
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Brigitte Zeenat Nazroo
Systemic Team & Individual Coach (ACC-ICF) -Jungian Psychotherapist - Mediator (CNV) - English & French Soft Skills Trainer
All these techniques are valuable for allowing the person to explore further, to give more information, to clarify matters for themselves mainly. At times, you can just repeat the last word or one of the most important last words … with an interrogative tone, which will open the door for more sharing from the patient. Often, clarification is not so much for the listener to understand better as for the patient to voice thoughts and feelings with more clarity.
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The third step to active listening is to summarize and confirm the main points and issues that the patient has shared with you. Summarization is a technique that involves condensing and organizing the patient's information into a coherent and concise statement. Confirmation is a technique that involves checking with the patient if your summary is correct and complete, and if they have anything else to add or change. You can use summarization and confirmation to demonstrate your comprehension, to highlight the key themes and problems, and to prepare for the next steps or actions.
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Brigitte Zeenat Nazroo
Systemic Team & Individual Coach (ACC-ICF) -Jungian Psychotherapist - Mediator (CNV) - English & French Soft Skills Trainer
Summarizing is probably the most difficult. It is always best to ask the patient if they would say it that way. How do they feel about saying it that way ? Let’s remember we are there to organize the patient’s information in a concise way. We are not adding any element to it but we are bringing light onto what seems to be the core of the issue. In so doing, it will hopefully allow the patient to open new doors and take new steps and actions.
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The fourth step to active listening is to respond and empower the patient. Response is a technique that involves giving feedback, advice, or suggestions to the patient based on their needs and goals. Empowerment is a technique that involves helping the patient to identify their strengths, resources, and options, and to make informed decisions about their care and well-being. You can use response and empowerment to show respect and appreciation, to offer guidance and support, and to promote the patient's autonomy and agency.
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Brigitte Zeenat Nazroo
Systemic Team & Individual Coach (ACC-ICF) -Jungian Psychotherapist - Mediator (CNV) - English & French Soft Skills Trainer
A good time to ask them to review their needs and modify their goal if needed. Asking permission is the first necessary step for giving feedback, advice or making suggestions, always stating you may be wrong and asking whether they’d want to correct or add anything or take time to process. Acknowledging their strengths and expressing appreciation can be done at the same time. To me, we don’t empower anyone. We only support a patient’s empowerment to make their own decisions, split goals into subgoals and deadlines and find ways to monitor their own progress. However, we can shed light onto what they don’t yet see as strengths, how to turn "weaknesses" into strengths, on resources or options and help them expand beliefs and break barriers.
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The fifth step to active listening is to adapt and adjust your listening style and strategies according to the patient's situation, personality, and preferences. Adaptation is a technique that involves modifying your tone, language, and pace to match the patient's level of comfort, understanding, and engagement. Adjustment is a technique that involves changing your approach or focus based on the patient's feedback, cues, or needs. You can use adaptation and adjustment to show flexibility and responsiveness, to avoid miscommunication or conflict, and to enhance the quality and effectiveness of your listening.
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Brigitte Zeenat Nazroo
Systemic Team & Individual Coach (ACC-ICF) -Jungian Psychotherapist - Mediator (CNV) - English & French Soft Skills Trainer
Adaptation, adjustment or empathy. Empathy takes place naturally when one is connected to the heart’s intelligence. Instinctively, we will use the necessary words, language, stories, metaphors that will connect with the patient. We can also learn to do that by listening and mimicking the patient in their language, pace, expressions, style in some way. However, if the connection of the heart is not there, the patient will feel it and will not respond in the same way.
The sixth and final step to active listening is to follow up and follow through with the patient. Follow-up is a technique that involves contacting the patient after the initial conversation to check on their progress, to provide additional information or resources, or to schedule another meeting. Follow-through is a technique that involves completing any tasks or actions that you agreed to do or that the patient requested from you. You can use follow-up and follow-through to show commitment and accountability, to reinforce your relationship and trust, and to ensure the patient's satisfaction and well-being.
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Brigitte Zeenat Nazroo
Systemic Team & Individual Coach (ACC-ICF) -Jungian Psychotherapist - Mediator (CNV) - English & French Soft Skills Trainer
I would schedule another meeting on that particular one if we agreed to have another. However, providing additional feedback or resources and checking on their progress as a follow-up without a schedule can be necessary in some cases as long as the patient has been pre-informed and given their consent. If the patient was running some risk, we have to go beyond what we usually do, be available at certain agreed times and provide resources the patient could resort to in case of need. Following through with what you have been requested and agreed to do or yourself offered to do goes without saying and is part of our ethics.
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Brigitte Zeenat Nazroo
Systemic Team & Individual Coach (ACC-ICF) -Jungian Psychotherapist - Mediator (CNV) - English & French Soft Skills Trainer
With patients who have complex social issues, the relationship has to be handled with the utmost care as you may be the only person the patient is building a relationship with. Moreover, the patient may be very vulnerable, which leaves no place for being judgemental. We have to guard even more against stereotypes and cultural biases.