March 2023 Susan Pellandini Activelistening MODULE OBJECTIVES After completing this chapter the student will be able to Demonstrate ways of listening that draws the individual into open communication ID: 1048243
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1. Active-listeningHydrotherapy Hub March 2023Susan Pellandini
2. Active-listeningMODULE OBJECTIVESAfter completing this chapter, the student will be able to:Demonstrate ways of listening that draws the individual into open communication.
3. Active-listeningFor a successful professional relationship, communication is key. The success of the treatment can depend upon effective communication of the practitioner in knowing how the subject is truly feeling during the treatment.For the top 500 English words used on a daily basis, multiple meanings are put to each one; therefore, one trying to decipher what is meant can be quite the challenge!We may think we are communicating effectively and simply but misunderstanding and misinterpretation occur far more than we realize.Effective communication, including listening, is the work of a life-time.
4. Active-listeningWhen relaying a message verbally, the person we are talking to often gets the first draft of what we are trying to say and that can be misunderstood – even at our best efforts of clarity.A verbal message can be accompanied by non-verbal signals that may conflict with the anticipated message.Tone of voice clashed with body language can convey dissonance.A person voicing frustration with flaring nostrils, wide eyes and raised voiced yet with a smile can convey confusion.
5. Active-listening
6. Active-listeningCommunication barriers occur at the listener’s end as well.It has been said that one can listen 4-5 times faster than people can speak.The mind can drift and daydream, make lists and plans all before a completed sentence.We all have the habit of listening with filters:Our own anxieties Attitudes Roles Our desiresPrejudicesAll of these can color what we hear or don’t hear.When both the speaker and listener have strong opinions about the message, communication error increases.
7. Factors Affecting CommunicationPower differentialUnderstanding power dynamics is important in a therapeutic relationship.There is a natural power differential in many relationships: Parent/childEmployer/employeeTeacher/studentHealth care practitioner/client or patientThe parent, teacher, employer or health care practitioner inherently have more power. By virtue of their role, these authority leaders are to care for the well-being of the other. The child, student, employee or client are in a more vulnerable position. Theoretically, the power differential exists to bring assistance to those more vulnerable. The child should feel safe to grow under the nurturing parent. The client should receive benefit from the practitioner.
8. Factors Affecting CommunicationWith the inherent power differential in the therapeutic relationship, it is implied acknowledgment that the health care practitioner (in this case, the person providing the hydrotherapy treatment) has more knowledge in hydrotherapy than the individual receiving the treatment. Furthermore, the power dynamics are amplified with the physical aspects of the treatment. In some cases, the practitioner is standing over the person receiving treatment, as in the Fomentation Treatment. The treated individual is usually partially clothed. Even though proper draping is practiced for privacy, the psychological effect of a partially clothed client with a fully clothed practitioner creates an imbalance of power. Lastly, the client’s physical safety is in the hands of the practitioner as the practitioner’s hands come into contact with the client during therapeutic aspects of the treatment.
9. Factors Affecting CommunicationWith the power differential in the therapeutic relationship, two questions arise:How is the person with more power (the one giving the hydrotherapy treatment) handling that power?How is the person with less power (the individual receiving the treatment) responding to the practitioner’s use of power?The person who holds the power could be tempted to abuse that power in multiple ways: physically, emotionally, financially, or professionally. For example: a practitioner is performing a Steam Bath on an individual who happens to be a dentist and asks, “As you are here, would you care if I asked you a question about my wisdom teeth?”In ethical practice, the person in power must consistently say “no” to what she could easily get and focus excellent care on the individual. The person performing the treatment must ethically and consciously choose to adhere to the integrity of the client’s boundaries in a setting where the client has relaxed those boundaries.
10. Factors Affecting CommunicationIndividuals in the vulnerable position feel less free to defend themselves or ask questions about the treatment they don’t understand.Individuals being treated in a hydrotherapy setting need to know that they have the power to say “no.”Individuals can feel that their questions or comments of concern can be misconstrued by the practitioner and they can feel psychologically stupid or non-important.The growing trend in health care is to invite the client or patient into the decision-making process to minimize the power differential. Educating individuals to take responsibility for their health can be a challenge in a life-time of “doctor knows best.”With best efforts made to create an atmosphere of equality, understand that at some level, the power differential will always exist in the therapeutic relationship.
11. Factors Affecting CommunicationHow to lessen the power differential:During the health history and interview process, sit eye-to-eye with the subject.Treat the individual as a person, not an object.Communicate appropriate self-disclosure. When spoken well and at the right moment, this can further trust and safety between you and the subject.Set policies and practices that protect the subject.Welcome comments or questions for clarity. You may say something like, “Let me know if you ever feel uncomfortable with any part of the treatment.”
