Transcript Module II Session 2 Communicating with Caretakers

Module II: Communicating with
Caretakers, Children, and Adolescents
Key Questions:
• What is communication?
• How can I communicate effectively with caretakers?
• What factors facilitate or hinder communication
with children and adolescents?
• What are useful strategies and techniques to
communicate with children and adolescents?
So…… What is…
COMMUNICATION ???
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Communication Is....
– Process of sending and receiving messages from
one person to another so that both understand
the messages
– Sending and receiving of information from one
person to another with a feedback.
– Interchange of thoughts, opinions , information
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Types of Communication
1. Verbal (speaking and listening)
2. Non-verbal (body language)
 Facial expressions
 Posture
 Touch
 Gestures/ expressions
3. Writing and Reading (digital)
Activity:
Identifying ‘Good’ & ‘Bad’ techniques in
Communicating with Caretakers
1. Get into your four host team groups.
2. Work together with your team to quickly
arrange the communication cards into two
groups.
Good Communication
Bad Communication
Are you communicating effectively with caretakers?
Share your good practices!
How are you an active listener? (what specifically do you do?)
How do you show interest in the caretaker? (what specifically
do you do or say?
How do you build confidence in the caretaker to continue to
engage with you?
How do you recognize or praise the caregiver? (specific examples)
How do you give practical suggestions?
How do you address the caretakers questions and concerns?
Key Communication Skills:
Communicating with Children or Caretakers
1. Be an active listener
-
involves paying active attention, shows you care
helps client think more clearly about the problem
Techniques: repeating, clarifying, paraphrasing, reflecting feelings, summarising
2. Check for understanding
- helps clients explore and visualize their problems
- helps counselor get required information
3. Ask and answer questions
- helps clarify client’s understanding
Remember to always:
• Give accurate answers
• Give information not advice
• Answer appropriately and relevantly
• Use simple clear language
Are you a ‘child friendly health worker’?
What works?
What doesn’t work?
- get down to child’s eye level
- speak softly
- smile
- be honest
- identify and respect normal
expressions of emotion (e.g.
crying or anger is okay)
- give the child choices
- talk about things that interest
the child
- respect their privacy!
DON’T
don’t say ‘be a big boy’
don’t make the child feel like a
‘baby’
don’t pity the child
don’t compare the child to
others
Useful Techniques for
Communicating with Children
Empathy
- Ability to reflect on what is said, suspending judgement and see the
world through others’ eyes.
Empty chair
- virtual bringing an absent person into the session
- helps child prepare to enact solutions in difficult situations
»symbolic and powerful techniques
Techniques for communicating with children (cont’d)
Enactment
- Understanding child/family interaction in problem solving.
-Child is asked to show/act what happens if the problem arises
-Observe the communication process and interaction and identify where
the problem lies.
Commenting
- Sensing child’s mood/ reaction to issues.
- Process feelings and action or reactions seen
- A way of clarifying and making a child aware of his/her environment.
» Ability to make child aware of ,talk about, clarify
and understanding child’s and actions
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Techniques for communicating with children (cont’d)
Questioning
a) Closed questions
- usually accompanied by responses; ‘yes’ or ‘no’
- are interrogative, judgemental,.
e.g. do you live on your own????
do you take your medicines everyday???
b) Open questions
- usually provide explanatory, expression responses
- are seeking more information and clarification.
e.g. how has HIV/AIDS affected your life at
school?
» 5Ws and 1H questions
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Techniques for communicating with children (cont’d)
Externalising
- Separating the problem/issue at hand from the child.
For example:
always call the child by his/her name
do not label them in relation to bad behaviour
»Used to normalise situations which the child thinks
are abnormal
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Modes of Communicating with Children
1. Drawing
- A powerful activity for opening hidden
cupboards in a child’s life.
- Children communicate their emotional
state without having to put it into words.
- Most children enjoy drawing.
»A practical tool for counselling
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Modes of Communication… (cont’d)
2. Story telling
- Children don’t like lots of direct questions
and long lectures.
- A story serves as a useful tool for problem
solving.
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Modes of Communication… (cont’d)
3. Play/ Drama
- Expression of their feelings about events and how
they make sense of their world.
- Children act out or imitate things occupying
their brain.
»helps in understanding the type of
emotions they are experiencing
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Barriers to effective communication
Language
Lack of confidence
Poor attitude
Lack of sufficient information
Poor listening
Lack of creation of rapport (discussion)
Environment
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Strategies for overcoming barriers
• Use local language
• Understand your emotions
• Refer situations where you get emotionally
involved
• Know your limits and strengths
• Develop good listening skills and attending
behaviour
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Strategies… (cont’d)
• Relax
• Open
• Lean forward
• Eye contact
• Sit at the same level with the child
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Communicating with Adolescents
• Adult medicine consists of adult clinicians
communicating with other adults, who share
largely similar social values and norms about
health, even taking account of cultural
differences.
• In Paediatrics, health professionals negotiate
treatment decisions with the parents, with
children's participation obtained by
explanation and parental authority.
Communicating with Adolescents (continued)
• In contrast, in consultations with adolescents,
health professionals are faced with the
challenge of communicating with a personality
undergoing rapid physical, psychological and
social changes.
• The adolescent may not share an adult's
understanding of society or adult cognitive
abilities to decide between treatment
alternatives.
To effectively communicate with adolescents,
we need to consider the adolescent’s:
• physical concerns
• psychosocial concerns
• cognitive abilities and capacity for
understanding choices, and making decisions
Issues around the management of chronic illness, for example,
can be quite different with a 13 year old boy in very early
puberty who has poorly developed abstract thinking compared
with a 16 year old girl who is sexually mature, at final height,
and has well developed adult cognitive skills.
Activity:
Improving Communication with Adolescents
Group 1: Suggest a few helpful concepts during the
first visit with an adolescent and their family.
Group 2: What changes could you make to a
clinical setting to make it more "adolescent friendly?”
Group 3: What items are critical to ask in the
psychosocial history of a 16-year-old adolescent?
Helpful concepts during the first visit with an
adolescent and their family
• Assuring confidentiality
• Involving the family unless there are particular contraindications
• Using good listening techniques
• Being aware of the hidden agenda
• Interviewing the adolescent with a developmentally oriented
approach
• Including a psychosocial history in the history taking
• Making sure the adolescent understands the diagnosis and
treatment plan.
• Liking the Adolescent
Making the clinical setting more adolescent
friendly…
• Having appropriate materials in the waiting room and offices
for teens
• Setting up special times for teens to come to the clinic
• Making sure the exam table does not face the door and have
privacy curtains available
• Allowing more time for the first visit
• Discussing with the adolescent his/her preference for
involving parents/caretakers.
Getting the psychosocial history of a
16-year-old adolescent…
• Home situation
• Educational/school issues
• Activities and hobbies the teen is involved in
• Drug use including alcohol, cigarettes and other drug use
• Sexuality issues including relationships, types of sexual
activity, sexual orientation, contraception, STIs.
• Mental health assessment
• Sexual or physical abuse particularly in teens with higher risk
profile or problems
As health professionals communicating with all
clients we need to be:
• Open
• Approachable
• Flexibile
• Respectful
• Trustworthy
• Caring
• Patient
• Accepting
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And we should NOT:
• Be judgemental
• Use a commanding tongue
• Impose adult values on children
• Compare children
• Make empty promises to children
• Talk too much
• Interrupt the child/adolescent
• Blame the child/adolescent
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Key Messages
Children and adolescents may not
remember exactly what you did or what you
said, but they will always remember how you
made them feel.
Treat each child/adolescent as an individual
Involve caretakers/parents
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