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Managing difficult conversations

Professional curiosity is where a practitioner seeks to explore and understand what is happening in someone's life, rather than making assumptions or accepting what they are told at face value. It involves looking out for signs that things are not right and seeking out the evidence of what is really happening. Professional curiosity sometimes involves difficult conversations.

The conclusion from a Leeds Safeguarding Review found:

Providing good support sometimes involves difficult conversations. This may involve talking to people about extremely personal and sensitive subjects…. Understandably sometimes people will be reluctant or resistant to having these conversations [with practitioners] or be reluctant to accept support that threatens their sense of privacy and dignity. Equally it can be difficult for practitioners to broach such subjects or know how to manage such sensitive conversations[1].

In this review, it was found that care workers found it difficult to have such conversations that were so important to that person's care. If one is to look further, think wider and see more, this will sometimes involve difficult conversations so as to enable someone to be safe or to promote their wellbeing. 

Tips for managing difficult conversations

Each individual situation will be different, but managing difficult conversations is a skill that can be developed, alongside confidence, through planning, practice and experience. Consider these tips:

Don't put it off

  • Raise the issue as soon possible, deal with it, don't put it off. Difficult conversations have the potential to become increasingly difficult if not dealt with promptly.

Prepare

  • Take some time to think things through—what are the main points you need to make? How can you best say, what you need to say?
  • If you know the person isn't going to agree with you, also prepare some examples and factual information to support what you are saying
  • Identify strengths the person holds that you might highlight in this conversation. Have some ideas about how they might draw on these strengths to move through and beyond the difficult conversation
  • Make use of supervision - Address any tensions or fears you hold about the difficult conversation, raise any gaps in your knowledge or skills
  • Consider and provide for the person's communication and support needs to take part in the conversation
  • Once fully prepared, arrange an appropriate place and time to hold the conversation 

Practice

  • You may find it helpful to role play the scenario with a colleague or manager. This will help you to develop a range of possible responses to the challenges you anticipate
  • Busy day-to-day practice may mean this is not possible, however try at least to rehearse the conversation in your mind; in particular, how you will open the conversation and the key points you need to make

During the conversation

  • Keep the agenda focused on the topics you need to discuss. Stay focused on the needs of the person at risk
  • Keep the conversation open, using open questions which begin with phrases such as "Why do you think…", "Help me understand why…", or "Explain to me …"
  • Share what you need to and then listen and be empathetic. Always be diplomatic. Be open to the other person's view and interpretation of the situation.
  • Stay objective, keep your calm, and listen carefully and considerately to what they have to say. Give them time to speak. Allow spaces for silence; allow emotions to be expressed. Remember that a lot of communication is based on body language

Decisions

  • Almost always with difficult conversations, there is a 'now what?' that needs to be answered. Be clear on the reasons for any particular outcome and allow them to reflect on the positive aspects for all parties involved.
  • You may need to suggest some time out to reflect on the conversation. 
  • Acknowledge any disappointment someone may have.

Reflection

  • Reflect on your approach, what worked well, what might have been done differently.
  • Consider how you will be able to build upon this conversation in your next meeting with the person.

What else can I do?

  • Explore what training and support is available within your organisation to develop skills and confidence in these areas.
  • Learn more about professional curiosity, read the One Page guides
  • A Professional Curiosity Power Point presentation has also been developed to support training which includes reference and links to reviews whereby professional curiosity was a key theme. This could also be used to support practice discussions and reflection in team meetings. Please email the LSAB Strategy Unit for a copy; LSAB@leeds.gov.uk     

[1] Leeds Safeguarding Adults Review: Thematic Review (unpublished)

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