Skip directly to search Skip directly to A to Z list Skip directly to navigation Skip directly to site content Skip directly to page options
CDC Home

TB Contact Investigation Interviewing Skills Course

Day 1: Communication Skills for Building Rapport during Contact Investigation Interviewing (39 slides)

Text Only Version

Return to Main Menu

Slide Number

508 Compliance Text


(Title Slide). Communication Skills for Building Rapport during Contact

Investigation Interviewing


Learning Objectives

After this session, participants will be able to:

  1. Describe how to build rapport
  2. List at least six effective communication skills
  3. Describe assertive, passive, and aggressive behavior


(Title Slide). Building Rapport


Building Rapport

Building rapport is the key to a successful case/health care worker relationship

What is Rapport?


  1. relation of trust between people
  2. a feeling of sympathetic understanding
  3. in accord, harmony
  4. having a mutual understanding


How Do You Build Rapport?

Methods to build rapport

       Use  effective communication skills

       Find common ground

       Display respect and empathy

[IMAGE: Two women and a man sitting at a table talking and drinking a beverage.]


(Title Slide). Effective Communication Skills


Effective Communication Skills

  1. Active listening
  2. Using appropriate nonverbal communication
  3. Using appropriate voice and tone
  4. Communicating at the case’s level of understanding
  5. Giving factual information
  6. Using reinforcement
  7. Summarizing important points from the conversation


What is Active Listening?

       Hearing what is said and paying attention to how it is said so the conversation can be adjusted to elicit the needed response

       Utilizing various verbal and nonverbal techniques


What are Some Active Listening Techniques?

       Paraphrasing and summarizing


       Being silent


Active Listening
Paraphrasing and Summarizing (1)

What is paraphrasing and summarizing?

       Rewording or rephrasing a statement to

      Verify information

      Demonstrate engagement in the conversation


Active Listening Paraphrasing and Summarizing (2)

How do you do it?

       Use phrases such as “What I’m hearing is…” or “It sounds like you are saying…”

       Do not repeat the person’s exact words

       Avoid phrases like “I know what you mean.”


Active Listening Paraphrasing and Summarizing Example (1)

Example 1:

Case: “I am feeling very tired these days and the meds mess up my drug use. I don’t know if it’s all worth it.”

How would you paraphrase this statement?


Active Listening Paraphrasing and Summarizing Example (2)

Example 2:

Case: “I can’t tell you the names of all my contacts. I just hang out at the pool hall; there is a guy we call Slim, another one named JD. ”

How would you paraphrase this statement?


Active Listening
Reflection (1)

What is reflection?

       Putting words to a case or contact’s emotional reactions

       Acknowledging a case or contact’s feelings shows empathy and helps build rapport

       Helps to check rather than to assume you know what is meant


Active Listening
Reflection (2)

How do you do it?

       Reflect back to the case or contact what you think they have said


      It sounds like you are feeling worried…

      I understand you are having trouble with…


Active Listening
Reflection Example (1)

Example 1:

Case: “I’m feeling tired and this whole interview is making me nervous. YOU are asking me too many questions.”

How would you reflect  this statement?


Active Listening
Reflection Example (2)

Example 2:

Case: “I don’t want an HIV test. I don’t want to know if I have AIDS. If there is nothing I can do about it, what’s the point in knowing?”    

How would you reflect this statement?


Active Listening
Using Silence

How can silence indicate you are actively listening?

  • It allows the case an opportunity to answer questions


Active Listening Exercise

Refer to Appendix  I

[IMAGE: Clipart of two people talking.]


B. Using Appropriate Nonverbal Communication

Nonverbal communication

      Is an important aspect of building rapport

      Can be both what the interviewer or case conveys with his/her body language

       Interviewer should

      Display appropriate body language

      Be observant of the case’s body language


Appropriate Nonverbal Communication for Interviewer

      Eye contact

      Facial expressions

      Looking attentive


      Leaning forward


      Nodding head

      Movement and mirroring

Refer to Appendix J

[IMAGE: Clipart of various facial expressions.]


[IMAGE: Table.]

