Applying Communication Skills by Helping Clients Tell Their Stories - Essay Example

Running head: THE SKILLED HELPER MODEL The Skilled Helper Model- Applying communication skills by helping tell their stories Humber College/University of New Brunswick The Skilled Helper Model- Applying communication skills by helping clients tell their stories For a therapeutic relationship to become successful, it is critical for both patient and health professional to establish good communication. Open communication along with trust and honesty would greatly enhance the goal of a helper in accomplishing the first step of the Skilled Molder Helper. A helper is tasked with the responsibility of helping patients to solve their problems by effectively guiding them using skilled helper model that was proposed by Egan and Schroeder in 2009. In most cases, an obstacle to good storytelling is the identity of the interviewer since the clients are not comfortable with revealing sensitive information about themselves or their disease to a stranger – the helper in this case ( Egan & Schroeder, 2009). By using the Skilled Helper Model, a helper may gradually apply the verbal and non-verbal communication skills that were learned in class to improve the therapeutic relationship between the patient and himself. For this paper, the subject I have chosen is a neighbor who underwent appendectomy in a community hospital two years ago. It is best to maintain the confidentiality of the client as I have promised her. The client can be referred to as Susan, a 35 year-old mother of two children who stays at home to care for her family. The client warmly accommodated me in her living room where the interview was conducted. The main purpose of this interview is to illustrate how I effectively applied the verbal and non-verbal communication skills that I have learned in class. Preparing or the interview was not that easy since a wrong question or comment may further alienate the client. Also, the introduction is a crucial part for the first task since rapport must be established immediately to make the client feel comfortable during the interview process. There was a need to balance my goals at the same time make the client feel at ease so the interview process would go well. At the beginning, there was tension as my neighbor was not really the sociable type. She is often alone at home and would occasionally smile at me as I pass by every morning. She only agreed to the interview knowing that this could help me in my studies. The first thing that I tried to establish was trust and connection between us. I took the cue from Lein and Wills ( 2005) steps in patient-centered interviewing so I began by introducing myself and my role. Sarah just smiled at me and felt at ease, she even offered me coffee to which I politely declined. After observing that the client is ready and her privacy is assured ( Lein and Wills, 2005) , I started with open ended questions that would not pressure her to give a response. The first question was “ Can you tell me about your experience when you had an operation two years ago?” Sarah obliged by telling me basic information such as how the pain started, how she was admitted to the emergency room and the rest of the confinement at the hospital. Admittedly, the details were many that I had to practice active listening and keep on tuning in lest I get distracted by my thoughts and hinder the therapeutic dialogue that was developing ( Egan & Schroeder, 2009). There were also times wherein Sarah paused for a while to recollect some details about her experience. The silence should not be perceived as daunting since this period gives time for the client to look into their emotions so they can spontaneously express themselves during the therapy process ( Sharply, Munro & Elly,2005 ). The silence that Sarah needed was less than a minute to recollect her experience but it did provide a wealth of information about her attitude, perspective and feelings about the operation. It was Sarah herself who terminated the silence and started sharing her thoughts. During the time that Sarah was illustrating her confinement at the hospital, I was completely absorbed in listening to her experience. It can be sensed that she needed someone to relate her painful recovery as well as her loneliness since her husband was very busy that time. On top of that she expressed her worry about her two kids who were very young then. The struggle between attending to her emotions and caring for people around her was overwhelming that has made her depressed after the operation. Listening to Sarah meant silence on my part complemented by an occasional nod to express my agreement. It was also necessary that a helper must be nonjudgmental, show empathy and compassion as well as detect both verbal and nonverbal cues in the course of the interview to completely understand the patient ( Shipley, 2010). During the interview, it was quite a struggle on my part how to make Sarah answer the questions objectively since she got emotional at certain moments. It was an intricate process to discover how she truly felt about the healthcare service since her thoughts were