Communicating with Clients & Families: Interviewing Skills
description
Transcript of Communicating with Clients & Families: Interviewing Skills
Communicating Communicating with Clients & with Clients &
Families: Families: Interviewing SkillsInterviewing Skills
Emily Eckley MS, RDEmily Eckley MS, RD
[email protected]@utk.edu
Celebrating Diversity Celebrating Diversity ConferenceConference
April 28, 2006April 28, 2006
ObjectivesObjectives Describe the steps to take when preparing to Describe the steps to take when preparing to
interview a client & their family.interview a client & their family.
List the skills needed to conduct culturally List the skills needed to conduct culturally appropriate interviews.appropriate interviews.
Ask culturally appropriate questions when Ask culturally appropriate questions when working with a client & families from another working with a client & families from another culture.culture.
Describe the cultural influences on verbal and Describe the cultural influences on verbal and non verbal communication.non verbal communication.
PlanPlan Define culture Define culture
Discuss components of a culturally Discuss components of a culturally appropriate interviewappropriate interview Before the interviewBefore the interview During the interviewDuring the interview After the interviewAfter the interview
Skill Building: Case StudySkill Building: Case Study
CultureCulture
Integrated pattern of human behavior that Integrated pattern of human behavior that includes:includes: Thoughts, communications, languagesThoughts, communications, languages Practices, beliefs, values, customsPractices, beliefs, values, customs Courtesies, rituals, manners of interacting and Courtesies, rituals, manners of interacting and
roles, roles, Relationships & expected behaviors Relationships & expected behaviors
Of racial, ethnic, religious or social groupOf racial, ethnic, religious or social group
The ability to transmit the above to The ability to transmit the above to succeeding generationssucceeding generations National Center for Cultural Competence, 2006.
An Iceberg Concept of An Iceberg Concept of CultureCulture
Dress • Age Race/Ethnicity Gender • Language
Eye behavior • Facial expressions Body language • Sense of self
Notions of modestyConcept of cleanliness • Emotional response patterns Rules for social interaction • Child
rearing practices Decision-making processesApproaches to problem solving• Concept of justice
Value individual vs. group • Perceptions of mental health,
illness, disability • Patterns of superior and subordinate role in relation to status by age, gender, class
And much more……
National Center for Cultural Competence, 2006
Adapted by the NCCC
An Iceberg Concept of An Iceberg Concept of CultureCulture
The iceberg concept of culture is widely used and
available in the public domain, for example see:
Culture Matters www.peacecorps.gov
Or
www.genderandpeacekeeping.orgNational Center for Cultural Competence, 2006
Culturally Sensitive Culturally Sensitive InterviewingInterviewing
Before the SessionBefore the Session Develop self-awarenessDevelop self-awareness Increase knowledge of commonly held cultural Increase knowledge of commonly held cultural
beliefs & interacting styles of patients/clientsbeliefs & interacting styles of patients/clients
During the SessionDuring the Session Complete an assessment by conducting a cultural Complete an assessment by conducting a cultural
interviewinterview
After the SessionAfter the Session Make a plan to negotiate between the culture of Make a plan to negotiate between the culture of
the patient/client & the medical culturethe patient/client & the medical culture
Pachter & Harwood, 1996
The First Step – The First Step – Increase Your Own Increase Your Own
AwarenessAwareness ““Know Thyself”Know Thyself”
BeliefsBeliefs ValuesValues LifestylesLifestyles PracticesPractices
Complete Cultural Self-AssessmentComplete Cultural Self-AssessmentNational Center for Cultural National Center for Cultural CompetenceCompetencehttp://gucchd.georgetown.edu/nccc/http://gucchd.georgetown.edu/nccc/
Campinha-Bacote, 2003.Pederson, 2002.
Ways to Increase Self Ways to Increase Self AwarenessAwareness
Recognize communication stylesRecognize communication styles Learn about cultural & linguistic Learn about cultural & linguistic
differencesdifferences Develop interest in other culturesDevelop interest in other cultures Become sensitive to myths and Become sensitive to myths and
stereotypesstereotypes Be able to discuss your own cultureBe able to discuss your own culture Explore your own valuesExplore your own values Learn about relationshipsLearn about relationships
Pederson, 2002.
