Communication Constraints

Challenging situations can and do arise in community services and health workplaces. When they do, it is vital that you have the skills and knowledge to be able to:

• Recognise the situation.
• Plan a response.
• Take action.
• Utilise the skills of others when required.

It is far better to seek assistance in managing a situation than to attempt to resolve it on your own and then discover that you do not yet have the capacity to do so safely and effectively.

Working within community services and health involves working with people across many different types of interactions and communication exchanges. Some situations are predictable and easy to manage, while others are far less predictable and can change rapidly.

These complex situations can require intervention and guidance from more experienced workers in order to ensure safety and appropriate outcomes for everyone involved.

Here are some examples of situations which can be challenging to manage:

• Providing support to a person experiencing trauma or grief.
• Managing a critical incident.
• Dealing with threats of violence or harm.
• Dealing with verbal and physical abuse.
• Managing a complex situation involving multiple points of view.
• Providing support and guidance to a person affected by alcohol or other drugs.
• Responding to a potential situation of child abuse, harm or neglect.
• Addressing a situation where an older person is at risk of harm or in danger.

Sometimes there are early signs that indicate a situation might become more complex and challenging. It is useful to recognise these early signs, so you can respond appropriately to them.

Some early signs and their descriptions are shown in the table below:

If you observe an early sign which could indicate a situation may become more complex and challenging, you should stop and think carefully about how to respond.

Consider your organisation’s requirements for dealing with complex or challenging situations. Often there will be a policy or procedure to follow, or information in a flow chart about how to act.

You may have a more experienced colleague or supervisor close by who can offer you guidance and tips on the best way to manage a situation. Sometimes just having another person close to hand can give you the confidence to manage a situation with minimal support.

In some situations, it may be more appropriate to seek direct intervention from another person who has more skills and experience than you do.

You need to be alert to indicators of risk which can suggest that a child, young person or adult may be experiencing abuse, harm or neglect.
Some of these indicators are shown in the table below:

Your organisational procedures will determine how you respond in a situation where you observe early indicators of risk. Often you will need to seek guidance and direction from others or take  action to respond to the situation and then report it to others.

You should always follow the procedure of your organisation, and make sure you inform your supervisor or team leader if you need to manage a complex or challenging situation. Your supervisor  or team leader may need to provide additional or different support or make a change to intervene in some way.

You will often have a duty of care responsibility to clients, as well as to others in the vicinity. You should act in a way which shows you are doing your best to keep yourself and everyone around you safe from harm.

This means making decisions which promote physical and mental safety and wellbeing and avoiding doing anything which puts safety and wellbeing at risk.

Duty of care can be complex and require careful thought and planning. Sometimes your duty of care responsibility to one person might impact your responsibility to another person.

Duty of care aspects

You should consider all aspects of duty of care in your work role:

• Legal—what the law says you must do.
• Ethical—what is morally the best course of action to take.
• Organisational—what the policies, procedures and directions of your organisation require you to do.
• Professional—what the expectations are for a person holding your qualifications and position.

Duty of care can sometimes be more complex if the person is an adult rather than a child, or when it is not clear if you have a duty of care responsibility to that person.

Your duty of care may be higher if a person has a mental illness, is frail and elderly, has a cognitive or behavioural disability, is affected by substances or alcohol or if they have an acquired brain injury. In situations such as these, you may owe the person a higher duty of care because they may be less able to make sound and reasonable decisions for themselves.

It is important to remember to interact with people based on their age and to avoid treating people as though they are younger than they are, simply because you owe them a higher duty of care. Think about how you can fulfil your duty of care requirements whilst also treating the person appropriately, with dignity and respect.

Mandatory reporting is a very specific type of communication that is sometimes required in a community services or health workplace.

Mandatory reporting is a process of making a notification to the relevant authorities that you know or suspect that a child or young person has been harmed or is at risk of harm. This risk can relate to physical, emotional and sexual abuse and neglect.

