Listening quality leads to greater working alliance and well-being: Testing a social identity model of working alliance.

OBJECTIVES: Characterization of psychotherapy as the "talking cure" de-emphasizes the importance of an active listener on the curative effect of talking. We test whether the working alliance and its benefits emerge from expression of voice, per se, or whether active listening is needed. We examine the role of listening in a social identity model of working alliance. METHODS: University student participants in a laboratory experiment spoke about stress management to another person (a confederate student) who either did or did not engage in active listening. Participants reported their perceptions of alliance, key social-psychological variables, and well-being. RESULTS: Active listening led to significantly higher ratings of alliance, procedural justice, social identification, and identity leadership, compared to no active listening. Active listening also led to greater positive affect and satisfaction. Ultimately, an explanatory path model was supported in which active listening predicted working alliance through social identification, identity leadership, and procedural justice. CONCLUSIONS: Listening quality enhances alliance and well-being in a manner consistent with a social identity model of working alliance, and is a strategy for facilitating alliance in therapy.

[The OMAGE comprehension interview: a method for building patient-centered care plans]. / Entretien de compréhension Omage : une méthode pour élaborer des plans de soins centrés sur le patient.

OMAGE comprehension interviews (CIs) use a card game as a vehicle for active listening. CIs performed by training professionals revealed new information for 92% of patients. CIs seem to be an effective method for building patient-centered management plans, can be used by a wide range of health professionals and as prerequisites for medication reconciliation and patient education.

Active listening, shared decision-making and participation in care among older women and primary care nurses: a critical discourse analysis approach from a gender perspective.

BACKGROUND: Nursing care for older women represent a challenge worldwide due to its characteristics. When communication is impaired between primary care nurses and older women living alone, an imbalance in power relations occurs. The main objective of this study is to analyse the power relations between older women and primary care nurses in situations of active listening, shared decision-making and participation in care. METHODS: We developed a qualitative study in southern Spain using a discursive and gender approach. We used purposeful sampling to interview older women who lived alone and received home nursing care. Simultaneously, we conducted focus groups with primary care nurses who provided home care to older women. A linguistic analysis of the transcripts was carried out. RESULTS: Nine semi-structured face-to-face interviews were conducted with older women who lived alone and two face-to-face focus groups with four primary care nurses in each. The discourse of the participants demonstrated an imbalance in power relations. Influenced by work overload, active listening was considered a privilege in primary care nurses´ discourse. Regarding shared decision-making, older women´s discourses revealed "mirages" of real situations where they thought they were deciding. Participation in care was difficult since older women saw themselves as a nuisance in nurses´ presence, and primary care nurses did not facilitate older women's engagement. Older women weren´t considered when organising home visits and had interiorised a subordinated feeling. Similarly, a strict sense of identity made primary care nurses feel powerful in their relationships with older women. CONCLUSIONS: The discourse of older women represented them as victims of a hostile panorama whilst they were sometimes satisfied with the deficient care received. The discourse of primary care nurses used more discursive strategies to represent themselves as professionals committed to caring. However, it also revealed deficiencies in care, discriminatory elements, and feelings of being limited by their working conditions. Active listening to older women and engagement in decision-making readjust empower the older women. Attending to the needs and concerns of primary care nurses could recalibrate the power imbalance between them and healthcare organisations.

Remote family education and support program for parents of patients with adolescent and early adulthood eating disorders based on interpersonal psychotherapy: study protocol for a pilot randomized controlled trial.

