Thursday, June 30, 2011

Communicating & Counseling Skills

I cannot stress the importance of good communication.  Lactation Consultants must be able to effectively communicate and counsel moms, dads, couples, families, pediatricians, obstetricians, communities, neighbors, etc...We have an agenda, like so many other professionals do, and how we communicate it will often cause others to accept or reject our message.

I recently listened to the speech "Love Wins" at the CAPPA Conference and agree with the philosophy in all areas of life...raising children, maintaining a good marriage, sharing faith, promoting lactation...  My husband always says, "the one who gets angry loses--the argument and their reputation."  There is never a good reason to use fear or intimidation to manipulate individuals or convince them to breastfeed.  We must apply the "Love Wins" principle when giving breastfeeding advice.  Put yourself in the mom's shoes.  Often postpartum moms are exhausted, confused, sad, weepy, in pain and lonely.  Be compassionate.  Be gentle.  Be reassuring.  Be comforting.  Be kind.  Behave!  I have heard statements made by LC's that make me cringe.  Of course these statements come from LC's that also have terrible bed-side manners.  Let's decide now to improve the reputation of the profession by always being gracious.  Remember, "people to not care how much you know until they know how much you care."

Besides being kind and using common sense, there are some effective tools to use in communication.  I want to share the 3 Step Counseling Model because it is easy to remember and it works!
Climbing the steps to communication success
Three Steps to Communication Success: 

  1. Ask OPEN-ENDED Questions (I don't necessarily like the connotation of the word, but because it rhymes with the other two steps, I remember this step by associating it with the word "interrogate").

Open-ended questions are questions that cannot be easily answered with a "yes" or "no" or other one-word answers.  My favorite open-ended question is "How do you feel about breastfeeding?"  That can really open communication up and help get to the root of the problem.  Remember, our goal is to meet the mother's needs and this is one way to pinpoint what direction you will need to go with your counseling.

While asking open-ended questions, help the dialogue by using the following four probing methods to confirm understanding:

1. Extending
Get the rest of the story; example: “Can you tell me a little more about how you feel about what your mother said?”
2. Clarifying
Make sure you understand what the client means; example: “When you say that breastfeeding may be embarrassing, are you saying you may be embarrassed, or those around you?"
3. Reflecting
Let the patient know you have heard what she has said; example: “So, you think your mother would disapprove?"
4. Re-directing

Move the patient to explore a different related subject; example: “Besides milk supply, what other concerns do you have about breastfeeding?”
Now that communication is flowing...remember to constantly use the second step

This step encourages mom to continue opening up to says, "you are not alone in your feelings." Get used to (genuinely) sharing that "a lot of moms feel the same way" or "I have heard several moms say this exact thing."  another way to validate is to share personal experience by stating, "I thought that very thing not too long ago..."  This step will become more comfortable with practice.  It is probably the most forgotten step, and the most necessary...never go on to the third step without first camping on this one!  A mom may confide that she doesn't feel like she is making enough milk for her child, and our first response may be to educate (the third and final step).  We may want to dive right in with "if baby is getting enough wet diapers..." if baby is gaining looks health...etc.  By jumping right to educating, the mom is made to feel insignificant and shouts the message that her feelings are NOT valid.  It will kill a conversation and close doors to further counseling.  Take time to validate.
Okay, the step we are all so very good at...the last step in the sequence...
     3. EDUCATE

Here is where we get the opportunity to answer specific questions.  It is not the time to share everything we know about the topic.  We are not trying to overload the mom, but rather simplify her life by giving her specific advice.  Share in a loving-compassionate way the correct, accurate answer.  Once we have identified the real problem and have isolated the concern, we may address it and help the client get over this hurdle.  Also, a relationship has been established and the next time a problem arises, it will be much easier to get to the root of things since the client will feel comfortable sharing with you.  The client will know you really listened and she will feel like a person worthy of your time.  It is amazing the results that can come from being a good listener and by asking the right questions.  Counseling from the heart reaches the heart of the matter.

We also have to keep in mind when talking to adults to use methods that appeal to the adult learner.  The history and principles of teaching adult learners can be found on the web.  I have included a few to peruse at your convenience.

Communication is as much of our job as assessment and intervention; in fact, we may never get to the other aspects of our profession without proper communication.  This may not be a large portion of the IBCLC Exam, but it is a large portion of your vocation.  Practice.  Smile.  Be inviting in your personality.  Love others.  Be yourself. 

Looking forward to hearing about your successes,
Christy Jo Hendricks, IBCLC, Doula

For counseling the grieving mother, please be aware of local resources for your families
As you locate excellent resources, please advise so I can add them to my website under "resources"

1 comment:

  1. Very, very important information here, Christy. Excellent article. Thank you!!