HEALTH COMMUNICATION SKILLS

HEALTH COMMUNICATION SKILLS

1. Basic skills
Self Disclosure, Listening, Expressing
2. Advanced skills
3. Conflict skills
4. Social skills
5. Public skills

BASIC SKILLS
Self Disclosure
Rewards of Self Disclosure
Increased Self Knowledge
Closer intimate relationship
Improved communication
Lighter guilt feelings
More energy
Blocks to Self Disclosure
Fear of rejection
Fear of punishment
Fear of being talked about behind your back
Fear that someone will take advantage of you

Practice in Self Disclosure
1. INFORMATION
Tell about your job, last vacation or some interesting experience
2. THOUGHTS, FEELINGS & NEEDS REGARDING THE PAST OR FUTURE
Tell about your opinion about ambitions at work, how you feel about it & what needs you have regarding it
3. HERE & NOW COMMUNICATIONS
Tell about how you are feeling attracted to the other person

BASIC SKILLS
Listening
Understand someone
Enjoy someone
Learn something
Give help

Keywords : wanting & intending
Blocks to listening
1. Comparing
2. Mind reading
3. Rehearsing
4. Filtering
5. Judging
6. Dreaming
7. Identifying
8. Advising
9. Sparring
10.Being right
11. Derailing
12. Placating

Four steps to effective listening
1. Active listening
2. Listening with empathy
3. Listening with openness
4. Listening with awareness

1. Active listening
An active process that requires your participation
Ask questions & give feedback
You get a fuller appreciation of what’s being said
You are a collaborator in the communication process
The ways to listen actively ; paraphrasing, clarifying & feedback
Paraphrasing
To state in your own words what you think someone just said
Absolutely necessary to good listening
Example ; what I hear you saying is, in other words, let me understand, so basically how you felt was, what happened was, etc

Five big dividends
1. People deeply appreciate feeling heard
2. Paraphrasing stops escalating anger & cools down crisis
3. Paraphrasing stops miscommunication, false assumption, errors & misinterpretations are corrected on the spot
4. Paraphrasing helps you remember what was said
5. When you paraphrase you’ll find it  much harder to compare, judge, rehearse, advice,etc

Clarifying
Often goes along with paraphrasing
Asking questions until you get more of the picture
Sharpen your listening focus so that you hear more than vague generalities
Let’s the other person know that you are  interested
I’m willing to work at knowing & understanding you
Feedback
Active listening depends on feedback
Helps the other person understand the effect of the communication
It is another chance to correct errors & misconceptions
3 important rules for giving feedback : IMMEDIATE, HONEST & SUPPORTIVE
2. Listening with empathy
Only one requirement : simply know that everyone is trying to survive
You don’t have to like everyone or agree with them, but recognize that you do share the same struggle
Saying to yourself


3. Listening with  openness
Listen selectively
Filtering out everything that makes sense
Pouncing on whatever seems false or silly
A skill you can learn
The most important rules is to hear the whole statement, the entire communication, before judging

4. Listening with awareness
1.To compare what’s being said to your own knowledge of history, people & the way things are. You do this without judgement, simply making note of how a communication fits with known facts

2. To hear & observe congruence. Does person’s tone of voice, emphasis, facial expression & posture fit with the communication

Total Listening
1. Maintain good eye contact
2. Lean slightly forward
3. Reinforce the speaker by nodding or paraphrasing
4. Clarify by asking question
5. Actively move away from distractions
6. Be committed, even if you’re angry or upset, to understanding what was saidBASIC SKILLS
EXPRESSING

1. Observation
I broke the toaster this morning
2. Thought
Unselfishness is essential for a successful marriage
3. Feeling
I missed Mr..x & felt a real loss when he left for Europe
4. Need
Could you just hug me for a while?
Rules for effective expression
Messages should be direct
Messages should be immediate
Messages should be clear
Messages should be straight
Messages should be supportive
2. Advanced skills

Body Language
You can’t “not communicate” with others
Without saying a word, you reveal your feelings & attitudes
Albert Mehrabian ; the total impact of a message :
7%    verbal (words)
38%    vocal (volume, pitch, rhythm)
55%    body movements (mostly facial expressions)
Communicate nonverbally
1. Body movements
Facial expressions
Gestures
Postures & breathing
2. Spatial relationships
How much distance you put between yourself & the other person