Interpreting Body Language

Nonverbal Cues

Possible Meaning

Faltering eye contact

Boredom or fatigue

Intense eye contact

Fear, confrontation, or anger


Fear or nervousness

Stiff posture

Discomfort or nervousness

Elevated voice

Confrontation or anger

Prolonged and frequent periods of silence

Disinterest, loss of train of thought, or fatigue


Discomfort, disinterest, nervousness, possible drug use


C. Using Appropriate Voice and Tone

Voice and tone

       Use natural volume and tone 

       If voice is too loud, the case may be intimidated

       If too soft, the message may be inaudible or sound hesitant


       Use regular pace

      If too fast, it can indicate a feeling of being rushed

      If too slow, it can sound tentative


D. Communicate at Case or Contact’s Level

       Avoid technical terms and jargon

       Limit the amount of information shared

      “Need to Know”  vs. “Nice to Know”

       Clearly explain necessary medical and technical terms and concepts

       Repeat important information


E. Give Factual Information

       Correct misconceptions

       Provide comprehensive TB information

       Avoid irrelevant information

[IMAGE: Two women sitting on a couch, talking.]


F. Use Reinforcement

       Sincerely compliment or acknowledge the case after hearing intentions to use, or descriptions of, healthy behaviors

       Use smiles and affirmative nods and words


  1. Summarize Conversation (1)
  • Throughout the conversation, periodically summarize what has been said
  • Summarizing gives the case an opportunity to correct information that you may have misunderstood


G. Summarize Conversation (2)

       Give the case an opportunity to summarize the conversation, for example:

      “We have covered a lot today. In your own words, review for me what we have discussed.”

      “Please tell me what you heard me say. This will help me provide you with any additional information you need.”

       Avoid phrases such as:

      “Do you have any questions?”

      “Do you understand?”


(Title Slide) Communication Pitfalls

[IMAGE: Clipart of a worried man looking down a hole.]


Communication Pitfalls to Avoid (1)

       Being defensive or distant

       Interrupting, not allowing patient to finish speaking

       Giving false assurances

       Providing personal opinion and advice


Communication Pitfalls to Avoid (2)

       Overpowering the case

      Speaking loudly

      Standing over the case

      Making condescending statements

      Asking several questions at once

       Being aggressive


Group Discussion
Barriers to Communicating

       What are some barriers to communicating with cases?

       What impact could they have on the interview?

       How can these be prevented or overcome?


Assertive, Passive, and Aggressive Behavior

[IMAGE: Clipart of two men boxing.]


Assertive, Passive, or Aggressive Definitions

       Assertive: to maintain one’s rights without compromising the rights of others

       Passive: to relinquish one’s rights in deference of others

       Aggressive: to demand one’s rights at the expense of others


Assertive, Passive, or Aggressive Examples (1)

       Passive: “When you have an opportunity, it would be helpful to get the names of people you spent time with.”

       Assertive: “It’s important to identify your contacts. Let’s start making a list of the people you spend the most time with.”

       Aggressive: “You must give me all the names of your contacts. NOW!”


Assertive, Passive, or Aggressive Examples (2)

       Passive: “That smoke really bothers me. I’ll go outside while you smoke in here.”

       Assertive: “Although you may smoke outside in the courtyard, smoking is not permitted in the building because it is a health risk to others.”

       Aggressive: “How can you be so disgusting and insensitive smoking in here. Get out of here!”


Being Assertive

       By being assertive with cases and others we are not only asserting our rights but also the rights of those not present – the contacts who may have been exposed to TB

       To be effective in this role, a belief in what you are doing is required

       Remember: You have the responsibility and obligation to elicit information that will reduce TB in your community


Assertive, Passive, or Aggressive Exercise

Refer to Appendix K

[IMAGE: Clipart of two people talking.]



  1. What are some ways to build rapport with a case?
  2. What are six effective communication skills?
  3. What is the difference between assertive, passive, and aggressive behavior?
Contact Us:
  • Centers for Disease Control and Prevention
    Division of Tuberculosis Elimination (DTBE)
    1600 Clifton Rd., NE
    MS E10
    Atlanta, GA 30333
  • 800-CDC-INFO
    TTY: (888) 232-6348
  • Contact CDC–INFO The U.S. Government's Official Web PortalDepartment of Health and Human Services
Centers for Disease Control and Prevention   1600 Clifton Road Atlanta, GA 30329-4027, USA
800-CDC-INFO (800-232-4636) TTY: (888) 232-6348 - Contact CDC–INFO
A-Z Index
  1. A
  2. B
  3. C
  4. D
  5. E
  6. F
  7. G
  8. H
  9. I
  10. J
  11. K
  12. L
  13. M
  14. N
  15. O
  16. P
  17. Q
  18. R
  19. S
  20. T
  21. U
  22. V
  23. W
  24. X
  25. Y
  26. Z
  27. #