Assess the role of effective communication and interpersonal interaction in health and social care with reference to theories of communication

Figure 2: Problems in the Communication Cycle.

Taking turns in speaking and listening is one of the features that allow the communication cycle to work effectively. Interrupting people who are speaking or not listening to what people are saying disturbs the communication cycle. Furthermore communication is most effective when the message is clear. However communication is only effective when both the sender and receiver understand the same information as a result of communication. A variety of factors, as shown in the above figure, can disrupt the smooth flow of the communication cycle and be obstacles to effective communication.

1.2: Tuckman’s Group Formation Theory

Bruce Tuckman defined a model of ‘group development’ based around on different stages of group activity. Tuckman’s theory implies that groups ought to go through these stages to be effective. The four stages are outlined in the figure below.

Figure 3: The process of group formation.

• Forming: This involves group members coming together and asking simple and general questions about the aims and purpose of the group, each member’s role and commitment to it. In The first stage of the group development people tend to feel anxious, nervous and also confused in their interaction with other people within the group. Team members tend to behave independently and although friendliness can exist they do not know each other well enough to completely trust one another. Time is spent planning, collecting information and bonding. During this stage a leader comes in. The forming stage is important because in this stage the members of the team exchange some personal information and make new friends. This is also a good opportunity to see how each member of the team works as an individual and how they react to pressure.
• Storming: The second stage is a stage of disagreement within the group. The members of the group may argue over the topic that they discussing where they may have fall outs. They may challenge its aims and sometimes refuse to accept. In this stage you see things like power and control becomes the main issue with the group. The communication between the members should begin to develop towards the end of this phase. The storming stage is necessary to the growth of the team. Tolerance of each team member and their differences should be stressed. Without tolerance, acceptance and patience, the group will fail.
• Norming: this is the stage when the group recognises and develops the group identity. A strong set of shared standards, norms of behaviour and a group culture begins to emerge.  The group then agrees and focuses on one achievement within the group. They also begin to share plans. The group then becomes consistent, group members start to develop and everyone within the group works together to resolve problems.  
• Performing: this is the stage where the group starts to mature and begins to work more effectively. The members of the group now tend to focus more on the main goal that they want to achieve rather than on things like relationships between the members. The group relationship by this stage has become more secure as this is based on trust and shared support.

A group may or may not achieve the performing stage. Effective teams do but other less effective groups may stop at one of the earlier stages, especially if they are unable to resolve the challenges or crises linked with that stage of group development. Successful communication within a group situation is a key factor on whether a group reaches the performing stage. Group communication is different to one-to-one communication. People often interact and communicate differently in group situations compared with when they are interacting in one-to-one situations. Usually, people are more controlled and formal in group interactions than in one-to-one situations. Burnard (1992) partially explains this by pointing out that people have to make compromises in the way they communicate within group situations because there is always a tension between the needs of the group and those of the individual.

Group communication follows different patterns to one-to-one communication. R.F. Bales (1970) identified a number of different communication strategies that are used in groups. Some of these are outlined below:

• Proposing strategies where new ideas, suggestions or plans of action are put forward in a positive way.

• Building strategies in which a group member extends or develops ideas and proposals offered by other group members.

• Disagreeing, where a difference of opinion or disapproval of the contributions or behaviour of other group members is expressed.

• Defensive strategies in which group members put up a defence of their own position, ideas or views when other group members question or disagree with them.

• Blocking strategies which are used to place obstacles or difficulties in the way of other group members’ proposals or contributions – these tend to be negative manoeuvres, designed to frustrate other group members’ efforts.

• Summarising, a communication strategy that seeks to support and maintain the work of group members.

• Inclusive behaviours which aim to bring less powerful or more isolated group members into discussions.

• Exclusive communications have the opposite intention and effect to inclusive behaviours, they aim to block other people’s communication and frustrate interaction.

Some of the strategies listed above are designed to encourage and support effective communication in groups. However others are more negative in their effects. Sometimes negative behaviours are unintentional, at other times conduct such as irrelevant talking, changing the subject and using complicated language are used deliberately to disrupt communication or exclude members of the group.

1.3: Egan (1986)

Egan says that there are some basic “micro skills” that can help to form a sense of contribution or caring presence when working with other people. This is a technique which is used by care workers. It helps the clients or the patients to trust the care given and to feel safe as this helps effective communication.

Egan defines these skills as below:

• S: Face squarely. This is important that the body direction you adapt to convey the message that you are involved in the communication with client or whoever you are dealing with. The main thing is that you have to face other people because this shows that you are involved and taking interest in the communication.
• O: Keep an open posture: Egan suggests that crossed arms or legs might send a message that you are not involved with the person that you are communicating. Having an open posture involves not having crossed arms or legs by doing this you will feel more involved in the communication.
• L: Lean:  Egan states that moving a slight towards the person is often interpreted e.g. I am with you. Movements may help to convey interest in the communication.
• E: Use of good eye contact. Having a good eye contact with a patient makes the communication stronger and you will feel more involved. Eye contact is linked with deep conversation this is when you wanting to know more and also you will feel more involved.
•  R: Be relaxed: during communication it is very important you do not fiddle. It is important that you feel nice and comfortable during communication and also feel relaxed with your own non-verbal behaviour.  

                                                                   

1.3: Group structures and communication patterns

Communication in a group is mainly influenced by the group’s structure as this determines what kind of relationship and communication chances that the group members can have.  Communications in a group is based on a hierarchy. People who are at the bottom have small opportunities to cooperate with one another. This is common in the health and social sector, but this hierarchical group relationship has faced criticism that it limits communication opportunity.

More and more care workers are challenging the right to make a role to care and also to make important decisions such as treatments. Because of this care workers are consistently being challenged by a negative response of hierarchical group relationship.

   

   

   

Figure 4: Hierarchical group relationships

A circular group structure shows more chances and opportunities for the members to cooperate with the other members. There is a structure called circle type this is often seen in the health and social sector where management and leadership changes around between members. The communication with the people is better and also more direct between the members.

   

Figure 5: Circular group structure

There is a complex type of group called clique. People that belong to this inner group have close contact and they tend to communicate better with other people. Other members feel inaccessible and also they find quite difficult to communicate and interact with the group as a whole. Communication can be hard and it may not flow freely in a clique style structure. In health and social care settings care workers can be based around different group structures.

 

Figure 6: Clique structure

Effective interpersonal communication is very important in the health care area. Communication between the carer and the patient is one of the most important fundamentals for improving the patient’s approval. Patients that understand their illness and procedure they may need to take such as treatment or operation and if they believe that the carer is concerned and will support them they will (patient) show better satisfaction and more likely to able to communicate better with you and the trust builds up.

The better communication that you have with the patients or the service user the more they open up about information about their health and their illness that they have been suffering.  Effective interpersonal communication also helps the health system by making it more competent and also cost effective.

Bibliography

Books:

Moonie|Neil, Health & social care, GCE AS Level Single Award, Heinemann Educational Publishers, 2005.

Stretch|Beryl and Whitehouse|Mary, Health & social care, Level 3, Pearson Education, 2010.

Articles:

Bales, R.F. (1970), Personality and Interpersonal Behaviour, Holt, Rinehart and Winston, New York

Burnard, P. (1992), Communicate, Edward Arnold, London

Burnard, P. (1992), Effective Communication Skills for Health Professionals, Chapman and Hall, London.

Websites:

http://www.collinseducation.com/resources

http://www.infed.org/thinkers/tuckman.htm

http://www.oscehome.com/Communication-Skills.html

http://www.people-communicating.com/active-listening.html

Lecture notes:

Effective communication PowerPoint

Handouts

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