LISTENING AND EMPATHIC RESPONDING (1)

table of contents

1. Introduction
2. Importance of practitioner empathy in predicting treatment adherence
3. Listening and understanding
4. What is empathic listening?
5. THE LISTENING PROCESS

In developing trust, probably no other skills are more valuable than listening and empathic responding.

LISTENING AND EMPATHIC RESPONDING (1)

Introduction

To develop a therapeutic alliance and effective therapeutic relationships, trust is essential.

Importance of practitioner empathy in predicting treatment adherence

“Squier” discussed it the following points:

1)     Patient adherence is higher when physicians allow patients to express and dissipate their tensions and anxiety about their illness and when physicians take the time to carefully answer the patient's questions;

2)     practitioners who demonstrate responsiveness to patients' feelings have patients with higher adherence rates and better satisfaction with the relationship;

3)     patients who perceive their physicians as understanding and caring are more likely to carry out the treatment plan and ask for further help or advice when they need it; and

4)     health care providers who encourage patients' expressions of feelings and participation in the treatment plan have patients with higher rates of adherence.

These findings have important implications for pharmacy practice.

Again, feeling understood strengthens the therapeutic alliance between the patient and the provider. This, in turn, improves treatment adherence.

Listening and understanding

What is empathic listening?

The practice of being attentive and responsive to others’ input during conversation is defined as Empathic listening.

Enabling yourself giving more heartfelt response, making an emotional connection, finding similarities between their experience and your own, you have to Listen empathically to others.

As a health care provider, what should you be listening for from the patient?

What do you need to understand?
1. Is it the progression of the disease?
2. Is it the presentation of symptoms?

Far too often this is the only information the health care provider gathers.

What is really needed is an understanding of how illnesses affect people.

1. We need a shift from treating the disease to treating people who are ill. Even our language in health care reduces people to their illnesses.
2. We call patients diabetics, arthritics, hypertensives, and so on. In actuality, diabetes is only part of who the individual is. Our lives are far more complex than our illnesses.
3. If we are to be effective in helping to treat our patients' illnesses, we need to start understanding more about the individual. How does this patient interpret the illness and its treatment?

a. For example, does the patient understand what diabetes is?
b. Does the patient understand the treatment plan?
c. Are there any perceived barriers to carrying out the treatment plan?
d. Is the patient frightened? Overwhelmed?

This kind of information needs to be gathered, understood, and responded to in a way that conveys caring. How do we do this?

THE LISTENING PROCESS

1. The process starts with an act of will.

We must first will ourselves to listen. I must consciously say to myself, "I am going to listen."

2. Next, we must give someone our complete and undivided attention. Often, people do not pay attention long enough to be good listeners.

• Attention is an essential element of listening.

• Attention must be given; therefore, it is a gift. Giving patients your attention is one powerful way to let them know that they are valuable. Everyone needs this.

To give someone your attention takes will and effort.

• It is something that is consciously done.

• Giving attention requires that you not be distracted or interrupted and hurriedly saying to the other, “Go ahead, I'm listening. You just said..." Listening is not simply repeating the words back.

• Attention means that you focus your energy on the needs of this person.

3. Probably the greatest barrier to true listening is our tendency to judge or evaluate the communication, problem, or feelings of the other.

Understanding is different from evaluation of rightness or wrongness, goodness or badness.

To truly listen, we must temporarily give up our need to judge-give up the perspective that our frame of reference is the correct one. This is a process called bracketing.

• It is very difficult to do. It is the giving up of prejudices, biases, or frames of reference before you listen.

• For example, a woman tells a man friend about an upsetting encounter she had with another friend. He thinks that this is typical of the way women respond. By definition, he has not listened, because of the judgment he has made. By lumping his friend with all women, he fails to see how she uniquely has been affected by the encounter. As a result, he fails to truly listen and be empathic.

4. Only through true listening can a person be empathic.

• The focus of true listening is not so much on the correctness of an idea that is expressed; the idea itself is subjective. The idea is not an absolute.

• With listening, focus shifts from ideas to feelings used to express the idea the commitment to the idea. This is what true listening is about: seeing the idea from the other's perspective, then feeding that back.

• Through the empathic response, people begin to feel understood. It is the consistency of empathic responses over time that produces trust.

• Listening takes great courage, because in the process of truly listening to someone else's ideas or feelings without judgment, you run the risk of being changed by the ideas of questioning your own ideas.

• A common way of responding that gets in the way of listening is trying to fix a problem the other person is describing. When people present us with a problem or are having a difficult time emotionally, we often become anxious. We believe we must do something immediately. We want to quickly fix or minimize whatever is wrong in order to reduce our own anxiety. Usually the problem does not get solved this way, and the patient ends up feeling even less understood.

5. One of the primary reasons for listening and empathic responding is to help the patient feel less alone or isolated.

As Carl Rogers States, “For the moment, at least, the recipient finds himself or herself a connected part of the human race. ...

If someone else knows what I am talking about what I mean, then to this degree l am not so strange, alien, or set apart.

I make sense to another human being. So, I am in touch with even in relationship with others. I am no longer an isolate.”

• To put this another way, when we feel alone in a problem, hopelessness often goes with that.

• If no one else understands, the problem seems unsolvable.

• If someone can express understanding at an emotional level then the person is not alone.

• If someone else can understand, then the problem must be solvable. At least, so it seems.

• Therefore, listening and empathic responding offer hope.

The next time a patient presents a problem and you feel anxious, use that anxiety as a trigger to demonstrate your understanding, rather than trying to escape your anxiety by minimizing the problem.

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