PUBH1382​ ​Australian​ ​Health​ ​Care​ ​System  

Week​ ​8​ ​(Section​ ​B):​ ​Mental​ ​Health​ ​3 
INSTRUCTORS:​ ​Mervyn​ ​Jackson​ ​&​ ​Amy​ ​Loughman 
 

Learning​ ​Objectives 

1. Understand​ ​different​ ​types​ ​of​ ​types​ ​of​ ​communication​ ​in​ ​healthcare​ ​practice 
a. Therapeutic 
b. Professional 
2. Understand​ ​the​ ​reasons​ ​for​ ​the​ ​importance​ ​of​ ​effective​ ​communication​ ​as 
healthcare​ ​practitioners 
a. Benefits​ ​of​ ​good​ ​communication 
b. Noise​ ​and​ ​Errors​ ​of​ ​communication 
3. Components​ ​of​ ​effective​ ​verbal​ ​communication 
a. Develop​ ​a​ ​list​ ​of​ ​do’s​ ​and​ ​don’ts​ ​for​ ​verbal​ ​communication 
b. Identify​ ​areas​ ​of​ ​professional​ ​jargon​ ​and​ ​consider​ ​clearer​ ​ways​ ​to​ ​express 
these​ ​ideas 
4. Identify​ ​aspects​ ​of​ ​non-verbal​ ​communications​ ​and​ ​how​ ​these​ ​can​ ​affect:  
a. Gesture​ ​and​ ​posture 
b. Facial​ ​expressions 
c. Gaze 
d. Personal​ ​space​ ​and​ ​touch 
e. Do’s​ ​and​ ​don’ts​ ​for​ ​non-verbal​ ​communication 
5. Specific​ ​issues​ ​regarding​ ​clinical​ ​communication 
a. Interpersonal​ ​skills 
b. Active​ ​listening 
c. Sensitive​ ​management​ ​of​ ​anger​ ​and​ ​anxiety. 
 

 
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Notes 

There​ ​are​ ​significant​ ​demands​ ​on​ ​the​ ​ability​ ​to​ ​effectively​ ​communicate​ ​to​ ​ensure​ ​the 
highest​ ​quality​ ​of​ ​healthcare​ ​in​ ​Australia.​ ​These​ ​challenges​ ​will​ ​include​ ​the​ ​following 
domains: 

·​​ ​ ​ ​ ​ ​ ​ ​Effectively​ ​communicating​ ​at​ ​all​ ​stages​ ​of​ ​the​ ​patient/client​ ​therapeutic​ ​contact 

·​​ ​ ​ ​ ​ ​ ​ ​Dealing​ ​with​ ​culturally​ ​diverse​ ​patients 

·​​ ​ ​ ​ ​ ​ ​ ​Effectively​ ​interacting​ ​with​ ​the​ ​unique​ ​interrelationships​ ​with​ ​the​ ​families​ ​of​ ​patients 

·​​ ​ ​ ​ ​ ​ ​ ​Working​ ​efficiently​ ​and​ ​productively​ ​with​ ​colleagues​ ​and​ ​co-workers 

·​​ ​ ​ ​ ​ ​ ​ ​Being​ ​an​ ​effective​ ​member​ ​on​ ​multidisciplinary​ ​or​ ​inter-disciplinary​ ​health​ ​care​ ​teams 

Multidisciplinary​ ​teams​ ​–​ ​contributing  Interdisciplinary​ ​teams​ ​–​ ​working​ ​across 

own​ ​profession​ ​specific​ ​information​ ​withi professional​ ​boundaries​ ​to​ ​ensure​ ​quality
a​ ​complex​ ​health​ ​care​ ​plan​ ​–​ ​involves  care​ ​–​ ​whole​ ​team​ ​involved​ ​in​ ​the 
working​ ​with​ ​other​ ​professionals​ ​–  management​ ​of​ ​the​ ​person​ ​–​ ​patient​ ​focus
profession​ ​focus 

1. Different​ ​types​ ​of​ ​communication 

There​ ​are​ ​two​ ​main​ ​forms​ ​of​ ​communication​ ​required​ ​of​ ​a​ ​Healthcare​ ​Professional​ ​[HCP] 
1. Therapeutic​ ​communication 

This​ ​is​ ​the​ ​communication​ ​between​ ​HCP​ ​and​ ​clients/patients​ ​and​ ​their​ ​families​ ​to​ ​ensure 
quality​ ​health​ ​care​ ​that​ ​will​ ​improve​ ​or​ ​promote/maintain​ ​patients​ ​health​ ​well-being​ ​This 
therapeutic​ ​communication​ ​has​ ​three​ ​main​ ​purposes 
a. Collect​ ​profession-specific​ ​health​ ​care​ ​information​ ​about​ ​the​ ​patient​ ​(clinical 
assessments​ ​including​ ​interviews) 
b. Provide​ ​feedback​ ​to​ ​the​ ​patient/family​ ​in​ ​the​ ​form​ ​of​ ​diagnoses,​ ​prognoses​ ​and 
suggested​ ​therapeutic​ ​interventions 
c. In​ ​conjunction​ ​with​ ​the​ ​patient,​ ​formulate,​ ​implement​ ​and​ ​evaluate​ ​the​ ​agreed​ ​upon 

 
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therapeutic​ ​intervention​ ​to​ ​improve/maintain​ ​patient​ ​health 

 
2. Professional​ ​communication 
 
Tis​ ​is​ ​the​ ​communication​ ​between​ ​the​ ​HCP​ ​and​ ​colleagues​ ​(either​ ​same​ ​profession​ ​or 
another​ ​health​ ​profession)​ ​to​ ​ensure​ ​consistent​ ​and​ ​appropriate​ ​care​ ​of​ ​patients​ ​within​ ​the 
modern,​ ​complex​ ​health​ ​system.​ ​This​ ​involves​ ​effective​ ​communication​ ​of 
profession-specific​ ​information​ ​and​ ​understanding/comprehending​ ​different​ ​clinical 
perspectives​ ​from​ ​other​ ​professionals 
 

The​ ​five​ ​steps​ ​in​ ​any​ ​communication​ ​process 

Communication​ ​can​ ​be​ ​defined​ ​as​ ​the​ ​successful​ ​transfer​ ​of​ ​information​ ​(including​ ​its​ ​total 
meaning)​ ​from​ ​one​ ​person​ ​to​ ​another.​ ​The​ ​transfer​ ​of​ ​“meaning”​ ​is​ ​the​ ​key​ ​to​ ​this 
definition.​ ​Effective​ ​communication​ ​only​ ​occurs​ ​when​ ​the​ ​sender​ ​of​ ​a​ ​message​ ​and​ ​the 
receiver​ ​of​ ​that​ ​message​ ​totally​ ​agree​ ​on​ ​the​ ​meaning​ ​associated​ ​with​ ​that​ ​communication. 
This​ ​will​ ​not​ ​only​ ​involve​ ​the​ ​verbal​ ​content​ ​of​ ​the​ ​message​ ​but​ ​also​ ​the​ ​non-verbal​ ​content 
and​ ​the​ ​context​ ​of​ ​the​ ​sent​ ​message. 

