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Surrey County Council offer a range of generic and bespoke MECC training courses

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MECC is an approach to behaviour change that uses interactions that organisations and individuals have with other people to support positive changes

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How To Listen Better: 5 Essential Phrases for Reflective Listening — How Communication Works

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Listening is a skill, but many of us do it poorly. If we can learn to do it better, it can produce dramatic improvements in our lives. I am going to teach you five stock phrases I use when I do reflective listening, active listening, or looping back. It goes by a bunch of different names, but it

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It's Not About the Nail - Righting Reflex

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It's Not About the Nail - Righting Reflex

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You don’t have permission to access this resource.

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This programme is in partnership with...

About the Making Every Contact Count programme

Aims and ambitions

Make Every Contact Count (MECC) enables the delivery of consistent and concise health and wellbeing information and encourages individuals to engage in conversations about their health at scale across organisations and populations.

The fundamental idea underpinning the MECC approach is simple. It recognises that staff across health and care, local authority and voluntary sectors have thousands of contacts every day with individuals and are ideally placed to support health and wellbeing.

MECC is intended for anyone who has contact with people to "Make Every Contact Count" and develop public health knowledge.

How learners will benefit from doing this course

The MECC elearning programme is designed to support learners in developing an understanding of public health and the factors that impact on a person's health and wellbeing. It focuses on how asking questions and listening effectively to people is a vital role for us all.

A MECC interaction takes a matter of minutes and is not intended to add to existing busy workloads, rather it is structured to fit into and complement existing engagement approaches.

Who it's aimed at?

MECC is for everyone, it is not restricted to one person, profession or organisation.

For organisations, MECC means providing staff with the leadership, environment, training and information they need to deliver the MECC approach.
For staff, MECC means having the competence and confidence to deliver health and wellbeing messages, to help encourage people to change their behaviour and to direct them to local services that can support them.
For individuals, MECC means seeking support and taking action to improve their own health and wellbeing.

More information

If you do not require a certificate, the Making Every Contact Count programme is freely available to access without having to register by clicking on the images below.

IMPORTANT: If you require evidence of learning, please register and then log in to access this programme on the elfh Hub. More information can be found on how to do this below

Gain CPD points and continue your personalised care learning experience.

This programme forms part of the Personalised Care Institute's library of personalised care training for all healthcare professions. If you would like to obtain a certificate and CPD points for your ongoing CPD records, and learn a lot more about personalised care, then please visit the Personalised Care Institute website to register and access.

Special thanks

Special thank you to the Project Reference Group who provided their expertise and guidance in the development of this eLearning.

Project Reference Group Members:

Phil Godfrey, Public Health Development Manager & MECC Programme Lead, HEE Wessex

Em Rahman, Head of Public Health Workforce Development, HEE Wessex

Lara Hogan, Programme Lead, Academy of Public Health

Sally James, Public Health Workforce Specialist, HEE West Midlands

Sarah Hassell, Workforce development manager, PHE East Midlands

Chris Sharpe, Workforce Development Manager, PHE Yorkshire and the Humber

Alison Farrar, Public Health workforce manager, HEE North West

Branwen Thomas, Workforce Programme Lead, PHE South East & HEE Thames Valley

Joanne McEwan, Public Health Development Manager, HEE Thames Valley

Deb Lear, Head of Public Health workforce development, HEE South West

Joanne Keeling, Workforce Development Manager, PHE South East

Lancashire Care Foundation Trust would like to thank staff from the New Economics Foundation for their contributions and support in developing the Five Ways to Wellbeing session.

How to access

Available to all

The Making Every Contact Countprogramme is freely available to access here.
Please note your progress and completion of sessions will not be recorded and you will not be able to generate a record of completion. If you require evidence of learning, please register and then log in to access this programme on the elfh Hub.

If you already have an account with elfh, then you can enrol on to the Making Every Contact Countprogramme by logging in to the elfh Hub, selecting My Account > Enrolment and selecting the programme. You can then access the programme immediately in the My elearning section.
Access guidance > Register >
To view the Making Every Contact Count programme, select the View button below. If you already have an account with elfh, you will also be able to login and enrol on the programme from the View button.
View >
Not an NHS organisation?

