How to Coach Yourself and Others Coaching and Counseling in Difficult Circumstances | Page 76

This book is in B&W, not color - Print page in Grayscale for Correct view! Repetition (9/28) Using lots of repetition was viewed as useful for the same reasons, so that if the patient failed to understand at one moment because they were distracted, they might be able to grasp what was being said the next. “Repeat repeat repeat … I think you should never assume they understand what you’re trying to communicate. I think you should take it for read that you’re going to have to repeat it. You might have to write it down. You might have to say it over and over again. In several different situations, you might have to get somebody else to say it”. Use silence (2/28) Allowing long pauses was recommended as a way to elicit some response from certain patients. “Slowly, softly, empathically, sympathetically and allow them time to talk when they’re ready and if you need long silences, then you have long silences. It’s a tool for your trade.” Quiet, not loud or shouting Although mentioned for thought disordered patients (1/28), this seemed to be particularly important for agitated/overactive (10/28) and aggressive/irritable patients (9/28). This had a potential ‘calming effect’ on patients and was considered to help them ‘listen a bit more’ by requiring them to be silent themselves and concentrate. Doing the reverse, mirroring the loud voice of the patient or shouting was reported as being likely to make patients more agitated, and it was pointed out that it was possible to be assertive without ‘raising your voice’. As the following excerpt shows, it was even possible to use this technique during telephone conversations: “I watched a colleague of mine coach a client on the phone once, they put it absolutely magical, he was trying to help this client deal with the housing, and the client kept swearing at people, and my colleague was just sitting there, reading the paper with his feet up on a desk looking so relaxed, and every now and again he would just, it was like a conductor conducting an orchestra he would just, lower, lower, just like that. And it was wonderful watching the client just moderate his behaviour, to these very gentle interventions from the worker.” However in extreme circumstances then it could be allowable to try shouting: ‘if the aggression is at that level that somebody's actually trashing something then you can just shout, stop, and then that can actually help sometimes as well’. Tone of voice (3/28) A sympathetic, empathetic and caring tone of voice was mentioned in relation to dealing with upset and distressed patients. Writing and drawing (4/28) These were seen as options when verbal communication was not proving effective, or to open a second channel via which information could be conveyed and exchanged. Diagrams and pictures could be drawn, writing down information for the patient to take away with them and look at it when they were able to concentrate or to use as a reminder to do certain tasks: ‘if they've got something written in front of them that can help them as well to remember what they’re supposed to be doing and when they're supposed to be doing it.’ Less vs. more gesticulation and movement Movement and gesticulation were other available channels for communication. With thought disordered patients (4/28), instead of giving instructions verbally, a combination of showing what they needed to do with gesticulations might prove more effective: ‘you might need to get alongside them and model what to do’. ‘Eye contact’ and ‘facial expressions’ could also be part of this process. However for agitated or overactive patients, the nurses advised precisely the opposite, be ‘still’, ‘not fidgeting’, ‘slowing down movements’: ‘just don't gesticulate too much or things that can often can raise feelings of agitation’. For [email protected] Property of Bookemon, do NOT distribute 78