Here​ ​are​ ​the​ ​five​ ​key​ ​steps​ ​to​ ​effective​ ​communication 

1.​ ​ ​ ​ ​ ​The​ ​sender​ ​formulates​ ​an​ ​idea/notion​ ​to​ ​be​ ​communicated 

​ ​2.​ ​ ​ ​ ​ ​The​ ​sender​ ​encodes​ ​the​ ​idea​ ​into​ ​a​ ​(verbal​ ​plus​ ​non-verbal)​ ​message 

3.​ ​ ​ ​ ​ ​The​ ​message​ ​travels​ ​from​ ​the​ ​sender​ ​to​ ​the​ ​receiver​ ​via​ ​the​ ​communication 
channel/medium​ ​and​ ​within​ ​a​ ​specific​ ​context 

4.​ ​ ​ ​ ​ ​The​ ​receiver​ ​[from​ ​their​ ​unique​ ​cultural​ ​perspective]​ ​decodes​ ​the​ ​[complete]​ ​message 
to​ ​determine​ ​its​ ​meaning 

​ ​5.​ ​ ​ ​ ​ ​The​ ​receiver​ ​sends​ ​enough​ ​feedback​ ​to​ ​the​ ​sender​ ​to​ ​confirm​ ​that​ ​both​ ​agree​ ​of​ ​the 
meaning​ ​of​ ​the​ ​sent/received​ ​idea 

 
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2. Reasons​ ​for​ ​effective​ ​communication​ ​in​ ​healthcare 

Reasons​ ​for​ ​being​ ​a​ ​good​ ​communicator​ ​include: 

 
1. To​ ​be​ ​effective​ ​as​ ​a​ ​Healthcare​ ​Professional​ ​[HCP] 

a) Communicate​ ​effectively​ ​with​ ​patients​ ​(and​ ​their​ ​families) 

b) Communicate​ ​effectively​ ​with​ ​colleagues​ ​(within​ ​the​ ​profession) 
c) Communicate​ ​effectively​ ​within​ ​multidisciplinary​ ​and​ ​interdisciplinary​ ​teams 

2.​ ​Effectiveness​ ​within​ ​your​ ​career 

a) Communicate​ ​effectively​ ​in​ ​your​ ​first​ ​job​ ​interview​ ​and​ ​subsequent​ ​job​ ​or 
promotion​ ​interviews 
b) Communicate​ ​effectively​ ​with​ ​supervisors​ ​and​ ​(later)​ ​employees​ ​that​ ​have​ ​to​ ​be 
managed 
c) Communicate​ ​effectively​ ​in​ ​case​ ​conferences​ ​and​ ​national/international 
conferences​ ​on​ ​research​ ​findings​ ​and​ ​professional​ ​practice 
d) Communicate​ ​effectively​ ​with​ ​government​ ​and​ ​non-government​ ​organizations​ ​for 
grants,​ ​etc 
 

​ ​The​ ​concept​ ​of​ ​“noise” 

Noise​ ​is​ ​anything​ ​that​ ​disrupts​ ​effective​ ​communication​ ​and​ ​can​ ​interfere​ ​at​ ​every​ ​step​ ​of 
the​ ​communication​ ​process.​ ​Some​ ​examples​ ​of​ ​noise: 

​ ​1. Therapeutic​ ​communication​​ ​–​ ​the​ ​patient/receiver​ ​may​ ​have​ ​a​ ​disability 
(language/cognitive)​ ​that​ ​prevents​ ​them​ ​from​ ​understanding​ ​the​ ​communicated​ ​message 

​ ​2. Professional​ ​communication​​ ​–​ ​the​ ​HCP​ ​uses​ ​professional​ ​jargon​ ​that​ ​precludes 
colleagues​ ​from​ ​other​ ​health​ ​professions​ ​from​ ​gaining​ ​a​ ​full​ ​understanding​ ​of​ ​the​ ​patients 
presenting​ ​problem 

Problem​ ​with​ ​errors​ ​in​ ​communication 

 

 
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1. Miscommunication​ ​is​ ​one​ ​of​ ​the​ ​most​ ​common​ ​causes​ ​of​ ​patients​ ​complaints  
2. Multidisciplinary​ ​teams​ ​have​ ​the​ ​potential​ ​to​ ​provide​ ​high​ ​quality​ ​patient​ ​care,​ ​but 
research​ ​has​ ​found​ ​that​ ​communication​ ​errors​ ​within​ ​the​ ​team​ ​severely​ ​limits​ ​this 
potential 
3. Written​ ​communication​ ​error​ ​rates​ ​threatens​ ​patient​ ​safety 
 

Top​ ​contributing​ ​factors​ ​to​ ​Medical​ ​errors​ ​in​ ​large​ ​health​ ​care​ ​settings 

http://www.ahrq.gov/professionals/education/curriculum-tools/teamstepps/longtermcare/
module1/igltcintro.html 

3. Effective​ ​verbal​ ​communication 

Effective​ ​verbal​ ​communication​ ​is​ ​comprised​ ​of​ ​several​ ​important​ ​components. 

 
1. Content​ ​and​ ​word​ ​choice 

 
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a) Need​ ​ ​a​ ​clear​ ​understanding​ ​of​ ​what​ ​needs​ ​to​ ​be​ ​conveyed​ ​–​ ​that​ ​is​ ​a​ ​level 
understanding​ ​that​ ​allow​ ​you​ ​to​ ​teach​ ​these​ ​concept​ ​to​ ​someone​ ​who​ ​is​ ​naïve​ ​to 
this​ ​concept 
b) Need​ ​to​ ​choose​ ​words​ ​that​ ​are​ ​clear,​ ​unambiguous​ ​and​ ​unnecessarily​ ​technical​ ​–  
c) Need​ ​to​ ​adjust​ ​communication​ ​(content​ ​and​ ​word​ ​choice)​ ​to​ ​match​ ​receiver’s​ ​level 
of​ ​understanding​ ​–​ ​consider​ ​describing​ ​diagnoses​ ​to​ ​colleague​ ​versus​ ​patient 

2. Grammar​ ​and​ ​pronunciation 

a) Poor​ ​grammar​ ​and​ ​mispronunciation​ ​creates​ ​a​ ​bad​ ​impression​ ​and​ ​confusion. 
Correct​ ​grammar​ ​[and​ ​spelling]​ ​and​ ​pronunciation​ ​ensure​ ​clarity,​ ​maximizes 
effective​ ​communication​ ​and​ ​inspires​ ​confidence​ ​and​ ​trust​ ​of​ ​the​ ​HCP​ ​by​ ​the 
receiver 
b) Good​ ​communicators​ ​focus​ ​on​ ​grammar,​ ​spelling​ ​and​ ​pronunciation​ ​at​ ​School,​ ​at 
University​ ​and​ ​throughout​ ​the​ ​rest​ ​of​ ​their​ ​working​ ​lives​ ​–​ ​it​ ​is​ ​not​ ​something​ ​that​ ​is 
incidental​ ​and​ ​needs​ ​only​ ​to​ ​be​ ​focussed​ ​on​ ​later​ ​in​ ​life 
 