If you are not an NHS health or care organisation and therefore do not qualify for free access elfh Hub, you may be able to access the service by creating an OpenAthens account.

To check whether or not you qualify for free access via OpenAthens, you can view the eligibility criteria and register on the ' OpenAthens ' portal.

Registering large numbers of users

If you are a HR, IT or Practice Manager and would like to register and enrol large numbers of staff within your organisation for access onto the Making Every Contact Count programme, please contact elfh directly.

Organisations wishing to use their own LMS

For HR departments wanting to know more about gaining access to courses using an existing Learning Management System please contact elfh directly to express interest.

More information

Please select the following link for more information on how to use the elfh Hub.

elfh is a NHS England programme in partnership with the NHS and professional bodies

© elearning for healthcare 2023

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Making Every Contact Count - elearning for healthcare

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This programme is in partnership with... Aims and ambitions Make Every Contact Count (MECC) enables the delivery of consistent and concise health and wellbeing information and encourages individuals to engage in conversations about their health at scale across organisations and populations. The fundamental idea underpinning the MECC approach is simple.

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Example MECC conversation - smoking

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Example MECC conversation - weight management

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Making Every Contact Count – Weight Management

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Example MECC conversation - alcohol

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Example MECC conversation - link worker

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Making Every Contact Count - Link worker

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If you use assistive technology (such as a screen reader) and need a version of this document in a more accessible format, please email publications@phe.gov.uk. Please tell us what format you need. It will help us if you say what assistive technology you use.

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Making Every Contact Count (MECC): practical resources

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If you use assistive technology (such as a screen reader) and need a version of this document in a more accessible format, please email publications@phe.gov.uk. Please tell us what format you need. It will help us if you say what assistive technology you use.

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MECC Link - Simple Signposting to Better Health and Wellbeing

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MECC Link - Simple signposting to better health and wellbeing

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MECC Link is a simple but flexible online tool that has been carefully designed to support an approach to positive behaviour change called 'Making Every Contact Count' (MECC). MECC Link helps you to raise awareness, motivate and signpost people to help them to improve their health and wellbeing.

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Health Equity in England: The Marmot Review 10 Years On

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This report by the Institute of Health Equity and commissioned by the Health Foundation explores widening health inequalities over the past decade and proposes recommendations for action.

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Understanding the drivers of healthy life expectancy: report

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Key points of the report are: healthy life expectancy (HLE) can be defined as 'a measure of the average number of years a person would expect to live in good health based on contemporary mortality rates and prevalence of self-reported good health' improving HLE remains a priority across government.

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Change Talk and Sustain Talk | Psychwire

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William Miller on the therapist’s active role in evoking change talk.…

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Clients tell us where they are in the process of change. In Tip #69 we looked at change talk, the specific client language we hear when a client is moving toward change. We support the change process by reflecting change talk and by skillfully eliciting more. Just as change talk can be usefully categorized, its opposite, sustain talk, can, too.

For example:

Desire: "I don't want to eat vegetables."

Ability: "I can't walk more."

Reasons: "Eating this won't help with my constipation."

Need: "I don't need to lose weight."

Commitment: "I'm not going to keep this food record."

Taking Steps: "I haven't done any exercise."

Feeling powerless means
you are focused on
something you can't control.

Drawing on my fine command
of the English language,
I said nothing.
Robert Benchley

When we encounter change talk, we reflect it in order to accentuate it. The best response to sustain talk is silence. An exception is when you are hearing only sustain talk. A brief reflection of sustain talk signals to the client that you are listening and accept what is true for him. This serves the important process of engagement. For example, you may notice you are arguing with the client. All the statements you hear are pointing to not changing. Very briefly reflecting some of what you hear can end the argument and regain rapport. Then switch to open-ended questions (Tip #60) that will elicit change talk.

