How can you encourage patients to share their feelings with you?

In our world of healthcare, we’re not just dealing with patients; we’re connecting with people. Each person has feelings, fears, and hopes. It’s our job to truly hear them. We need to listen—really listen. Let’s ditch the medical jargon and talk like real people. Let’s acknowledge the emotions they’re going through and offer our support, both medically and emotionally. We’re in this together. When we truly connect, we can provide the kind of care that touches the heart, not just the body.

Show them you care for them. Deep listening, have patience. Don't judge. Make them feel comfortable. This helped me a lot in my clinical practice.

Not only does it show you care, it shows you’re actually competent. A single, well directed open ended question asked without presumption or prejudice can make all the difference.

Creating a safe space is key to encouraging patients to share their feelings. However, something very important to note is that we shouldn't be pressuring patients to open up. A common misconception in the field of psychology is that if a patient "opens up" or even "finds the cause" of an issue, that they will somehow feel better or be able to overcome challenges more promptly. This is not always the case. Our brain does an incredible job of protecting us from details that we may not need to recall. If we want a patient to open up, let's avoid pressuring them to speak while giving them an opportunity to do so when they are ready. Letting the patient know you are ready to listen when they are ready to speak can be all it takes.

Sit down, look comfortable, make eye contact and smile. (I learned this with kids.) "What's on your mind?" Just listen. Let them finish. "What else?" Listen. "How would you rather feel about that?" Listen "What can you do about that?" Listen "How can I help with that?" Listen Listen, just listen.

At med-school we were taught to ask about ICE - Ideas, Concerns and Expectations. When patients talk about their symptoms they often won’t say that they are concerned it’s cancer or don’t mention that they were expecting to get a scan. Without asking about ICE, clinicians could fail to address their patients’ main worries. It is useful to ask similar questions after proposing a treatment plan. Which shows respect for patients’ opinions and is an opportunity to identify barriers to engagement.

As part of the staff in the radiotherapy department, I always greet the patients and introduce myself, saying I’m not a Physician, but I will take care of you too. I have created your treatment plan; you can ask me whatever involves that, but not clinical aspects because I’m not a doctor. Since these patients typically go more than three fractions to the Department), If the patient wants to share, I listen hard and try to talk with the patient about whatever they are interested in communicating with me. I’ll do my best to hear them and say I appreciate you sharing this. This disease is brutal; I admire your strength and determination to continue. Ultimately, you will become a different person, more aware of valuable things in life.

Connection and genuine interest is absolutely necessary in case management. Acknowledgement and validation around hardships and struggles and celebration over victories, no matter how small help to build relationships. Some of my favorites phrases are, "That is really interesting, can you tell me more" and "Wow, that sounds extremely difficult. You are so strong." These aren't generic statements, I am truly interested in their lives and what they are experiencing because it is important to look at people holistically. Someone who is in survival, will not be able to focus their attention on something that may happen in the future. Empathy, compassion, and genuine interest is felt and helps to improve relationships which is foundational.

Creating a safe and comfortable environment takes time. In my experience, the worst thing you can do is push the issue. Psychological safety is necessary for people to express what is makes them feel most vulnerable. Over time, with authentic connection you will create an environment where patients will share more openly, the amount shared will increase as trust and safety are established. This takes time and consistency. I empower my patients to only share what they are comfortable with and know that my therapeutic practices will allow them to feel seen and safe, and at that time they will share more. Patient-centered care allows the patient to dictate the pace.

Creating a safe space is paramount to the development of a therapeutic relationship & ways to unveil information in a client interaction. My go-to is reminding clients they have autonomy over their care & I am a guide for them to get to the end that they desire. Clients feel confident and supported when they know they are in control & can trust their provider to provide expertise in the areas they are seeking support.

Ask open ended questions that require them to answer more than a yes or no Frequently check on them on how they’re feeling, my therapist is very good at doing this Don’t judge, assume or label Share your own experiences to help them open up and find a common ground

Building rapport through kindness and understanding is very helpful. People can sense when someone is not sincere from a mile away.

Consider asking the patient how they are feeling and if there is anything they are concerned about that you can help with. Let the patient know you are there to help them and want to help them as much as possible in compliance with healthcare and privacy protocols and organizational guidelines. It is essential to develop and establish trust between the case manager and the patient and rapport with the client. The working relationship between a case manager and the patient is dynamic, so remember to be consistent in how you interact with the patient after the initial rapport is established. Be attentive, kind, compassionate, present, and professional. Be a safe and soft place for patients to land their fears and concerns.

In my current line of work, I can facilitate and evaluate many clinician and member/patient interactions. The most significant success I have seen is when the clinician normalizes the member's experience. In my latest coaching session, an experienced case manager met a member reluctant to share his feelings after a recent loss. She reassured him, "It's okay not to talk yet. Your feelings are valid, and your journey is unique." The case manager respected his boundaries, and as trust grew, the member opened up, finding solace in journaling. Their therapeutic relationship blossomed, highlighting the power of patience and empathy.

What's important to note here is that follow-through isn't merely about meeting obligations. It’s also about being adaptive and responsive to emerging needs and barriers, always aiming to improve or optimise care. There's a dynamic quality to it; it’s not a “set and forget” approach but a commitment to ongoing, active engagement.

One thing I've found helpful is that consistency is the key. If we provide a referral, we are to be consistent and to follow up. Also, we are to review that resource before providing it to confirm they are still in business. Sometimes we believe we are enabling when we follow up for our clients instead of teaching them to follow up, but first we need to role model, teach them, then give them the opportunity to do it for themselves! LFM

In healthcare, the commitment to patient care reflects the core principles of the National Committee for Quality Assurance (NCQA). Patient-Centered Care: The approach prioritizes patients' emotions and progress, ensuring their unique needs are respected. Effective Communication: Regular communication fosters trust and understanding between patients and providers. Care Coordination: Prompt action in arranging referrals and ensuring access to resources streamlines healthcare and enhances the patient experience. Quality Improvement: Commitment to ongoing support demonstrates a commitment to continuous quality improvement. Patient Engagement: Encouraging patients to share their feelings actively engages them in their care decisions.

Be authentic. I find that when you are yourself and comfortable with who you are, clients are more likely to share. If I don’t know something, I ask questions and allow them to teach me.

Start where your client is comfortable. Some people dive right into their concerns, others are slower to warm up. They might prefer to focus on skills and psychoeducation. I let clients know they are in the driver's seat, we go where they want. This is especially helpful with teens. Ensure you are validating and not too quick to go into problem solving. And with some clients an appropriate level of self disclosure can help build rapport and trust (used cautiously).

I would also include normalizing the patient experience to add to the responses. No one is perfect; hiccups and mishaps happen. It's okay for people to feel what they are feeling.