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Dear Elizabeth,
Oh dear, I cant recall exactly what we wrote in the Health Behaviour Change book! Its not near me, so I'll deposit in this post a brief summary of what's in my head right now, if that's OK?
Then come back to us with further comments or questions.
You ask about the difference between buidling rapport and setting the agenda. They are linked, the first is a description of the state of the relationship, the second a quite specific task. Do the latter well, and rapport will be enhanced hugely. However, just buidling rapport does not help a lot to set the agenda!
I'll try putting this another way! Agenda-setting was a term I borrowed in the early 1990s to describe a task - when a practitioner is facing a patient, often with a long-term condition like diabetes, and there are many change topics they could talk about. But which one do they start with? Who decides? As you probably know, its all too often the practitioner, with a resulting negative imact on the patient (and their rapport). Agenda-setting is a task in which the practitioner tries to lay out the possibilities, and invites the patient to say what change topic they would like to talk about. the idea is not to into any topic in too much detail, but to skim the surface at the beginning of a consultation, adding practitioner ideas too. Then they agree about what to talk about, and even the order in which they will do thid, and get back to this agenda-setting process at the end of the consultation.
Its a quite specific task, agenda-setting. my partner Nina Gobat is doing her PhD thesis research on measuring this skill. We also wrote about it in "Motivational Interviewing in Health Care".
Does this help, Elizabeth?
Kind regards,
Steve |
