Hsiu-Wen LAI, Social Worker and Project Manager
Vita TU, Occupational Therapist and Project Manager
Imagine this common scenario: a patient, grappling with pain and discomfort, seeks solace from their burn rehabilitation therapist. In response, they're met with well-meaning but perhaps disconnected advice: "Don't overthink it. You have to endure the pain because it’s part of the rehabilitation process."
While the sentiment behind such words is understandable—rehabilitation does involve pain and discomfort—how does this response truly resonate with the patient?
These dialogues are commonplace during the process of rehabilitation. Burn patients who are grappling with both physical pain and emotional turmoil will frequently confide in their physical or occupational therapists, or other professionals who are part of the burn team. Yet, when emotions like depression, frustration, and anger are left unaddressed or when the patient feels that they have not been properly acknowledged, they can evolve into stumbling block that hinder the patient’s progress in rehabilitation.
This is why empathic communication is important. By fostering genuine understanding and connection, therapists can transform routine conversations into pivotal moments of support and motivation. Through empathic responses, therapists and other members of the burn team can cultivate an environment of trust, empowering patients to confront emotional hurdles head-on.
In this article, we discuss empathic communication within burn rehabilitation by exploring its role in patient care, and how it serves as a cornerstone in overcoming emotional obstacles on the path to recovery.
Why is empathic communication important in burn rehabilitation?
How should a therapist respond when faced with a patient's expression of pain and discomfort? In the example above, the therapist's reply may have seemed reasonable on the surface, addressing the immediate concern with pragmatic advice. However, effective communication goes beyond simply acknowledging the words spoken, it delves deeper into understanding the person behind those words and the emotions they're experiencing.
A truly empathic response not only acknowledges the physical impact of burn scars, but also recognizes the individual's emotional state. It involves actively listening and empathizing with the patient's feelings and expectations, so that patients will feel like they are genuinely heard and understood. When a patient senses that their emotions are being acknowledged and validated, they're more likely to open up and share more about their experiences. Therapists can then gain valuable insights into the patient's emotional state and the stressors they face during rehabilitation. Therapists can also uncover the underlying motivations needed to sustain their patient’s commitment to rehabilitation.
Empathic communication involves setting aside preconceived notions of what should be said or what the therapist thinks the patient should do, and instead focusing on empathizing with the patient's emotions and needs. By prioritizing the patient's emotions, therapists can establish a rapport that encourages open dialogue and fosters trusts. When patients feel that they are understood, their journey toward recovery will feel less arduous and less lonely.
What are examples of empathic communication?
Here is an example of a conversation between therapist A and his burn patient.
Patient: "I do rehabilitation every day, but it hurts and feels so uncomfortable."
Therapist A: "I've seen this a lot in my clinical practice, and it's normal. You just have to endure the pain, because pain is simply part of rehabilitation."
Patient: "But after doing rehabilitation every day, I wake up the next morning and my scars feel as tight as ever. It’s as if yesterday’s efforts were for nothing, so I have to start all over again the next day."
Therapist A: "Don't overthink this. Just work hard every day, and eventually you will be fine."
What are the patient’s expectations? What are the patient’s emotions?
What does the therapist’s reply convey to the patient?
Now let’s look at the same conversation but with therapist B.
Patient: "I do rehabilitation every day, but it hurts and feels so uncomfortable."
Therapist B: “It sounds like doing rehabilitation makes you very uncomfortable. Is there any particular item in your rehabilitation plan that makes you particularly uncomfortable?”
Patient: “It's painful when you bandage my hand into a fist, and my hand will tend to feel numb. After a while, it feels very uncomfortable.”
Therapist B: “You must really want to make progress, so you still adhere to this item in your daily rehabilitation program, even though it makes you so uncomfortable. Do you think there are any adjustments that we can make to your program that could make you feel better?”
Patient: “Actually, after doing rehabilitation every day, I wake up the next morning and my scars feel as tight as ever. It’s as if yesterday’s efforts were for nothing, so I have to start all over again the next day."
Therapist B: “It sounds like this situation makes you feel very depressed, but you still do rehabilitation seriously every day. How do you convince yourself to push forward with rehabilitation every day?”
Patient: “I have no choice but to do it. You also told us that this is the stage when scar growth and scar contracture are at their strongest, so rehabilitation is necessary to at least maintain gains without regressing.”
Therapist B: “You work really hard to get better, and you are very patient in the face of pain. Although you are frustrated during the process, you still muster up the energy to continue every day. Your experience is really worth sharing with other burn patients to encourage them.”
Let’s analyze this conversation.
