Communication - Centers for Disease Control and Prevention
Communication Skills for Building Rapport During Contact Investigation Interviewing 1 Learning Objectives After this session, participants will be able to: 1. Describe how to build rapport 2. List at least six effective communication
skills 3. Describe assertive, passive, and aggressive behavior 2 Building Rapport 3 Building Rapport
Building rapport is the key to a successful case/health care worker relationship What is Rapport? Definition: 1: relation of trust between people 2: a feeling of sympathetic understanding 3: in accord, harmony 4: having a mutual understanding 4 How Do You Build Rapport?
Methods to build rapport Use effective communication skills Find common ground Display respect and empathy 5
Effective Communication Skills 6 Effective Communication Skills A. Active listening B. Using appropriate nonverbal communication C. Using appropriate voice and tone D. Communicating at the cases level of understanding E. Giving factual information
F. Using reinforcement G. Summarizing important points from the conversation 7 A. What is Active Listening? Hearing what is said and paying attention to how it is said so the conversation can be adjusted to elicit the needed response
Utilizing various verbal and nonverbal techniques 8 What are Some Active Listening Techniques? Paraphrasing and summarizing Reflecting Being silent
9 Active Listening Paraphrasing and Summarizing (1) What is paraphrasing and summarizing? Rewording or rephrasing a statement to Verify information Demonstrate engagement in the conversation
10 Active Listening Paraphrasing and Summarizing (2) How do you do it? Use phrases such as What Im hearing is or It sounds like you are saying Do not repeat the persons exact words Avoid phrases like I know what you mean.
11 Active Listening Paraphrasing and Summarizing Example (1) Example 1: Case: I am feeling very tired these days and the meds mess up my drug use. I dont know if its all worth it. How would you paraphrase this statement?
12 Active Listening Paraphrasing and Summarizing Example (2) Example 2: Case: I cant tell you the names of all my contacts. I just hang out at the pool hall; there is a guy we call Slim, another one named JD. How would you paraphrase this statement?
13 Active Listening Reflection (1) What is reflection? Putting words to a case or contacts emotional reactions Acknowledging a case or contacts feelings shows empathy and helps build
rapport Helps to check rather than to assume you know what is meant 14 Active Listening Reflection (2) How do you do it? Reflect back to the case or contact what you
think they have said Examples It sounds like you are feeling worried I understand you are having trouble with 15 Active Listening Reflection Example (1) Example 1:
Case: Im feeling tired and this whole interview is making me nervous. YOU are asking me too many questions. How would you reflect this statement? 16 Active Listening Reflection Example (2) Example 2: Case: I dont want an HIV test. I dont want to
know if I have AIDS. If there is nothing I can do about it, whats the point in knowing? How would you reflect this statement? 17 Active Listening Using Silence How can silence indicate you are actively listening?
It allows the case an opportunity to answer questions 18 Active Listening Exercise Refer to Appendix I 19 B. Using Appropriate
Nonverbal Communication Nonverbal communication Is an important aspect of building rapport Can be both what the interviewer or case conveys with his/her body language Interviewer should Display appropriate body language Be observant of the cases body language 20
Appropriate Nonverbal Communication for Interviewer Eye contact Facial expressions Looking attentive Posture Leaning forward Gestures Nodding head Movement and mirroring
Refer to Appendix J 21 Interpreting Body Language Nonverbal Cues Possible Meaning Faltering eye contact
Boredom or fatigue Intense eye contact Fear, confrontation, or anger Rocking Fear or nervousness Stiff posture
Elevated voice Discomfort or nervousness Confrontation or anger Prolonged and frequent periods of silence Disinterest, loss of train of thought, or fatigue
Fidgeting Discomfort, disinterest, nervousness, possible drug use 22 C. Using Appropriate Voice and Tone Voice and tone Use natural volume and tone
If voice is too loud, the case may be intimidated If too soft, the message may be inaudible or sound hesitant Pace Use regular pace If too fast, it can indicate a feeling of being rushed If too slow, it can sound tentative 23 D. Communicate at Case or Contacts Level
Avoid technical terms and jargon Limit the amount of information shared Need to Know vs. Nice to Know Clearly explain necessary medical and technical terms and concepts Repeat important information 24 E. Give Factual Information Correct misconceptions
Provide comprehensive TB information Avoid irrelevant information 25 F. Use Reinforcement Sincerely compliment or acknowledge the case after hearing intentions to use, or descriptions of, healthy behaviors Use smiles and affirmative nods and words
26 G. Summarize Conversation (1) Throughout the conversation, periodically summarize what has been said Summarizing gives the case an opportunity to correct information that you may have misunderstood
27 G. Summarize Conversation (2) Give the case an opportunity to summarize the conversation, for example: We have covered a lot today. In your own words, review for me what we have discussed. Please tell me what you heard me say. This will help me provide you with any additional information you need.
Avoid phrases such as: Do you have any questions? Do you understand? 28 Communication Pitfalls 29 Communication Pitfalls to Avoid (1)
Being defensive or distant Interrupting, not allowing patient to finish speaking Giving false assurances Providing personal opinion and advice 30 Communication Pitfalls to Avoid (2) Overpowering the case Speaking loudly
Standing over the case Making condescending statements Asking several questions at once Being aggressive 31 Group Discussion Barriers to Communicating What are some barriers to communicating with cases?
What impact could they have on the interview? How can these be prevented or overcome? 32 Assertive, Passive, and Aggressive Behavior 33
Assertive, Passive, or Aggressive Definitions Assertive: to maintain ones rights without compromising the rights of others Passive: to relinquish ones rights in deference of others Aggressive: to demand ones rights at the expense of others
34 Assertive, Passive, or Aggressive Examples (1) Passive: When you have an opportunity, it would be helpful to get the names of people you spent time with. Assertive: Its important to identify your contacts. Lets start making a list of the people you spend the most time with.
Aggressive: You must give me all the names of your contacts. NOW! 35 Assertive, Passive, or Aggressive Examples (2) Passive: That smoke really bothers me. Ill go outside while you smoke in here. Assertive: Although you may smoke outside in
the courtyard, smoking is not permitted in the building because it is a health risk to others. Aggressive: How can you be so disgusting and insensitive smoking in here. Get out of here! 36 Being Assertive By being assertive with cases and others we are not only asserting our rights but also the
rights of those not present the contacts who may have been exposed to TB To be effective in this role, a belief in what you are doing is required Remember: You have the responsibility and obligation to elicit information that will reduce TB in your community 37
Assertive, Passive, or Aggressive Exercise Refer to Appendix K 38 Review 1. What are some ways to build rapport with a case? 2. What are six effective communication skills?
3. What is the difference between assertive, passive, and aggressive behavior? 39
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