Think of these steps like a surgeon's checklist. You wouldn't move to the next step of surgery if the person's name was incorrect. Similarly, don't move on to the next step until the other person signals to you that they feel heard. You can tell by feeling the tension in the room decrease, your own shoulders relaxing, a softening in their face and tone of voice, and/or them saying "yes, that's right". If instead, they're saying no they feel something else, that's great! It's another listening opportunity to understand them.

• Name emotions FIRST

  • Name the emotion you observe or think they are feeling “It seems like you’re feeling x”

  • Continue empathetic listening skills until person feels understood, by saying “that’s right”, or repeats themselves less

• Ask/Assess knowledge, understanding, worries and goals

  • If they’re saying no, assess what they are really saying no to

  • If they’re really fixated on something, ask them more about it

  • Continue to ask questions until you and the person feel like you understand the story behind their concerns/behavior

• Mirror/Match

  • Summarize the person’s understanding and goals, and match person’s tone and level of complexity

• Educate

  • Tailor teaching to their emotions, goals and gaps in understanding 

  • Identify medical team’s goals and why

  • Continue to teach until the person feels like they understand your goals and their gap in understanding is met

• Strategize together toward person’s and your goals

  • Offer choices and possible solutions to person, and offer opportunity for person to make suggestions and empower person to make decision

  • Assess person’s understanding and how they feel the decision meets their goals and if they want to make any changes