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person(s) within the context of addressing a challenging situation or realizing a
potential” (p. 180). Wong further notes that “...the instillation of courage reduces
fear, perseveration combats a desire to give up, confidence addresses low self-
efficacy, inspiration resolves a lack of motivation or creativity, and hope decreases
pessimism” (p. 184).
Encouragement can include pointing out patients’ strengths, validating their
goals and decisions, and positively reframing their statements (Wong 2015 ). For
example, your patient says, “I’m sorry to be asking so many questions.” You might
respond, “You care very much about your child and want to do what’s best for him.
Your questions are valid ones.”
10.2.1 Guidelines for Using Influencing Statements
- Establish rapport first. Patients will be more likely to listen to and be affected by
your influencing responses once they believe you know what you’re talking
about, that is, once you have demonstrated your expertise and credibility (Wong
2015 ). - Get to know the patient. You may be off base with your opinions if you deliver
them too early in the session, before you have a sense of who the patient is
(strengths, needs, challenges). Even if you are correct in your opinion, patients
may think you’re “working from a script” and/or making generic statements that
could apply to any patient. At best, they will disregard your opinion. At worst,
they will feel disrespected and angry. - Consider individual and cultural differences. “There is some preliminary evi-
dence suggesting that encouragement might be relatively more important to the
success and well-being of women, minority groups, and some non-Western cul-
tures...individuals from non-Western collectivistic cultures might define them-
selves more strongly in terms of their relationships with others...[and perhaps be]
more open to the influence of encouragement provided from significant others”
(Wong 2015 , p. 187). - Be genuine. You must be sincere. It’s important that you mean what you say and
not simply attempt “to fill the silence,” try to make patients feel better, or offer
false reassurance. For example, to a patient who has just received an abnormal
test result and is sobbing, you say, “I know it’s difficult to get this news, but I’m
sure that you will be able to handle this diagnosis.” Although well-intentioned
and likely related to a belief that you are empowering the patient, your influenc-
ing response will seem “hollow.” - Provide evidence. When you make an influencing statement, provide evidence to
support it. If you tell a couple they are going to be great parents, include the
reasons you believe that. If you tell a patient that keeping his test result a secret
from everyone may be a mistake, explain why. - Build off patient comments. A positive influencing statement may be “viewed as
more credible by the [patient] if it is based on arguments endorsed or provided
10 Providing Guidance: Advice andfiInfluencing Skills