Note:​ ​modern​ ​media​ ​(eg​ ​text​ ​messaging)​ ​can​ ​create​ ​bad​ ​verbal/written 
communication​ ​habits,​ ​future​ ​HCPs​ ​need​ ​to​ ​clearly​ ​discriminate​ ​between​ ​mediums. 
In​ ​professional​ ​health​ ​care​ ​situations,​ ​they​ ​should​ ​always​ ​use​ ​standard​ ​English 
grammar,​ ​spelling​ ​and​ ​pronunciation 

 
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3.​ ​Tone​ ​–​ ​there​ ​are​ ​a​ ​number​ ​of​ ​basic​ ​expression​ ​tones,​ ​some​ ​used​ ​purposively​ ​to​ ​elicit 
different​ ​responses​ ​and​ ​one​ ​that​ ​never​ ​should​ ​be​ ​used​ ​in​ ​professional​ ​settings 
 
 

Type  When​ ​to​ ​use 

a. Formal​ ​interview​ ​tone 

First​ ​interview 

b. Problem​ ​solving​ ​tone  Diagnosis​ ​phase​ ​of​ ​interview 

c. Directive​ ​tone  Instructions​ ​–​ ​treatment​ ​phase 

[Orders​ ​–​ ​employees​ ​but​ ​never 
with​ ​patients] 
  

d. Question​ ​and​ ​answer​ ​tone  Seeking​ ​feedback 

  

e. Expressive​ ​[emotion]​ ​tone  Never​ ​in​ ​a​ ​professional​ ​setting 

  

f. Incidental​ ​communication    

· Small​ ​talk  · building​ ​rapport 

· commentary  · filling​ ​silences 

a) Formal​ ​interview​ ​tone​ ​–​ ​first​ ​interviews​ ​should​ ​be​ ​formal​ ​occasions​ ​where​ ​the​ ​HCP 
needs​ ​to​ ​create​ ​a​ ​competent,​ ​confident,​ ​professional​ ​impression​ ​[tone].​ ​The​ ​design 
and​ ​layout​ ​of​ ​the​ ​clinic​ ​and​ ​the​ ​behaviour​ ​of​ ​all​ ​clinic​ ​staff​ ​should​ ​be​ ​professional. 
The​ ​interview​ ​should​ ​be​ ​scripted​ ​and​ ​include​ ​all​ ​the​ ​relevant​ ​professional/clinical 

 
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phases:​ ​introductions;​ ​expectations;​ ​information​ ​sharing/gathering,​ ​etc.​ ​This​ ​initial 

communication​ ​phase​ ​is​ ​expected​ ​by​ ​the​ ​patient​ ​and​ ​will​ ​provide​ ​confidence​ ​and 
reduce​ ​any​ ​patient​ ​anxiety.​ ​Note,​ ​it​ ​is​ ​also​ ​designed​ ​to​ ​maximize​ ​patient​ ​disclosure 
of​ ​relevant​ ​personal​ ​information. 
b) Problem​ ​solving​ ​tone​ ​–​ ​a​ ​problem​ ​solving​ ​tone​ ​is​ ​rational,​ ​objective​ ​and​ ​unbiased,​ ​it 
is​ ​used​ ​to​ ​indicate​ ​that​ ​the​ ​HCP​ ​is​ ​analysing​ ​the​ ​patient’s​ ​presenting​ ​information​ ​to 
arrive​ ​at​ ​a​ ​correct​ ​answer/diagnosis.​ ​A​ ​significant​ ​part​ ​of​ ​a​ ​HCPs​ ​role​ ​consists​ ​of 
verbally​ ​collecting​ ​important​ ​professional-specific​ ​information​ ​from​ ​the​ ​patient​ ​and 
providing​ ​explanations​ ​and​ ​possible​ ​solutions​ ​to​ ​the​ ​patient.​ ​The​ ​problem​ ​solving 
[work]​ ​tone​ ​is​ ​what​ ​the​ ​patient​ ​rightfully​ ​expects​ ​from​ ​the​ ​HCP.​ ​The​ ​major​ ​clinical 
challenge​ ​during​ ​the​ ​diagnostic​ ​phase​ ​is​ ​to​ ​maximize​ ​patient​ ​disclosure​ ​of​ ​clinically 
relevant​ ​information 
c) Directive​ ​tone​ ​–​ ​is​ ​an​ ​authoritative​ ​but​ ​inclusive​ ​tone.​ ​It​ ​is​ ​aimed​ ​at​ ​ensuring​ ​the 
patient​ ​understands​ ​his/her​ ​role​ ​in​ ​treatment​ ​(and​ ​is​ ​part​ ​of​ ​the​ ​strategy​ ​to 
maximize​ ​adherence).​ ​Its​ ​correct​ ​use​ ​includes​ ​contextual​ ​information​ ​and​ ​an 
explanation​ ​of​ ​the​ ​importance/value​ ​of​ ​the​ ​patient’s​ ​behaviour​ ​in​ ​the​ ​successful 
outcome​ ​of​ ​the​ ​proposed​ ​clinical​ ​intervention​ ​–​ ​to​ ​convince​ ​the​ ​patient​ ​that​ ​their 
[adherence]​ ​behaviour​ ​is​ ​key​ ​or​ ​essential​ ​to​ ​their​ ​recovery.​ ​If​ ​this​ ​tone​ ​is​ ​used​ ​with 
incorrect​ ​content​ ​[orders],​ ​then​ ​the​ ​patient’s​ ​anxiety​ ​will​ ​increase​ ​and​ ​their 
resistance​ ​to​ ​therapeutic​ ​suggestions/advice​ ​will​ ​increase​ ​and​ ​there​ ​will​ ​be​ ​a 
subsequent​ ​increase​ ​in​ ​non-adherence. 
d) Question​ ​and​ ​answer​ ​conversational​ ​tone​ ​–​ ​an​ ​important​ ​phase​ ​in​ ​all​ ​clinical 
interviews​ ​is​ ​a​ ​time​ ​to​ ​determine​ ​the​ ​degree​ ​of​ ​understanding​ ​in​ ​both​ ​the​ ​HCP​ ​and 
the​ ​patient/client.​ ​This​ ​involves​ ​developing​ ​listening​ ​and​ ​paraphrasing​ ​skills.​ ​The 
HCP​ ​paraphrases​ ​what​ ​the​ ​patient​ ​has​ ​explained​ ​to​ ​verify​ ​the​ ​HCP’s​ ​understanding 
of​ ​what​ ​the​ ​patients​ ​perceives​ ​to​ ​be​ ​the​ ​[symptoms​ ​of​ ​the]​ ​presenting​ ​problem.​ ​This 
also​ ​allows​ ​the​ ​patient​ ​to​ ​check​ ​the​ ​health​ ​professional’s​ ​understanding​ ​of​ ​their 
concerns​ ​and​ ​provides​ ​an​ ​extra​ ​opportunity​ ​for​ ​them​ ​to​ ​amend​ ​or​ ​add​ ​relevant 
information.​ ​Note,​ ​this​ ​should​ ​move​ ​through​ ​the​ ​following​ ​phases:​ ​problem 
presentation;​ ​diagnosis​ ​and​ ​rationale​ ​for​ ​the​ ​diagnosis;​ ​treatment​ ​parameters 
including​ ​the​ ​importance​ ​of​ ​the​ ​role​ ​of​ ​the​ ​patient;​ ​and,​ ​outcome/resolution​ ​(or 
prognosis)​ ​in​ ​terms​ ​of​ ​recovery​ ​time​ ​and​ ​final​ ​health​ ​status​ ​(full​ ​or​ ​less​ ​than​ ​full 
recovery) 