Preparing for the Preparing for the InterviewInterview
Seek to increase Cultural KnowledgeSeek to increase Cultural Knowledge Process of learning about basic world views of Process of learning about basic world views of
different culturesdifferent cultures
World view is:World view is: The set of explanations used by a group of The set of explanations used by a group of
people to explain life’s eventspeople to explain life’s events Includes explanations about nature of:Includes explanations about nature of:
realityreality knowledgeknowledge reason or logicreason or logic relationshipsrelationships
Boyle & Andrews, 1995.
What Knowledge Is What Knowledge Is Needed?Needed?
History of cultureHistory of culture Roles of: Roles of:
EducationEducation MoneyMoney ValuesValues Attitudes Attitudes Behaviors Behaviors
Communication stylesCommunication styles Language & slang Language & slang Resources for teaching & learningResources for teaching & learning How culture is perceived How culture is perceived Other informationOther information
Pederson, 2002.
How To PrepareHow To Prepare ReadRead
AskAsk
EngageEngage
ObserveObserve
AnalyzeAnalyze
Meaningful Exchange, 2005.
During the SessionDuring the Session
Develop & utilize culturally Develop & utilize culturally appropriate interviewing skillsappropriate interviewing skills
Conduct a cultural interviewConduct a cultural interview Client centered interviewingClient centered interviewing Understanding a client’s social situationUnderstanding a client’s social situation
Navigate the complexities of Navigate the complexities of communicating across culturescommunicating across cultures
Cultural Interviewing Cultural Interviewing SkillsSkills
AwarenessAwareness Solid knowledge foundationSolid knowledge foundation Clear communicationClear communication Sense of humorSense of humor Honesty & genuinenessHonesty & genuineness InnovationInnovation FlexibilityFlexibility EmpathyEmpathy Respect, value , care, & trustRespect, value , care, & trust
Bauer & Sokolik, 2002
Utilizing the SkillsUtilizing the Skills
Listen respectfullyListen respectfully Use the teaching & learning Use the teaching & learning
techniques of other culturestechniques of other cultures Establish empathic rapport with Establish empathic rapport with
persons from other culturespersons from other cultures Analyze feedback accurately Analyze feedback accurately Develop new ideas Develop new ideas Make it fun!Make it fun!
Pederson, 2002
Conducting Cultural Conducting Cultural AssessmentsAssessments
EVERY client should have a cultural EVERY client should have a cultural interviewinterview
Information from the interview Information from the interview should be used to form a culturally should be used to form a culturally relevant treatment planrelevant treatment plan
Campinha-Bacote, 2003
Client Centered Client Centered Interviewing ModelInterviewing Model
Focuses on client experiences Focuses on client experiences
4 dimensions of this experience:4 dimensions of this experience: Ideas about what is wrong Ideas about what is wrong Feelings, especially fears, about being Feelings, especially fears, about being
illill Impact of problems on own functioningImpact of problems on own functioning Expectations about what should be Expectations about what should be
donedoneStewart, 1995
Questions for Client Questions for Client Centered InterviewingCentered Interviewing
““What do you call the problem?”What do you call the problem?”
““What do you think caused the problem?”What do you think caused the problem?”
““How bad is it?” How bad is it?”
““Why do you think it started when it did?”Why do you think it started when it did?”
““How does it affect your life?”How does it affect your life?”
Kleinman, 1978
Questions for Client Questions for Client Centered InterviewingCentered Interviewing
““What kind of treatment do you What kind of treatment do you think will work?”think will work?”
““What do you fear most about the What do you fear most about the problem?”problem?”
““How can I be of most help to you?”How can I be of most help to you?”
““What other remedies or treatments What other remedies or treatments for your problem have you used?”for your problem have you used?” Kleinman, 1978
Learning More About the Learning More About the ClientClient
Social Stressors & Support Networks
Literacy & Language
How Environment has Changed
Control Over Environment
How to Learn about Client’s How to Learn about Client’s Social ExperienceSocial Experience
““Where are you from?”Where are you from?”
