TB Contact Investigation Interviewing Skills Course

(Title Slide). Communication Skills for Building Rapport during Contact

Investigation Interviewing

After this session, participants will be able to:

(Title Slide).Building Rapport

Building Rapport

Building rapport is the key to a successful case/health care worker relationship What is Rapport?

Definition:

1. relation of trust between people
2. a feeling of sympathetic understanding
3. in accord, harmony
4. having a mutual understanding

How Do You Build Rapport?

Methods to build rapport
Useeffective communication skills
Find common ground Display respect and empathy

[IMAGE: Two women and a man sitting at a table talking and drinking a beverage.]

Title Slide).Effective Communication Skills

Effective Communication Skills

1. Active listening
2. Using appropriate nonverbal communication
3. Using appropriate voice and tone
4. Communicating at the case’s level of understanding
5. Giving factual information
6. Using reinforcement
7. Summarizing important points from the conversation

What is Active Listening?

Hearing what is said and paying attention to how it is said so the conversation can be adjusted to elicit the needed response

Utilizing various verbal and nonverbal techniques

What are Some Active Listening Techniques?

Paraphrasing and summarizing
Reflecting
Being silent

Active Listening
Paraphrasing and Summarizing (1)

What is paraphrasing and summarizing?
Rewording or rephrasing a statement to
Verify information
Demonstrate engagement in the conversation

How do you do it?
Use phrases such as “What I’m hearing is…” or “It sounds like you are saying…”
Do not repeat the person’s exact words
Avoid phrases like “I know what you mean.”

Active Listening Paraphrasing and Summarizing Example (1)

Example 1:

Case: “I am feeling very tired these days and the meds mess up my drug use. I don’t know if it’s all worth it.”

How would you paraphrase this statement?

Active Listening Paraphrasing and Summarizing Example (2)

Example 2:

Case: “I can’t tell you the names of all my contacts. I just hang out at the pool hall; there is a guy we call Slim, another one named JD. ”

How would you paraphrase this statement?

Active Listening
Reflection (1)

What is reflection?

Putting words to a case or contact’s emotionalreactions
Acknowledging a case or contact’s feelings shows empathy and helps build rapport
Helps to check rather than to assume you know what is meant

Active Listening
Reflection (2)

How do you do it?
Reflect back to the case or contact what you think they have said
Examples…
It sounds like you are feeling worried…
I understand you are having trouble with…

Active Listening
Reflection Example (1) 

Example 1:

Case: “I’m feeling tired and this whole interview is making me nervous. YOU are asking me too many questions.”

How would you reflect this statement?

Active Listening
Reflection Example (2)

Example 2:

Case: “I don’t want an HIV test. I don’t want to know if I have AIDS. If there is nothing I can do about it, what’s the point in knowing?”

How would you reflect this statement?

Active Listening
Using Silence

How can silence indicate you are actively listening?

• It allows the case an opportunity to answer questions

Active Listening Exercise

Refer to Appendix I

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B. Using Appropriate Nonverbal Communication

Nonverbal communication

Is an important aspect of building rapport
Can be both what the interviewer or case conveys with his/her body language
Interviewer should
Display appropriate body language
Be observant of the case’s body language

Appropriate Nonverbal Communication for Interviewer

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Interpreting Body Language

C. Using Appropriate Voice and Tone

Voice and tone

Use natural volume and tone
If voice is too loud, the case may be intimidated
If too soft, the message may be inaudible or sound hesitant
Pace
Use regular pace
If too fast, it can indicate a feeling of being rushed
If too slow, it can sound tentative

D. Communicate at Case or Contact’s Level

Avoid technical terms and jargon
Limit the amount of information shared
“Need to Know”
 vs. “Nice to Know”
Clearly explain necessary medical and technical terms and concepts
Repeat important information

E. Give Factual Information

Correct misconceptions
Provide comprehensive TB information
Avoid irrelevant information

[IMAGE: Two women sitting on a couch, talking.]

F. Use Reinforcement

Sincerelycompliment or acknowledge the case after hearing intentions to use, or descriptions of, healthy behaviors

Use smiles and affirmative nods and words

8. Summarize Conversation (1)

• Throughout the conversation, periodically summarize what has been said
• Summarizing gives the case an opportunity to correct information that you may have misunderstood

G. Summarize Conversation (2)

Give the case an opportunity to summarize the conversation, for example:
“We have covered a lot today. In your own words, review for me what we have discussed.”
“Please tell me what you heard me say. This will help me provide you with any additional information you need.”
Avoid phrases such as:
“Do you have any questions?”
“Do you understand?”

(Title Slide) Communication Pitfalls

[IMAGE: Clipart of a worried man looking down a hole.]

Communication Pitfalls to Avoid (1)

Being defensive or distant
Interrupting, not allowing patient to finish speaking
Giving false assurances
Providing personal opinion and advice

Communication Pitfalls to Avoid (2)

Overpowering the case
Speaking loudly
Standing over the case
Making condescending statements
Asking several questions at once
Being aggressive

Group Discussion
Barriers to Communicating

What are some barriers to communicating with cases?
What impact could they have on the interview?
How can these be prevented or overcome?

Assertive, Passive, and Aggressive Behavior

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Assertive, Passive, or Aggressive Definitions

Assertive: to maintain one’s rights without compromising the rights of others
Passive: to relinquish one’s rights in deference of others
Aggressive: to demand one’s rights at the expense of others

Assertive, Passive, or Aggressive Examples (1)

Passive: “When you have an opportunity, it would be helpful to get the names of people you spent time with.”
Assertive: “It’s important to identify your contacts. Let’s start making a list of the people you spend the most time with.”
Aggressive: “You must give me all the names of your contacts. NOW!”

Assertive, Passive, or Aggressive Examples (2)

Passive: “That smoke really bothers me. I’ll go outside while you smoke in here.”
Assertive: “Although you may smoke outside in the courtyard, smoking is not permitted in the building because it is a health risk to others.”
Aggressive: “How can you be so disgusting and insensitive smoking in here. Get out of here!”

Being Assertive

By being assertive with cases and others we are not only asserting our rights but also the rights of those not present – the contacts who may have been exposed to TB
To be effective in this role, a belief in what you are doing is required
Remember: You have the responsibility and obligation to elicit information that will reduce TB in your community

Assertive, Passive, or Aggressive Exercise

Refer to Appendix K

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Review

1. What are some ways to build rapport with a case?
2. What are six effective communication skills?
3. What is the difference between assertive, passive, and aggressive behavior?