in settings of ambivalence and resistance …

… don’t push (“righting reflex”) but reflect … Pollack et. al. discuss how to talk with patients and families when they are resistant to discussing the future or are ambivalent and unable to make a decision.

Criteria to know if we have been successful …

  • Letting patients talk as much as clinicians;
  • Keeping question-asking to a minimum and using reflective¬†statements
  • Providing advice only after asking permission to do so.
Applying Motivational Interviewing Techniques to Palliative Care Communication. Pollak, KI et. al. JPM. DOI: 10.1089/jpm.2010.0495.