Of course, it's wise to avoid anything that will evoke sustain talk. Examples: "Why don't you eat fruit?" "Could you walk after work?" "Why didn't you write in your food record?" "Why don't you want to lose weight?" This style of wording can be tricky to avoid. We ask these questions in an effort to move the change process along. Unfortunately, they are more likely to elicit sustain talk and stall the flow toward change. Review the questions that elicit change talk in Tip #69.

When using summaries to begin a transition or to end a session (Tip #72), mention just a bit of sustain talk and as carefully as possible include all the change talk you heard. Strike a balance between ignoring the sustain talk and acknowledging it. This may mean using minimizing language. For example: "You don't particularly like vegetables." "You haven't yet begun to exercise." "You are unsure about whether eating more fiber will help your constipation."

For those who use the decisional balance concept to work with ambivalence to change, it is common to explore each of the four squares. (Pros and cons of changing, pros and cons of staying the same.) This way of looking at decision-making is very useful when it does not matter what the person chooses to do. For example, choosing which type of equally beneficial exercise the client will pursue. However, for a food behavior change such as eating more fruits and veggies, there is an assumed "right" choice. The client came to you with a goal and this change is tied to that goal. In these discussions, it is counterproductive to deliberately evoke sustain talk.

A final note: Resistance and sustain talk are not exactly the same thing. Sustain talk is about the behavior, and resistance is about the relationship between you and the client. For example, take the statement "I won't drink skim milk and you can't make me." The first part is sustain talk. The second part is resistance. Understanding this distinction may help you decide which way to go when you encounter negative statements. If you are hearing resistance, roll with it. "Indeed, I can't make you do anything. It is your choice." In response to sustain talk, it will be more effective to ask questions likely to elicit change talk. "Tell me more about benefits you would get from eating lower fat foods."

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Clients tell us where they are in the process of change. In Tip #69 we looked at change talk, the specific client language we hear when a client is moving toward change. We support the change process by reflecting change talk and by skillfully eliciting more.

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In my last blog, I have briefly introduced the Drama Triangle and the three roles in it. If the triangular setting is healthy and serves all players' interests, there might be no reason to change it. Temporary discomfort may help people to achieve better results sometimes. However, if the triangular relationship becomes detrimental for those involved, and result in long-term conflicts, low performance, and resentments, it is probably the time to escape the triangle.

One way to identify the point to escape the Drama Triangle is by probing the imbalance between players' intentions as well as in the relationship. The players should take some distance and potentially exit the triangular setting if they are dissatisfied with the situation. Constructive changes help all people to refocus on the matter and the positive sides of things. It does not matter which player initiate the change first. All the three players are so closely bound together, change in one will automatically provoke a change in the relationship dynamics and the others.

So how can we escape the Drama Triangle constructively? Here are a few steps we can consider.

Create Self-awareness

The first step to escape the Drama Triangle is to understand what it entails, be aware of the role you are playing in a particular circumstance, and be watchful not to take one of the three roles.

You can ask yourself a few powerful questions to improve your self-awareness. Questions such as: What role you are playing in the Drama Triangle? How long you have been playing that role? How is it serving you? Is this role where you'd like to be? If not, what can you do to change it? What are the actions you need to take to escape it?

By becoming self-aware of your stance in the Drama Triangle, you will become mindful and avoid taking any role in it. You will not be the passive Victims who'd be dependent on others to provide solutions, or the Rescuers who'd jump in other people's issues uninvited, or the Persecutors who'd criticize others without being helpful to tackle the underlying problem.

Change and Get Help to Change

The next step after creating awareness is to take action and implement desired changes. Note that making and sustaining change can be challenging, as you are moving out from your 'comfort zone'.

It's suggested that people can form groups and obtain support from each other who are facing the same type of challenges. It's helpful to be part of a bigger group, where you can relate to and build rapport and trust with the people. Be part of a group helps you to realize you're not alone, and that you can offer and receive support, encouragement, and innovative ideas to and from others.

An alternative is to get yourself a coach, who can help you to gain clarity on your goals, empower you to plan actions, implement and anchor the desired changes. This is also discussed later in the Empowerment Triangle.