Patient: "I do rehabilitation every day, but it hurts and feels so uncomfortable."
Therapist B: “It sounds like doing rehabilitation makes you very uncomfortable. Is there any particular item in your rehabilitation plan that makes you particularly uncomfortable?”
The response of Therapist B acknowledges the expression of physical discomfort of the patient. He is saying: “I hear your discomfort and I want to work with you to find a solution.”
Patient: “It's painful when you bandage my hand into a fist, and my hand will tend to feel numb. After a while, it feels very uncomfortable.”
Therapist B: “You must really want to make progress, so you still adhere to this item in your daily rehabilitation program, even though it makes you so uncomfortable. Do you think there are any adjustments that we can make to your program that could make you feel better?”
Therapist B understands and acknowledges the patient’s discomfort, but he also affirms the patient’s tolerance to discomfort that comes from a desire to get better. He also lets the patient know that adjustments can be made, giving the patient a sense of control over his rehabilitation.
Patient: “Actually, after doing rehabilitation every day, I wake up the next morning and my scars feel as tight as ever. It’s as if yesterday’s efforts were for nothing, so I have to start all over again the next day."
Therapist B: “It sounds like this situation makes you feel very depressed, but you still do rehabilitation seriously every day. How do you convince yourself to push forward with rehabilitation every day?”
Therapist B acknowledges the patient’s frustration and by asking questions, he then guides the patient to reflect on what he has done so far, emphasizing the patient’s determination and resilience.
Patient: “I have no choice but to do it. You also told us that this is the stage when scar growth and scar contracture are at their strongest, so rehabilitation is necessary to at least maintain gains without regressing.”
Therapist B: “You work really hard to get better, and you are very patient in the face of pain. Although you are frustrated during the process, you still muster up the energy to continue every day. Your experience is really worth sharing with other burn patients to encourage them.”
Therapist B again praises the patient’s efforts.
The burn patient’s expectations and emotions were caught by Therapist B, and his response conveyed that he understood the patient's discomfort, but it also affirmed the patient's efforts. When discussing possible solutions, the patient expressed his frustration once more, and Therapist B guided the patient to look at his own efforts and verbalize them, thus reaffirming the patient's efforts once again. Therapist B also pointed out to the patient that he can make suggestions to adjust the rehabilitation intervention, thus giving the patient a greater sense of agency and control over his rehabilitation.
Key points for guiding the patient through empathic communication
Emotional hurdles on the path to recovery can leave burn patients feeling overwhelmed, anxious, and lacking in self-assurance. However, when patients express these concerns to their therapist or to other members of the burn team, these concerns shouldn’t be treated as “complaints,” but instead should be seen as an opportunity for empathic communication.
To summarize the key points of empathic communication:
1. Understanding and Validation
By understanding and acknowledging the patient's emotions, therapists can create a supportive environment where patients feel heard and valued. When patients feel understood, they're more inclined to open up further, allowing therapists to delve deeper into their thoughts and challenges during rehabilitation.
2. Demonstrating Care and Support
Patients benefit immensely when they perceive that their therapist genuinely cares about their well-being. This sense of care not only fosters trust but also encourages patients to actively engage in their recovery journey, knowing they have someone by their side.
3. Recognizing Effort and Progress
One of the most powerful aspects of empathic communication is its ability to highlight the patient's efforts and progress. By acknowledging the progress made, therapists instill a sense of hope and motivation in patients, reinforcing their resilience and determination to overcome obstacles.
4. Empowering the Patient
Through empathic communication, therapists can guide patients through difficult moments by helping them recognize their own resilience and regain a sense of control over their lives. For example, giving the patient some flexibility or choice in terms of rehabilitation interventions (without sacrificing rehabilitation goals) can help the patient feel his concerns were heard, but also that he is an active participant who can make decisions about his rehabilitation. Therapists play a crucial role in fostering a positive mindset conducive to recovery.
Conclusion:
Empathic communication isn't just about listening; it's about actively engaging with patients, understanding their emotions, and supporting them every step of the way. By implementing these tips, therapists can create a nurturing environment where burn patients feel empowered to overcome obstacles and embrace the journey towards healing.
To learn more about the psychosocial factors that affect post-burn rehabilitation and how therapists and other professionals in the burn team can help the patient overcome these challenges, check out our online course Psychosocial Factors Affecting Burn Rehabilitation.
This course will help you:
Identify the factors (individual and familial) that affect burn patients during rehabilitation.
Explain the impact of these psychological hurdles on rehabilitation.
Develop strategies to mitigate the impact of psychosocial factors.
This is more effective for us and more beneficial effect of patients.