Allowing patients to externalize and personalize their hearing loss may lead to better patient morale and cooperation, convincing even reluctant users to wear their hearing aids.
Psychologist Michael Harvey, PhD, who is in private practice in Framingham, MA, speaking at the American Academy of Audiology's AudiologyNow! conference in March, said externalizing conversations has proven successful for his patients. “It is theoretical imagery,” he said. “The helper — psychologist or audiologist — doesn't try to help right away, but instead becomes an investigative reporter, wanting to learn as much as possible about the hearing loss without trying to help. We try to develop an exposé on the identity of the hearing loss and how it relates to the patient.”
The first step is to elicit a description of the problem from the patient. Dr. Harvey suggested asking the patient what form the hearing loss takes, what its voice sounds like, and what it looks like. These questions may seem juvenile, Dr. Harvey said, but “once the older patients get over the initial awkwardness, it becomes fun.”
Next, the audiologist or psychologist maps the effect of the problem by talking with the patient about how hearing loss has successfully and unsuccessfully disrupted his life. Hearing specialists worry that asking these questions puts them into unfamiliar territory, but Dr. Harvey said how they frame the conversation can make all the difference.
“Often I get the remark that … hearing specialists don't have training or time to do this, which is valid, but the neat thing is that this is a way of talking about hearing loss relatively safely without going after feelings directly,” Dr. Harvey said. “It is a way to lighten up the session and talk about powerful stuff within the confines of confidence and time.”
He suggested saying something like, ‘I only have a couple of minutes, but can you give me a snapshot, a little taste, of how and why [hearing loss] is important to you?’
The answer to that question may seem obvious, but Dr. Harvey said asking the patient's opinion helps empower him and make him feel more in control of his situation. It also positively affects the patient-audiologist relationship, affirming that the hearing professional is an ally in the quest to overcome hearing loss.
Trying to force a patient to change will most likely be unsuccessful, Dr. Harvey explained. “The more disempowered the patient feels, the less likely he is to change. That is why we elicit the patient's position about how he feels about the problem as a way to get the patient talking about why he should change.”
One of Dr. Harvey's patients, a 67-year-old man, called his hearing loss the Joker. He agreed with Dr. Harvey that the hearing loss was negatively affecting his relationships and that action needed to be taken to beat the villain. “In allowing the patient the space to tell you more about why this is important to him, you can bear witness to an amazing transformative experience,” he said.
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