There are very specific rules about mandatory reporting, and they are different across the states and territories and depending upon the work role you hold in your organisation. It is important you access the most up to date information which is relevant to your location regarding mandatory reporting.

Child Protection Legislation

Each state and territory have their own legislation which relates to child protection. These laws apply the principle of acting in the best interests of the child as the primary consideration.

This table gives you a brief summary of the legislation which may apply to your own jurisdiction:

Choosing What and How to Report

In some situations, you may need to report concerns or challenges directly to your supervisor. In other situations, you may be required to report directly to an authority such as the Department of Human Services.

This will depend on several factors:

• What your job role is.
• Whether you hold a duty of care responsibility towards the person.
• Whether you believe or know that the person has experienced harm or neglect.
• Whether you are required by law to make a report under mandatory reporting requirements.
• You should check your organisation’s policies and procedures and the legal requirements which apply in your state or territory.

A constraint is something that limits or restricts you so having a communication constraint means there is something that is restricting clear communication. There are many factors which can affect the communication you have with another person.

It is important to be able to identify as many of the factors that affect communication as possible. Once you have identified them, you will be able to take steps to resolve them using your communication and interpersonal skills.

Some of these relate to environmental factors, whilst others are specific to the person and their characteristics and experiences.

Environmental Factors

These include:

• Distractions such as outside noise, wind, rain, movement of others.
• Temperature such as being too hot or cold.
• Threats to safety such as violence, road accidents, dangerous workplace situations, risk of infection.
• Comfort and familiarity such as being in a place which is unknown, feels uncomfortable or is not culturally appropriate or relevant.

You can use your observation skills as well as your knowledge of the person with whom you are communicating to help you identify environmental factors which might affect communication.

Person Specific Factors

These include:

• Medication effects such as changes to thinking processes, impact on short term memory, reduced ability to concentrate and focus, or fatigue.
• Mental illness effects such as changed perception, disturbed thinking, hallucinations, loss of sense of reality, or post-traumatic stress.
• Triggers such as those related to previous trauma or those known to prompt a behavioural change in the person.
• Disability or condition related factors such as communication impairment, sensory loss, cognitive impairment or acquired brain injury.
• Requirements of other tasks and responsibilities such as needing to pick up a child from school, attend to caring duties or go to work or study.

You can use your knowledge of and relationship with the person, and your knowledge of factors related to their medication, condition and potential triggers to help you identify situations where communication may be affected.

Once you have identified the factors which affect communication, you can take steps to resolve them. In some cases, your response can be quite simple, while in other cases you may need to think carefully about how to respond.

Resolving environmental constraints

Many environmental constraints are relatively simple to resolve. This table shows you how:

Situations of conflict can occur in community services and health care settings. Conflict requires careful management and it is important to act appropriately so you can ensure safety for everyone involved and achieve a positive outcome for clients.

You can use your communication skills to assist you in reducing the chance that conflict occurs, defusing the situation quickly and efficiently when it does occur and finding a resolution that is acceptable and appropriate.

Before you begin to manage conflict, it is important to understand what conflict means, and what it can look and feel like for different people.

When can Conflict Occur?

Conflict can occur between individuals, amongst workers and between people in the general public. Children, adolescents and adults all experience conflict in different ways.

Conflict can have an emotional and mental impact on a person and can negatively affect their wellbeing. Some conflict situations can also involve physical effects, including the physical experience of stress and burnout and the physical impact of actual violence and harm.

How Conflict Affects Individuals

People experience conflict in different ways, depending on:

• Their age.
• Their previous experiences.
• Any disabilities or mental illness which they may have.
• Their cultural and linguistic background.
• Whether there is a power imbalance between the people.
• Whether there is a systemic or broader rights-based issue related to the experience of conflict.

Some people may find that conflict has a profound effect on their wellbeing, while others may move on quickly from a conflict situation. This does not mean that being able to move on from conflict is ‘better’ in some way; it simply means that people are different and come to a situation of conflict from many different standpoints.

