Topic Three - motivational dialogue
Motion: Creating rapport is more important than getting on with treatment
For...
You need to establish rapport before you can talk about the substance use and its treatment. If there is no rapport then there is no point to any kind of intervention; service users will not take in anything that is said to them, they will probably dislike their practitioner, and are likely to drop out.
Against...
Establishing rapport is important and needs to be part of dealing with the problem the service user wants help with. It is no good wasting time just trying to strike up some rapport. Service users want to know that they are going to get the help they need and that their practitioner has that as their focus.
The question here is whether building rapport is enough. Of course, it is important but so is getting on with some form of intervention. The point is illustrated in the short article by a young doctor in training cited below. He talks about his experience during the COVID pandemic when, for a variety of reasons, it was proving difficult to establish rapport with people being admitted to hospital with a life-threatening illness.
In all the busy hospital departments during the COVID pandemic it was crucial to get on with essential treatments, but it was also important to establish rapport and try to put at ease people who were experiencing distressing and potentially life-threatening symptoms. It is important to experiment with what works for the practitioner’s style and what is acceptable to the huge mix of service users.
The key challenge of rapport building is posed by the sheer diversity of service users.
Building effective rapport improves compliance with treatment, satisfaction, and overall outcome.
In a busy department there is no time to 'talk about the weather' and so you have to establish rapport quickly as part of getting on with the care programme.
Find the full text of the article here…
Butt MF (2021) Clinical Medicine 21: e662–3 doi: 10.7861/clinmed.2021-0264
All kinds of things are justified by the need to identify or create a rapport with service users. How important is this and how far do you take it?