Use Non-Violent Communication (NVC)

In my last blog article, I have used a fictitious conversation at the workplace to demonstrate the Drama Triangle in motion. One simple way to escape the Drama Triangle in motion is to use non-violent communication (NVC).

The NVC allows people to communicate with honesty and empathy, instead of implying wrongness on each other. It enables people to share their observations harmoniously, offers a great opportunity for them to exchange feelings and establish deep connections, helps them to understand the needs and requests from other parties, and set the tone for a win-win solution.

As a result, all parties are more compassionate and less defensive, conflicts are less likely to occur, and people are more likely to take responsibility and work collaboratively to achieve a common goal.

Adopt the Empowerment Triangle

Womeldorff created a new triangle in The Empowerment Dynamic (TED), in which he has pivoted the Drama Triangle into a set of relationships or roles that are more passionate and empowering, and can lead to a positive approach to life's challenges.

TED shifts the roles from the Victim, Rescuer, Persecutor to the Creator, Coach, and Challenger. It helps us to change mindsets, work towards the desired outcomes, and generate greater awareness and more options.

In the Empowerment Triangle:

Victims change to Creators, who focus on outcomes, rather than problems. Creators get clarity over the outcomes they are trying to create in lives, and take responsibility for initiating actions to achieve those desired outcomes.

Rescuers take on the role of Coaches, who are compassionate and believe in Creators. They empower Creators by helping them develop goals and action plan through inquiry. Coaches encourage challenge and support individuals to create their own solutions, instead of solving the problem on their behalves.

Persecutors adopt the role of Challengers, who challenge assumptions and status quo and focus on growth and development. They hold Creators accountable for taking actions and making progress, they lift people up instead of criticizing or blaming.

It is important to realise that shifting from the Drama Triangle roles to the Empowerment Triangle roles require a huge amount of creativity, courage and effort, especially for someone who has assumed themselves in a particular role for long. TED promotes a mindset change, and an empowered and resourceful way of thinking, which see obstacles as challenges and increases our ability to improve options and desired outcomes.

I hope you found this article helpful. Please share your thoughts in the comment section below.

Learn more about self-awareness, emotional intelligence, creating psychological safety, asking powerful questions, and professional coaching skills in our ICAgile Certified Professional Agile Coaching online course ICAgile Certified Agile Coaching online course.

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In my last blog, I have briefly introduced the Drama Triangle and the three roles in it. If the triangular setting is healthy and serves all players' interests, there might be no reason to change it. Temporary discomfort may help people to achieve better results sometimes.

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In observing human transactions, Dr Berne identified three ego states, or roles, that everyone has: the Child, the Parent, and the Adult.

The Child state is when we go back to feelings and actions that we would have engaged in when we were children. This state isn't always negative. According to Berne, our creativity, spontaneous actions, and wonder come from here. But it's also the home of other actions and feelings - like sulking, brooding, pouting, showing displeasure, or sudden anger.

The Parent state is when we play, often unconsciously, a "parent type" role - we imitate what our parents would have done in a situation. These can be things like criticizing, scolding, advising, nurturing, and caring actions.

The Adult state is the most objective of the three. It's stable, reasonable, and able to observe what's going on in the moment to make a rational decision. The goal of Transactional Analysis is to help people understand that each role has its place and importance, but that, in most situations, people should play the Adult role.

Types of Human Transactions

Individuals in these roles interact through two types of transactions: complementary transactions and crossed transactions.

Complementary transactions occur when two people communicate with each other in the same role:Person A: Did you finish that staff review yet? I really need it. (Adult role)Person B: Yes. Actually, I was about to send you the results. (Adult role)orPerson A: Hey, would you like to leave work a bit early and go for a bike ride by the river? (Child role)Person B: Yeah! I don't have a lot going on, so leaving early sounds great. (Child role)These conversations were clear because both people were communicating in the same roles. Problems occur, however, with crossed transactions.