BACKGROUND: In cases of adolescent and early adulthood eating disorders, despite the importance of the patients' relationship with their parents, conflict and confusion frequently occur among them. Interpersonal psychotherapy (IPT) is a present-focused psychotherapy that emphasizes the interpersonal context of symptoms. We developed a remote family education and support program exclusively for parents of patients with eating disorders, based on the principle of IPT. The use of IPT is expected to reduce conflicts in the patient-parent relationship. Consequently, parents will be better able to listen to patients, and patients will be better able to express their thoughts and desires. In this study, we describe the protocol for a randomized controlled trial designed to examine the effectiveness of this program in promoting effective communication in their home based on active listening skills of parents of patients with adolescent and early adulthood eating disorders. METHODS: Participants will be parents of patients aged 12-29 years with adolescent and early adulthood eating disorders. Individually randomized, parallel-group trial design will be employed. Seventy participants will be allocated to one of two treatment conditions: (1) remote family education and support program (four, 150 min weekly group sessions) for parents plus treatment-as-usual for patients (consultation by physicians or no treatment), or (2) waiting for the control condition (parents will wait to start the program for 8 weeks) plus treatment-as-usual for patients. The primary outcome measure will be parents' active listening ability as measured by the Active Listening Attitude Scale at 8 weeks after randomization. Additionally, perception of social support (Social Provision Scale-10 item), loneliness (UCLA Loneliness Scale), mental health status (K6), family function (Family Assessment Device), and parent-evaluated eating disorder symptoms (Anorectic Behavior Observation Scale) will be assessed. Data from the intention-to-treat sample will be analyzed 8 weeks after randomization. DISCUSSION: This is the first study to evaluate the effectiveness of a family education and support program for parents of patients with adolescent and early adulthood eating disorders based on IPT. If this type of intervention is effective, although indirect, it could be a new support method for this patient population. TRIAL REGISTRATION: Clinical Trials. gov ID NCT05840614.

For patients with adolescent and early adulthood eating disorders, although the relationship with their parents is an important interpersonal dynamic, conflicts and confusion often arise between patients and their parents. On the other hand, parents who live with individuals with eating disorders are frequently involved in interpersonal disputes, leading to a heavy psychological burden and elevated levels of depression and anxiety. It has been found that highly depressed or anxious parents tend to have difficulty listening carefully to their patients. Additionally, parental anxiety often promotes an overprotective response. Interpersonal psychotherapy (IPT) is a present-focused psychotherapy that emphasizes the interpersonal context of symptoms. In IPT, the patient and therapist work within interpersonal therapeutic domains, such as interpersonal role disputes with different expectations and role transitions. We developed a remote family education and support program exclusively for parents of patients with eating disorders based on IPT principles. In the present study, we describe the protocol for a randomized controlled trial designed to examine the effectiveness of this program in promoting effective communication within their homes, focusing on the active listening skills of parents of patients with adolescent and early adulthood eating disorders.

Question asking in active listening scale for early adolescents: Behavioral measure development and initial validation.

Relational theories of human development explain how stereotypes and their underlying ideologies thwart social connections that are fundamental for individuals to thrive, especially in early adolescence. Intervention research to address this crisis of connection is still emergent and active listening is one promising strategy to this end; however, its efficacy has not been examined in part because no validated measures of active listening for this population exist. This validation study is the first to examine whether the behavioral dimensions of one form of active listening can be captured using a coding scheme to assess adolescents' engagement in a live interviewing task (N = 293). Importantly, the measure was developed within the context of a theory-driven intervention to train adolescents in transformative curiosity and listening to enhance connection. Findings indicate that two dimensions underlie the measure as hypothesized, open-ended questions and follow-up questions, with acceptable internal consistency. The measure is sensitive to change in adolescents' questioning skills before and after the intervention. Further, asking follow-up questions was positively related to empathy and also predicted a respondent's perception of their interviewer as a good listener. The effect for asking open-ended questions was moderated by dyad-level tendencies to elicit disclosure from others. The current measure not only examines question asking as a more nuanced behavioral dimension of active listening than previous measures, it is also the first to do so among a sample of early adolescents. The measure will be useful in assessing active listening interventions' efficacy to address the crisis of connection.

Understanding the communication skills that support nurses to provide person-centred care.

Communication is a process of sharing information and developing relationships through interaction. It is essential for nursing care, providing a basis for nurses to establish therapeutic relationships and trust with patients and their families. It is often assumed that nurses can intuitively communicate well; as a result, traditionally there has been a lack of formal training in this area. However, communication is a skill that can be developed and enhanced. This article explains the elements of communication and discusses the skills required by nurses to communicate effectively and provide compassionate, person-centred care. The author outlines two communication models to demonstrate how nurses can use these skills to deliver bad news and support people in distress.

