managing the patient, parent and practice iii “the dentist-child relationship”
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MANAGING THE PATIENT, PARENT AND PRACTICE III THE DENTIST-CHILD RELATIONSHIP Slide 2 COMMUNICATING WITH CHILDREN Effective communication is a primary objective. Communicate in two basic ways: verbally: school activities,pets,articles of clothing, childrens television programs, books, muppets non-verbally: holding young child in lap; touching tenderly, smiling approvingly Slide 3 MULTISENSORY PERSPECTIVE Transmitter: Dentist Medium: Office Environment Receiver: Child Patient Slide 4 TELL-SHOW-DO Tell-Show-Do is the classical model for communicating with children in the dental environment. Developed (first documented in the literature) by Harold Addelston, of New York Universitys School of Dentistry. Slide 5 TELL before during after TELL using euphemisms (substitute language) Understanding critical Be honest in your TELLing! Slide 6 SHOW SHOW (demonstrate) the child what will be happening,how it will happen, and with what equipment. But, it is not wise to SHOW fear- promoting instruments. Remember the multi-sensory perspective in SHOWing: children can HEAR, SEE, TOUCH, TASTE, and SMELL. Slide 7 DO DO what you said you were going to do. DO it in the manner you said you were going to do it. As you DO it, continue to TELL the child what you are DOing. DO NOT DO until the child has a clear awareness and understanding of what you are going to DO. DO it expeditiously! Slide 8 GINOTT PRINCIPLES Acknowledge the childs experience. Grant in fantasy what you cannot grant in reality. Children are equal in dignity. Praise Give children choices-offer options Acknowledge correctness Children need to be liked. Slide 9 GORDON MODEL FOR COMMUNICATING WITH CHILDREN Parent Effectiveness Training by Thomas Gordon Slide 10 ROADBLOCKS TO COMMUNICATION Ordering, Directing, Commanding Warning, Admonishing, Threatening Exhorting, Moralizing, Preaching Advising, Giving Suggestions/Solutions Lecturing Judging, Criticizing, Blaming Praising Name Calling, Ridiculing, Shaming Interpreting, Analyzing, Diagnosing Reassuring, Sympathizing, Consoling Probing, Questioning, Interrogating Withdrawing, Distracting, Humoring Slide 11 OWNING THE PROBLEM In the dental setting (and in every human relationship) there are times when: The dentist owns the problem; that is, some need the dentist has is not being met. The child owns the problem; that is, some need of the child is not being met. There is no problem, as the needs of both the child and the dentist are being met. Slide 12 THREE PROBLEM CIRCUMSTANCES IN THE DENTAL ENVIRONMENT Child is whining because doesnt want to be in dental chair; wants to be finished and with parent. But child is being cooperative so dentist can complete the treatment. THE CHILD OWNS THE PROBLEM. Child is comfortable, seeming enjoying the experience, and cooperative. THERE IS NO PROBLEM. Child is satisfying needs, but is being uncooperative, tangibly interfering with dentist having his/her needs met of completing the treatment. THE DENTIST OWNS THE PROBLEM. Slide 13 OWNING THE PROBLEM Area of Acceptable Behavior for Dentist: Child Owns the Problem There is No Problem Area of Unacceptable Behavior for Dentist: Dentist Owns the Problem Slide 14 WHEN THE CHILD OWNS THE PROBLEM ENCODING PROCESS CHILD TIRED DECODING PROCESS TIRED When are you going to be finished? Child Dentist Slide 15 WHEN THE CHILD OWNS THE PROBLEM ENCODING PROCESS CHILD TIRED DECODING PROCESS TIRED When are you going to be finished? Child Dentist You want to get back to school. No, I didnt mean that. I meant I am really tired of holding my mouth open.. Slide 16 WHEN THE CHILD OWNS THE PROBLEM ENCODING PROCESS CHILD TIRED DECODING PROCESS TIRED When are you going to be finished? Child Dentist Youre getting tired. Slide 17 ACTIVE LISTENING... In active listening, the receiver tries to understand what the senders message means. S/he then puts his/her understanding of it into own words and feeds it back to the sender for verification. Does not send a message of own--such as an evaluation, opinion, advice, analysis or question--only understanding of the senders message. Slide 18 ACTIVE LISTENING...... is used when: the child owns the problem. Slide 19 ACTIVE LISTENING... Helps children discover exactly what they are feeling. Helps children become less afraid of negative feelings. When dentist accepts the feelings the child learns that feelings are friendly. Promotes a relationship of warmth between the dentist and the child. Being heard and understood is very satisfying. Facilitates problem-solving by the child. Influences the child to be more willing to listen to the dentists thoughts and ideas. Slide 20 WHEN THE DENTIST OWNS THE PROBLEM When the dentist is prevented from accomplishing what needs to be done, that is, the childs behavior is effectively preventing such, the dentist, owns the problem. At such times, the dentist must confront the childs behavior in such a manner as to change it. This is done most effectively by using I messages. Slide 21 YOU MESSAGES ARE NOT HELPFUL Our natural tendency in times when the child is not behaving in a manner acceptable to us is to send a you message: YOU stop that! YOU must not do that! Dont YOU ever! YOU are being bad! YOU are not acting like a big girl! Why cant YOU be good?! YOU should know better. Slide 22 YOU MESSAGES... Are put-downs. Impugn the childs character. Deprecate the child as a person. Shatter the childs sense of self; self- esteem. Underline the childs inadequacies. Cast a judgement on the childs personality They point the finger of blame toward the child, and are roadblocks to communication. Slide 23 WHEN THE DENTIST OWNS THE PROBLEM ENCODING PROCESS Frustrated I cannot put the rubber raincoat on with hands over the mouth.! Dentist Slide 24 WHEN THE DENTIST OWNS THE PROBLEM ENCODING PROCESS I Am Bad DECODING PROCESS Frustrated You sure are no help! DentistChild Slide 25 WHEN THE DENTIST OWNS THE PROBLEM ENCODING PROCESS He is Frustrated DECODING PROCESS Frustrated Dentist Child I cannot put the rubber raincoat on with hands over the mouth. Slide 26 I MESSAGES I messages are more effective in influencing a child to modify behavior. I messages must less apt to provoke resistance and rebellion. I messages are less threatening to the child. I messages are more effective because they place responsibility for change within the child. Slide 27 I MESSAGES I messages can be sent non- verbally as well: A stern look says, I am unhappy with you behavior. A firm positioning of a squirming child in the chair says, I need to work on a non-moving target. Slide 28 SUMMARY When you have a problem with the childs behaviorSEND AN I MESSAGE! When the child is having a problemACTIVE LISTEN! When neither of you have a problem, continually reinforce the childs behavior, citing tangible aspects of that behavior. Slide 29 SELECTING AND USING APPROPRIATE TERMINOLOGY Slide 30 VOICE INTONATION The tone of the dentists voice can also be a very effective way to alter the childs behavior. Kind to firm, or soft to stern voice can communicate much! Im upset! has shock value and can gain the childs attention quickly.