Communication Skills for High Stress/High Risk Situations Master Class Dr. Vincent T. Covello Director, Center for Risk Communication New York City Tel. 1-917-270-5280 Email: vincentcovello@yahoo.com

Communication Skills for High Stress/High Risk Communication: Master Class Presentation Outline Introduction/Overview Tools and Skills Resources Strategies \ HERC v 3.1 HERC Workshop Topic 1: High Impact Communication Fundamentals Jan 2004

High Concern/Risk Communication Literature 8000 Articles in Peer Reviewed Scientific Journals 2000 Books Reviews of the Literature by Major Scientific Organizations US, National Academy of Sciences: “Improving Risk Communication” (1989) UK, Royal Society: “Risk: Analysis, Perception and Management (1992) Copyright, Institute for High Concern Communication

Research Literature Examples Gladwell, M., “Blink” Kahneman, D., “Thinking Fast and Slow” Covello, V. and Hyer, R, “Effective Media Communication During Public Health Emergencies ============ Lehrerer, J., “How We Think” Fisher, R., “Getting to Yes” (Ury, W., “Getting Past No”) Ekman, P., “Emotions Revealed” (Also, “Telling Lies: Clues to Deception”) Tufte, E., “Visual Explanations” Copyright, Institute for High Concern Communication

High Stress/High Risk Communication Literature: Dr. Randall A. Hyer and Dr. Vincent T. Covello “Effective Media Communication During Public Health Emergencies: A World Health Organization Handbook” World Health Organization, United Nations: Geneva, April 2007 (www.amazon.com or www.who.int/bookorders) Copyright, Institute for High Concern Communication

“Top Questions about Ebola: Simple Answers” Dr. Vincent T Covello and Dr. Randall A. Hyer, 2014 http://www.astho.org/Infectious-Disease/ HERC v 3.1

FRONTAL LOBE PARIETEL LOBE OCCIPITAL LOBE TEMPORAL LOBE CEREBELLUM

Parts of the Brain Involved in Fear Response Amygdala Hypothalamus Copyright, Institute for High Concern Communication

Introduction/Overview Tools and Skills Resources Strategies Topic Outline Introduction/Overview Tools and Skills Resources Strategies HERC v 3.1 HERC Workshop Topic 1: High Impact Communication Fundamentals Jan 2004

Communication Skills for High Stress/High Risk High Communication: Definition A science-based approach for communicating effectively in: • high stress situations • high risk situations • low trust situations • high stakes situations • controversial situations HERC v 3.1

High Stress/High Risk Communication Goals Inform and Educate Build or Repair Trust Persuade and Convince Copyright, Institute for High Concern Communication

High Impact Communication Skills: Application Areas High Stress/High Risk Situations Health, Safety, and Environmental Issues Cost Overruns/Project Delays/Operational Disruptions Controversial Approvals/Permissions/NIMBY / Employee Issues (e.g., complaints, bias, prejudice, discrimination) Crises, Emergencies, and Disasters Disease Outbreaks, Accidents, Emergencies Natural Hazards Other Crises (e.g., Shootings, Scandals, Sexual Abuse, Lawsuits, Protests) Organizational Change Mergers/Downsizing/Rapid Growth/Relocation/Reorganization Layoffs/Funding Cuts/Reforms Changes in Policies, Mission, Systems, or Strategic Objectives

Three Key Messages High concern communication is a science-based discipline High concern situations change the rules of communication The key to high concern communication success is anticipation, preparation, and practice Copyright, Institute for High Concern Communication

FRONTAL LOBE PARIETEL LOBE OCCIPITAL LOBE TEMPORAL LOBE CEREBELLUM

Message Preparation: Handout “Basic Risk Communication/Message Mapping Templates” Copyright, Dr. V Covello, Center for Change/Risk Communication

Best Practices Risk Communication/High Concern Communication Templates (see handout) Rule of 3 Template Primacy/Recency Template 27/9/3 Template CCO Template -- 1N=3P Template -- AGL-4 Template -- TBC Template

FRONTAL LOBE PARIETEL LOBE OCCIPITAL LOBE TEMPORAL LOBE CEREBELLUM

HCC Literature: Example “The Magic Number Seven, Plus or Minus Two: Some Limits on Our Capacity for Processing Information” George A. Miller (Department of Psychology, Princeton University) The Psychological Review, 1956, vol. 63, pp. 81-97 Copyright, Institute for High Concern Communication

Limits of the Brain Low Stress Rule of 7 High Stress Rule of 3 27/9/3 Copyright, Institute for High Concern Communication

Visuals

Parts of the Brain Involved in Fear Response Amygdala Hypothalamus Copyright, Institute for High Concern Communication

Copyright, Dr. V Covello, Center for Change/Risk Communication

Open House/Forum/Information Exchange

Open House Meetings

THEORIES, TOOLS AND TEMPLATES

Best Practices Risk Communication Templates (see handout) Rule of 3 Template Primacy/Recency 27/9/3 Template CCO Template 1N=3P Template IDK Template AGL-4 Template Copyright, Institute for High Concern Communication

HIGH CONCERN COMMUNICATION THEORIES Trust Determination Theory Negative Dominance Theory Mental Noise Theory Risk Perception Theory

High Concern/Risk Comm. Theories* Trust Determination When people are stressed, they want to know that you care before they care what you know Mental Noise When people are stressed, they have difficulty processing information – hearing, understand, remembering Negative Dominance When people are stressed, they focus more on the negative than on the positive Risk Perception When people are stressed, the gap between perception and reality widens * Holding constant other variables Copyright, Institute for High Concern Communication

TRUST DETERMINATION THEORY

Trust Determination Theory When people are stressed or upset, they typically: want to know that you care before they care what you know Trust Determination Theory Copyright, Institute for High Concern Communication

People Want To Know That You Care Before They Care What You Know Assessed in first 9–30 seconds Listening/ Caring/ Empathy/Compassion 50% Competence/ Expertise 15–20% All Other Factors 15–20% Honesty/ Openness 15–20% 31 31 31

Trust Determination Theory When people are stressed or upset, they often distrust that others are: listening, caring, empathy honest, open, hard working competent, expert Copyright, Institute for High Concern Communication

Case Study: Walter Reed Hospital (2007) Q: “Do you hold yourself accountable for the squalid conditions provided for wounded soldiers at Walter Reed Hospital” A: “I’m trying not to say I’m not accountable.” Q: “How could you not have known? A: “I don’t do barracks inspections at Walter Reed Hospital.” Q: “Why did you do so little?” A: “Walter Reed Hospital is not my only command.” Source: March 6, 2007, Washington Post MedCom Commander, Walter Reed Hospital General K. Kiley Copyright, Institute for High Concern Communication

Best Practices Risk Communication Templates (see handout) Rule of 3 Template Primacy/Recency 27/9/3 Template CCO Template 1N=3P Template IDK Template Copyright, Institute for High Concern Communication

Case Study: BP Oil Spill (2010) Copyright, Institute for High Concern Communication

Case Study: BP Oil Spill (2010) BP CEO Tony Hayward Copyright, Institute for High Concern Communication

BP Oil Spill (2010): BP CEO Tony Hayward “I’m sorry. We’re sorry for the massive disruption it has caused their lives. And there is no one who wants this over more than I do. I’d like my life back.” (May 30, 2010)

Mayor Giuliani, 9/11 “The number of casualties is more than any of us can bear ultimately.”

Mayor Giuliani, 9/11 “The number of casualties is more than any of us can bear ultimately. And I believe we will become stronger. Stronger economically, politically, and most importantly, emotionally.”

Mayor Giuliani, 9/11 “The number of casualties is more than any of us can bear ultimately.”

Trust Determination Theory Assessed in first 30 seconds Listening / Caring / Empathy 50% Competency/ Expertise Dedication/ Consistency / Commitment 15-20% 15-20% Honesty/ Openness/ Transparency 15-20% Copyright, Dr. V Covello, Center for High Concern Communication

Credibility Ladders High Credibility Medium Credibility MOST CREDIBLE High Credibility Medium Credibility Low Credibility LEAST CREDIBLE Copyright, Institute for High Concern Communication

Credibility Ladder: Drug Safety/Drug Recalls (US, 2013) Pharmacist Professor (medical research) Physician/Nurse/PhD Health Official Friend/Family member (with personal experience) Middle manager (drug manufacturer) Hired expert/consultant Company executive (pharmaceutical) MOST CREDIBLE LEAST CREDIBLE Copyright, Institute for High Concern Communication

Credibility Transference A lower credible source takes on the credibility of the highest credible source that agrees with its position on an issue. Copyright, Institute for High Concern Communication

Credibility Reversal When a lower source attacks the credibility of a higher source, the lower source loses further credibility. The only information source that can effectively attack the credibility of another source is one of equal or higher credibility. Copyright, Institute for High Concern Communication

Credibility Reversal . Copyright, Institute for High Concern Communication

Case Study: Gulf War (1990-1991) Copyright, Institute for High Concern Communication

Templates: Trust Determination CCO Template (C)ompassion (C)onviction (O)ptimism Copyright, Institute for High Concern Communication

MENTAL NOISE THEORY Mental Noise Theory

Mental Noise Theory When people are stressed or upset, they typically: have difficulty, hearing, understanding, and remembering information Mental Noise Theory Copyright, Institute for High Concern Communication

Stress and mental noise can reduce Mental Noise Theory 20% 100 Stress and mental noise can reduce the ability to process information by up to 80% Copyright, Institute for High Concern Communication

Templates: Mental Noise Rule of 3 Template Primacy/Recency Template 27/9/3 Template AGL-4 Copyright, Institute for High Concern Communication

27 words 9 seconds 3 messages Template: 27/9/3 27 words 9 seconds 3 messages * Note: Words processed as phrases count as only one word Copyright, Institute for High Concern Communication

Template: Primacy/Recency “When people are stressed and upset, they typically focus most on that which is said first (primacy) and last (recency).” Low Stress Situations: Brain processes information based on linear order (e.g., 1, 2, 3) High Stress Situations: Brain processes information based on primacy/recency (e.g., 1, 3, 2) Copyright, Institute for High Concern Communication

Template: Average Grade Level (AGL) Minus 4 “When people are stressed and upset, they typically process information at four grade levels below their average grade level.” Low Stress Situations: Brain processes information at AGL (average grade level) High Stress Situations: Brain processes information at AGL-4 (average grade level minus 4 grade levels) Copyright, Institute for High Concern Communication

Non-Verbal Communication Provide up to 75 percent of message Override verbal content Are intensely and quickly noticed Are interpreted negatively Are specific to a culture Copyright, Institute for High Concern Communication

Resource Materials: Non-Verbal Communication P. Ekman, “Telling Lies: Clues to Deception” P. Ekman, “Emotions Revealed” D. Morris, “Body Talk: A Dictionary of Human Gestures” Copyright, Institute for High Concern Communication

West Nile Message Map Haiti, 2001 Question: What can people do to protect themselves from … Remove Standing Water Wear Protective Clothing Use Insect Repellent Puddles Long Sleeves DEET Text Text Text Text Text Text Text Text Text Flower Pots/Bird Baths Long Pants 23% Text Text Text Text Text Text Text Text Text Cup of Water Dusk and Dawn Medical Research Text Text Text Text Text Text Text Text Text Haiti, 2001 Copyright, Institute for High Concern Communication

Question: What can people do to protect themselves from …? West Nile Virus Map: Question: What can people do to protect themselves from …? Key Message “Remove Standing Water” Key Message “Wear Protective Clothing” Key Message “Use Insect Repellent” 1.1 Puddles 2.1 Long Sleeves 3.1 DEET 1.2 Flower Pots/Bird Baths 2.2 Long Pants 3.2 23% 1.3 Cup of Water 2.3 Dusk and Dawn 3.3 Medical Research Copyright Dr. V. Covello, Center for Change/Risk Communication 59 HERC v 3.1Copyright, Dr. V Covello, Center for Change/Risk Communication HERC Workshop Topic 1: Risk Communication Fundamentals Jan 2004 1-59

Tool: Message Mapping Strategy – 7 Steps Identify a high concern/risk related issue or scenario Identify key stakeholders (audiences) Identify stakeholder questions and concerns Develop key messages Develop supporting information Conduct testing Plan for delivery “Most of the concerns and questions of upset or concerned people can be predicted in advance.” Copyright, Institute for High Concern Communication

The APP Template: Basic High Concern/Risk Communication Strategy Anticipate Scenarios/Stakeholders/Concerns Prepare Messages/Messengers/Means Practice Drills/Exercises, Simulations/Rehearsals Copyright, Dr. V Covello, Center for Change/Risk Communication

Stakeholder: Question or Concern Message Map Stakeholder: Question or Concern Key Message 1 (9 words on average) Key Message 2 (9 words on average) Key Message 3 (9 words on average) Supporting Message Supporting Message Supporting Message Text Text Text Text Text Text Text Text Text Supporting Message Supporting Message Supporting Message Text Text Text Text Text Text Text Text Text Supporting Message Supporting Message Supporting Message Text Text Text Text Text Text Text Text Text Copyright, Institute for High Concern Communication

27 words 9 seconds 3 messages Template: 27/9/3 27 words 9 seconds 3 messages * Note: Words processed as phrases count as only one word Copyright, Institute for High Concern Communication

NEGATIVE DOMINANCE THEORY

Negative Dominance Theory When people are stressed or upset, they typically: focus much more on negative information than on positive information === 1n=3p Negative Dominance Theory Copyright, Institute for High Concern Communication

Templates: Negative Dominance 1N=3P Template IDK Template Copyright, Institute for High Concern Communication

Nobel Prize Winner in Economics Book: “Thinking Fast and Slow“ Loss Aversion Theory Prof. D. Kahneman Nobel Prize Winner in Economics Book: “Thinking Fast and Slow“

Negative Dominance (Loss Aversion) Theory Negative Information Positive Information 1 Positive Information 3 Positive Information 2 Copyright, Institute for High Concern Communication

1 N = 3P Template Three positives for one negative ================= Avoid the words: “No, Not, Never, Nothing, None” Avoid Using Absolutes (In high stress situations: “Never say never, never say always, never use an absolute.”) Getting past “NO” (Expand the pie; win/win/interest based bargaining))

Case Study: Walter Reed Hospital (2007) Q: “Do you hold yourself accountable for the squalid conditions provided for wounded soldiers at Walter Reed Hospital” A: “I’m trying not to say I’m not accountable.” Q: “How could you not have known? A: “I don’t do barracks inspections at Walter Reed Hospital.” Q: “Why did you do so little?” A: “Walter Reed Hospital is not my only command.” Source: March 6, 2007, Washington Post MedCom Commander, Walter Reed Hospital General K. Kiley Copyright, Institute for High Concern Communication

General K. Kiley, MedCom Commander, Walter Reed, Congressional Testimony Q.: “Do you hold yourself accountable for the squalid conditions provided for wounded soldiers at Walter Reed” A.: “I’m trying not to say I’m not accountable.” Q.: “How could you not have known? A.: “I don’t do barracks inspections at Walter Reed.” Q. “Why did you do so little?” “Walter Reed is not my only command.” Source: March 6, 2007, Washington Post

Template: 1 Negative = 3 Positives (1N = 3P) Balance negatives with three positives Avoid absolutes (“never say never”) Negative bias (non-verbal communication) Avoid repetitions high visual negatives Copyright, Institute for High Concern Communication

