Using Person-Centered Communication to Uncover Hidden Needs
Research shows that it takes a person an average of seven years between realizing they’re having difficulty hearing and taking action on their hearing loss. But even when a person takes the step of making the first appointment with a hearing care professional, they still might not be entirely motivated and ready to accept help.
So how can a hearing care professional support a client who isn’t ready to do something about their hearing loss? And what constitutes good hearing care beyond just fitting the technology?
Hearing loss can be considered as a journey and the needs and perspective of the person experiencing the hearing loss will change along the way. Understanding where a person is on that journey makes it possible to make recommendations that are appropriate for the individual – and not necessarily directly related to what the audiogram says.
The most effective way to motivate a person with hearing loss to take action is to understand what made them come to the appointment in the first place. By uncovering their needs, the hearing care professional can offer them a suitable treatment plan that can consist of anything from general information about hearing loss to communication strategies to hearing technology.
Guidelines recently published by the National Institute for Health and Care Excellence in the UK recommend using motivational interviewing as a way of engaging a person with hearing loss about their condition, as well as involving them in goal setting for the treatment. This technique can make it easier to determine where a person is on their hearing loss journey and how to personalize their treatment plan.
The Ida Motivation Tools – the Line, the Box and the Circle –provide a simple and easy-to-use framework for motivational interviewing which allows hearing professionals to assess the readiness of their clients and engage them in their own treatment.
The Motivation Tools
Ida’s Motivation Tools are a way to bring motivational interviewing into an appointment. They have the potential to unlock issues that the person with hearing loss may not have thought about sharing, or that the professional didn’t think of to ask, during the intake interview.
The Line is a quick way to assess a person’s readiness to take action as well as their confidence in using hearing technologies. The Line is based on two simple questions:
1. “On a scale of 1 to 10, how important is it for you to improve your hearing?”
2. “On a scale of 1 to 10, how confident are you in your ability to wear and use hearing technologies?”
Discussing a person’s replies and asking follow-up questions about why they placed themselves on the Line where they did (“Why are you a 7 and not a 3?” or “What would it take to bring you from a 5 to an 8?”) helps assess their motivation and fine-tune the counseling approach.
For instance, a person with low motivation is better served by information than technology. Tell them about their hearing loss and send them home with reading material.
Similarly, someone who is motivated to improve their hearing but apprehensive about using technology could benefit from support in the form of a tutorial or a family member to sit in on the appointment.
The Box is useful for resolving ambivalence. It is built around two sets of questions: What are the advantages and disadvantages of taking action? What are the advantages and disadvantages of staying as you are today? The questions help narrow down the source of ambivalence, allowing the professional to offer tailored advice, information and support.
The Box can be used in an initial appointment if the person with hearing loss seems ambivalent, or if their score on the Line falls somewhere in the middle. The Box can also be helpful when talking to people who are dissatisfied with using hearing technology. Weighing the advantages and disadvantages helps them express why they are dissatisfied with the technology, making it easier to make adjustments to improve their experience.
All people with hearing loss go through different phases on their hearing journey, from when others notice that they have difficulty hearing, to testing their hearing, to seeking advice from a professional, and ultimately purchasing and using hearing technology.
The Circle can be used by hearing care professionals as a personal reflection tool to assess where their clients are on their hearing journey and what interventions make the most sense at the time of the appointment. The Circle can also be used in the appointment to explain the different phases of the hearing journey and to illustrate a person’s progress on their path to better communication.