Individualized behavior-based safety-leadership training: A randomized controlled trial.

INTRODUCTION: Construction site managers play a critical role in occupational safety in the construction industry. This study aimed to develop and test a method for training construction site managers in positive feedback and active listening by incorporating the behavioral training components of behavior analysis, goal setting, practice with behavior feedback, homework, and maintenance planning into individualized behavior-based safety-leadership training (IBST), and to assess the effect of IBST on construction site managers' safety-leadership behaviors and performance. METHOD: In a naturalistic randomized controlled trial, construction site managers were randomly assigned to an experimental group (n = 16) or a control group (n = 19). The experimental-group managers received IBST, while the control-group managers received no training. Paired sample t-tests on pre- to post-training (i.e., six weeks after the final training session) were performed separately for the experimental- and control-group managers. RESULTS: The safety-leadership behaviors of the experimental-group managers improved in terms of favorable feedback (d = 0.99, p <.01), safety-specific feedback (d = 0.89, p =.02), behavior-specific feedback (d = 0.66, p =.02), antecedent listening (d = 0.68, p =.02), and consequential listening (d = 0.78, p =.01). In addition, safety-leadership performance improved in terms of transformational leadership (d = 0.78, p =.01) and contingent-reward leadership (d = 0.64, p =.02). No significant change was found for the control-group managers. CONCLUSIONS: The results indicate that behavior analysis, goal setting, practice with behavior feedback, homework, and maintenance planning are effective behavioral training components of safety-leadership training. Positive feedback and active listening were also found to be important behavioral requisites for transformational and contingent-reward leadership. PRACTICAL APPLICATIONS: IBST can be used to develop occupational safety in the construction industry by improving construction site managers' safety-leadership behaviors and performance.

Recasting the gold standard - part II of II: communicating healthcare options along a continuum of care.

SERIES OUTLINE: This is the second part of a two-part series on spectrum of care that encourages practitioners to tailor case management to the patient along a continuum of acceptable options. Part I defined the spectrum of care and broadened its approach beyond initial cost-of-care considerations. This second article introduces strategies for initiating conversations with clients about their needs, wants and expectations specific to healthcare options and case management decisions. It will explore how open inquiry, reflective listening, transparency and unconditional positive regard facilitate dialogue between providers and their clients as they collaborate on decision-making along a spectrum of care. RELEVANCE: Contextual case management prioritizes interventions that are appropriate for both the patient and the client. To identify and explore which healthcare options represent the best fit for those impacted most by medical decisions, veterinarians need to make space for clients to feel comfortable sharing their perspectives. Clients are more likely to be engaged in decision-making when their insight is actively solicited. They have much to share with us as experts about their cat's overall health and wellness needs. Inviting clients to contribute to the consultation and being receptive to hearing what motivates their choices helps us to structure conversations around healthcare options. The ability to communicate healthcare options is as vital as the provision of healthcare, if not more so.

How to break bad news.

RATIONALE AND KEY POINTS: Breaking bad news is a fundamental yet challenging aspect of the role of healthcare professionals, including nurses. This article provides a step-by-step framework that nurses can use when delivering bad news and having challenging conversations with patients and/or families. • Preparation is important to ensure that challenging conversations are carried out in a suitable physical environment and with family members and/or friends present as appropriate. • Using a framework can aid nurses when undertaking challenging conversations, ensuring that all necessary aspects of the process are incorporated. • Nurses need to manage the expectations of patients and family members and respond appropriately to their emotional reactions. REFLECTIVE ACTIVITY: 'How to' articles can help to update your practice and ensure it remains evidence based. Apply this article to your practice. Reflect on and write a short account of: • How this article may help you to deliver bad news using a step-by-step framework in your practice. • How you can use the information in this article to communicate effectively and address emotional distress when breaking bad news.

The Effect of Combined Auditory Training on Concurrent Sound Segregation in Young old: A Single-Blinded Randomized Clinical Trial.