 
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e) Expressive​ ​tone.​ ​This​ ​should​ ​be​ ​avoided​ ​at​ ​all​ ​costs​ ​and​ ​involves​ ​an​ ​emotional 
dimension​ ​and​ ​indicates​ ​the​ ​personal​ ​thoughts​ ​and/or​ ​feelings​ ​of​ ​the​ ​professional. 
This​ ​tome​ ​should​ ​never​ ​be​ ​used​ ​in​ ​the​ ​clinic​ ​setting​ ​(either​ ​with​ ​patients​ ​or​ ​other 
clinic​ ​or​ ​professional​ ​staff).​ ​This​ ​tone​ ​is​ ​spontaneous,​ ​emotional,​ ​uninhibited​ ​and 
should​ ​be​ ​restricted​ ​to​ ​occasions​ ​such​ ​as​ ​home​ ​or​ ​socializing​ ​in​ ​non-work​ ​settings 
f) Incidental​ ​communication 
i. Small​ ​talk​ ​–​ ​this​ ​tone​ ​is​ ​used​ ​to​ ​build​ ​rapport​ ​with​ ​the​ ​patient​ ​and​ ​is​ ​typically 
part​ ​of​ ​the​ ​initial​ ​communication​ ​(that​ ​is,​ ​when​ ​the​ ​HCP​ ​greets​ ​the​ ​patient​ ​in​ ​the 
waiting​ ​room).​ ​The​ ​topics​ ​that​ ​are​ ​typically​ ​discussed​ ​include​ ​the​ ​weather;​ ​difficulty 
finding​ ​the​ ​clinic,​ ​problems​ ​with​ ​parking,​ ​etc.​ ​This​ ​conversation​ ​is​ ​utilized​ ​to​ ​put​ ​the 
patient​ ​(and​ ​the​ ​family)​ ​at​ ​ease​ ​but​ ​is​ ​limited​ ​to​ ​and​ ​ceases​ ​upon​ ​entry​ ​into​ ​the 
professional​ ​suite. 
ii. Commentary​ ​–​ ​the​ ​use​ ​of​ ​commentary​ ​occurs​ ​when​ ​there​ ​is​ ​a​ ​professional 
task​ ​to​ ​be​ ​completed​ ​that​ ​does​ ​not​ ​involve​ ​the​ ​patient​ ​in​ ​answers​ ​or​ ​questions​ ​(for 
instance​ ​the​ ​movement/preparation​ ​of​ ​test​ ​or​ ​other​ ​equipment.​ ​These​ ​tasks​ ​will 
vary​ ​across​ ​HCP​ ​groups.​ ​The​ ​commentary​ ​should​ ​include​ ​what​ ​the​ ​HCP​ ​is​ ​currently 
doing,​ ​what​ ​the​ ​subsequent​ ​procedure​ ​will​ ​involve​ ​and​ ​what​ ​the​ ​patient​ ​will 
experience​ ​(in​ ​terms​ ​of​ ​personal​ ​sensations​ ​and​ ​thoughts).​ ​Again,​ ​this 
communication​ ​is​ ​designed​ ​to​ ​reduce​ ​patient​ ​uncertainty,​ ​reduce​ ​patient​ ​anxiety, 
and​ ​thus,​ ​put​ ​the​ ​patient​ ​at​ ​ease 
 

Some​ ​do’s​ ​and​ ​don’ts: 

1.​ ​ ​ ​ ​ ​Do​ ​send​ ​clear​ ​simple​ ​messages 

2.​ ​ ​ ​ ​ ​Do​ ​use​ ​standard​ ​English​ ​and​ ​do​ ​not​ ​or​ ​minimize​ ​the​ ​use​ ​of​ ​slang 

3.​ ​ ​ ​ ​ ​Do​ ​not​ ​use​ ​professional​ ​jargon,​ ​create​ ​simple​ ​everyday​ ​explanations 

4.​ ​ ​ ​ ​ ​Do​ ​talk​ ​to​ ​the​ ​patient,​ ​do​ ​not​ ​talk​ ​directly​ ​to​ ​family​ ​members​ ​in​ ​the​ ​presence​ ​of​ ​the 
patient 

5.​ ​ ​ ​ ​ ​Do​ ​not​ ​talk​ ​at​ ​the​ ​patient 

6.​ ​ ​ ​ ​ ​Do​ ​be​ ​a​ ​good​ ​listener,​ ​use​ ​paraphrasing​ ​and​ ​probes​ ​to​ ​check​ ​your​ ​understanding 

 
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7.​ ​ ​ ​ ​ ​Do​ ​help​ ​the​ ​patient​ ​be​ ​a​ ​good​ ​listener,​ ​use​ ​probes​ ​to​ ​check​ ​their​ ​understanding​ ​of 
your​ ​explanations 

8.​ ​ ​ ​ ​ ​Do​ ​keep​ ​the​ ​patient​ ​talking,​ ​do​ ​explore​ ​all​ ​aspects​ ​of​ ​the​ ​problem​ ​and​ ​use​ ​techniques 
to​ ​minimize​ ​non-disclosure 

9.​ ​ ​ ​ ​ ​Do​ ​provide​ ​empathy​ ​and​ ​do​ ​avoid​ ​sympathy 

10.​ ​ ​Do​ ​use​ ​the​ ​patient’s​ ​name 

11.​ ​ ​Do​ ​not​ ​interpret​ ​the​ ​patient 

12.​ ​ ​Do​ ​not​ ​give​ ​the​ ​patient​ ​unsought​ ​or​ ​unrelated​ ​advice 

13.​ ​ ​Do​ ​not​ ​talk​ ​about​ ​others​ ​(including​ ​yourself) 

14.​​ ​ ​Do​ ​not​ ​tell​ ​patients​ ​you​ ​know​ ​how​ ​they​ ​feel​ ​or​ ​how​ ​they​ ​should​ ​feel 

