Navigating Sensitive Conversations

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 In Tip of the Month
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As health professionals, from time to time we have conversations with patients, families or coworkers that are sensitive in nature. Not all sensitive conversations are about breaking bad news, which is well covered in the Serious Illness Conversation Guides and education.  These sensitive conversations are about differences of opinion, addressing conflict and tension, or other situations in which you anticipate a negative or conflictual response from others.  In preparation for the conversation, there are several things to consider.

Sensitive conversations can present challenges, but it is how we handle ourselves and respond to others that can make the difference on the outcome of the conversations.

Always remember to:

  • Create a safe, confidential environment to have the conversation.
  • Assess for readiness to have the conversation
  • Don’t forget your trauma-informed lens
  • Demonstrate active listening skills and appropriate use of silence

The key is to shift your thinking…

  • From: I need to explain myself (or deliver a message)
  • To: I need to listen and learn more about what’s going on.

The listening is really the critical part.1

Five Steps for Tackling Sensitive Conversations

1.Prepare by walking through the “three conversations in one” ahead of time1

  • The “What Happened?” conversation: How do you see the situation? Where does your story come from (information,
    past experiences, policy)? What do you think you know about the other person’s viewpoint? What might their intentions
    have been? What may you have contributed to the issue?
  • The “Feelings” conversation: Explore and be aware of your feelings and possible triggers before initiating a conversation
    and be prepared to moderate these feelings if they arise during conversation.
  • The “Identity” conversation: How does this situation threaten you or have the potential to shake your sense of identity?
    What do you need to accept about yourself or the situation to be better grounded?

As a health professional, it is important to understand how everyone in the conversation is thinking and feeling, but not saying to each other.1

2.Check your purpose and decide whether to raise the issue at all1

  • Will it help you achieve the purpose of the conversation?1
  • If you don’t raise it, can you let go of it?1

3.Start from the “third story”1

If you do decide to raise a serious issue, do not lead in with your view or story.1

  • Approach it as a neutral person who is looking on and leading the conversation.1
  • Describe the problem as the difference between your stories.1
  • Include both viewpoints as a legitimate part of the discussion.1
  • Share your purpose, and let the other person know you’re looking to sort out the situation together.1

4. Explore their story and yours1

  • Actively listen to understand the other person’s perspective on what happened.1
  • Acknowledge the feelings behind the arguments and accusations.1
  • Paraphrase to confirm your understanding of how they feel.1
  • Reframe assumptions and clear up any misconceptions.1

5.Problem-solve1.

  • Create options that meet the other side’s most important concerns and interests.1
  • Talk about how to keep communication open as you go forward.1

Resources

  1. Center for Creative Leadership (CCL). 5 steps for tackling difficult conversations. Available from: https://www.ccl.org/articles/leading-effectively-articles/5-steps-for-tackling-tough-conversations/

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