Crossed transactions take place when two people communicate with each other in different roles:Person A: Did you finish that staff review yet? I really need it. (Adult role)Person B: Why are you always reminding me? I said I would finish it, and I'll get to it when I have time. (Child role)orPerson A: Hey, would you like to leave work a bit early and go for a bike ride by the river? (Child role)Person B: You really need to act more responsibly. Next time you ask me to do something like this, I'm going to tell the boss, and you'll get in trouble. (Parent role)

As you can see, when people communicate on the same level - such as Adult to Adult or Child to Child - communication is often easy. Nothing is misunderstood, and no frustration occurs.

However, when people communicate on different levels - such as Adult to Child or Child to Parent - then true communication often breaks down. This can lead to feelings of frustration, anger, or inadequacy, and it can damage relationships.

So, what does all of this mean for you? By learning the different roles that you, or your team, use to communicate, you can learn to communicate more effectively.

Games We Play

Now that we understand the different roles, let's consider the games that people often play while acting in these roles.

Eric Berne identified dozens of games that take place during human interaction. "Games" refer to human transactions that are predictable and have an ulterior, or hidden, motive - usually a payoff of some kind (such as sympathy or admiration) - for one or more of the players.

For example, if Jane clearly asks Dennis for help and gets it, this is not a game - it's what Dr Berne calls an "operation." But if Jane asks Dennis questions in an indirect way, without clearly seeking help - such as asking Dennis what he's doing and if he's busy, and then complaining about how much work she has - then this is the beginning of a game. Jane is trying to maneuver or manipulate Dennis into offering to help her.

Games are commonly used to get attention. Because the game's outcome is often dramatic, the initiator usually wants - and gets - attention.

To demonstrate our point, here are some examples of games.

"Why don't you.? Yes, but."

Consider this conversation:

Person A: I sure wish I had the time to finish all my work. It never ends!

Person B: Why don't you stay late to get it done?

Person A: Yes, but I have to pick up my kids after school.

Person B: Well, why don't you hire an assistant?

Person A: Yes, but that would be too expensive, and my boss wouldn't approve.

Person B: Why don't you come in on Saturday?

Person A: Yes, but I'm so busy on the weekends I wouldn't have time.

At this point, Person B has thought of several solutions and is out of ideas. There's silence. Person A has "won."

It's important to realize that this can look like an Adult-Adult interaction (two reasonable people trying to solve a problem). However, it's actually Child-Parent. Person A is the "helpless child," while Person B takes on the "wise parent" role.

What's the goal of this game? Well, although Person A might not realize it on a conscious level, she plays the game because it makes everyone else feel as if they are the ones who are inadequate. They can't find solutions to her problem - and deep down, she gets secret pleasure from turning down their suggestions.

Blemish

This is another common game in organizations. It often occurs when there's a new hire, or when someone gets a promotion to lead a team. In this game, the players feel comfortable only after they've identified someone else's blemishes or faults. They "pick apart" and criticize the outsider, looking for "bad" things:

He may have an Ivy League degree, but those people never have great people skills.

She probably got that promotion because her brother is in politics.

He probably really had to flatter the boss to get that job.

And so it goes. Blemish is a negative game that players use to feel superior and gain reassurance about themselves. Because they focus on the outsider, they don't discuss their own blemishes and faults. Most of the time, it's played from a Parent role, but with the enjoyment of a Child.

Using Transactional Analysis

To make the most of Transactional Analysis, analyze which roles you and your colleagues play. Try to be aware of this in all of your interactions, but particularly in any situation where communication is difficult.

Once you understand the roles, you can judge whether this makes your interaction a complementary or crossed transaction. You can then determine whether there's a risk that you're leading each other in the wrong direction (Child-Child complementary transactions) or responding inappropriately (when you're being a Child, or even a Parent, in a crossed transaction). When you pay extra attention to what you say, you're better able to respond as an Adult.

It's also important to recognize when someone else is playing a game. There are so many different types of games that we can't cover them all here, but you can find more examples in Dr Berne's book "Games People Play."

Refusing to play games with others is a way to separate yourself from the unpleasant consequences of those games - and establish yourself in the role of a rational Adult.