Situations of conflict can sometimes be avoided with some careful planning.

Think about the situation and the person with whom you are communicating. Assess the situation and consider what factors might make conflict more likely, as well as factors which will reduce the chance of conflict. Where possible, take steps to avoid conflict by encouraging the factors which reduce the chance of it occurring and removing any which make it more likely.

You could delay a conversation until a better time, ask the person if they feel ready to discuss a situation, observe the person for signs of stress or agitation, or locate your interaction in a neutral, non-threatening place.

Sometimes it is important to work within a conflict situation in a way which keeps everyone safe and avoids the situation getting worse.

In health and community services contexts, emotions sometimes run high and people can be experiencing significant levels of stress and anxiety. Many people also experience situations which challenge them mentally and psychologically, such as homelessness, poor physical health, poverty, lack of social connection and social isolation. All these factors can make it more likely that conflict will occur.

Communication skills are fundamental to defusing a potential conflict before it escalates.

Here are the steps to consider:

1. Identify the potential for conflict to escalate.
2. Monitor your own safety and that of others around you.
3. Consider a safe option for removing yourself and others from the situation if needed.
4. Discuss options that are based on a win-win approach where there are benefits for both parties.
5. Offer the option of coming back to the discussion later.
6. Use neutral vocabulary and a calm, relaxed but confident approach.
7. Keep the amount of words to a minimum.
8. Provide clear, direct information.
9. Focus on what you would like the person to do first, then next.
10. Work towards a safe, mutually beneficial resolution.

Defusing conflict does not mean you are simply ignoring a problem and hoping it goes away. Rather it means that you are setting the scene for the conflict to be resolved at a time and in a place where everyone can approach the situation calmly and there is a greater chance of success.

Consider the characteristics of the person with whom a conflict has occurred, so that you can take these into account when planning your response. Think about factors such as age, developmental stage, medication, mental and psychological health and triggers and stressors in the environment.

Remember that the approach you use with one person may not necessarily be appropriate with another.

There are times when you need to work with the conflict situation and plan a way forward. There are a number of Conflict Resolution Approaches you can use depending on the situation.

Competing Style

This is an approach where one party pushes ahead with their own goals with no concern for the other party’s needs in the conflict.

Although this can seem counter-productive, it can be an appropriate strategy in situations where you need to quickly deal with the conflict in order to complete a time critical task or be able to move forwards.

For example, if a health care professional needed to provide emergency care to a patient and a bystander was disagreeing, it would be essential that a conflict is resolved quickly, and bystanders moved away from the location so professionals can do their work. This approach requires highly confident, assertive behaviour and clear, direct speech with specific instructions and limited words.

Accommodating Style

This is an approach where one party focuses on the needs of the other and allows the person to succeed in the conflict by conceding or giving in to their requests.

It can be thought of as a ‘win-lose’ approach, but it can also be empowering in some situations. It’s important to be wary of it providing the other person with a false sense of power and control.

Collaborating Style

This is an approach based a win-win outcome, where both people in the conflict achieve success in some way.

Collaboration requires a high level of communication and the ability to read and interpret body language effectively. It revolves around finding a common goal or looking for options which are mutually acceptable to both parties.

Clear thinking, appropriate timing for the discussion and the ability to set and understand goals and outcomes are required for this approach to succeed.

Avoiding Style

This approach to conflict resolution is where no measures are taken to resolve the conflict, instead the conflict is avoided and each party may pretend as if the conflict doesn’t exist. This is often not recommended as it has low concern for the goal of either party and low concern for the relationship with the other person.

1. What is meant by a behaviour of concern?
2. Everyone's behaviours of concern are the same. T/F
3. What is meant by a trigger and how do they relate to a behaviour of concern?
4. What are four indicators of potential neglect?
5. Summarise the four approaches to conflict resolution and the key features of each.