Denyse Deslauriers BA, MA (Candidate)

Early Childhood Consultant

Ottawa Children’s Treatment Centre

February 25, 2011

AgendaIntroductions Relationships Definition of “sensitive news”Why sharing news is difficult for parents and

ECEsHow you tell makes a differenceStrategies for sharing newsWrap up and questions

Relationships

Mutual trustDialogueRespect

“The success of all types of interventions will rest on the quality of the relationships between professional providers and family members.” (Kalmanson & Seligman, 1992, p. 46)

What does a quality relationship look like?

Collaboration with families/Working together

Being sensitive and responsive to families’ needs/concerns

Self- awareness

What is “sensitive” news?Any information that causes a negative change

to a person’s expectations for their present and future (J. Olds, 2008)

Difficult for familiesCauses pain, hurt, distress

Raises emotions

Can cause a negative reaction

Difficult for ProfessionalsFear of being blamed

Lack of confidence in skill set

Fear of emotions

EthicsAs professionals, it is our ethical

responsibility to have the difficult discussion with the parent

You are the best person to have the discussion because you know the child and the parent

T _________________________E _________________________L _________________________L _________________________

Adapted from The Hanen Centre, A Module for Learning Language and Loving It, 2009

4 letters to remember when sharing news with parents

How You Tell Makes A Difference

Plan Ahead

RapportSetting

MessagePerson’s Reaction

RapportEstablish mutual trust

Emphasize positives as well as negatives

Give specific examples

Ensure consistent message among all providers involved

SettingPlan a mutually convenient time

Allow sufficient time for discussion

Ensure location is private and respectful

Eliminate distractions

MessageBe aware of purpose/goal of discussion and share that with family

Have supporting documentation available, i.e. screen/checklist

ReactionConsider how parents may react ahead of time and how you will respond

Consider cultural differences, family stresses, parent’s values and priorities, and acceptance of any problem

Parent: Concerns? What do you mean exactly?Teacher: Well we think Vanessa has a speech problem

and you really should have her assessed.Parent: A speech problem. What do you mean?Teacher: She isn’t talking like the other little children.

This is a big problem for us because we can’t just understand what she wants when she whines and cries. It may be because you give in to this behavior at home.

Parent: Whines and cries? I thought you said she was happy here. She has been here for two months now and I thought everything was fine.

Teacher: Well, Vanessa is doing OK in some areas but we have been concerned for quite a while about her speech. We wanted to give her a chance to settle in before we spoke with you.

Parent: Well, I really don’t know why Vanessa is acting like you say. At home, she is happy, and she actually uses quite a few words.

Teacher: Well, we have not heard one word at school.Parent: Well, I am not making it up. (getting irritated)

I thought her language was coming along pretty well. She has to have at least 30 words that she uses at home. Doesn’t she communicate with you here?

Teacher: Well, she does not say words. We think there is a problem and you need to have her assessed.

Parent: Assessed where? And what will the assessment tell us?

Teacher: I don’t really know where. Ask your doctor. The assessment will tell us what the problem is.

Parent: (with a frustrated ,angry tone creeping into her voice) But I don’t think there is a problem!

Reactions of parents & how you will respond

Grief : Need to empathize and support without trying to take control –” It’s difficult to hear this news about someone whom you care so much about”

Inadequacy, vulnerability, confusion: Need to empathize – “ I imagine hearing all this information could be overwhelming. I know it will take time to take this all in and decided what you want to do. There are many support systems in the community that are available when you are ready.

Anger: Need to empathize & redirect. Parents may be very angry when they hear your information, and blame you for not adequately solving their problems. Anger may be covering underlying fear- “I think it may be hard when someone tells you your child has a problem”.

Guilt: Need to educate- “ There was nothing that you did to cause these communication difficulties”.

Stage of Acceptance(Can be cyclical)

1. Denial: Parents may be very surprised and deny that there is a problem. They may attribute Joshua’s lack of interaction to the fact that he is just independent like other members of the family. You will need to educate the parents & describe further how the child’s behavior is not the same as being independent and the impact of his behavior on his learning and development ( need to educate , not dispute)

Resistance: Parents accept the problem but feel they are going to be an exception. May be a secret wish to prove the professionals wrong. Need to support parents while they explore their options.

Affirmation: Parents believe there is a problem & have confidence in their ability to deal with it. May become very involved in searching for information & linking up with different services. The problem may take over their lives , distracting them from other issues in their lives. Need to give parents time & space to work out these issues. Try to avoid power struggles.

Acceptance: Parents accept the problem & are able to place it into perspective with other issues in their lives. Feeling of “Life goes on”in the presence of this problem.- “It sounds like you are ready to move ahead to discuss some options for how best we can help Joshua”

Reflection How did you start? How did you introduce the sensitive

information? How did your recipient react? How did you respond? How did you continue to share the

information? How did you conclude?

Sharing the News Strategies1. Observe, Wait, and Listen2. Follow the Parent’s Lead

Get the parent’s perspective and respond

3. Take Turns4. Adjust Your Language5. Extend the Topic

Strive for agreement Explore possible solutions Agree on next steps

6. Scan

Observe, Wait and ListenBe comfortable and relaxed

with sharing newsFind out what parents know

and want to know (collaborative)

Watch for verbal and nonverbal cues

Deliver a warning shot

Adapted from The Hanen Centre, A Module for Learning Language and Loving It, 2009

Follow the parent’s leadBuild on what the parent says

Be caring and supportive – no blame

Use active listening – respond to words and feelings

Take turnsStart by establishing common interest/purposePause for parent’s perspective, reaction and

questionsBe curious

Agree on problem and priorities before jumping to solution

Brainstorm various options togetherEmphasize “we”, not “I” or “you”Leave final decision with parentFocus on informing, not disputing

Remember: “First seek to understand, then to be understood” – Steven Covey, 7 Habits of Highly Effective People

Adjust the way you talkKeep your opening statement brief

Give a little information at a time

Be clear, specific, and understandableDo not use jargon

Provide visual and/or written material if available and appropriate

Extend the topicInform

Clarify the issueShare your observations

ExplainE.g. reasons for your concern and child’s

behaviour

Talk about futureOutline what happens nextArrange for resources and supportsSet up follow up date

ScanCarefully observe reactions of all present for

discussion

Adapt your response to individual needs

What people value when receiving sensitive news

Comfort, care and compassion

Confident and knowledgeable explanations

Opportunity to ask questions and have concerns addressed

Follow up

It takes time…To absorb the information

To incorporate the information into what was already known

To sort through the emotions

Never assumeEverything that was said was heard

What was heard was understood

What was understood has been integrated into other knowledge

That the implications are clear and straightforward for the family

In conclusion“…people may forget what you said, people may

forget what you did, but people will never forget how you made them feel.”

Maya Angelou

Thank you!

Questions?