Affirming and Acknowledging ~ Keys to Reflective Listening

‘What is it like to be you?’ Imagine if this question were the fundamental or main question you kept in mind when counseling and working with your patients. Every one of us is unique and special. As health professionals, it is vital to be in the mind-set of genuine curiosity about each and every patient. Who is this singular and exceptional person before me is a very different counseling platform than ‘what is the problem this patient is presenting’. That is, often, we ‘see’ a patient defined by an issue; for example, a person struggling with overeating or obesity is first and foremost a person, as trite as that might sound. As with most health issues connected to behavioural choices, obesity/smoking/physical inactivity are not really or merely about obesity/smoking/physical inactivity. There are underlying, fundamental reasons that give rise to those health issues. One of the 4 strategies embedded in the Motivational Interviewing O.A.R.S acronym is Affirmation, a verbal skill that acknowledges and validates your patient’s experiences and feelings. Acknowledging or affirming are critical keys to ‘seeing’ through what your patient does (overeats, smokes etc) to who your patient is. An affirmation is not a compliment; it is an acknowledgement of what quality you see in your patient. For example, you might affirm with a statement like, ‘I want to acknowledge your courage in coming to meet with me today’ or, ‘I see how much you struggle with _______.’ Learning to acknowledge sincerely can sometimes dispel the elephant-in-the-room, something left un-said or a quality not-recognized in your patient that can be a barrier to successful behaviour change.  Acknowledging is an art and skill that allows both you and your patient to truly meet and co-create change behaviours that respect what it’s like for your client to be who she or he is.