Refusing to play can also have a powerful impact on the initiators of the games. They may become depressed, angry, confused, or frustrated - and they might even increase their efforts to involve you. Without your validation and acceptance, however, they often don't know what to do. If you remain firm and act as the Adult, they might follow your lead.

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Transactional Analysis - Learning the Games People Play

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Inequalities in life expectancy

Life expectancy is a key measure of a population's health status. Inequality in life expectancy is therefore one of the foremost measures of health inequality.

Life expectancy is closely related to people's socio-economic circumstances. The most common summary measure of these circumstances across a population is deprivation. The index of multiple deprivation is a way of summarising how deprived people are within an area, based on a set of factors that includes their levels of income, employment, education and local levels of crime.

This social gradient relationship holds true across the whole population - health inequalities are experienced by everyone, not just those at the very bottom and top. Figure 1 shows how, during 2015-19 in England, rising levels of neighbourhood deprivation were linked to falling levels of life expectancy.

There are also geographical inequalities in life expectancy. in 2017-19, the North East of England experienced the lowest life expectancy at birth for both men and women across England's regions, followed by the North West. Life expectancy in the four most southerly English regions was higher than the England average, whereas in all other regions, life expectancy was lower than the England average.

The north of England has a higher concentration of deprived neighbourhoods than the south of England, and therefore a greater proportion of communities where life expectancy is likely to be lower based on their levels of deprivation. But in addition to this, for any given level of deprivation, life expectancy in the north of England is lower than in the south of England.

The maps below illustrate differences in life expectancy at birth in 2017-19 by local authority areas. For women, the gap between the area with the lowest life expectancy (Blackpool, at 79.5 years) and the area with the highest (Westminster, at 87.2 years) is 7.7 years. For men, the gap is 10.5 years, also between Blackpool (74.4 years) and Westminster (84.9 years).
Hover over each local authority to see the average life expectancy at birth.

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What Are Health Inequalities? | The King's Fund

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This explainer provides an overview of how health inequalities are experienced in England's population.

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Understanding what influences behaviour is key to making behaviour change possible. Our brand new guide focuses on the COM-B model, which proposes ‘Behaviour’ is a result of ‘Capability’, ‘Opportunity’ and ‘Motivation’.

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This guideline covers a set of principles that can be used to help people change their behaviour. The aim is for practitioners to use these principles to encourage people to adopt a healthier lifestyle by, for example, stopping smoking, adopting a healthy diet and being more physically active.

Recommendations

This guideline recommends a set of principles to use as the basis for:

providing education and training for those delivering them

delivery of these activities, including one-to-one and community-based programmes and those aimed at specific populations

evaluation of their effectiveness and cost effectiveness

Who is it for?

National policy makers, commissioners, providers and practitioners in the NHS, local authorities and the community and voluntary sectors

Researchers, including those who oversee research funding

Social and behavioural scientists

Health economists working on health-related knowledge, attitude and behaviour change

Is this guideline up to date?

We checked this guideline in November 2017. We found no new evidence that affects the recommendations in this guideline.

Guideline development process
How we develop NICE guidelines
This guideline was previously called behaviour change.

Your responsibility

The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian.

All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.

Local commissioners and providers of healthcare have a responsibility to enable the guideline to be applied when individual professionals and people using services wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties.

Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.

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This guideline covers a set of principles that can be used to help people change their behaviour. The aim is for practitioners to use these principles to encourage people to adopt a healthier lifestyle by, for example, stopping smoking, adopting a healthy diet and being more physically active

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Who should hold the conversation?

Compassionate conversations can be held between, colleagues, a line manager, team leader or supervisor and those who they are responsible for, as well as between staff and patients. Tip: For some, holding a compassionate conversation may feel daunting at first. It is important to remember that your role is to hold the conversation, actively listen to your colleague, be compassionate and either signpost to further support and/or help; or enable colleagues to identify the most appropriate support for themselves.

What you bring to a compassionate conversation*?

A commitment - to cultivate self-awareness, suspend judgment and a desire to learn from others.

A skill set - to enhance interpersonal relations and navigate challenging conversations.

A process - to bring individuals or groups together and to appreciate our inter-connectiveness.

