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Therapeutic Techniques to Build Alliance with Complex Patients and Their Families

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1.  Normalizing is a very simple but powerful tool that can be used to reassure patients that others have experienced similar challenges and can facilitate further discussion of anxiety/discomfort. Which of the following is an example of “normalizing”?
  1. “I haven’t heard anyone else say that”
  2. “Oh, wow”
  3. “This is very common among others with hearing loss”
  4. “That must be hard”
2.  Which of the following in an example of reflective language?
  1. “OK”
  2. “What I am hearing is...”
  3. “So you are going to wear your hearing aids more, right?”
  4. “You should do what I am recommending”
3.  Asserting your educational background/training to emphasize why the family should listen to you, AKA being the “finger-wagger” has been shown to be:
  1. Effective in producing health behavior change by itself.
  2. Likely to open family’s up to a discussion of their challenges.
  3. Good for reducing barriers to medical adherence.
  4. Often ineffective in producing lasting, meaningful behavioral change.
4.  Which of the following could be considered components of deaf identity?
  1. Engagement with Deaf media
  2. Education/Work Environment
  3. Language Modality
  4. All of the above
5.  Addressing multicultural identity in an appointment is likely to:
  1. Increase resistance to adhering to medical recommendations.
  2. Anger your patient and the family.
  3. Facilitate a discussion of how the patient’s background and lived experiences are impacting them.
  4. Increase resistance from the family.
6.  Motivational Interviewing is:
  1. Elicits behavior change by exploring and resolving ambivalence.
  2. A good way to “trick” someone into doing something.
  3. Gets people excited to try something new.
  4. Will absolutely increase patient device usage.
7.  Eliciting change talk can be really helpful to get patients to discuss barriers and motivational challenges. For example, asking a patient “why are you a ‘7’ and not a ‘3’?” Does which of the following:
  1. Gets the patient talking about reasons FOR change.
  2. Gets the patient talking about reasons AGAINST change.
  3. Doesn’t pull for further conversation.
  4. Is a bad question.
8.  When counseling a family who just received a new diagnosis of hearing loss, which of the following communication strategies can be helpful?
  1. Ask specific, targeted questions
  2. Use reflective language, such as “it seems…” and “If I am understanding you correctly…”
  3. Ask closed ended questions, that pull for “yes” or “no”
  4. Tell the family about your previous professional experiences
9.  An effective communicative technique to utilize with challenging caregivers when providing medical advice is to:
  1. Review your training background.
  2. Inform the caregiver on the number of patients you have worked with.
  3. Ask for permission to provide additional information.
  4. There is no point in telling a challenging caregiver what to do.
10.  Thinking about where a patient is in the “stages of change” model can be helpful to determine how and to what degree a patient and their family should be counseled. Which of the following are stages of change?
  1. Pre-contemplation – No intention of changing behavior.
  2. Contemplation – Aware of a problem but no commitment to action.
  3. Preparation – Intent on making a change and making active plans.
  4. All of above

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