Effective workplace communication with employees with acquired brain injury
- Implementation guide
- Acquired Brain Injury (ABI)
- Talking about talking and listening
- Talking about learning
- Talking about the job
- Talking about tools
- Talking about safety
- Talking about quality and quantity
- Talking about teams and workmates
- Talking about problems
- Talking about changes
- Talking about futures
Talking about talking and listening
Whether it is verbal, non-verbal, spoken, written or visual communication, it is all about sending and receiving messages.
One of your key roles is to assist supported employees to communicate as effectively as possible. Effectively supporting employees with ABI will depend a great deal on your ability to adopt specific and individual communication strategies.
Three elements are involved in the process of transmitting information between people.
- A sender wants to communicate something such as an idea, opinion, fact, etc.
- A message or transmission is what the sender wants to say, why, and to whom. The sender needs to be clear on the purpose of the message and then work out how to form the message (the words, diagrams or symbols that will best convey the message as it is intended).
- A receiver gets the message, works out its meaning, and acts on it.
Communication is only effective when the people with whom you're communicating:
- receive your message
- understand it
- respond to it in the manner you intended.
At each stage of the process, there are many potential barriers to effective communication. These include:
- individual characteristics (age, gender, culture) of both the sender and the receiver of the message
- problems in the transmission of the message
- inattention to the message – for whatever reason
- a different interpretation of the message from the one intended.
Support staff also need to be aware of a range of other things that can have impact on communication. For example, a person's cultural and language background may influence:
- how accurately or completely they receive the message
- how willing they are to ask questions or indicate the need for more information
- how they interpret the non – verbal (gesture, body – language) part of a message.
Whatever the reason, if the receiver does not receive the message in a way very close to the way it was meant then communication has not occurred.
ABI can make it hard for an employee to talk and listen.
Along with the ability to use language itself, the interpersonal skills required for effective communication can be impaired by ABI. These impairments are often a major factor in a person's psychological and social difficulties following a brain injury. They are often a key reason for problems in getting and keeping a job.
No one can go to work and do their job properly without communicating with others. Supported employees should know their communication responsibilities:
- making their needs and choices known, for example, their personal goals, problems or grievances
- taking on information communicated to them, for example, the name of their supervisor, the days on which they work
- assisting their organisation meet its objectives by, for example, knowing the targets for their work area or making suggestions about improvements.
Fulfilling these responsibilities requires both support staff and supported employees to use talking and listening skills.
Trevor is in his late 40s. He completed two university degrees before he was 23. Twelve years ago, Trevor was involved in a car accident, which resulted in a severe brain injury.
A very quiet and polite man, Trevor works in Pikkenpak, putting labels on cans and assembling cartons. As well as having severe memory problems, Trevor can't plan ahead or organise information. So if Em says to him, 'We need ten of those boxes assembled by 12 o'clock. What time will you have to start?', Trevor can't organise what he knows about how long it takes to make each box to work out when he'll need to start. He has similar problems foreseeing the consequences of actions, so he doesn't recognise that if each box takes a minute to assemble and he doesn't start assembling them until 11.55am he won't finish in time.
Trevor can become quite upset when someone puts questions to him that require organising information or foreseeing consequences. For instance, if a supervisor says, 'We're going to lunch ten minutes early today, so what time will you have to start the boxes to get them done in time?', Trevor seems to know he should be able to work it out but he simply can't. He always looks very dejected when something like this happens.
I've been reading a book about the impacts of brain injury on individuals and their families. I didn't realize how profound these can be. Brain injury changes people – not just the way they are but often all the social aspects of their lives as well. People's roles and responsibilities in their family and at home change and there can be huge difficulties for people adjusting to them. It made me much more aware of how Trevor's life must have changed since he had his car accident. From what he and his carer have told me, he was a manager of a company, had a big house in Melbourne and a wife and two little kids. He couldn't work after the accident, and the marriage broke up. He lives in supported accommodation now and his kids don't really recognise him as their father. Those are huge losses. I'm sure he still grieves for what he once had, even though he can't seem to remember much of what happens on a daily basis here.
- Be self-aware. You need to show that you are supportive, attentive and confident to communicate well with a person with ABI. Make sure they know that you are focused on them and ready and willing to listen and assist them communicate to the best of their ability.
- Engage attention. Make sure that the environment is as free from distractions as you can make it, and that you are sure you have the person's attention before speaking with them. Begin the conversation with information that orients them to what is being discussed.
Trevor, I've turned off the radio because I want to talk to you about the new boxes we have. Do you remember we talked about getting some new boxes in today?
- Encourage conversation.
- Talk about what is happening at work, your day, the person's day and so on.
- Speak of familiar names, places, interests and experiences the person has had in the past.
- Use familiar photos and other pictorial reminders to prompt memory.
- Give the employee things to hold or touch that evoke sensations of memories.
- Always include the employee in the conversation; don't let others expect you to speak for him or her.
- Structure your messages. Be consistent: explain things before you do them, discuss them as you go, and when you've finished.
Let me tell you what we're going to do this morning. First we'll strip off old labels, then we'll assemble new boxes.
See, we're cutting the labels this way, then they pull off easily.
We've finished the labels now and have done a good job.
What do we think we'll do next?
- Keep conversation simple.
- Use short simple sentences.
- Allow plenty of time for the employee to take in what you say, and to respond.
- Present one idea at a time.
- Ask direct questions. People with memory impairments often find it easier to respond to direct or 'closed' questions. Instead of, What do you put on to make it safer when you strip the labels?, say, Do you wear gloves when you strip labels?
- Model communication behaviours.
- Speak realistically.
- Ignore inappropriate social responses – for example, laugh with the person if it is appropriate; if not, ignore their laughter and don't laugh yourself.
- Be calm – avoid using expressions like 'relax'.
- Don't argue with the employee.
- If the employee uses unusual language or swears, accept it without laughing/getting angry.
- If necessary, help provide the correct word or phrase without emotional reaction.
- Don't pretend to understand if you don't – ask the person to repeat what they've said.
- Help avoid frustration.
- Try to avoid situations where there are a lot of people talking, or a lot of other noise around.
- Provide quiet times and opportunities for conversation with the employee.
- Speak at a pace and in a tone that allows the employee to follow you.
- Allow the employee to search for the word they want but keep in mind that you may need to give them the word so they don't get frustrated.
- If they can't find the word, ask them to describe or show you what they mean; encourage mime or gesture.
- Be prepared to change the subject if the employee is getting frustrated.
- Help the employee maintain focus. People with ABI often have trouble focusing and staying on the topic. They may get distracted by unimportant aspects of the topic, or go off at a tangent. Deal with this by:
- giving them feedback
- redirecting the conversation by asking a question
- not responding to the tangents.
- Provide information. People with an ABI often seem to understand a lot more than they may actually do. The language they use may be quite complex but they may only be able to make sense of very simple language. Always try to:
- use familiar and concrete language
- focus each discussion on one main point
- break down information into small 'chunks'
- repeat important points
- ask the employee to repeat back to you what you have said.
- Help 'move' thinking. ABI can cause thinking to become very rigid or inflexible. An employee with ABI may get stuck with a particular idea or thought, or may be unable to change their opinion or the topic. When this happens, break the cycle by moving on to something different.