Healing Conversations

Appreciative Inquiry offers medical professionals a conversation starter

A strategy consultant to Fortune 500 businesses, Tony Silbert, faced this reality as his mother fought a long battle with lung cancer. His book, Healing Conversations, started with a personal way to bring greater meaning to his mother and their relationship during her end-of-life. But since then, what started as a question on a listserve - "What question would you ask if you were going to lose a sibling, parent, or loved one?" - has become nothing if not a movement.

"Healing Conversations is designed to help shape interactions in a positive light with open-ended, positively biased questions."

Silbert wrote the book for family members, but it gets more traction with long-term care professionals. Silbert's firm, Innovation Partners, has presented at the Aging in America conference, Positive Aging Conference and held numerous workshops for long-term care associations.

"What's so interesting, is people come expecting to make improvements in their work lives, but this Appreciative Inquiry approach works in every aspect of life: with co-workers and bosses, relationships at home, in sickness and in health."

And when health care professionals are using the approach, "it helps elders stay out of downward spiral, eases helplessness and hopelessness. These positive, open-ended questions open up new images that are positive, enabling patients to think about the good things in their lives, stories that may be buried," Silbert says.

Advising large health care organizations, such as the Lehigh Valley Health Network, Silbert's team replaces the traditional SWOT analysis (Strengths, Weaknesses, Opportunities, Threats). Instead, Innovation Partners advocates SOAR (Strength, Opportunities, Aspirations, Results).

"It's not just about how professional caregivers can boost quality of care and patient satisfaction, but equipping professionals with this positive approach also boosts employee satisfaction," Silbert says. "It's a low-cost, narrative intervention."

By arming professional caregivers with different types of questions, "we can help them understand the whole person, beyond why they're in a facility or facing treatments, whether life-threatening or not. We need to know more about patients as people and about their whole lives, to get the best results possible."

Silbert offers questions that move beyond yes/no, which often focuses on a pain or a problem. This is the negative aspect of this person's life; focus instead on the opportunity (what is desired) by asking open-ended questions such as:

"Who is most important in your life?"

"If you had three wishes, what would they be and how would life be different?"

"Are there people you would like to contact and renew relationships with?"

"Questions like this get beyond the illness or aging that's brought you to interact with the patient. Try to use language and words that are future-focused."

Healing Conversations is available at the Taos Institute.

Watch an interview with the author, Tony Silbert, conducted Dr. Bill Thomas.