Having difficult conversations​ – guidance

Difficult conversations are often an integral part of speech and language therapy. Having the confidence, knowledge, and skills to facilitate those conversations enables service users and employees to share their concerns, understand their needs and ultimately make choices, decisions and plans.

Read our information on what to consider when having difficult conversations and take a look through our list of resources.


These pages will sign post you to relevant resources and give you the opportunity to think through difficult conversations in practice-based scenarios.

Difficult conversations in speech and language therapy may include:

  • Giving diagnosis
  • Feeding-back assessment results
  • Discussing management plans and treatment options
  • Preparing for discharge
  • Interactions with families/relatives/friends/other professionals
  • Managing and supervising staff

These are all essential conversations, difficulties usually arise when there is a mismatch between understanding and expectations.

Please contact us with any feedback on these pages.

Related guidance


  • Kathryn Cann


View our page on meeting the HCPC standards for guidance to support you in adhering to the standards of the regulator, the Health Care Professions Council (HCPC).

Key sections include:

  • Promote and protect the interests of service users and carers
  • Communicate appropriately and effectively
  • Work within the limits of your knowledge and skills
  • Delegate appropriately
  • Respect confidentiality
  • Manage risk
  • Report concerns about safety
  • Be open when things go wrong
  • Be honest and trustworthy
  • Keep records of your work

The Health and Social Care Act (2008) Regulation 20: Duty of Candour states that every healthcare professional must be open and honest with patients when something that goes wrong with their treatment or care, causes, or has the potential to cause, harm or distress.

Being prepared

Anticipating that a conversation may be difficult enables you to be prepared and achieve the best possible outcomes for the conversation.

You should consider:

  • Where the conversation will take place, in terms of comfort and privacy
  • Your body language, facial expression, positioning
  • Your knowledge of, and relationship with, the service user/employee
  • Timing of the discussion
  • Time for questions
  • Support from others/family members/advocates/key workers
  • Having associated written information ready
  • How you will document the conversation

Ask what the service users/employees understanding is and what is important to them. Don’t make assumptions. Listen to them. Know the legal processes behind consent, confidentiality, capacity and documentation.

Building skills


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