295by the [patient]” (Wong 2015 , p. 193). For instance, “Your reasons to have test-
ing make a lot of sense.”10.2.2 Reasons to Use Influencing Responses
- To persuade patients to accept your advice. One common way to use influence is
when your offer advice to patients. In essence, you are attempting to “sell” your
recommendation. For instance, you might say, “Here is the contact information
for the local Alzheimer’s support group. You might want to try attending a ses-
sion.” Then follow your advice with an influencing response: “This group can be
very helpful for providing ongoing support to you and your family members.”
In one of Kao’s ( 2010 ) scenarios, a patient talks about going through the process
of genetic assessment for familial breast/ovarian cancer risk and expresses con-
cern about the lengthy process. Some genetic counselors provided advice cou-
pled with an influencing response. For example, “... Perhaps we can sit down
and sort out pro’s and con’s to having surgery and give you something to think
about while the testing is being performed [advice – counselor’s professional
recommendation]. That way hopefully by the time your results have come back
you will have thought everything through and can make a well-informed deci-
sion [influence-counselor’s opinion about why the advice is important] (p. 53)”;
and “We can discuss all of your options for your future healthcare now [advice-
counselor’s professional recommendation] - so that as soon as the results return
we can begin to implement which ever option you choose [influence- counselor’s
opinion about why the advice is important]” (p. 53). - To instill hope. Wong ( 2015 ) suggests influencing strategies for instilling hope.
The strategies include telling stories of how others have successfully coped with
similar problems, asking questions about the patient’s strengths (e.g., “I know
that you have faced some difficult health issues in the past. What helped you
then?”), and complimenting patients about their past actions and to explore their
strengths (e.g., Imagine a couple who have just learned their second child is
affected with PKU. They already have a child with PKU. The couple says they
are overwhelmed and in despair. You say, “You’ve managed to take such good
care of your other child and to remain positive. How have you done that?” - To guide patients away from ineffective attitudes or behaviors. Influencing
responses can help to shape patients’ behaviors during the session (e.g., to a
patient who seems stuck on the details of the risk figures rather than on the
decisions that need to be made, “I think you’re focusing on the numbers, rather
than on the possible impact a positive or negative test result will have for your
health”). They can also help to shape how patients are thinking about their situa-
tion and the information you have provided (e.g., “Talking through the reasons
you would and would not have testing can help you come to a decision.”). In the
cancer scenario described in Kao ( 2010 ), some counselors provided a “reality
check.” For example: “... I think that...you’re thinking several steps ahead of
10.2 Influencing Responses