Professional​ ​Jargon 

Every​ ​discipline​ ​has​ ​its​ ​own​ ​professional​ ​jargon.​ ​This​ ​might​ ​include​ ​words​ ​and​ ​phrases​ ​that 
are​ ​unique​ ​to​ ​the​ ​discipline,​ ​and​ ​others​ ​that​ ​are​ ​‘general’​ ​but​ ​have​ ​a​ ​specific​ ​meaning 
within​ ​the​ ​discipline.​ ​Some​ ​examples​ ​from​ ​psychology​ ​appear​ ​below.​ ​Jargon​ ​often 
improves​ ​the​ ​efficiency​ ​of​ ​communication​ ​between​ ​colleagues​ ​but​ ​obscure​ ​communication 
with​ ​a​ ​patient,​ ​or​ ​make​ ​them​ ​feel​ ​inferior.​ ​Think​ ​back​ ​to​ ​when​ ​you​ ​were​ ​first​ ​learning​ ​your 
area​ ​of​ ​specialty.​ ​Was​ ​there​ ​any​ ​particular​ ​language​ ​you​ ​had​ ​to​ ​learn?​ ​What​ ​sorts​ ​of​ ​words 
and​ ​phrases​ ​might​ ​you​ ​use​ ​between​ ​colleagues​ ​but​ ​not​ ​with​ ​patients?​ ​How​ ​about​ ​special 
acronyms?  

Some​ ​psychology​ ​jargon: 

- Executive​ ​function 
- Cognitive​ ​load 
- Working​ ​memory 
- Blunted​ ​affect 
- Sydrome 

 
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- ASD​ ​(autism​ ​spectrum​ ​disorder),​ ​GAD​ ​(generalised​ ​anxiety​ ​disorder),​ ​MDD​ ​(major 
depressive​ ​disorder) 
- Cerebellar​ ​signs 
- … 

4. Aspects​ ​of​ ​non-verbal​ ​communication 

http://bass-schuler.com/christopher-carter-2/ 

Some​ ​researchers​ ​estimate​ ​that​ ​over​ ​half​ ​of​ ​the​ ​message​ ​in​ ​a​ ​healthcare​ ​professional 
interaction​ ​with​ ​a​ ​patient​ ​is​ ​via​ ​non-verbal​ ​communication.​ ​HCPs​ ​rely​ ​on​ ​non-verbal 
communications​ ​to​ ​give​ ​effect​ ​and​ ​meaning​ ​to​ ​their​ ​important​ ​messages.​ ​Most​ ​humans​ ​are 
unaware​ ​of​ ​the​ ​impact​ ​of​ ​this​ ​form​ ​of​ ​communication​ ​and​ ​this​ ​section​ ​is​ ​to​ ​bring​ ​this 
aspect​ ​of​ ​communication​ ​to​ ​the​ ​conscious​ ​level​ ​of​ ​future​ ​HCPs.​ ​A​ ​simple​ ​demonstration​ ​is 

 
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the​ ​number​ ​of​ ​communication​ ​errors​ ​that​ ​occur​ ​when​ ​communication​ ​varies.​ ​For​ ​instance, 
demonstrations​ ​have​ ​shown​ ​that​ ​miscommunication​ ​increases​ ​as​ ​people​ ​shift​ ​from​ ​face​ ​to 
face,​ ​to​ ​telephone​ ​to​ ​email/social​ ​media.​ ​As​ ​non-verbal​ ​communication​ ​decreases, 
misunderstandings​ ​increase. 

Types​ ​of​ ​non-verbal​ ​communications 

1. Gestures​ ​and​ ​body​ ​posture 

a) The​ ​patients​ ​state​ ​of​ ​mind​ ​and​ ​health​ ​will​ ​be​ ​communicated​ ​both​ ​verbally​ ​[what 
they​ ​say]​ ​and​ ​non-verbally​ ​[how​ ​they​ ​present].​ ​Typically​ ​patients​ ​who​ ​are​ ​ill​ ​and/or 
depressed​ ​are​ ​likely​ ​to​ ​make​ ​fewer​ ​gestures​ ​and​ ​they​ ​will​ ​not​ ​be​ ​animated. 
b) The​ ​HCP​ ​will​ ​communicate​ ​many​ ​health​ ​related​ ​procedures​ ​both​ ​verbally​ ​and​ ​via 
gestures.​ ​Many​ ​procedures​ ​or​ ​therapeutic​ ​techniques​ ​are​ ​demonstrated​ ​using​ ​both 
a​ ​verbal​ ​explanation​ ​and​ ​a​ ​series​ ​of​ ​gestures 
c) HCP​ ​and​ ​patient​ ​conversations​ ​are​ ​regulated​ ​by​ ​non-verbal​ ​cues​ ​–​ ​this​ ​is​ ​typically 
called​ ​turn-taking​ ​where​ ​both​ ​verbal​ ​and​ ​non-verbal​ ​cues​ ​determine​ ​when​ ​one 
speaker​ ​is​ ​about​ ​to​ ​finish​ ​and​ ​there​ ​is​ ​an​ ​expectation​ ​that​ ​the​ ​other​ ​person​ ​will 
immediately​ ​respond.​ ​This​ ​will​ ​involve​ ​body​ ​posture​ ​[leaning​ ​forward],​ ​nodding​ ​of 
the​ ​head,​ ​and​ ​gaze​ ​[attending​ ​to​ ​the​ ​other​ ​person’s​ ​face].  

2. Facial​ ​expressions 

Facial​ ​expressions​ ​are​ ​predominately​ ​about​ ​the​ ​emotional​ ​content​ ​of​ ​communication. 
Researchers​ ​have​ ​reported​ ​that​ ​the​ ​facial​ ​expressions​ ​associated​ ​with​ ​basic​ ​emotions 
[happiness,​ ​sadness,​ ​surprise,​ ​disgust,​ ​etc]​ ​are​ ​universal​ ​–​ ​and​ ​thus​ ​all​ ​humans​ ​use​ ​them 
and​ ​need​ ​to​ ​understand​ ​their​ ​meaning.​ ​However,​ ​these​ ​same​ ​researchers​ ​noted​ ​that​ ​the 
expression​ ​of​ ​some​ ​of​ ​these​ ​emotions​ ​[eg​ ​disgust]​ ​is​ ​culture-bound​ ​and​ ​thus​ ​some 
patients​ ​will​ ​not​ ​display​ ​some​ ​of​ ​these​ ​basic​ ​emotions.​ ​In​ ​other​ ​cultures​ ​[including​ ​the 
Australian​ ​indigenous​ ​community],​ ​it​ ​is​ ​the​ ​absence​ ​of​ ​non-verbal​ ​communication​ ​[no 
facial​ ​expression,​ ​lethargy,​ ​averting​ ​the​ ​gaze]​ ​that​ ​represents​ ​a​ ​patient​ ​with​ ​serious​ ​illness 
and​ ​severe​ ​pain. 