1. Body movements
Body movements serve several communication purposes
Indicating : attitude, conveying feelings, serve as illustrators & regulators
Illustrators are nonverbal movements that accompany & illustrate verbal communication
Regulators are nonverbal cues that monitor or control the speaking of another individual facial expression
The most expressive part of the body
Some emotions can be interpreted reliably by looking only at that eyes & mouth
When observing facial expression: eyebrows are raised or lowered, the forehead is wrinkled or smooth & the chin is set or flaccid

Gestures
Arms & hands
People who talk with their hands
Unconsciously use regulating & illustrating gestures
Scratch the head in puzzlement, touch the nose in doubt, rub the neck in anger
Lock the hands behind the head as a statement of superiority
Cross arms in front the chest when feeling defensive or unwilling to communicate

Legs & feet
Sit with legs uncrossed & slightly apart, you communicate openness
Straddle a chair indicating dominance
Put one leg over the arm chair, suggesting indifference
Sitting with ankles crossed can be a sign of resistence
Sitting with one leg crossed over the other & swinging & forth is often a sign of bore dome, anger or frustration

Use another exercise to experiment with regulators
When a friend is talking, use different gestures to indicate nonverbally that you want your friend to :
Go on talking
Speed up
Slow down
Get to the point
Stop & let you talk
Stop & end the conversation

Posture & Breathing
Slumped posture can be a sign of feeling “low”, fatigue, a sense of inferiority
Erect posture is generally associated with higher spirits, greater confidence & more openness than slumped posture
Leaning forward tends to suggest openness & interest
Leaning away suggest lack of interest or defensiveness
A tense, rigid posture tends to be a sign of defensiveness, while a relaxed posture indicates openness
Breathing is another indicator of feelings & attitudes
Rapid breathing can be associated with excitement, fear, irritability, extreme joy or anxiety
A pattern of holding breath, alternating with short gasps for air is a sign of anxiety of built up tension
Shallow breathing in the upper chest often indicates thinking that is cut off from feelings
Deep breathing into the stomach is more likely to be associated with feelings & action

2. Spatial relationships
Polemics is the study of what you communicate by the way you use space
How far you stand from a person you’re talking to, how you arrange the furniture in your home & how you respond to others invading your territory are important nonverbal statements
Four distinct zones that people unconsciously use as they interact with others
( Edward T Hall- Anthropologist )
1. Intimate distance
2. Personal distance
3. Social distance
4. Public distance

Intimate distance
A close subphase of actually touching & a far sub phase of 6 to 18 inches from the body
Zone for lovers, close friends & children holding onto their parents or each other
Non intimates usually feel threatened if circumstances force them to share this space without nonverbal barriers to protect themselves
Personal distance
A close sub phase of 1,5 to 2,5 feet
A comfortable zone for talking at a party
Easily touch your partner, whereas in the far sub phase of 2,5 to 4 feet you can discuss something relatively privately without risking touch
In the far sub phase you are literally keeping your partner at arm’s length

Social distance
A close sub phase of 4 to 7 feet
You are most likely to transact such interpersonal business as talking to a client
This sub phase is often used manipulatively to indicate dominance
The far sub phase of 7 to 12 feet is most frequently used for formal business or social interactions
This distance also useful in an open office setting

Public Distance
A close sub phase of 12 to 20 feet which is usually used for relatively informal gathering such as a teacher working with a classroom of students or a boss talking with a group of employees
The far sub phase of 20 feet or more is reserved for politicians & celebrities

3. Conflict skills assertiveness
Teaches you to express your feelings, thoughts & wishes & to stand up for your legitimate rights without violating the rights of others
Is a skill you can acquire, not a personality trait that some people are born with & others are not
Like aggression & passivity, assertiveness is a social behavior that can be learned
Nobody is consistently assertive
You may be assertive with your children in one instance, aggressive with them in another & passive in still another
You might have no trouble being assertive with your family, yet find it almost impossible to be assertive with strangers
Learning to be assertive does not mean that you must always behave assertively
There are times when it is entirely appropriate to be aggressive, as it is when your life or property is being threatened
There are also times when it’s appropriate to be passive, such when a judge is lecturing you
Learning to be assertive means that you can choose when & where to assert yourself

Identifying The Three  Basic Styles Of Communication
Passive style
Aggressive style
Assertive style

