Communication is a clinical skill (Part 4)

As well as listening it is important to actively encourage the client to continue telling their story. Any behavior that has the effect of inviting clients to say more about the area they are talking about is a facilitative technique. At the beginning of the consultation our objective is to obtain as wide as possible an understanding of the patient’s problem or needs and the client’s agenda before exploring any one problem or issue in greater detail. As we discussed earlier, open-ended questions enable us to encourage the client to tell his story before we drill down into more detail.

Facilitative responses

Facilitative responses are both verbal and non-verbal communication skills and they include:

• Encouragement
• Silence
• Sharing of your thoughts
• Echoing
• Reflective listening or paraphrasing

Encouragement

Along with head nods and facial expressions, attentive listening signals clients to continue their story and it demands that we refrain from interrupting when they are speaking. Neutral facilitative comments might sound like:

• “uh-huh”, “go-on”, and “yes”.

Silence

For the most part verbal facilitation provided to clients is less effective unless it is followed by silence on the veterinarian’s behalf. Longer periods of silence are especially important when a client is having difficulty expressing himself, gathering his thoughts or trying to deal with difficult news regarding the patient. If the silence starts to feel uncomfortable it’s best to check in by reflecting on what you are seeing or sensing by your sensory acuity to his non-verbal communication:

“I’ve given you a lot of information just now. Would you be willing to share your thoughts.”

Sharing your thoughts

Sharing why you are asking certain questions is an excellent way to invite the client into your train of thought and encourage him to participate (Figure 1):

“Sometimes when a cat starts peeing outside the litter box it can be a sign of stress. I’m wondering if you think this might be what’s going on with Squeaky?”  [...]