Checking you’ve understood
There are four main reasons why it’s so important to check that you’re really understanding what the patient is saying:
- to make sure you’re really understanding what the patient is saying!
- to check what the patient has understood about what you’re saying
- because it demonstrates that someone is listening interestedly
- the patient may have gone round the houses so it’s important to check that you’re taking away the most important bit
Checking you’ve understood correctly what the other person is saying is a core mentalising skill, as it recognises that we often (or usually!) make assumptions about what the other person means, and we’re often wrong. Useful questions for checking understanding include:
- Please could you say a bit more about that so that I’ve understood you properly?
- I think what you’re saying is…
- When you said… did you mean that…?
- If I’ve understood you correctly….
- So it seems that you’re feeling…
- Can I just check I’ve got it right about…
A more speciﬁc way of checking and validating what the patient is saying is to reﬂect back what you think they are feeling. One of the most powerful beneﬁts patients can gain from conversations is the sense that their feelings have been recognised. The sorts of things you can say are:
- It sounds like you feel…
- You sounded really distressed when you were talking about ….
- I can see how upset/angry/anxious that makes you
- You seem particularly upset/angry/anxious about that
- Although you say it wasn’t a big deal, you sounded really upset when you talked about it.
It can also be helpful to repeat the last few words they’ve said, turning them into a question. (Rather than turning yourself into a parrot.) For example, if a patient says: ‘And then a rabbi scampered into the bushes’, you could repeat but with a questioning tone: ‘A rabbi scampered into the bushes?’ The patient will then clarify that it was a rabbit not a rabbi. (Mind you, if it was a rabbi, it would probably be an even more interesting conversation.)
Q.1 Whatphrases do you use, or might you use in future toreflectback what the patient seems to be feeling?
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