3. Gaze 

Gaze​ ​patterns​ ​vary,​ ​but​ ​are​ ​important​ ​in​ ​determining​ ​the​ ​patient’​ ​health,​ ​the​ ​patient’s 
attention​ ​and​ ​understanding​ ​of​ ​the​ ​therapeutic​ ​communication​ ​and​ ​the​ ​regulation​ ​of​ ​the 

 
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HCP-patient​ ​conversation​ ​[direct​ ​gaze,​ ​initial​ ​eye​ ​contact,​ ​then​ ​averted​ ​gaze​ ​with 
intermittent​ ​brief​ ​eye-contact]. 

 
4. Personal​ ​space​ ​and​ ​touch 
 

Personal​ ​space 
 

​​  
  

Personal​ ​touch  Professional​ ​touch 

     
  
  
 

​​  
 

 
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http://www.gopixpic.com/1000/personal-space/http:||www*gadgethovel*com|comics|20
09-08-03_personalspace*jpg/ 

Personal​ ​space​ ​provides​ ​identity,​ ​security​ ​and​ ​control​ ​over​ ​the​ ​social​ ​environment. 
HCP-patient​ ​interactions​ ​including​ ​consultations​ ​are​ ​regulated​ ​by​ ​room/furniture​ ​design 
and​ ​should​ ​be​ ​arranged​ ​to​ ​ensure​ ​there​ ​is​ ​no​ ​invasion​ ​of​ ​personal​ ​space.​ ​In​ ​many​ ​health 
care​ ​settings,​ ​patients​ ​are​ ​often​ ​required​ ​to​ ​give​ ​up​ ​personal​ ​space​ ​(medical​ ​procedures, 
chiropractic​ ​manipulations,​ ​basic​ ​care​ ​in​ ​hospitals,​ ​etc).​ ​Patients​ ​need​ ​to​ ​be 
informed/alerted​ ​when​ ​such​ ​procedures​ ​are​ ​about​ ​to​ ​commence​ ​(verbal​ ​statement​ ​plus 
directive​ ​gesture)​ ​and​ ​the​ ​patient’s​ ​response​ ​[consent]​ ​should​ ​be​ ​clearly​ ​understood​ ​by​ ​the 
HCP​ ​before​ ​any​ ​manual​ ​procedures​ ​commence. 
 
While​ ​touch​ ​communicates​ ​much​ ​about​ ​personal/social​ ​relationships,​ ​HCP​ ​touch​ ​has​ ​to​ ​be 
strictly​ ​within​ ​that​ ​particular​ ​professional​ ​practice​ ​(ethical)​ ​guidelines.​ ​The​ ​requirement​ ​to 
touch​ ​should​ ​be​ ​clearly​ ​stated​ ​and​ ​before​ ​touching,​ ​patient​ ​consent​ ​needs​ ​to​ ​be​ ​explicit 
 
Three​ ​rules​ ​to​ ​minimize​ ​discomfort,​ ​anxiety​ ​and/or​ ​stress 
• Treat​ ​patients​ ​respectfully 
• Allow​ ​patients​ ​as​ ​much​ ​control​ ​as​ ​practical 
• Recognise​ ​patient’s​ ​rights​ ​to​ ​privacy 

Finally,​ ​the​ ​HCP​ ​needs​ ​to​ ​consider​ ​the​ ​proper​ ​interpretation​ ​of​ ​all​ ​of​ ​their​ ​communication.  
If​ ​the​ ​patient’s​ ​verbal​ ​and​ ​non-verbal​ ​messages​ ​are​ ​incongruent​ ​with​ ​each​ ​other,​ ​then​ ​the 
HCP​ ​should​ ​explore​ ​and​ ​clarify​ ​such​ ​incongruity.​ ​Two​ ​examples​ ​that​ ​would​ ​need​ ​to​ ​be 
explored: 
1. A​ ​life​ ​threatening​ ​negative​ ​diagnosis​ ​is​ ​accompanied​ ​by​ ​a​ ​smile 
2. A​ ​verbal​ ​“I​ ​understand”​ ​is​ ​accompanied​ ​by​ ​a​ ​confused​ ​facial​ ​expression 

Some​ ​things​ ​to​ ​keep​ ​in​ ​mind​ ​for​ ​non-verbal​ ​communication 

1. Do​ ​ensure​ ​you​ ​have​ ​a​ ​high​ ​standard​ ​of​ ​hygiene 
2. Do​ ​ensure​ ​that​ ​you​ ​always​ ​have​ ​a​ ​professional​ ​appearance​ ​[dress​ ​and​ ​grooming] 

 
14 RMIT​ ​University​ ​©2017 
 

 
 

3. Do​ ​meet​ ​and​ ​greet​ ​the​ ​patient​ ​professionally​ ​[consider​ ​whether​ ​a​ ​handshake​ ​is 
appropriate​ ​and​ ​then​ ​be​ ​consistent​ ​with​ ​all​ ​patients​ ​–​ ​male​ ​and​ ​female,​ ​old​ ​and​ ​young] 
4. Ensure​ ​appropriate​ ​location​ ​–​ ​must​ ​be​ ​private​ ​and​ ​must​ ​not​ ​lead​ ​to​ ​interruptions 
5. Ensure​ ​appropriate​ ​seating​ ​arrangements,​ ​comfortable​ ​and​ ​considers​ ​the 
professional​ ​status​ ​[impression​ ​of​ ​competence]​ ​and​ ​appropriate​ ​personal​ ​space​ ​for​ ​all 
parties 
6. Ensure​ ​there​ ​is​ ​a​ ​professional​ ​but​ ​relaxed​ ​atmosphere​ ​[re​ ​HCP​ ​posture​ ​and 
non-verbal​ ​cues​ ​such​ ​as​ ​well-timed​ ​nods,​ ​conservative​ ​gestures​ ​and​ ​non-intrusive​ ​gaze] 
7. Provide​ ​clear​ ​indications​ ​of​ ​attention​ ​and​ ​appropriate​ ​encouragement​ ​for​ ​the 
patient​ ​to​ ​fully​ ​disclose​ ​relevant​ ​clinical​ ​information 
8. Overall​ ​create​ ​a​ ​session​ ​that​ ​maintains​ ​professionalism,​ ​an​ ​assurance​ ​of 
confidentiality​ ​and​ ​instils​ ​confidence​ ​in​ ​the​ ​patient 
 

5. Clinical​ ​communication  

All​ ​professionals​ ​require​ ​effective​ ​communication​ ​skills​ ​for​ ​successful​ ​interaction​ ​with 
others,​ ​including:​ ​patients;​ ​colleagues;​ ​supervisors;​ ​and​ ​other​ ​[health]​ ​professionals,​ ​i.e. 
clinical​ ​communication. 
 
Essential​ ​interpersonal​ ​skills 
 
1. Tactfulness​ ​and​ ​diplomacy​ ​–​ ​in​ ​the​ ​workplace,​ ​professionals​ ​will​ ​inevitably​ ​disagree 
with​ ​how​ ​others​ ​behave​ ​and/or​ ​what​ ​they​ ​say.​ ​While​ ​the​ ​popular​ ​media​ ​portrays​ ​people 
being​ ​critical,​ ​disparaging​ ​and​ ​putting​ ​the​ ​other​ ​person​ ​down,​ ​using​ ​tact​ ​and​ ​diplomacy​ ​get 
the​ ​correct​ ​message​ ​across​ ​while​ ​maintaining​ ​the​ ​professional​ ​working​ ​relationship. 
 
