In this topic, we continue exploring interpersonal skills with a focus on communication. Being a good communicator is crucial for anyone working in the health and wellbeing sector, especially for those in support roles where connecting with others is a core part of your job. Having strong communication skills means you can engage with tāngata whaiora and their whānau in a way that respects and supports their cultural values and identity. This approach is key to building trust, understanding needs, and delivering person-centred care.
Equally important is the ability to communicate effectively with other health and wellbeing professionals. In your role as a support worker, you will often be part of a broader care team or a multidisciplinary team. This may include doctors, nurses, counsellors, social workers, and other specialists. Clear and respectful communication ensures that all professionals involved have the information they need to provide safe, coordinated, and high-quality care for tāngata whaiora.
Communication Process
You may already have knowledge of the communication process, but let’s take a moment to review it by watching this video clip and answering some post watching questions
Video Title: How the Communication Process Works
Watch Time: 7.34
Pre Watch Question: Āta whakarongo -listen carefully to this video for the answers to the following questions:
- What is the Sender in charge of in the communication process?
- What is the Receiver in charge of in the communication process?
Post Watch Task: Answer these reflection questions about the communication process:
- As a support worker, when communicating a message to tāngata whaiora and their whānau what verbal and nonverbal feedback might indicate that your communication has been understood
- Will the verbal and nonverbal feedback that shows your communication has been received correctly differ across various cultural groups?
Source: Alanis Business Academy: YouTube
Communication Skills
To be effective in your role, it’s essential to master key communication skills. While many of these might be familiar to you, let’s take this opportunity to refresh and expand your knowledge on each one. Challenge yourself by reflecting on each skill—considering what you already know and how you practice it—before clicking on the expand button to explore further.
Active listening is a foundational communication skill that involves fully focusing on the speaker, understanding their message, and responding thoughtfully. It goes beyond just hearing words; it includes observing nonverbal cues, asking clarifying questions, and providing feedback that shows you are engaged (listening, interested and focused).
Key Practices:
- Maintain eye contact (when culturally appropriate).
- Nod or use verbal confirmations to show you are listening.
- Paraphrase or summarise what the speaker has said to confirm understanding.
- Avoid interrupting or jumping to conclusions before the speaker has finished.
- Allow for pauses for ‘thinking time’ as the speaker formulates what they want to say
- Use facial expressions that convey attentiveness and engagement. Smiling gently and showing concern or interest can encourage the speaker to continue sharing.
- Align your facial expressions and body position with the emotions being expressed by the speaker. For example, if they are sharing a distressing story, showing empathy and concern through your expressions can help convey that you are genuinely supportive.
- Recognise that facial expressions can vary across cultures. Be mindful of how your expressions might be interpreted and adjust them to be culturally appropriate.
Summarising and Paraphrasing are communication practices that help ensure understanding, clarify any potential misunderstandings, and demonstrate active listening.
Paraphrasing is restating someone else's ideas in your own words while keeping the original meaning. Summarising is condensing the main points of a conversation or text into a brief overview.
Key Practices:
- Emphasise important details or decisions by summarising them at the end of the conversation, ensuring that everyone is on the same page.
- After a tāngata whaiora or their whānau has spoken, summarise or paraphrase what they’ve said in your own words. This helps to confirm that you have correctly understood their message.
- By summarising or paraphrasing, you can encourage tāngata whaiora and their whānau to elaborate on their thoughts or feelings, promoting a deeper and more meaningful conversation.
Questioning is a practice that involves asking thoughtful and purposeful questions to gather information, clarify understanding, and encourage deeper thinking in conversations
Key Practices:
- Ask questions that require more than a 'yes' or 'no' answer to encourage detailed responses and explore thoughts and feelings. These are called open-ended questions
- If something is unclear, ask questions to clarify or gain a better understanding of what is being said. For example, “could you tell me more about that?”
- Frame your questions in a way that shows respect and avoids making the person feel judged or pressured.
