59involved in the discussion and or decision-making. Keep in mind, however, that
this might not always be the case. By attending to nonverbal communication, you
should be able to ascertain when it is appropriate to either request or offer to
meet individually with the primary patient.3.3.1 Setting the Stage for Good Attending
Now that you’ve reviewed a rather lengthy list of recommended physical attending
behaviors, you may be thinking you must use every one of them. Please keep in
mind two important points. First, no one is able to control any nonverbal behavior
for more than a few minutes at a time. Eventually, we all go back to our natural
responses. Second, not all of these behaviors will feel “natural/right” for you. Don’t
try to force behaviors that simply do not work. Do try, however, to offset behaviors
on the “generally not recommended” list with other, recommended ones. For
instance, if you are a “leg crosser,” don’t try to eliminate it completely. When you
do cross your legs, try to keep your other behaviors more open (uncrossed arms,
facing patients, giving eye contact). The most important thing to communicate to
patients is that you genuinely care about them.
Finally, we suggest you arrange your physical environment whenever possible to
maximize good attending. Select a chair that does not swivel or rock, one that has
arms so you can rest your hands on them rather than clenching them in your lap, and
one that fits your body so you can rest your feet on the floor. Select your clothing to
avoid jewelry you would be tempted to play with when counseling; wear high-
necked clothing if you have an extreme blushing response on your neck; and rear-
range furniture when possible to reduce physical barriers between you and the
patients.
3.4 Additional Suggestions for Attending Effectively
In order to build rapport and convey your interest and understanding to the patient,
we recommend the following:
- Be congruent. Your body should parallel your verbal message. When your words
and nonverbal behaviors are discrepant, the patient will tend to believe your non-
verbals. For example, if you say, “I can respect your decision to terminate the
pregnancy” while you are frowning and clenching your hands together, the
patient will probably decide you disapprove of the decision. - Get in sync. Your communication will be more effective if your demeanor is in
harmony with your patient’s. Synchronicity may increase empathy, promote a
common understanding, and/or lead to similarity of views (Ramseyer and
Tschacher 2011 ). Ramseyer and Tschacher ( 2011 ) studied nonverbal synchrony
(also known as coordination of movement [Tickle-Degnen and Gavett 2003 ; and
3.4 Additional Suggestions for Attending Effectively