12. Factors Affecting Communication2. Respectful boundariesTreat the subject as a person and not an object.Do within your power to make the subject at ease.Maintain a cheerful demeanor – inspire hope.If a subject feels like he/she can talk with the practitioner, then clear expression of the treatment experience is more likely to occur.Admit mistakes if need beSet policies in place (how to handle tardiness, confidentiality, no-shows, tips, etc.)
13. Factors Affecting CommunicationBoundaries define where one human being is and where the next one begins. They separate us in our individual environments. Boundaries can be subtle and distinct. They define your person and the space you occupy—the area you feel is under your control.There can be a boundary sensitivity between a health care provider and client or patient. Soon after an individual meets a provider, he is asked questions about his health that he likely has told no one else. Various areas of his body may be palpated that most people don’t touch. Health care providers are comfortable with these boundary adjustments, day after day; year after year. However, for the client or patient, these adjustments can be unusual, even stressful. At times, the client or patient struggle with discerning or communicating this anxiety.
14. Factors Affecting Communication3. EmotionsKeep boundaries with subject – you are not the psychotherapist.Ask how you can help cheer them on to health and healing.Refer to other appropriate health practitioners if necessary.Know your own emotions
15. The practitioner, not the client, has ultimate responsibility for ensuring that the therapeutic encounter works to the client’s benefit. The Ethics of TouchThe most important thing in communication is to hear what isn’t being said. Peter DruckerListening is an attitude of the heart, a genuine desire to be with another which both attracts and heals. J. Isham
16. Active-listeningReflecting back to the person what the listener heard in own words.Reflecting back to the person is a matter of the heart rather than just the head.Nonchalant, matter-of-fact tones will inhibit subject to articulate accurately what they are experiencing during the treatment.You feel ___________ about __________. (feeling word) (content)
17. The Ethics of Touch, pg. 66
18. Speak Invite ReflectSpeak: practitioner says succinctly what needs to be said in 1 minute or less.Invite: practitioner then invites response from subject. May use checking questions: What is your response?Does that sound ok?What do you think so far?Do you have any concern with this?Reflect: from time to time during the treatment as the person responds, practitioner succinctly reflects back what person described. This sequence can be practiced several times during the session.
19. Speak Invite Reflect #1Practitioner speaks: As you sit in the steam bath, I will be applying cold/wet towels to your neck and face to keep your brain cool. I will interchange them every 1-2 minutes.Practitioner invites: Is that ok with you?Subject/client responds: That sounds cold and constricting. Will I get a brain-freeze headache?Practitioner reflects: You sound apprehensive about this procedure. Practitioner speaks: As your body heats up fast, your face will feel hot, too. I will continue to check in with you and if the wet towels are too cold, I won’t change them as often. Does that sound do-able?Subject/client responds: I think I can manage that.
20. Speak Invite Reflect #2Practitioner speaks: During the fomentation treatment there will be a layer of heat on your chest for about 5 minutes. This will be followed by brisk cold friction for 30 seconds. This will alternate 3-4 cycles.Practitioner invites: Would you be comfortable with that?Subject/client responds: That sounds vulnerable. Will I be exposed?Practitioner reflects: I can understand how you would be uncertain about this procedure. Practitioner speaks: I will always have a towel replacing what is on your chest. The exchange will be quick and smooth so that you should not be exposed. Are you willing to try?Subject/client responds: I think I can manage that.
21. Speak Invite Reflect #3Practitioner speaks: During the hot foot bath, I will maintain the water temperature by adding hot water.Practitioner invites: Is that ok with you?Subject/client responds: That sounds like it would burn. I’m not sure I like that idea.Practitioner reflects: You sound uncomfortable with that idea. Practitioner speaks: As the water cools down and I add hot water, I will stir the water so that it does not burn you. “Hot” means only a few degrees above body temperature. Are you ok with that?Subject/client responds: I am willing to try if it’s therapeutic.
22. Speak Invite Reflect #4Practitioner speaks: Mr. ____, before we continue the treatment, I’d like to acknowledge the God of heaven to oversee this for you and ask for His healing blessing.Practitioner invites: Would you be open to that?Subject/client responds: Oh, I’ve not had a health practitioner pray for me before. Sure, that would be fine.Practitioner reflects: No pressure. Do you have any significant requests before I pray?Subject/client responds: I struggle with anxiety. Can you pray about that?
23. Effective communication adds to the success of the therapeutic relationship, which in turn adds to the success of the hydrotherapy treatment. People can be reticent about receiving a hydrotherapy treatment because of insufficient information, fearful expectations or the unknown. Breaking down the barriers by caring for the client and inviting the client to respond so you can provide the best treatment is opening the door for accomplishment. Using proven tactics of communication maintains healthy boundaries and provides confidence for our professional relationships.
24. Benjamin & Sohnen-Moe, The Ethics of Touch, Chapters 1, 3, Sohnen-Moe Associates, Inc., 2010White, Ellen, The Ministry of Healing, Chapter 15, 16, Pacific Press, 1905