This study aimed to investigate the behavioral results of perceptual learning in young old using double-vowel discrimination tasks in combined auditory training programs. In a single-blind randomized clinical trial, 35 participants were randomly divided into three groups and received different auditory training programs for six sessions using the software. To compare the double-vowel discrimination score, CV in noise test, and reaction time to the first and second vowels pre- and post-intervention, an analysis of variance was conducted. The discrimination score in the double vowel task and CV in noise test improved after training with no significant difference between the groups. After auditory training, the lowest RT1 was observed in the first intervention group, whereas RT2 decreased only in the second intervention. The present study showed that combined auditory training programs are as effective as conventional auditory training programs in improving speech perception in the elderly. Modifications in the sensory cortex could be investigated using electrophysiological recordings, but this was not conducted because of the pandemic. Supplementary Information: The online version contains supplementary material available at 10.1007/s12070-023-03923-x.

Analysing Power Relations among Older Norwegian Patients and Spanish Migrant Nurses in Home Nursing Care: A Critical Discourse Analysis Approach from a Transcultural Perspective.

Power relations in care are the link between patients and nurses regarding communication and the ability to act in this context. It can be affected when there is cultural interference between members, putting mutual understanding at risk in healthcare situations. This study analyses power relations in healthcare situations between older Norwegian patients and Spanish migrant nurses regarding active listening, shared decision-making, and patient participation. We performed a hermeneutical study endorsed in critical discourse studies framework from a transcultural perspective. A purposive sampling included older Norwegian patients living alone and Spanish migrant nurses working in Norway. Eleven face-to-face semi-structured interviews were conducted with older patients and four via videoconference with migrant nurses. The analysis followed hermeneutic considerations by Crist and Tanner, and linguistic analysis was performed. Shared decision-making and active listening situations sometimes showed a power imbalance that negatively influenced older Norwegian patients. However, Spanish migrant nurses were also conditioned by care organising institutions. This power triangle negatively affected the relationship between the older patients and migrant nurses, resulting in a lack of communication, personnel, time and trust. The migratory experience influenced the care provided by Spanish migrant nurses, shaping a series of cultural competencies acquired through the migratory process.

Teaching attentive listening to medical students: need and strategies.

Listening is a primary skill essential for learning and is positively correlated with academic achievement. It also enables a healthcare professional to fully explore patients' concerns in healthcare settings. There has been much discussion on how effective listening practices can facilitate students' learning. A clear understanding of listening as a 'process' and planned listening activities can help exploit listening skills in formal and informal learning contexts. This paper explores strategies through which listening can be taught to undergraduate medical students in a small group setting. A planned tutorial is discussed, including methods that can be used to teach listening skills. The simple guidelines provided here can be used in most small group teaching methods. These teaching strategies are likely to allow undergraduate students to evolve into better listeners and, therefore, better lifelong learners and future physicians.

Storytelling, Creativity and Writing as a Tool for Building Sophisticated Social Skills.

INTRO: The aim of the work is to prove the effectiveness of the recommendations developed by the authors for introducing the basics of storytelling into the educational process in the context of the development of sophisticated social skills. METHODS: A survey method was used to determine students' knowledge of storytelling. Previously 52% of students used the storytelling techniques only partly in classes, and 30% of students are not familiar with the storytelling features and have not previously used them. RESULTS: The survey revealed students' insufficient knowledge about storytelling. Comparison of students' skills before and after the experiment showed that the developed recommendations have an impact on learning effectiveness. Such findings are attributed to the fact that after the experiment 89% of students had high scores (90-98 points), while before the experiment only 15% of students possessed such skills, with their scores ranging from 82 to 90 points. CONCLUSION: Research findings may be used to develop creative texts that, among other things, drive sophisticated social skills. Practical significance. The research findings may be used by future and present scientific journalists, television journalists and presenters seeking to improve their professional and creative skills which would help them to stay competitive in the media industry.

Training spatial hearing in unilateral cochlear implant users through reaching to sounds in virtual reality.

