Phrases and forms of words that we have found useful



Check list of key skills

Choice talk

• Summarise & signpost a shift in the conversation

• Introduce the idea of choice

• Justify the introduction of choice & signpost ‘what’s important to you’ (preference talk)

• Check for reaction to choice

• Defer closure

Options talk

• Check existing knowledge

• List options

• Describe options

• Describe benefits and harms

• Checking understanding

• Introducing decision support

• Continue ‘what’s important to you’ (preference talk) where appropriate

Preference/ decision talk

• Summarise and check preferred next step (move to decision or more time?)

• Check ‘what is important to you’

• Move to making a decision

Below are some phrases and forms of words that we have found useful

|Example phrases you might like to use CHOICE TALK |

|“Now that we have agreed on the problem, we will now spend more time on what do next” |

|“There is more than one way to deal with this problem and the evidence shows that some treatments suit some people more than others”. |

|“There is lot of knowledge available about these options and I’d like to share this with you so that you can understand what might be relevant to you”. |

|“There are a number of options and a fair bit of evidence about pros and cons of each option– I would like to share that with you before we make a decision” |

|“Were you aware that there were different options?” |

|“Treatments are very different in what is done and what you need to do, plus they have very different consequences. Some of these things will be very important to you – |

|in terms of what you want or what you want to avoid. I’m very interested in what matters to you, and that is why I am going to describe the options that are available to|

|you”. |

|“For us to make the right decision we need to also understand what really matters to you in this choice”. |

|“I understand that you want my view on this, and I ill be happy to give you that, but is it okay if I describe the options to you in more detail so that you understand |

|what is at stake? Then we can come back to what might be best to do, and ask you what might matter most to you” |

| |

|Example phrases you might like to use OPTION TALK |

|“Are you already aware of how this problem could be managed or treated?” |

|“Have you been searching for information on this yourself?” |

|“It is possible to do three things in this situation, let me list them quickly before I describe them in more detail” |

|What to say if options are: |

|Similar: “Both options are very similar and involve taking medication on a regular basis” |

|Different: “These two options are different and will have different impact on you and your family, let me explain what they involve”. |

|“I am going to describe the most relevant risks and benefits of each option to you… let me know if I go too quickly or if you do not understand…” |

|“I will try and give you an idea of the likelihoods of each of these risks and benefits” |

|“Let me just check that I have explained this well enough- can you tell me what you have picked up from what I’ve told you?” |

|“Here is a diagram; Decision Grid etc that will help me describe the options to you. I am going to describe the possible risks as well as the possible benefits of each –|

|so lets start with…” |

|“There is a large amount of information to grasp here. Would you like me to provide you with materials which you could read and discuss with your family? And then we |

|could meet again when you have had a chance to digest it?” |

|Example phrases you might like to use PREFERENCE/DECISION TALK |

|“We have discussed the Options. Often patients feel it very hard to make a decision at this point. There is a lot to take in and it might be a good idea to take some |

|time, read some more and come back when you are ready to discuss this decision. Or you might prefer a different approach. Where do we go from here?” |

|“Do you need more time to digest all this or shall we move to make a decision today?” |

|“We have gone over the options, what they entail and the pros and cons of each. I already have some ideas about what matters to you but let me check – What is the most |

|important issue for you in all this?” |

|“Some people value x, and others value x, what I need to know is what matters to you” |

|“Have you had a chance to consider these options, from your point of view, in terms of what is important to you?” |

|“Think about them, how you feel about them and how you imagine things will be like if some of the likely consequences occur”. |

|“So, what are you thinking at this stage?” |

|“We have gone over the options and explored the risks and benefits and we have looked at what is important to you. Where does that leave us? Where do we go from here? Is|

|this helping you to make a decision?” |

|“We are moving towards a decision. We have gone over the options, explored the risks and benefits, and we’ve looked at what’s important to you – has this helped you make|

|a decision?” |

|“You seem to have been able to decide on the option that is best for you, are there any final concerns or questions that you want to ask?” |

|“It seems you have decided to do A. Do you want to have more time to consider this, or ask more questions?” |

|“What is your gut feeling you have from your thoughts? What are your ideas? What do you think you would feel if this was the outcome?” |

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