PART I INTERPERSONAL COMMUNICATION

Act of transmitting information, thought, opinions, or feelings, through speech, signs, or actions, from a source to a receiver. Interpersonal Communication 2

Communication is used to: Advocate (persuade a client of the benefits of the behavior). Educate (provide specific TB information). Counsel (assist client in making an informed decision). 3

Counseling Confidential dialogue between a medical provider and a client that helps a client to define his/her feelings, cope with stress, and to make informed decisions regarding treatment. 3

Characteristics of Effective Counseling: Client-centered (two experts in the room) Interactive Private and confidential Individualized 4

1.Communication skills 2.Technical information 3.Understanding the stages of the counseling process 5 Tools for Effective Counseling:

1.Prevention of TB transmission. 2.Provision of emotional support to TB clients. 3.Motivation of TB clients to complete treatment. 4.Helping clients make their own informed decisions about their behavior and supporting them in carrying out their decisions. 6 Objectives of TB counseling:

Advocacy:Persuade a client of the benefits of the behavior Education:Provide specific TB information Counseling:Assist client in making an informed decision regarding TB 7 Types of Communication:

Message Source Channel Receiver Effect Feedback 8 Key Elements of Communication Process:

Communication Process Sender Receiver Feedback Filter (Interpretation) Message

Effective communication requires: 10 The message to be: Clear and concise Accurate Relevant to the needs of the receiver Timely Meaningful Applicable to the situation

Effective communication requires: 11 The sender to: Know the subject well. Be interested in the subject. Know the audience members and establish a rapport with them. Speak at the level of the receiver.

Effective communication requires: 12 The channel to be: Appropriate Accessible Affordable Appealing

Effective communication requires: 13 The receiver to: Be aware, interested, and willing to accept the message. Listen attentively. Understand the value of the message. Provide feedback.

Begins with a recognition that not everyone experiences the world in the same way and that others’ views may be as correct – perhaps even more correct – than our own. Is learned. 14 Effective communication:

An understanding of one's own values and willingness to withhold judgment about the other people’s values. Skills in verbal and nonverbal communication. Ability to show empathy and encourage others. Skills in asking questions and listening. 15 Effective Communication Skills:

Ability to paraphrase and summarize the concerns of individuals and the community. Ability to observe and interpret behavior of other people. Ability to use language that other people understand. Skills to effectively use support materials. 16 Effective communication skills: (continued)

Clarifies Listens Encourages empathically Acknowledges Restates/repeats 17 An effective verbal communicator:

Nonverbal Signals: Express attitude. Are difficult to control. Are interpreted subconsciously and establish emotional background for communication. 1818

Our perceptions, beliefs, and values shape our attitudes. Perceptions cannot be correct or incorrect. They are unique for each individual. 19 Personal Values and Attitudes:

Personal Values and Attitudes: (continued) Being aware of your personal beliefs and how they affect others will help you to treat others in a respectful and nonjudgmental manner. How we communicate our beliefs and attitudes (both verbally and nonverbally) is an important aspect of our interactions with people. 20

Perceptions Are Motivated by: Past experiences Emotional condition Personal imagination Culture Age and gender Education 21

Reasons for Rumors and Misinformation Result from transmission of incomplete facts or exchange of information. People hear selectively, based on their values, interests, etc. 25

Counteraction of Rumors and Misinformation As many people as possible should hear the correct message directly from the expert. To counteract rumors effectively, medical providers need to understand the cause of the rumor. Printed materials are important. 2626

Types of Communication: Verbal 10% of information Nonverbal – gestures, body posture, tone and timbre of voice, eye contact, etc. 90% of information 2727

28 Good Body Language: Making eye contact Leaning towards Smiling Nodding

No eye contact Poor posture, leaning away Angry or bored expression Shuffling papers Looking at watch 29 Bad Body Language:

Gestures of Impatience: Drumming one’s fingers on the table or tapping with something. Fidgeting in the seat, swinging one’s leg. Examining one’s watch. Looking “past" you. Nonverbal Clues to a Client’s Feelings: 30

Gestures of Emotional Discomfort: Collecting nonexistent fibers. Shaking off one’s clothing. Scratching one’s neck. Taking off and putting on a ring. 31 Nonverbal Clues to a Client’s Feelings:

Gestures of Authority : Forefinger directed at you. Highly cocked chin. Posture “hands on hips." 32 Nonverbal Clues to a Client’s Feelings:

Gestures of Lie: Touching his face with his hand – as if he is “covering up" his mouth with his palm or rubbing his nose. Avoiding eye contact. 33 Nonverbal Clues to a Client’s Feelings: