The Healing Power of Empathy and Education Some simple counseling strategies can make all the difference to care of patients with hearing and balance issues. All Ears on Audiology
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All Ears on Audiology  |   July 01, 2018
The Healing Power of Empathy and Education
Author Notes
  • Elise Smith, AuD, CCC-A, is a clinical assistant professor of audiology at Towson University in Towson, Maryland. esmith@towson.edu
    Elise Smith, AuD, CCC-A, is a clinical assistant professor of audiology at Towson University in Towson, Maryland. esmith@towson.edu×
Article Information
Hearing & Speech Perception / Hearing Disorders / All Ears on Audiology
All Ears on Audiology   |   July 01, 2018
The Healing Power of Empathy and Education
The ASHA Leader, July 2018, Vol. 23, 16-18. doi:10.1044/leader.AEA.23072018.16
The ASHA Leader, July 2018, Vol. 23, 16-18. doi:10.1044/leader.AEA.23072018.16
As audiologists, we spend much of our time providing highly skilled doctoral-level services to patients. But we also should not underestimate the importance of incorporating counseling into our services.
This may sound daunting, considering the intricacies and stress involved in managing successful audiology practices, while also providing excellent patient care. However, with audiology-based counseling that is efficient, effective and adaptable for a diverse patient population, we can achieve successful patient outcomes while addressing the time and productivity priorities of busy clinical settings.
Given that each patient and family is unique, successful counseling should be customized, not one-size-fits-all. Audiologists can employ informational and personal-adjustment counseling across a variety of audiology specialty areas, such as hearing loss, balance disorders and other auditory-related disorders (such as tinnitus).
Informational counseling addresses factual content, while personal-adjustment counseling focuses on the emotional aspects and needs of the patient related to audiology services. Expanding one’s counseling skills takes practice. It may be beneficial to hone new counseling skills by starting with one or two new strategies over the course of a few weeks, then adding a few more over time.
Patient education
Helping patients to understand how hearing loss affects their daily life is a key component of patient education. Use audiology counseling sessions to educate the patient by demystifying the hearing- or balance-related difficulty. Describe what may cause the underlying symptoms, provide an explanation of the anatomy and physiology behind the diagnosis, and review options for moving forward.
Compared to personal-adjustment counseling, information-based counseling is often seen as easier and more prescriptive because it is more predictable. However, it is important to provide conversation breaks so the patient can process the information, reflect and respond. The patient can begin to take responsibility for their treatment during these pauses (see sources).
At this point, the patient needs to choose how to respond and directs what happens next in the appointment.
The audiologist’s role is to be neutral during this time, to create a safe space for the patient to express thoughts or feelings. A key factor is the audiologist’s ability to read between the lines and determine if the patient is ready to receive more facts and medical information.
Alternatively, the patient may require affective-based responses, such as acknowledgment of emotions the patient may be experiencing (see sources).
Identify stressors and coping strategies
Ask the patient what type of stress they experience as a result of their hearing- or balance-related problem. How does it affect their daily life? What coping strategies can you suggest that could benefit the patient?
Significant others can also share their secondary stress in these sessions. Family members and communication partners also feel the impact of a patient’s hearing loss. Caregivers may feel tension in the form of negative emotions and difficulty understanding the patient’s perspective.
Give both parties the opportunity to see the effects on each other’s lives and communication abilities. Then, identify short- and long-term communication goals. These should include the patient’s treatment goals, and should also define the role family members can play in helping the patient to reach these goals.

Family members and communication partners also feel the impact of a patient’s hearing loss.

Storytelling narratives
Some patients may feel empowered by telling you their personal story. Illness narratives put the narrator in a position of power, and storytelling becomes part of the healing process (see sources). The patient feels valued and in control when telling their story. They also feel acknowledged and can learn from their own experiences.
Patient storytelling allows the audiologist to learn about the patient’s perception of their diagnosis. Their perception of the problem actually may be very different from the initial problem identified during the case history.
Unfortunately, many audiologists work in settings with limited time for each patient visit and may hesitate to integrate storytelling narratives into their daily practice. In these circumstances, consider that researchers have found that patients in an outpatient clinical setting typically speak less than 90 seconds when given uninterrupted time at the beginning of an interview (see sources).

Patient storytelling allows the audiologist to learn about the patient’s perception of their diagnosis.

Transition planning and health literacy
The recently updated “Transition Planning in Health Care Model,” based on the Royal College of Nursing model, is a three-stage model that outlines health literacy goals to help teenagers and young adults transition to increased autonomy and self-advocacy skills in the audiology setting (see sources).
The authors of the model include goals for both the audiologist and the patient, separated into three stages based on patient age. Health literacy is not confined to pediatrics. Adults also have health literacy difficulties in terms of the ability to understand and integrate health information and related services.
Misunderstanding of how to access and navigate the health care system may prevent people from seeking audiology services or achieving successful outcomes. The U.S. Department of Health and Human Services and the Centers for Disease Control and Prevention both offer online health literacy resources and tools for professionals.
Barriers to professional empathy
Do audiologists inherently have professional empathy? When Jodi Halpern, a psychiatrist studying clinical empathy, examined physicians’ emotional attunement to patients, she found that provider anxiety posed a barrier to professional empathy (see sources).
This anxiety may stem from busy schedules, limited time and productivity requirements. Another barrier to professional empathy was viewing patients’ emotional needs as not necessary to care. As a result, notes Halpern, providers need to be educated on psychosocial care.
Halpern also differentiates detached concern—a factual understanding of the patient’s experience—from empathy, the emotional form of understanding and appreciating the patient’s experience. Empathy allows audiologists to adjust their responses to patients’ communication and behavior during clinical interactions.
To best serve their patients, audiologists need to periodically examine their professional empathy, address the barriers they may face, and be sure to take care of their own emotional needs.
Sources
Denz, M., Keller, A., Kiss, A., Ruttimann, S., & Wossmer, B. (2002). Spontaneous talking time at start of consultation in outpatient clinic: Cohort study. British Medical Journal, 325(7366), 682–683. [Article] [PubMed]
Denz, M., Keller, A., Kiss, A., Ruttimann, S., & Wossmer, B. (2002). Spontaneous talking time at start of consultation in outpatient clinic: Cohort study. British Medical Journal, 325(7366), 682–683. [Article] [PubMed]×
Halpern, J. (2003). What is clinical empathy? Journal of General Internal Medicine, 18(8), 670–674. [Article] [PubMed]
Halpern, J. (2003). What is clinical empathy? Journal of General Internal Medicine, 18(8), 670–674. [Article] [PubMed]×
Holland, A .L., & Nelson, R. L. (2014). Counseling in communication disorders: a wellness perspective. San Diego, California: Plural Publishing.
Holland, A .L., & Nelson, R. L. (2014). Counseling in communication disorders: a wellness perspective. San Diego, California: Plural Publishing.×
Luterman, D. M. (2017). Counseling persons with communication disorders and their families. Austin, Texas: Pro Ed.
Luterman, D. M. (2017). Counseling persons with communication disorders and their families. Austin, Texas: Pro Ed.×
Pajevic, E., & English, K. (2014). Teens as health care consumers: Planned transition and empowerment. Audiology Today, 26(6), 14–18.
Pajevic, E., & English, K. (2014). Teens as health care consumers: Planned transition and empowerment. Audiology Today, 26(6), 14–18.×
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July 2018
Volume 23, Issue 7