I wrote this article for an assisted living magazine but the technique of “Redirection and Resolution” works in a wide range of situations where negative feedback needs to be managed in a calm, professional manner.
Asking the daughter of a new resident about how her mother was adjusting seemed like a benign question. The executive director felt confident the answer would be positive because, according to feedback from team members and the resident herself, the move appeared to be going well. But her daughter saw it differently. She said other family members thought her mom was very unhappy and she was receiving pressure from them to “take care of the situation.” How did the executive director respond to this unexpected information?
Unexpected negative feedback from residents or their families may trigger resistance, anxiety and trepidation. While this is a normal response to unwanted feedback, it is also a “moment of truth” in which the recipient can either intensify the concern or shift the conversation towards a better outcome.
One approach to shifting the conversation is called “redirection and resolution.”
This approach may not come easy when confronted with an unhappy resident or family member; effective redirection and resolution takes practice, patience, and flexibility. But it works because it is based on proven communication strategies that promote the collaborative pursuit of a solution.
Redirection and resolution is, in essence, a communication dance. Much like the waltz, which depends on three beats, this strategy consists of three steps: diffusing, discovery, and strategizing. Diffusing calms down resistance while discovery expands and clarifies the primary concern. Finally, strategizing identifies a consumer-favored approach to addressing their concern.
Diffusing, which helps preserve rapport amid stress, consists of three stages. The first stage of diffusing helps a recipient of negative feedback resist the temptation to overreact. Left unchecked, resistance triggers a cascade of escalating emotions that lead to angry and defensive responses. An effective way to short circuit this reaction is called “naming.”
Naming involves assigning a neutral name such as “unexpected information” or “new concerns” to negative feedback. The neutral name makes the feedback less personal and threatening, and it allows the recipient a way to calm down “hot thoughts” and remain professional. In this instance, the executive director should take a moment to privately rename the feedback:
• “My resident has an unexpected concern.”
• “My resident’s daughter has brought some new information to my attention.”
The second stage of diffusing consists of addressing the client’s need to be heard and understood. There is obviously a need for the daughter to tell the specifics of what is causing the concern. However, the executive director should be aware that there is a less obvious, but equally important need to recognize and connect with the adult child’s psychological agenda.
The developmental theme of middle age is an emerging crisis which, instead of a sudden occurrence, is an incipient shift in complexity and tone. Externally, the seminal event is usually sickness or death in the family, but it can also involve major upheavals with children, careers, aging parents, and core relationships.
Up to the early forties, the pattern of building a career, raising children, and other measures of success remains fairly predictable. Middle age disrupts and forever changes this pattern. The world begins to take a more somber turn as illness, loss of relationships, career changes, and poor outcomes being more frequent and unpredictable. As such, the middle years usher in a higher state of volatility as a list of daunting tasks related to these upheavals leaves little time to plan, resolve, or recuperate.
Each one of these upheavals unto themselves present a formidable challenge, but arriving in uneven clusters, as is the case in midlife, they can destabilize and exhaust even the most competent adult, highlighting the primary developmental task of middle-age adults: to maintain stability in world of increasing personal volatility.
Understandably, anything that destabilizes the job of “keeping everything together” is threatening and cause for alarm. An effective way to acknowledge this need is to ask open-ended questions embedded with language that expresses developmental empathy. Say:
• “Tell me more about the anxiety surrounding the situation with your mother.”
• “What do you think is destabilizing the situation?”
The third stage of diffusing is acknowledging the client’s concern without assigning blame, which reinforces the tone of mutual respect and desire for collaboration. Reassure the family member that their concern is being heard with phrases such as:
• “Your mother having second thoughts about changing residences is very upsetting.”
• “Despite your good intentions, the situation is causing conflict with your family.”
Remember: The goal of diffusing is to preserve rapport amid the stress of negative feedback.
Discovery, which helps the recipient of feedback to understand more clearly the concern, consists of two stages. The first stage of discovery involves using open-ended questions to gain more information about the concern. A good starting point is with a permission prompt:
• “May I ask you a few questions about the conversations you and your family have been having with your mother regarding this issue?”
Permission prompts set an inclusive tone for follow-up questions. There are three simple discovery prompts that are effective for follow up questions: tell me, what, and how:
• “Tell me more about your mother’s experience since she moved in.”
• “How is your family reacting to your mother’s concerns?”
The second stage of discovery involves reflective listening. Reflective listening takes the client’s answers to open-ended questions and reflects them back to signal they have been heard and understood correctly:
• “Based on what you have told me so far, you feel your mother is experiencing ambivalence about her decision to change living environments.”
• “Your mother has changed her mind.”
Remember: The goal of goal of discovery is to explore and clarify the client’s primary concern
Strategizing, which consists of a collaborative approach to find a solution, has three stages. The first stage of strategizing explores the client’s perspective on what needs to be done to manage the situation. A good starting point is with a preference prompt:
• “What is your preference for approaching this concern?”
• “How would you like to approach this situation?”
Preference prompts provide an effective starting point to exploring possible solutions with follow-up questions. Based on the family member’s response to your preference prompts, a productive follow-up question may be:
• “Tell me more about how that would work.”
• “How does your family feel about this approach?”
The second stage of strategizing utilizes reflective listening to summarize and confirm the client-favored approach. As in the second stage of discovery, mirror back the family member’s response to questions to communicate that they have been heard and understood:
• “From what you have told me so far, you would prefer we set up a meeting with the family to discuss the ambivalence issue and ways we can collectively help your mother with this transition.”
• “You feel that we need to address your sibling’s concern first before we attempt to help with your mother’s transitions concerns.”
The third stage mobilizes the client-favored approach into an action plan.
• “Let’s schedule a family meeting later on this week.”
• “When can I meet with you and your siblings?”
Remember: The goal of strategizing is to identify a client-favored approach and map out an action plan.
While presented as a three-step process, redirection and resolution in practice is more fluid based on the give and take of conversations and changing circumstances. Circling back to diffuse a new concern that arises in discovery is common. Revisiting discovery with new information from other family members or changing directions when the client-favored approach proves unworkable is all part of the dance.
What is important to remember is that a successful resolution of consumers’ concerns depends on a willingness to diffuse, the patience to question and listen, and the flexibility to trust a client-favored approach to addressing concerns. By doing so, you can communicate respect for your residents and their family members, helping you to meet their needs.