2. Courtesy​ ​and​ ​respect​ ​–​ ​showing​ ​courtesy​ ​or​ ​consideration​ ​of​ ​others​ ​(correctly 
greeting​ ​someone,​ ​making​ ​room​ ​in​ ​crowded​ ​venues,​ ​including​ ​others​ ​in​ ​conversation 
groups,​ ​opening​ ​doors,​ ​taking​ ​turns,​ ​checking​ ​with​ ​waiting​ ​patients​ ​that​ ​they​ ​are​ ​being 
attended​ ​to,​ ​etc)​ ​will​ ​improve​ ​the​ ​ambiance​ ​and​ ​quality​ ​of​ ​the​ ​workplace.​ ​Showing​ ​respect 
indicates​ ​that​ ​you​ ​value​ ​the​ ​person,​ ​that​ ​they​ ​are​ ​important​ ​to​ ​you​ ​and​ ​that​ ​you​ ​wish​ ​to 
have​ ​a​ ​productive​ ​working​ ​relationship​ ​with​ ​them​ ​(be​ ​they​ ​colleagues​ ​or​ ​patients).​ ​Respect 
is​ ​demonstrated​ ​by​ ​appropriate​ ​greetings​ ​(eg​ ​titles,​ ​names,​ ​etc)​ ​and​ ​providing​ ​undivided 

 
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attention​ ​during​ ​all​ ​interactions​ ​(this​ ​includes​ ​appropriate​ ​posture,​ ​eye​ ​contact​ ​and 
iterative,​ ​responsive​ ​conversations.​ ​Displaying​ ​courtesy​ ​and​ ​showing​ ​respect​ ​will​ ​always 
achieve​ ​a​ ​positive​ ​outcome. 
 
3. Empathy​ ​–​ ​is​ ​the​ ​ability​ ​to​ ​understand​ ​how​ ​others​ ​feel​ ​(both​ ​colleagues​ ​and 
patients).​ ​The​ ​technical​ ​term​ ​for​ ​this​ ​ability​ ​comes​ ​from​ ​theory​ ​of​ ​mind.​ ​This​ ​skill​ ​develops 
by​ ​imagining​ ​yourself​ ​in​ ​their​ ​situation​ ​and​ ​is​ ​demonstrated​ ​to​ ​them​ ​by​ ​listening 
[understanding]​ ​and​ ​communicating​ ​to​ ​them​ ​that​ ​you​ ​understand​ ​[caring​ ​behaviour,​ ​tact 
and​ ​respect].​ ​Just​ ​directly​ ​telling​ ​them​ ​you​ ​understand​ ​is​ ​not​ ​enough 
 
4. Genuineness​ ​–​ ​the​ ​impression​ ​developed​ ​by​ ​consistently​ ​acting​ ​in​ ​a​ ​professional 
manner​ ​[both​ ​to​ ​your​ ​colleagues​ ​and​ ​to​ ​patients] 
 
5. Appropriate​ ​self-disclosure​ ​–​ ​occurs​ ​when​ ​you​ ​reveal​ ​some​ ​past​ ​experience​ ​and 
should​ ​be​ ​restricted​ ​to​ ​occasions​ ​where​ ​you​ ​wish​ ​to​ ​demonstrate​ ​you​ ​have​ ​experience​ ​in 
this​ ​situation.​ ​This​ ​experience​ ​should​ ​illustrate​ ​your​ ​knowledge​ ​and​ ​competence​ ​and​ ​will 
also​ ​indicate​ ​that​ ​you​ ​have​ ​empathy​ ​for​ ​their​ ​situation/current​ ​reality. 
 
6. Assertiveness​ ​[not​ ​aggressiveness]​ ​–​ ​healthcare​ ​professionals​ ​need​ ​to​ ​comfortably 
and​ ​confidently​ ​express​ ​their​ ​ideas​ ​while​ ​respecting​ ​the​ ​ideas/perceptions​ ​of​ ​others. 
Assertive​ ​communication​ ​sends​ ​clear,​ ​direct​ ​messages​ ​to​ ​others​ ​while​ ​remaining​ ​relaxed 
and​ ​respectful.​ ​Generally​ ​assertive​ ​skills​ ​are​ ​used​ ​when​ ​others​ ​are​ ​using​ ​emotional, 
aggressive​ ​communication​ ​styles.​ ​Note,​ ​HCPs​ ​should​ ​reply​ ​to​ ​such​ ​outbursts​ ​in​ ​an​ ​even 
and​ ​assertive​ ​manner​ ​(rather​ ​than​ ​escalating​ ​the​ ​communication​ ​interchange​ ​to​ ​match​ ​the 
other​ ​person’s​ ​aggressive​ ​tone).​ ​The​ ​ultimate​ ​use​ ​of​ ​the​ ​assertive​ ​tone​ ​is​ ​to​ ​present​ ​your 
views​ ​in​ ​an​ ​even,​ ​non-confrontational​ ​manner​ ​so​ ​that​ ​information​ ​and​ ​not​ ​emotion​ ​holds 
sway. 
 
 

 
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Effective​ ​communication​ ​with​ ​patients 

 
 
 

 
http://www.blurrent.com/article/18-underrated-ways-your-mom-is-active-listening- 
 
Active​ ​listening​ ​is​ ​aided​ ​by​ ​the​ ​following​ ​behaviours 
1. Encourage​ ​patient​ ​communication 
2. Paraphrasing​ ​to​ ​check/demonstrate​ ​your​ ​professional​ ​understanding 
3. Offering​ ​expertise​ ​and​ ​a​ ​willingness​ ​to​ ​be​ ​involved 
4. Leading​ ​and​ ​exploring​ ​themes​ ​to​ ​promote​ ​patient​ ​self-disclosure 
5. Being​ ​open​ ​to​ ​allow​ ​patients​ ​to​ ​introduce​ ​related​ ​[previously​ ​undisclosed]​ ​issues 
6. Remaining​ ​silent​ ​with​ ​the​ ​patient​ ​–​ ​provide​ ​opportunity/time​ ​for​ ​them​ ​to​ ​present 
their​ ​thoughts/perspectives 
7. Showing​ ​acceptance​ ​of​ ​the​ ​patients​ ​current​ ​[ill]​ ​state​ ​and​ ​their​ ​struggles/challenges 
to​ ​re-gain​ ​health 
8. Remaining​ ​non-judgmental​ ​and​ ​respecting​ ​the​ ​rights​ ​of​ ​others​ ​to​ ​have​ ​alternate 

 
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ideas/opinions 
9. Giving​ ​recognition​ ​to​ ​positive​ ​health​ ​changes 
 
Barriers​ ​to​ ​effective​ ​communication​ ​as​ ​a​ ​HCP 
1. Provide​ ​reassurance​ ​via​ ​unrealistic​ ​prognosis​ ​[outcomes] 
2. Minimizing/trivializing/ignoring​ ​patient’s​ ​feelings 
3. Approving/disapproving​ ​of​ ​the​ ​person​ ​[patient​ ​or​ ​colleague]​ ​and​ ​their 
thoughts/feelings 
4. Giving​ ​personal​ ​advice​ ​in​ ​a​ ​professional​ ​role 
5. Becoming​ ​defensive​ ​and​ ​emotional​ ​about​ ​decisions​ ​or​ ​even​ ​proposals 
6. Demanding​ ​that​ ​a​ ​patient​ ​explain​ ​or​ ​disclose​ ​something​ ​they​ ​do​ ​not​ ​wish​ ​to 
7. Making​ ​sweeping​ ​generalizations​ ​(especially​ ​involving​ ​stereotypes​ ​=​ ​eg​ ​a​ ​typical 
patient​ ​does…..] 
 