BACKGROUND AND PURPOSE: Use of unilateral cochlear implant (UCI) is associated with limited spatial hearing skills. Evidence that training these abilities in UCI user is possible remains limited. In this study, we assessed whether a Spatial training based on hand-reaching to sounds performed in virtual reality improves spatial hearing abilities in UCI users METHODS: Using a crossover randomized clinical trial, we compared the effects of a Spatial training protocol with those of a Non-Spatial control training. We tested 17 UCI users in a head-pointing to sound task and in an audio-visual attention orienting task, before and after each training.
Study is recorded in clinicaltrials.gov (NCT04183348). RESULTS: During the Spatial VR training, sound localization errors in azimuth decreased. Moreover, when comparing head-pointing to sounds before vs. after training, localization errors decreased after the Spatial more than the control training. No training effects emerged in the audio-visual attention orienting task. CONCLUSIONS: Our results showed that sound localization in UCI users improves during a Spatial training, with benefits that extend also to a non-trained sound localization task (generalization). These findings have potentials for novel rehabilitation procedures in clinical contexts.

Coaching Strategies for Behavioral Voice Therapy and Training.

Coaching is one of the most common words in our modern vocabulary and has many meanings depending on the setting in which it is used. Coaching facilitates positive changes to achieve a goal, usually through indirect approaches, including improving an individual's outlook on their behaviors or attitudes. Its application has spread beyond the corporate world, and many medical specialties use coaching principles. The goals of this article are to introduce coaching as a profession, and to explore the function of a vocal coach to improve communicative and vocal performance. Moreover, differences between voice therapy and voice training are highlighted, including the principles subjacent to these interventions and the use of coaching strategies. Four strategies of professional coach practitioners adapted to the training and therapy of the voice with applications to both are described. These are: powerful questions, active listening, changing habits, and implementation intention. The use of these strategies may help individuals to achieve high voice performance. Most importantly, the speech-language pathologist voice specialist can apply these strategies particularly in cases of behavioral dysphonias, which can be resistant to traditional voice therapy.

Talking About Things: A Patient Cue for Sensitive Healthcare Problems and Effective Physician Responses.

In routine healthcare consultations, patients often use prefaces containing the word "thing", including "the thing is", "there's this thing" or "one more thing". Although "thing" is an all-encompassing term that is used in myriad ways, in this article we show that thing-prefaces perform a specific job. This study uses Conversation Analysis to analyze 90 video-recorded primary care consultations with 14 primary care physicians in the United States. Patients' thing-prefaces mark the upcoming talk as a disclosure of sensitive information that may reflect negatively on the patient, physician or service (e.g., medication nonadherence, refill was not sent to pharmacy). Patients pursue explicit resolution of these problems (e.g., personalized recommendation, lab work, referral) despite these problems being downplayed and treated as delicate. Because patients may "talk around" these sensitive issues, thing-prefaces can be an important cue for physicians that patients are seeking resolution for a sensitive healthcare problem.

Application and impact assessment of an interactive journal club format among endocrinology fellows-in-training in a tertiary hospital academic center: a case study.

Background: The interactive journal club is designed to utilize a new approach in appraising research in order to maximize the benefits of the traditional journal club. In this new approach, the participants are actively involved in a structured process of critical data appraisal rather than just being passive listeners. In this case study, we applied the interactive journal club format and assessed its impact among our endocrinology fellows-in-training. Methods: We conducted four interactive journal club sessions within a four-week span, one per each week via a virtual platform. The 12 participants were the same throughout all sessions. Each session was recorded following informed consent. At the end of all sessions, feedback was obtained, tabulated and compared. Results: Sessions lasted from 59 to 83 minutes (mean, 67.75 minutes). Participants became more active and spontaneous as the sessions progressed. All participants found the format more fun and proactive. This approach allowed more critical thinking and processing of information. Salient features include increased self-esteem and confidence, additional learning from other participants, better retention of information, and utilization in future practice. Conclusions: Traditional approaches are transformed from passive presentations of recent developments in medicine into an interactive discussion while allowing the retention of the spirit and essence of a traditional journal club, as well as exploring new and improved approaches in clinical training and education.

The influence of active listening on parents' perceptions of clinical empathy in a stuttering assessment: A preliminary study.

