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.
- Dealing with issues in the workplace
- Inclusive communication
- Information governance
- Mental capacity and supported decision-making
- Meeting the HCPC standards
- 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.
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.
- Peer, clinical and managerial supervision is an excellent way to reflect on difficult conversations – view our supervision guidance.
- Some trusts and organisations offer training in managing conflict or difficult conversations.
- See our A to Z of practice-based scenarios.
- ACAS, the Advisory, Conciliation and Arbitration Service, provides information on challenging conversations and how to manage them.
- Seek advice or support from your peers and reflect on actions using the RCSLT Clinical Excellence Networks, RCSLT Hubs and professional networks.
- Better Conversations with Aphasia – University College London’s free online course aimed at SLTs, other health professionals, carers and people with aphasia.
- Talking about end-of-life care: communication – video by the General Medical Council and Hospice UK (formerly the National Council for Palliative Care) with insights from service users about what constitutes good communication.
- Professionalism: having the conversation (PDF) – article in Bulletin (September 2012) by Rosemarie Mason, Jennie Vitkovitch, Jill Jepson, Rod Lambert.
- Browse our A to Z of practice-based scenarios.