- Use questions that prompt tāngata whaiora and their whānau to reflect on their experiences, feelings, and choices.
- Ensure that your questions do not suggest a particular answer, allowing the person to respond freely and honestly.
Effective collaboration with tāngata whaiora and their whānau requires clear, respectful communication and a shared understanding of goals and responsibilities.
Key Practices:
- Build a trusting relationship by being consistent, reliable, and open in your communications.
- Involve the appropriate people in decision-making processes to ensure their voices are heard.
- Use appropriate communication channels (e.g., meetings, emails, case notes) to keep everyone informed and maintain the confidentiality of this information
- Ensure that all information is provided in a way that is easily understood by tāngata whaiora and their whānau, considering language barriers, literacy levels, and cultural contexts.
- Work and communicate together as a team
Content: The language you use to communicate with tāngata whaiora and their whānau is especially important in health and wellbeing settings, where complex information needs to be clearly understood. Language must also be respectful and inclusive
Key Practices:
- Use simple, everyday words rather than technical jargon. If specialised terms are necessary, take the time to explain them to ensure everyone understands.
- Break down complex information into manageable chunks, allowing time for everyone to fully understand each point before proceeding
- Use visual aids (e.g., diagrams, pictures) to enhance understanding.
- Be mindful and respectful of the cultural context when choosing words and phrases. Some terms may have different meanings or connotations in different cultures.
- Confirm with tāngata whaiora and their whānau how they wish to be addressed and ensure you have all pronunciations and spellings correct
- Be ready to adjust your language based on the nonverbal feedback you receive, such as signs of confusion or discomfort.
Overcoming Communication Barriers
Communication barriers can significantly impact the effectiveness of your interactions with tāngata whaiora and their whānau. Flip the cards learn more about barriers to communication and strategies for overcoming them.
H5P here
As a support worker, you will be collaborating and communicating with a multidisciplinary team of professionals to support tāngata whaiora and their whānau. Alongside your fellow support workers, members of the multidisciplinary team may include:
- Healthcare Providers: Doctors, nurses, and specialists, to discuss treatment plans, medical updates, and patient care.
- Mental Health Professionals: Including psychiatrists, psychologists, and counsellors, to collaborate on therapeutic approaches and share insights on client progress.
- Social Workers: To coordinate services, address social and environmental needs, and ensure comprehensive support for the client.
- Case Managers: To manage and track the overall care plan, monitor progress, and adjust services as needed.
- Occupational Therapists and Physiotherapists: To discuss rehabilitation goals, therapy plans, and progress updates.
- Dietitians and Nutritionists: To coordinate on dietary recommendations and nutritional support for clients.
- Addiction Specialists: To collaborate on strategies for substance use treatment and recovery.
- Peer Support Workers: To share experiences and strategies for supporting individuals with lived experience of mental health or addiction challenges.
- Administrative Staff: For scheduling, documentation, and coordination of services within the organisation.
- Other Support Providers: To meet health and wellbeing needs such as medicine management, access to funding and benefits, specialised services and support.
In this activity you will read the following 3 case studies, then use the documentation tool to identify the key communication practices demonstrated by the support worker in each situation.
Case Study
Support Worker John
John, a support worker for a home care organisation. He is documenting the daily progress of his client, Aroha, who is recovering from surgery. Aroha has made significant progress in her mobility, but she’s still experiencing some pain.
John writes the following in Aroha’s notes:
“Aroha carried out her self-care activities independently. She continues to self- administer 1g of paracetamol every 6 hours. She reports that her pain level is at a 4 out of 10, which is a slight improvement from yesterday's 5 out of 10. She states she is satisfied with her current pain management plan.
Aroha walked 20 meters today with a cane. She has completed one full set of the exercises as per her physiotherapy plan. Aroha reported she feels her mobility and ability to carry out her exercises has improved over the last 2 days. She states she is “feeling much stronger and less wobbly”.
Aroha, her husband, eldest son and I discussed her goals. Aroha feels she is making good progress towards her goals, and no adjusts to them are needed at this time.”