PURPOSE: The primary purpose of this preliminary study was to explore whether a clinician's use of active listening skills (i.e., client-directed eye gaze and paraphrasing) influenced parents' perceptions of clinical empathy in a stuttering assessment. A secondary purpose was to determine whether parent age, education, or parent concern predicted perceived clinical empathy. METHOD: Participants (n = 51 parents/guardians of children who stutter) watched two counter-balanced videos of a clinician demonstrating either high or low frequency use of active listening skills during the clinician's initial assessment with a standardized patient actor portraying a parent of a child who stutters. After each video, parents rated the clinician's empathy and active listening skills via the Jefferson Scale of Physician Empathy for Observers (JSPEO; Hojat et al., 2017) and the Counselor Activity Self-Efficacy Scales - Modified (Victorino & Hinkle, 2018). Participants then completed a demographic questionnaire and rated their concern about their child's stuttering. RESULTS: Paired t-tests demonstrated significantly higher ratings of perceived clinical empathy in the high frequency active listening condition compared to the low frequency condition (d = 0.548). Simple linear regression analyses indicated parent age or level of education did not predict perceived clinical empathy. An independent samples t-test indicated that parent concern about stuttering did not predict perceived clinical empathy. CONCLUSIONS: Preliminary findings suggest that the clinician was viewed as significantly more understanding, concerned, and caring (i.e., perceived as empathic) when active listening skills were used. Parents' ratings of empathy on the JSPEO, based on high levels of active listening by the clinician, were not associated with parents' ages, education levels, or concern about their children's stuttering. This may reflect the value of active listening in clinical relationships regardless of variables specific to the recipient (e.g., parent of a child who stutters). Given that parents are more apt to share thoughts and emotions about their child's communication with clinicians who demonstrate empathic qualities, this preliminary study suggests that the use of active listening skills warrant emphasis in clinical training.

Short-term plasticity of neuro-auditory processing induced by musical active listening training.

Although there is strong evidence for the positive effects of musical training on auditory perception, processing, and training-induced neuroplasticity, there is still little knowledge on the auditory and neurophysiological short-term plasticity through listening training. In a sample of 37 adolescents (20 musicians and 17 nonmusicians) that was compared to a control group matched for age, gender, and musical experience, we conducted a 2-week active listening training (AULOS: Active IndividUalized Listening OptimizationS). Using magnetoencephalography and psychoacoustic tests, the short-term plasticity of auditory evoked fields and auditory skills were examined in a pre-post design, adapted to the individual neuro-auditory profiles. We found bilateral, but more pronounced plastic changes in the right auditory cortex. Moreover, we observed synchronization of the auditory evoked P1, N1, and P2 responses and threefold larger amplitudes of the late P2 response, similar to the reported effects of musical long-term training. Auditory skills and thresholds benefited largely from the AULOS training. Remarkably, after training, the mean thresholds improved by 12 dB for bone conduction and by 3-4 dB for air conduction. Thus, our findings indicate a strong positive influence of active listening training on neural auditory processing and perception in adolescence, when the auditory system is still developing.

"I'm listening, did it make any difference to your negative emotions?" Evidence from hyperscanning.

Hyperscanning refers to simultaneously recording the brain activity of two or more people participating in the same cognitive activity to reveal the underlying processes. Active listening is a necessary and important part of interpersonal emotional regulation; however, few studies have addressed the corresponding brain activity. Therefore, this study aims to explore the regulatory effect of active listening and changes in the brain using functional near-infrared optical spectroscopy(fNIRS) in real situations requiring interpersonal emotional regulation. Behavioral results show that active listening has a significant effect on improving individuals' negative emotions. According to the neuroimaging results, the orbitofrontal cortex (OFC), right dorsolateral prefrontal cortex (right dlPFC), right temporoparietal junction (right TPJ), and left dorsolateral prefrontal cortex (left dlPFC) were significantly activated. In addition, band analysis showed interpersonal brain synchronization (IBS) increments at the orbitofrontal cortex (OFC), right dlPFC, right TPJ, and left dlPFC at different frequencies. Measurements of IBS and behavioral coherence showed that the increases of IBS at the OFC, right dlPFC, right TPJ, and left dlPFC were not significantly correlated with depression, anxiety, and the empathy level of the emotional regulator. The present study provides brain imaging evidence for the effectiveness of active listening in interpersonal emotional regulation.