Communicating difficult things well

Establishing effective relationships with parents and carers

Jo Fox

Our INTENT, when we communicate, is NOT as important as the other person’s

perception of our intent

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Transmitting

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Context

• The PARALANGUAGE – the non verbal elements in speech such as tone of voice, look in eye, mirroring of body language, hand gestures, and state of emotions that the listener can detect.

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• Hearing is the recognition of sound

• Listening is something we chose to do and involves both hearing and looking for meaning – we are fully present.

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5 main categories of response to others communication.

1. Evaluative : making a judgement about the worth, goodness or appropriateness of the other person’s statement.

2. Interpretive: paraphrasing – attempting to explain what the other person’s statement means

3. Supportive: attempting to assist or bolster the communicator

4. Probing: attempting to gain additional information, continue discussion or clarify a point.

5. Understanding: attempting to discover completely what the other communicator means by his or her statements.

• IN order of how frequently they occur in daily conversation

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Exercise – the opposite of talking

• In groups of three tell a story about parents. It can be personal, professional, about someone you know, even someone you do not know.

• Each person should get a turn to tell the story. One person should be an active listener and the other an observer of the process.

• Tell this story for 5 minutes – no more and no less. If you run out of things to say it is the responsibility of the listener to encourage them to say more.

• The observer should take notes of the different communication skills demonstrated during the five minutes. Also be on the look out for any themes that emerge about parents during the discussion.

• Each person is to take a turn in each role.

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Feeback from Exercise • What does our use of language tell us about our

values and judgements we make? • What families are we comfortable/anxious with? • What dynamic are we adding to the situation?• Did we include fathers?• What were you thinking when listening to your

colleagues?

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A relational task- Connection• The most important tool? How do you listen, look, make sense, interpret?• Parents perspective – what do they see, hear, feel and think when they

are hearing you?• Child has to remain priority – how can they be an integral part of any

communication process?

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Understanding the sub text

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Kieran McKeown, A guide to what works in family support services for vulnerable families (Dublin, 2000)

15%

15%

40%

30% TherapeuticTechnique

Client Hopefulness

Client Characteristics& Social Support

Relationship betweenclient and therapist

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Exercise

• Listen to the audio• What do you think is happening• Write down how you feel as you are listening

Feedback• What could he have done differently?• What do we need to be aware of when talking to

parents/carers?

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Engagement

“Engagement is the basic task of a child and families worker but can never be taken for granted and must always be worked for”

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Often ‘hard core’ families so interactions characterised by:•guardedness or reluctance to share information•avoidance and a desire to leave the relationship•strong negative feelings such as anxiety, anger, suspicion, guilt or despair.

The family context

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We need to accept that:

• The best we may be able to achieve is honesty rather than positive feelings and a high degree of mutuality

• Conflict and disagreement are not something to be avoided, but are realities that must be explored and understood.

The family context

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• Failure to consider where families are starting from (probably different from the professionals)

• Failure to focus on strengths as well as weaknesses

• Failure to understand the impact of shame

Why many interventions fail

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Potential parental responses

• Genuine commitment

• Compliance / approval seeking

• Tokenism

• Dissent / avoidance

(Horwath and Morrison, 2000)

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Strategies for enhancing engagement • Before you start, check your mindset (your own

biases and assumptions)• Have realistic expectations:

– It is reasonable that involuntary clients resent being forced to participate

– Because they are forced to participate, hostility, silence and non-compliance are common responses that do not reflect my skills as a worker

– Due to the barriers created by the practice situation, clients may have little opportunity to discover if they like me

– Lack of client co-operation is due to the practice situation, not to my specific actions and activities

(Ivanoff et al, 1994 )

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During initial contacts • Adopt a non-defensive stance

• Be clear, honest and direct and acknowledge the involuntary nature of the relationship

• Clarify roles and expectations, including what is required of the client

• Explain consequences of non-compliance and the advantages of compliance

(Ivanoff et al, 1994 ) 19

Avoid

• Expressions of over-concern

• Moralising

• Criticising the client

• Making false promises

• Displaying impatience

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Avoid • Ridiculing the client

• Blaming the client for his/her failures

• Being dogmatic

• Rejecting the client’s right to express different values and preferences

(Ivanoff et al, 1994 )

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Try to• Invite participation

• Understand how the client sees the problem as well as how we see it

• Understand what the client wants, as well as what we want

(Ivanoff et al, 1994 )

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Identifying resistance, 4 categories• Hostile resistance: anger threats,

intimidation, shouting

• Passive aggressive: compliance covers antagonism and anger

• Passive hopeless: Tearfulness and despair about change

• Challenging: Cure me if you can!

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How might resistance show itself?• By only being prepared to consider 'safe' or

low priority areas for discussion.

• By not turning up for appointments

• By being overly co-operative with professionals.

• By being verbally/and or physically aggressive.

• By minimising the issues.(Egan, 1994)

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• Becoming impatient and hostile

• Doing nothing, hoping the resistance will go away

• Lowering expectations

• Blaming the family member

• Absorbing the family member's anger

• Allowing the family member to control the assessment inappropriately

What might we be doing to make it worse?

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What might we be doing to make it worse?

• Becoming unrealistic

• Believing that family members must like and trust us before assessment can proceed.

• Ignoring the enforcing role of some aspects of child protection work and hence refusing to place any demands on family members.

(Egan, 1994)

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Working with Resistance

• What strategies do you currently have?• Work with and alongside• Find something that is done well and work from

there

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Productive approaches• Give practical, emotional support -

especially by being available, predictable and consistent

• See some resistance and reluctance as normal

• Explore our own resistance to change and by examining the quality of our own interventions and communication style

(Egan, 1994)

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• Establish a strong and well-articulated relationship by – clarifying all the rules of sharing records, – inviting people to meetings– sharing with them how and why you have to

make decisions – explaining the complaints procedure

(Egan, 1994)

Productive approaches

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• Helping family members to identify incentives for moving beyond resistance

• Tapping the potential of other people who are respected as partners by the family member

• Understanding that reluctance and resistance may be avoidance or a signal that we are not doing our job very well

(Egan, 1994)

Productive approaches

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Effective communication involves• Logical discussion

• Focusing

• Prioritising

• Summarising

• Setting realistic limits

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• Universalising

• Confronting

• Educating

• Modelling behaviour

Effective communication involves

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• Recognising difference

• Accepting

• Allowing ventilation

• Relating to feelings

• Direct intervention in the environment

Effective communication involves

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Feelings that empower communication

• Compassion

• Passion

• Integrity

• Respect

• Authenticity

• Courage

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Exercise - Communications

Stop = • things I need to stop doing• things the organisation needs to stop doingStart =• Things I need to start doing• Things the organisation needs to start doing Stay =• Things I do well already• Things the organisation does well already

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Managing Risk

• Importance of planning • Use of history• Consider environment• Timing

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“Professional Cynicism”

• Parents/carers not always honest or engagement may be superficial

• Importance of boundariesTwo key questions:1. What has changed for the child since your

involvement?2. What has the parent done differently to make child’s

life better?

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On message?

“To be effective in the lives of disempowered people, you have to be seen as a part of the solution – not as part of the problem”

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Secondary Trauma

• The work is hard and need to make good use of supervision

• Resilience in ourselves• Accepting ‘uncertainty’ as part of our day to

day work

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Information overload

• Moved from an environment of information scarcity to information overload.

• How do we distinguish between true but useless (TBU) and true and useful information?

• How many different sources are there for information available to you?

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When communicating remember:

• Information does not always equal knowledge;

• Knowledge does not always equal wisdom;

• Wisdom does not always equal action

Saying is NOT doing

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