John completes his documentation with the date, his name, job title and signature in line with the organisations documentation policy.
Case Study
Support Worker Sam
Sam is a mental health support worker. They have been asked to provide an update to the multidisciplinary team on Moana. Moana is a resident at the Kowhai Wellness Centre, where she has been receiving support for her mental health recovery and improving her ability to perform self-care tasks independently.
Sam verbally communicates the following:
"Morena, Hi everyone, I’m Sam the mental health support worker. I’m here to provide an update on Moana’s progress in carrying out self-care.
Over the past week, Moana has shown significant improvement in her ability to perform self-care tasks independently. She’s now able to manage her morning routine, including getting dressed, preparing a simple breakfast, and taking her medication on time, without needing any prompts or assistance.
However, she still requires some support with more complex tasks, like managing her weekly medication schedule and preparing meals that require multiple steps. Moana has expressed that she’s feeling more confident overall, but she does sometimes feel overwhelmed and stressed by these more complex tasks.
To support her, I’ve been working with her on breaking down these tasks into smaller, manageable steps, and I’m encouraging her to continue using the coping strategies we’ve discussed. She noted that having these smaller steps was helpful.
I’m recommending that we maintain the current level of support, but I’m open to any suggestions or adjustments that the team may think are necessary to help Moana continue progressing."
Case Study
Support Worker Carlos
Carlos, a community health support worker, is sitting with Mei, who speaks very little English, in her living room. Mei needs to understand her new medication regimen.
Carlos: "Hi Mei, we’re going to talk about your new medicine today (points to the medicine bottle). I have this medicine information in Mandarin to help make things easier, (hands her the document) and I also brought this translation chart with Mandarin and English numbers and words to help us out. Let’s go through it together."
Mei: (nods) "Good, Okay."
Carlos: (Holding up the medication box and pointing to it) "This is your new medicine your doctor told you about. The name of it is here and here is what it is for (points to the sections in the medicine information and pauses while Mei reads)”
Mei: “yes, this one for blood pressure. I need to take it every day?”
Carlos: (smiling and nodding) “yes, that’s right, it’s for your blood pressure and you do need to take it every day. Let’s use this chart while I explain (points as he talks) You will take one tablet in the morning and one tablet at night.
Mei: (nods) “yes, okay”
Carlos: “Let’s make sure we understand each other, can you tell me when you are going to take this new medicine (points to medicine box)?”
Mei: “okay, yes. (holds up medicine), this new medicine, I take 1 tablet (holds up one finger) in the morning (points to the correct words on chart) and I take 1 tablet (holds up one finger) at night (points to the correct words on chart). Take every day, for my blood pressure”
Carlos: (watches Mei’s gestures as she talks and nods) “Perfect, that’s correct. Every day you will take 1 blood pressure tablet in the morning and 1 blood pressure tablet at night (repeats the same gestures as Mei used as he talks uses chart)
Mei: “Thank you Carlos, I understand now”
Carlos: “Well done, Do you have any questions Mei?
Mei: “No, thank you very much Carlos”
Carlos: "You’re welcome, Mei. Anytime you need to go over it again, I’m here."
H5P here
Another vital communication skill is the ability to address situations where emotions and stress have escalated, creating barriers to effective communication. Escalation happens when an individual’s emotional state intensifies, which can lead to verbal aggression or, in some cases, physical confrontation. Conversely, de-escalation involves employing strategies to diffuse a tense or hostile situation.
As a community support worker, mastering the art of de-escalation is essential. Effectively managing these situations not only protects your safety but also ensures the well-being of those you support. Recognising the signs of escalating emotions and responding with appropriate techniques can help maintain a calm, supportive environment and maintain positive.
Reflection
Think back to a situation in your life where your emotions became heightened and led to an escalated interaction with another person. This could have happened during a conversation, a disagreement, or even a challenging situation at work, home, or with friends. With that situation in mind record your thoughts on the following:
Recall the details of the situation.
- Who were you interacting with?