Barriers​ ​to​ ​effective​ ​communication​ ​from​ ​a​ ​patient 

As​ ​well​ ​as​ ​considering​ ​how​ ​your​ ​intended​ ​messages​ ​are​ ​interpreted​ ​by​ ​patients,​ ​there​ ​is 
also​ ​the​ ​patient’s​ ​ability​ ​to​ ​communicate​ ​with​ ​you​ ​that​ ​is​ ​worth​ ​considering.​ ​There​ ​can​ ​be​ ​a 
number​ ​of​ ​reasons​ ​why​ ​a​ ​patient​ ​may​ ​experience​ ​barriers​ ​to​ ​effective​ ​communication. 
These​ ​can​ ​include​ ​the​ ​following. 
 
1. Ineffective​ ​coping​ ​behaviour​ ​which​ ​includes: 

● Compensation​ ​–​ ​focus​ ​on​ ​one​ ​[minor,​ ​positive]​ ​aspect​ ​but​ ​not​ ​the​ ​whole​ ​problem 
● Denial​ ​–​ ​that​ ​a​ ​professional​ ​error​ ​has​ ​been​ ​made​ ​regarding​ ​a​ ​life-threatening 
diagnosis 
● Displacement​ ​–​ ​attribute​ ​problem​ ​to​ ​others​ ​or​ ​to​ ​some​ ​uncontrollable​ ​event​ ​(eg,​ ​an 
addiction) 

Rationalization​ ​–​ ​providing​ ​an​ ​incorrect​ ​explanation​ ​to​ ​justify​ ​inappropriate​ ​or 
unacceptable​ ​behaviour 
 
 
 

 
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2. ​ ​ ​Anger 
 

 
http://www.inmagazine.net/dia-de-la-madre-diez-cosas-que-tu-mama-probablemente-odia-
de-ti/ 
 
Anger​ ​-​ ​patients​ ​become​ ​angry/frustrated​ ​for​ ​many​ ​reasons​ ​and​ ​while​ ​such​ ​patient-HCP 
interchanges​ ​are​ ​not​ ​acceptable,​ ​they​ ​occur​ ​and​ ​the​ ​HCP​ ​needs​ ​to​ ​manage​ ​such​ ​situations 
in​ ​an​ ​appropriate​ ​manner.​ ​Some​ ​guidelines​ ​include: 
• Learn​ ​to​ ​recognize​ ​anger​ ​or​ ​settings​ ​that​ ​create​ ​anger/frustration 
 
• Stay​ ​calm,​ ​respectful,​ ​genuine 
 
• Be​ ​assertive​ ​–​ ​see​ ​above 
 
• Do​ ​not​ ​match​ ​the​ ​patient’s​ ​emotions​ ​by​ ​becoming​ ​aggressive/angry 
 

 
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• Calmly​ ​and​ ​firmly​ ​present​ ​health​ ​care​ ​guidelines​ ​(re​ ​clinic​ ​procedures,​ ​professional 
behaviour,​ ​or​ ​treatment​ ​protocols,​ ​etc) 
 
• Only​ ​make​ ​realistic​ ​promises/assurances​ ​and​ ​then​ ​keep​ ​them 
 
• Given​ ​angry​ ​patients​ ​time​ ​and​ ​space​ ​to​ ​calm​ ​down 
 
• Exit​ ​any​ ​situation​ ​that​ ​has​ ​the​ ​possibility​ ​of​ ​aggression​ ​and​ ​harm​ ​[while​ ​statistically 
rare,​ ​assaults​ ​on​ ​HCP​ ​do​ ​happen​ ​and​ ​you​ ​need​ ​to​ ​have​ ​safety​ ​protocols​ ​for​ ​you​ ​and​ ​clinic 
staff] 
 
3.​ ​ ​ ​Anxiety 
 

 
http://blueheronhealthnews.com/site/2012/04/16/white-coat-symptoms-proven-in-studies/ 
 
Anxiety​ ​–​ ​patients​ ​become​ ​anxious​ ​for​ ​many​ ​reasons​ ​(including​ ​white​ ​coat​ ​syndrome, 
uncertainties​ ​associated​ ​with​ ​diagnosis,​ ​treatment,​ ​prognosis,​ ​etc).​ ​The​ ​HCP​ ​needs​ ​to 
manage​ ​such​ ​situations​ ​and​ ​in​ ​an​ ​appropriate​ ​manner.​ ​Some​ ​general​ ​guidelines​ ​include: 
 
• Learn​ ​to​ ​identify​ ​the​ ​signs​ ​of​ ​excessive​ ​anxiety 
 
• Acknowledge​ ​situations​ ​[places,​ ​diagnosis,​ ​procedures,​ ​etc]​ ​that​ ​increase 

 
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uncertainties​ ​and​ ​the​ ​chances​ ​of​ ​the​ ​patient​ ​experiencing​ ​anxiety 

 
• Communicate​ ​(both​ ​verbally​ ​and​ ​non-verbally)​ ​information​ ​to​ ​decrease​ ​uncertainty 
and​ ​increase​ ​the​ ​patient’s​ ​ability​ ​to​ ​be​ ​calm​ ​and​ ​relaxed​ ​in​ ​these​ ​settings/conditions 
 
• Never​ ​minimize​ ​or​ ​trivialize​ ​patient​ ​anxiety 
 
• Make​ ​other​ ​staff​ ​members​ ​aware​ ​of​ ​the​ ​(over)​ ​anxiety​ ​in​ ​particular​ ​patients​ ​and​ ​put 
in​ ​place​ ​protocols​ ​to​ ​ensure​ ​that​ ​during​ ​their​ ​visit​ ​their​ ​level​ ​of​ ​anxiety​ ​does​ ​not​ ​escalate 
 
• If​ ​it​ ​becomes​ ​an​ ​impediment​ ​to​ ​treatment​ ​protocols,​ ​consider​ ​advising​ ​patient​ ​to 
seek​ ​anxiety​ ​management 
  

  

  

 
21 RMIT​ ​University​ ​©2017