Passive style
You don’t directly express your feelings, thoughts & wishes
You may try to communicate them indirectly by frowning, crying or whispering something under your breath
You tend to smile a lot & subordinate your needs to those of others
If you do speak up directly, you make disclaimer such as i’m no expert.. I’m really not sure etc
A passive style includes a soft, weak, even wavering voice
Pauses & hesitation are common
You are likely to be at a loss for words
You may ramble, be vague & use the phrases “ i mean” & “you know” often
Your posture is likely to be slouched & perhaps you will lean againts something for support
Your hands are apt to be cold, sweaty & fidgety
Eye contact is difficult for you, you tend to look down or away

Aggressive style
You are quite capable of stating how you feel, what you think & what you want but often at the expense of other’s rights & feelings
You tend to humiliate others by using sarcasm or humorous put-downs
You are likely to go on the attack when you don’t get your way & you stir up guilt & resentment in others by pointing a finger of blame
Your sentence often begin with “you…” followed by an attack or a negative label
You use absolute terms such as “always” & “never” & describe things in a way that implies that you’re always right & superior
When you are behaving aggressively, you tend to move with an air of superiority & strength
Your eyes are narrowed & expressionless
Your posture is that of a solid rock : feet planted apart, hands on hips, jaw clenched & jutting out, gestures rigid, abrupt & intimidating
Sometimes you point your finger or make a fist
You are so intent on being right that you don’t really hear what others are saying, even when you ask them a direct question

Assertive style
You make direct statements regarding your feelings, thoughts & wishes
You stand up for your rights & take into account the rights & feelings of others
You listen attentively & let other people know that you have heard them
You are open to negotiation & compromise, but not at the expense of your own rights & dignity
You can make direct requests & direct refusals
You can give & receive compliments
You can start & stop a conversation
You can deal effectively with criticism, without becoming hostile or defensive
When you are behaving assertively, you convey an air of assured strength & empathy
Your voice is relaxed, well modulated & firm
While you are comfortable with direct eye contact, you don’t stare
Your eyes communicate openness & honesty
Your posture is balanced & erect

Special Assertive Strategies
Broken record
Content to process shift
Momentary delay
Time out

Assertive Skills Practice
Broken record
Calmly & firmly repeat your statement as many times as necessary for the person to get your message & to realize that you won’t change your mind
Use body language to support your statement
Stand or sit erect, look the other person in the eye, keep your hands quietly at your sides
Content to process shift
When the focus of a conversation is drifting away from the topic you want to talk about
You simply shift from the actual subject being discussed (the content) to what is going on between you & the other person (the process)
Often involves some self disclosure about how you are feeling or thinking in the interaction at that very moment
Momentary delay
You may feel compelled to respond immediately to any situation
Make sure that you understand the other person, analyze what has been said, go inside & become aware of what you feel, think & want in this situation, consciously influence the situation so that you are more likely to get the outcome you want
Time out
When you know that what you are discussing is important, but the discussion is at an impasse, delay the conversation until another time
Time out is valuable when the interaction is too passive or too aggressive
Time out can also be used when you just want some room to think
Set up a specific time in the near future to continue your discussion

Assertive Skills Practice
Ideally you will practice these skills with a sympathetic friend before you apply them in your daily life
Many people find it helpful to rehearse their assertive lines in front of a mirror in order to make sure that their body language is consistent with what they’re saying
Tape recording an imagery assertive conversation can also be very useful

4. Social Skills Making Contact
The world is full of interesting strangers
Everyday potential friends & lovers pass you in the hall way
They eat next to you
It’s frightening to step out of your anonymous role & make contact
What would you do if you were rejected?
The fear of strangers
Outmoded 19th century social restriction
Strangers must be introduced before initiating conversation
Self depriciating
Habitual negative thoughts
They don’t want to talk to me
Inferiority
Unworthy
Unattractive
5 ways to cope with fear of stranger
1. Analyze what you say to yourself
2. Reframe your approach behavior
3. Reframe rejection
4. Deal with the emotional blow when rejected
5. Plan to get rejected

2 Basic rules for successfully making contact
1. To give what you would like to receive
Attention, interest, respect & liking that you want musat also be something you offer to others
2. To have an outward rather than an inward focus
Listen to other person instead of rehearsing your next remark or worrying about your hair or your awkwardness

Body Language For Making Contact
Move toward the other person
Lean forward
Uncross your arms & legs
Make eye contact
Smile
Let your responses show
Touch the other person
Ice breakers
start talking
Ask for information
Is there a gift shop in the lobby?
Give a compliment
Your purse has some of the most intricate tooled leather work i’ve ever seen
A little humor
You could get old waiting for a table in this restaurant
Use current events
This city’s full of muggers
The art of conversation
Questions
Active listening
Self disclosure