better and better…
In the course of training new therapists, there always seem to be lessons available to all, even those of us charged with guiding their education. Ocular motility activities and the Accommodative/Vergence relationship are well documented and the resources for learning in these areas are plentiful and always held in high stead. Not so abundant though might be books on patient communication; specifically, understanding what questions to ask or not ask patients during given Vision Therapy activities, and why? To the casual observer, questions during a Vision Therapy session may seem benign or even scripted, and to be fair some are. For me, the good therapists are the therapists who work hard to evoke thought inducing awareness building responses by working beyond the script and above the innocuous ideas. These therapists communicate differently both with their words and with their body language. They ask questions whose answers will serve a purpose, or lead their patient into uncharted territory with the goal of staking claim to the new found and coveted real estate called progress. For my money, the communication skills of the therapist become so important in efficacious Vision Therapy because a well timed and penetrating question can often be the difference between the “ah ha” moment we all strive for, and what my friend Linda Sanet refers to as the “business as usual” response.
Anyone who has ever been in a committed relationship for longer than five minutes knows how easy it can be for your words to be misconstrued. Have you ever said something to your spouse only to have them understand something totally different? How does it happen that what they heard has nothing to do with what you actually said? Your intention with the spoken message passed through their filter and became something totally different — and you have no idea how. Sound familiar? Unfortunately, this breakdown in communication doesn’t end with intimate relationships. So often it occurs with family members, friends, co-workers, and patients. Communication is key, especially patients.
In the Vision Therapy room, communications gaps such as these are unavoidable. We are human beings, after all, and we all communicate and perceive differently. As therapists though, we can always work to improve ourselves, our line of thinking, and the manner in which we phrase questions. One of my earliest posts in this blog was on the topic of communication in the VT room, and when things get rocky and I’m feeling as if my patients are not achieving because of my approach, I will revisit these ideas. Here are some thoughts that are considered:
- Do the patient’s struggles have anything to do with how I am asking the questions?
- If I come at this problem from a different angle with different questions, would that change the result?
- Is my physical position in the room somehow a factor? I don’t consider myself an intimidating presence, but perhaps I’m hovering over the patient (or in their perceived personal space) and somehow changing their perception of what I am looking for, and in turn affecting their willingness to take a shot at solving a problem. Body language is so often an overlooked factor in communication.
- If I let someone else ask the questions, what would happen?
- Should I try having someone else ask these questions?
- Have I asked enough questions?
- Have I asked the right questions?
- Am I giving the patient enough time to formulate an answer?
- Am I REALLY listening to their answer?
There are many paths to positive communication in the Vision Therapy room and certainly we all have our own methods. Paramount for evolving therapists is that our passion and determination to improve as therapists is driven equally by our need to improve our communication skills as to our understanding of pursuits, saccades and the accommodative/vergence relationship. Communication belongs to the speaker and is a skill set unto itself; it also seems to truly be the determining factor between the good therapists, and the great ones.