TB Contact Investigation Interviewing Skills Course

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

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

Definition:

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

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.]

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

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

Paraphrasing and summarizing
Reflecting
Being silent

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.”

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?

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?

Reflection (1)What is reflection?Putting words to a case or contact’s emotionalreactions
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

Reflection (2)How do you do it?
Reflect back to the case or contact what you think they have said
Examples…
It sounds like you are feeling worried…
I understand you are having trouble with…

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?

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?

Using SilenceHow can silence indicate you are actively listening?

• It allows the case an opportunity to answer questions

Refer to Appendix I

[IMAGE: Clipart of two people talking.]

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

Eye contact
Facial expressions
Looking attentive
Posture
Leaning forward Gestures
Nodding head
Movement and mirroring
Refer to Appendix J

[IMAGE: Clipart of various facial expressions.]

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
Pace
Use regular pace
If too fast, it can indicate a feeling of being rushed
If too slow, it can sound tentative

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

Correct misconceptions
Provide comprehensive TB information
Avoid irrelevant information

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

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

Use smiles and affirmative nods and words

8. 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

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?”

Being defensive or distant
Interrupting, not allowing patient to finish speaking
Giving false assurances
Providing personal opinion and advice

Overpowering the case
Speaking loudly
Standing over the case
Making condescending statements
Asking several questions at once
Being aggressive

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

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!”

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!”

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

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?