““Why did you decide to come Why did you decide to come to this to this country?”country?”
““When did you come?”When did you come?”
Source: Carrillo, 1999
How Environment has Changed
How to Learn about Client’s How to Learn about Client’s Social ExperienceSocial Experience
““How much of a problem is money in your How much of a problem is money in your life?” life?”
““Are you ever short of food or clothing?”Are you ever short of food or clothing?”
““How do you keep track of How do you keep track of appointments?”appointments?”
Control Over Environment
Carrillo, 1999
How to Learn about Client’s How to Learn about Client’s Social ExperienceSocial Experience
““What is causing the most stress in your What is causing the most stress in your life?”life?”
““How do you deal with the stress?”How do you deal with the stress?”
““Do you have family or friends that you Do you have family or friends that you can call on for help?”can call on for help?”
Social Stressors & Support Networks
Carrillo, 1999
How to Learn about Client’s How to Learn about Client’s Social ExperienceSocial Experience
““What trouble do you have reading your What trouble do you have reading your medication bottles or appointment slips?”medication bottles or appointment slips?”
““What language do you speak at home?”What language do you speak at home?”
““Do you have a hard time communicating Do you have a hard time communicating what you want to say to your healthcare what you want to say to your healthcare providers?”providers?”
Literacy & Language
Carrillo, 1999
Navigating the Navigating the Complexities of Complexities of CommunicationCommunication
Most people assume that the most Most people assume that the most important aspect of communication is important aspect of communication is verbalverbal
Much of our meaning is communicated Much of our meaning is communicated nonverballynonverbally
Interpreting nonverbal communication Interpreting nonverbal communication can be challenging when interacting with can be challenging when interacting with someone of a different culturesomeone of a different culture
Mutha, 2002
Verbal CommunicationVerbal Communication LanguageLanguage
SpokenSpoken WrittenWritten
Degree of directnessDegree of directness
Loudness/PitchLoudness/Pitch
Appropriate subjects for conversationAppropriate subjects for conversation
Emotional expressivenessEmotional expressiveness
Randall-David, 1989
Nonverbal Nonverbal CommunicationCommunication
Facial expressionsFacial expressions GesturesGestures
Eye contactEye contact DistanceDistance
TouchTouch SilenceSilence
Body movementsBody movements
Randall-David, 1989
Ways to Become Actively Ways to Become Actively Involved in the Involved in the
Communication ProcessCommunication Process Learn proper forms of addressing in the client’s Learn proper forms of addressing in the client’s languagelanguage
Learn basic words & sentences in the client’s Learn basic words & sentences in the client’s languagelanguage
Work effectively with interpreterWork effectively with interpreter Use a positive tone of voiceUse a positive tone of voice
Repeat important information more than onceRepeat important information more than once Reinforce verbal instructions with written Reinforce verbal instructions with written
materialsmaterials
Watch the client’s non verbal communicationWatch the client’s non verbal communicationRandall-David, 1989
After the InterviewAfter the Interview Debrief & analyzeDebrief & analyze
What went right?What went right? What went wrong?What went wrong? How can I improve?How can I improve?
Seek additional informationSeek additional information
Put together ALL the informationPut together ALL the information
Form a planForm a plan
Forming a PlanForming a Plan
Goal: Negotiate between the culture Goal: Negotiate between the culture of the client & the medical cultureof the client & the medical culture
Tailor the treatment/intervention to Tailor the treatment/intervention to meet the client & family’s needsmeet the client & family’s needs
Make the client & family feel Make the client & family feel comfortable & part of the processcomfortable & part of the process
Wrap UpWrap Up
We live & work in very culturally We live & work in very culturally diverse environmentsdiverse environments
Through preparation & directed use Through preparation & directed use of skills, we can work effectively of skills, we can work effectively cross-culturallycross-culturally
This is a continual processThis is a continual process
Skill Building:Skill Building:Case StudyCase Study
Questions???Questions???
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