- What was the topic or issue being discussed?
- What was the context or environment like?
Think about what contributed to your emotions escalating in that moment.
- What were the specific triggers or stressors? (e.g., feeling unheard, facing criticism, or being in a tense environment)
- Were there external factors that contributed? (e.g., noise, interruptions, or distractions)
- Were there internal factors involved? (e.g., personal stress, fatigue, or previous unresolved conflicts)
How did you respond when your emotions heightened:
- How did you behave? (e.g., raising your voice, withdrawing, or becoming defensive)
- What did you say, and how did you say it? (e.g., using a harsh tone, interrupting, or expressing frustration)
- How did you physically react? (e.g., clenching your fists, pacing, or gesturing)
Identify and name the emotions you felt in the moment:
- How did you feel during the interaction? (e.g., angry, frustrated, anxious, or helpless)
- What physical sensations did you experience? (e.g., racing heartbeat, sweating, or feeling tense)
What was the result of this escalated interaction:
- How did your heightened emotions affect the conversation or interaction?
- What was the response of the other person?
- Did this escalation help or hinder resolving the situation?
What could have prevented this escalation of your feelings?
- Could the other person have communicated differently?
- Could they have used a more understanding or empathetic tone, different choice of words or different non-verbal language?
- Could you have responded differently?
- Could you have used a different approach in your tone or choice of words to express yourself, was there an opportunity for you to pause and collect your thoughts before responding?
Were you able to uncover some insights about what contributed to the situation? Reflecting on this helps you recognise how escalation occurs and how it can impact a person experiencing heightened emotions. Understanding these factors is key to building more effective communication skills and developing strategies for handling these moments with empathy and awareness when in the role of a support worker.
Factors that contribute to Escalation
When tāngata are in a healthcare setting, escalation can be a response to underlying distress or frustration. It can result from various factors, such as:
- Shock/Trauma: Receiving unexpected or difficult news can trigger an emotional response.
- Mental Health Issues: Conditions like depression, bipolar disorder, or schizophrenia can make managing emotions challenging.
- Cognitive Conditions: Dementia, head injuries, and other cognitive impairments can lead to confusion and frustration.
- Developmental Stage: Children or adolescents may have less emotional control, making them more prone to escalations when they feel overwhelmed, scared, or frustrated.
- Communication Barriers: When a person cannot express their needs or understand what is happening, they may feel frustrated.
- Fear, Anxiety, and Confusion: Uncertainty about their health or unfamiliarity with the healthcare setting can create feelings of fear.
- Previous negative experiences: Individuals who have experienced poor treatment, disrespectful communication, medical errors, or trauma in healthcare settings may feel distrustful or anxious in future interactions, increasing their sensitivity to feeling dismissed or mistreated and heightening the potential for defensive or aggressive responses.
- Feeling Overwhelmed: Managing multiple stressors—physical, emotional, or social—can cause individuals to reach a breaking point.
Effective communication can play a significant role in preventing or reducing tension. This involves:
- Listening carefully: Show the individual that you’re fully present and interested in their concerns.
- Providing clear information: Ensure that your instructions or explanations are easy to understand and avoid using complex medical jargon.
- Validating their emotions: Let the person know that their feelings are understood and acknowledged, even if you can’t resolve their situation immediately.
However, it’s important to remember that even with clear communication, escalation may still occur due to factors beyond your control.
How to De-escalate an Escalating Situation
In any escalating situation, safety is the top priority for everyone involved—the person showing signs of distress, the support worker, and any others present. When an individual becomes agitated or aggressive, it’s crucial to consider both physical and psychological safety.
Complete the following reading activity to discover effective de-escalation strategies.
Reading
Click HERE to download and read the article from Starship Hospital on de-escalation of agitated patients. Then answer the following questions:
- What should you do if the de-escalation strategy you are using is not effective?
- What does “emotional regulation” mean, and how can it affect a person’s interactions with others?
- If you find yourself becoming overwhelmed or upset while dealing with an escalating situation, what actions could you take?