focused on her family. I had to gradually distract her from the emotions by carefully asking close-ended questions such as “ Do you think the nurses attended properly to your pain complaints?” She promptly replied “ Yes, they were helpful and listened to my complaints and gave me medicine to relieve my pain”. She said it casually but the tone of her voice revealed bitterness. She needed someone to attend to her depression that was dismissed by the nurses around her. This scenario reminded of a case presented by Shipley ( 2010) wherein the nurses did not take advantage of non-verbal cues to get more information from the patient. Had the nurses detected Sarah’s depression through non-verbal cues, she could have been referred to a psychologist for counseling after recovery. Later, I also asked her if the doctor who attended to her was caring enough. She responded by saying that “ I was just one of the patients he had to visit within a day”. This made me probe deeper to assess the quality of healthcare she has received. So, I asked an open ended questions like “ What made you feel that way towards your doctor ?” And “How did you feel about such treatment ?” She paused for a moment and told me that he was very cold and just gave orders to the nurse to give Sarah pain-killers. At that point, I had to express empathy by saying that “It must have been terrible for you to be treated that way as a patient”. Sarah immediately said “ Yes and I would avoid being confined in a hospital again even if I get very sick”. Empathy has a high therapeutic value that can be beneficial in counseling process (Clark, 2010). Apparently, I made her comfortable enough to reveal to me very sensitive issues surrounding her confinement. In a way, the first step of the task immediately progressed to deeper levels where the client divulged very crucial issues. In a way, I was successful in earning the trust and rapport of the client. This would later pave way towards better therapeutic process. I further withheld myself from asking leading questions which may totally shift our topic to emotional issues Sarah was dealing with that time. Eventually, I had to end the interview by asking her a summary of her experience. Sarah obliged by sparing me the other emotional details and concluded that the operation went well. She didn’t question the competence of the doctor nor the nurses but she emphasized her emotional needs that were unmet that time. She also apologized for being emotional during the interview. I assured her that it was but normal to express her feelings and her identity would be kept confidential. The summary went along well which is a requisite in helping the client to put everything together according to Egan and Schroeder (2009). Conclusion The interview taught me a lot of valuable lessons especially in the area of communication. In the everyday course of our lives as health professionals, we often rely on data, graphs, information to be able to evaluate or assess what is happening to a patient. What we often overlook is the fact that communication plays a vital role in establishing therapeutic relationships. It is not enough to simply listen to the clients complaints about their illness or ailments. A far more important aspect is trying to understand what the client is trying to say through verbal and non-verbal clues. In this case, I appreciated the value of silence as means of deepening rapport by respecting the client’s recollection of experiences. Moreover, I had provided the right open-ended and closed ended questions that led me to certain discoveries about the patient’s perspective. Aside from being an empathic listener, it is also important to be objective and not passing any judgment towards the client’s perspective. It is also extremely valuable to be able to respond appropriately to the client by showing expressing verbal and non-verbal cues. The right amount of probing, the balance of speech and silence, and the relaxed but focused manner of interviewing the client would eventually yield good results. It was very enlightening and amazing to discover how much message the client wanted to express but health professionals missed such messages. One mistake that the doctor and nurses often committed in this case is having the wrong perception that a patient only needs to physically heal. This lesson would always guide me in establishing an open and trusting therapeutic relationship with my clients in the future. References Clark, A. (2010). Empathy: An integral model in the counseling process. Journal of Counseling& Development, 88,349-356. Egan, G. & Schroeder, W. (2009). The skilled helper. (1st Canadian ed.). Toronto: Nelson Education Limited. Lein, C. & Wills, C.E. (2007). Using patient-centered interviewing skills to manage complex patient encounters in primary care. Journal of the American Academy of Nurse Practitioners, 19(5), 215-20. Retrieved October 01, 2010 from Proquest database. Shipley, S. (2010).Listening: a concept analysis. Nursing Forum, 45( 2 ), 126-133. Sharpley ,C., Munro, D. & Elly, M. ( 2005). Silence and rapport during initial interviews Counselling Psychology Quarterly, 18(2), 149–159. Read More