A gift - a connection, to really listen to a person and they feel heard.

*Adapted from: The Compassionate Listening Project, Seattle, USA.

How should I approach a compassionate conversation?

Whether it's taking place virtually or in person, it's important to hold a compassionate conversation in a safe, neutral, confidential space. This will enable you to focus on the individual, and they have the freedom to share their thoughts and feelings. Reassure the individual that the conversation is confidential (unless there is a stated intent to harm self or others).

Take a moment

Check your intentions - compassionate conversations happen when we want to have a meaningful and constructive conversation with someone.

Be self-compassionate - The foundation of compassion for others is with how we treat ourselves.

Make the time to listen - Avoid assumptions. Could we unwittingly giving the impression that their needs don't matter?

Recognise our shared humanity - Our interconnectedness and shared humanity.

Learn how be a different kind of observer - From 'passive' to an 'active' observer.

For example, an empathetic reflection and an offer of support, I notice you look a little concerned, could I
help at all?' can go a long way to supporting someone who may be feeling isolated and in need of support.

Take a moment, 'Compassionate Conversations', Linda Keenan and Gareth Corser, NHS Elect.

Tips

Be authentic. Authenticity is at the core of compassionate communication.

Be present: Listen to hear what the individual is saying. We sometimes listen to respond. When you listen to understand, you are in a better position to determine the appropriate response.

Avoid assumptions, as this can lead to misunderstanding. Ask the individual to explain anything that you need to understand more, to give you both clarity within the conversation. Be curious to find out the reasoning behind their decision.

Avoid judgement. However, do not be afraid to ask/hear the uncomfortable question, begin to lean in with the discomfort of uncomfortable discussions to promote learning and growth.

Explore, be aware of, and personally work through any biases you hold prior to commencing a 1-1 conversation in promoting equity and inclusive practice. For example, if you hold a negative bias towards accents that are different to yours, then ensure that you're listening to understand is even more earnest than usual.

Reflect on any outdated narratives or assumptions you've held and demonstrate a willingness to unlearn.

Good practice for compassionate conversations

Compassionate conversations are:

Caring and compassionate - they give space to enable employees to holistically explore their thinking.

Employee led - they enable the employee to lead the conversation and focus on the most important things to them.

Supportive - they enable colleagues to identify the most appropriate support for themselves.

Non-Judgemental - this helps us to stay neutral and focus on understanding others point of view. Recognise our ability to connect within sameness and difference whilst suspending judgement.

Do not

Take a traditional directive and argumentative style.

Identify and solve the problem for the individual.

Argue or debate. Make it known that you are there to listen to their concerns.

Rush through without listening.

Questions that can be asked as part of the conversation

Ask open-ended questions using "How", "What" or "Tell me...", to enable the individual to share and clearly articulate what they8want to say.

Inquiry - questioning hints*

Hints: What can help?

Be present for them- Turn-off your 'mind-chatter'

Ask open questions - 'How' or 'What'?

Empathy

Ask questions which follow their interests, not your agenda....

Mirror and paraphrase

Use bridges - 1-3 of their words

Don't feel you have to fill the silence

Stay out of judgement

Hints: What to avoid

Closed questions - 'Can' or 'Do'

'Why' questions (can sound interrogative or accusatory)

Don't make statements dressed as questions

Saying 'I know just how you feel'

Telling them your own story

Start a sentence with, 'At least...'

Avoid sympathy

Avoid collusion

Online blogs and guides

Websites

Books and guides

Self-Compassion: Dare to Lead, Brené Brown

Mindset: The Outward Mindset, The Arbinger Institute

Leading teams in difficult times: Teaming, Amy Edmondson

Compassionate Leadership: Compassionate Leadership: Sustaining Wisdom, Humanity and Presence in Health and Social Care, Professor Michael West

YouTube

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Compassionate conversations: a guide to holding compassionate conversations with colleagues

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Compassionate conversations can be held between, colleagues, a line manager, team leader or supervisor and those who they are responsible for, as well as between staff and patients. Tip: For some, holding a compassionate conversation may feel daunting at first.