- What does “cognitive load” refer to, and how might it contribute to a person’s increasing agitation?
To ensure safety, it is crucial to identify the early signs of escalation and potential triggers so that they can be managed effectively, reducing the risk of escalation:
- Verbal Cues: Raised voice, rapid speech, hight pitch voice, threats, or incoherent speech.
- Non-verbal Cues: Aggressive gestures, pacing, clenched fists, shaking, fidgeting, or tense body language.
- Psychological Triggers: Fear, anxiety, frustration, emotional distress, feelings of threat, being unheard, or a perceived lack of control.
If a situation begins to escalate, here is a summary of some key strategies to help bring it under control:
Your calm manner can set the tone for the interaction. Maintain steady body language and a soothing voice. Showing agitation or anxiety can escalate the situation further.
Ensure both you and the individual or group have enough space. People in distress may feel trapped, so giving them room can help reduce feelings of pressure or threat.
Keep your arms relaxed at your sides and make soft eye contact. Avoid crossing your arms, as this can appear defensive.
Saying things like “I can see that you’re upset” or “It sounds like you’re feeling frustrated” can help the person feel heard and understood. This validation can help defuse anger or frustration.
In times of escalation, people may struggle to process complex information. Keep your language simple and to the point, and ask one question or make one statement at a time.
Providing options, even small ones, can give the person a sense of control over the situation. For example, “Would you like to sit down or stay standing while we talk?”
Shift the conversation from the problem to finding solutions. Ask the individual how you can assist them or what they feel would help in the situation.
To illustrate de-escalation in action, read the following case study featuring Maria, a community health worker, as she engages with the Johnson family during a challenging visit.
Case Study
Maria and the Johnson Family
Maria, a community health worker, was visiting the Johnson family as part of her regular health support of Lily Johnson. Upon arrival, she sensed tension in the air; Mr. Johnson was pacing anxiously in the living room while Mrs. Johnson sat on the couch, visibly upset. Their young daughter, Lily, clung to her mother, sensing the unrest.
Recognising the early signs of escalation, Maria approached the situation with care. She initiated contact by greeting the family warmly and using a calm, reassuring tone. “Hello, I’m here to help. What’s been going on today?”
As Mr. Johnson began to express his frustrations about their recent health challenges, Maria practiced active listening. She nodded and maintained eye contact, allowing him to vent his feelings. “It sounds like you’re feeling really overwhelmed,” she empathised, validating his emotions. This acknowledgment helped to ease some of his agitation.
While Mr. Johnson spoke, Maria noticed Mrs. Johnson becoming increasingly anxious. To address this, she shifted her focus to her. “Mrs. Johnson, how are you feeling right now? I’m here for you too.” This gesture of inclusion helped diffuse the tension in the room.
As the conversation continued, Maria used open-ended questions to encourage communication. “What are your main concerns about Lily’s health? Let’s figure this out together.” This approach empowered the Johnsons to share their thoughts, allowing them to feel heard and in control of the situation.
When Mr. Johnson’s voice began to rise again, Maria remained calm and employed verbal de-escalation techniques. “I understand this is frustrating. Let’s take a deep breath together,” she suggested, demonstrating a calming technique that encouraged everyone to pause and regroup.
By the end of the visit, the Johnson family felt more at ease. Maria’s effective communication skills and de-escalation strategies not only helped diffuse the immediate tension but also strengthened the relationship between the family and their community health support. Through her actions, Maria demonstrated the vital role of community health workers in promoting a safe and supportive environment for families in need.
End of Topic
Tino pai! Great work! You have completed this section on communication. You now understand that effective communication with tāngata whaiora and members of the multidisciplinary team is essential for respectful interactions. You’ve also learned strategies to overcome barriers to communication, including methods for de-escalating situations.
Reflect on what you’ve learned and consider how you can apply these skills in your practice. Your ability to communicate effectively will greatly enhance your interactions and support for those you work with. Keep up the excellent work!
