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Communication Therapeutic Communication and Active Listening Communication • Stroke can often affect a person’s ability to communicate ideas, wishes, thoughts and feelings. • It can also affect the person’s ability to understand an other’s ideas, wishes, thoughts and feelings. • Changes in communication after a stroke often result in distress, and it is important to communicate in a way that is meaningful for the person. Rules for Effective Communication Being positive optimistic & realistic Pitch at the right level Break into chunks Stop and summarise frequently Mirroring Watch for body language Check out understanding Communication Repeat as necessary Do not use jargon Use written/ pictorial aids Do not ignore the patient Avoid unhelpful chit chat Choose your topic Activity • Use the following directions to draw a picture (work on your own and do not ask any questions about the directions): • • • • • • • • • • Draw an egg shape. Draw a small circle touching the egg shape. Draw a small circle inside the circle you have just drawn. Draw three straight lines coming out of the circle that touch at one end. Repeat just below. Draw two longer lines coming out of the egg shape. Draw a line to join up these two lines. Draw three straight lines inside the shape you have just created. Draw two lines coming out of the bottom of the egg shape. Draw two short lines coming out of the lines that you have just drawn. • Do not move on to the next slide until you have finished the above. Does Your Drawing Look Like This? Barriers to Effective Communication •The environment •Own circumstances, levels of stress and priorities •Own personal style •Patient characteristics Core Counselling Skills • Rogers (1957) talked about core counselling conditions, which he thought were essential ingredients for a therapeutic relationship. • Empathy - Empathy is the ability to “stand in the patient’s shoes” . • Genuineness - To be real, natural and open and not ‘act’ your job role, being spontaneous and willing to share your own experiences and feelings (this has to be done carefully!) • Warmth - Remaining open. Not showing defensiveness or blame the patient or others for situations/events and treating everyone with equal worth. • Unconditional Positive Regard - Accepting and valuing the person, regardless of their background. convey positive regard and respect for them Empathy Unconditional Positive Regard Warmth Genuineness Active Listening • Repeating – • Select something the person has just said that seems important, and repeat it back to them. • Re – Phrasing • Saying the same thing but re-wording it slightly. • Paraphrasing – • Summing up the main points of the story to ensure you have picked up on all of the important details. • Reflection of Feeling – • Listening to the patient and deducing from what they are telling you, how they are feeling. Dealing with Discomfort • “Contain” distress, which means making the person feel it is ok, allowed (people often say sorry for crying), and safe and contained. • Try not to take anger or frustration personally. It can help to reflect back the feeling “ It sounds like . . .”. • Paraphrasing and summarising can be used to draw out key points – things you may have identified that the person could move forward. Summary • Good communication skills are not necessarily something that come naturally, or easily, no matter what your role is and how much patient contact you have. • We could all improve on our communication skills by using some of the techniques mentioned, but the most important of all is active listening. • We asked many patients about their experiences in hospital following stroke and the majority of them said that the one thing they really could have done with was somebody to listen to them.