It is based on three elements:
1.Everyone wants listening and understanding.
That means that the listener must have listening skills and empathy.
That also means that understanding is required and that agreement is irrelevant.
The mental approach is called ‘unconditional positive regard’. This means the suspension of judgement and ego is needed in order to pay full attention to the other person. Let them tell their story without interrupting or being defensive. As they talk, you need to communicate your understanding. Genuine responses that keep them talking.
2. Everyone wants to be valued and included.
Start with the intention that the patient has something to offer. They have values, wants, and concerns that are valid to them. They are an expert on their own body and careful listening will reveal valuable diagnostic information and their outcome. It is incumbent on the interviewer to ask good questions, be curious, and follow up appropriately. The patients desired outcome is an essential determination.
3. Everyone wants to be engaging in something worthwhile and meaningful.
Once a patient knows that they are understood, that the outcome they desire is the goal of treatment, and that they will be supported in the effort, they follow through. The remaining barriers are money, time, inconvenience, and fear. If they truly believe they are getting what they want, the first three mean much less.
Fear is a separate issue to be dealt with. If trust has been built, it will lessen. Empathy and compassion help sort out a means of dealing with fear. All fear must be validated. The fear is real even if the reason for the fear is obscure. The reason is not relevant. Fear can be very deep seated and may be from a psychological trauma that has been suppressed. If possible, identify the fear or anxiety producing behaviors or objects. If they cannot be eliminated then sedation or anesthesia may be the answer.
Photo by Dave Hutt, www.dmddigitalphoto.com