Template: I Don’t Know (IDK) Repeat the question (optional) Say you don’t know/can’t answer/wish you could answer Give the reason(s) why you don’t know or can’t answer the question Indicate follow up Bridge to what you can say about the issue Copyright, Dr. V Covello, Center for Change/Risk Communication

RISK PERCEPTION THEORY

Risk Perception Theory When people are stressed or upset, they typically: the gap between perception and reality becomes wider look for information about trust, benefits, and control Risk Perception Theory Copyright, Institute for High Concern Communication

Risk Perception Theory: Fear/Outrage Factors (short list) Lower Concern/Fear Trustworthy sources Large benefits Under one’s control Voluntary Fair Natural origin Children not victims Higher Concern/Fear Untrustworthy sources Few or unclear benefits Controlled by others Involuntary Unfair Human origin Children as victims Copyright, Institute for High Concern Communication

Templates: Risk Perception Theory TBC Template Copyright, Institute for High Concern Communication

Template: Trust, Benefits, Control (TBC) Key Message 1: Trust Message Key Message 2: Benefits/Fairness Message Key Message 3: Control Message Copyright, Institute for High Concern Communication

Risk Perception (Fear) Factors Lower Concern/Fear Trustworthy sources Large benefits Under one’s control Higher Concern/Fear Untrustworthy sources Few or unclear benefits Controlled by others Copyright, Institute for High Concern Communication

Risk Perception (Fear) Factors Trust Listening/Caring Competence/Expertise Honesty/Transparency Benefits/Fairness Societal Community Personal Control/Voluntariness Choice Voice Knowledge Actions/Things for people to do Copyright, Institute for High Concern Communication

SPECIAL TOPICS

Addressing Cultural Diversity Culture: Groups who share a common: Identity Set of beliefs, values, and behaviors Definition of boundaries (e.g., what is right and wrong, proper or improper) Definition of how life is to be conducted. Discussion Points: We are first individuals not a member of a cultural group. However, there are general patterns of behaviors in groups that most of us follow. HERC v3.1

“Iceberg” Model SEE THIS BEHAVIORS SEE LITTLE OF THIS CORE BELIEFS VALUES CORE BELIEFS HERC v3.1

Cultural Diversity Latino/Hispanic Risk Communication Model High Religiosity High Family Values Strong Gender Roles Low Level of Trust in Government Copyright, Institute for High Concern Communication

Special Topics Cultural Diversity Copyright, Institute for High Concern Communication

Cultural Diversity Latino/Hispanic Risk Communication Model High Religiosity High Family Values Strong Gender Roles Low Level of Trust in Government Copyright, Institute for High Concern Communication

Afghanistan: Values Hospitality Saving Face Honor Religion Respect for Elders

Afghanistan: Gestures Avoid Using Left Hand Do not pass things or touch food with left hand Personal space (closer than In West) Do not show the bottom of your feet ===== Business cards (not widely practiced) -- Take with right hand, treat with respect -- Place in table in front of you

Special Topics Non-verbal Communication Copyright, Institute for High Concern Communication

Non-Verbal Communication Provide up to 75 percent of message Override verbal content Are intensely and quickly noticed Are interpreted negatively Are specific to a culture Copyright, Institute for High Concern Communication

Resource Materials: Non-Verbal Communication P. Ekman, “Telling Lies: Clues to Deception” P. Ekman, “Emotions Revealed” D. Morris, “Body Talk: A Dictionary of Human Gestures” Copyright, Institute for High Concern Communication

CONCLUSION/ SUMMARY

Takeaways Three Takeaway Messages Three Takeaway Tools Three Takeaway Inspirational Quotes Copyright, Institute for High Concern Communication

Three Takeaway Messages High concern communication is a science-based discipline High concern situations change the rules of communication The key to high concern communication success is anticipation, preparation, and practice Copyright, Institute for High Concern Communication

Three Neuroscience-Based High Stress/High Risk Communication Tools 27/9/3 Template (Rules of 3) CCO Template 1N=3P Template Copyright, Institute for High Concern Communication