22 References. MBTI Type & Client Communication. Course Content. Learning Objectives. MBTI Module 4:

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1 Learning Objectives MBTI Module 4: MBTI Type & Client Course Description Client communication and creating a flexible communication style suited to handle all MBTI personality preferences can have a positive effect on the practice team. Effective communication requires good working knowledge of personality types, full understanding of your own type, and how to communicate with others. Module 4 will explore ways to connect with clients by using the knowledge gained from modules 1 3. You can do this by understanding the differences between yourself and others and applying what you know about preferred communication techniques from each type. Learning Objectives Learn how to use an understanding of individual MBTI preferences to improve client communication: Identify your preferred style. Tune in to others styles and needs by noticing clues that reveal their personality preferences. Adjust your communication preferences to fit the needs of others. Learn about the effective 4-stage model for doctor client and staff client communication: In stage 1, understand how to effectively initiate interaction based on the client s preference for extraversion or introversion. In stages 2 and 3, investigate the needs of the client and suggest action based on the client s style for both sensing or intuition and thinking or feeling. In stage 4, learn about closure and if a client needs a swift conclusion or would rather discuss options. Explore the challenge of being flexible with your own style. Learn how your applied knowledge of MBTI type can encourage and guarantee satisfaction and adherence from clients: Understand that through flexibility with your own type, clients are more likely to adhere to your advice and guidelines discussed about the necessary care for a pet. Practice using the model indicated in the chapter. Consider making lists or write down helpful tips about each type to remember how to influence your clients most effectively. Learn how to ask the client revealing questions for each type to gauge how to handle the subject. Once you learn about how to apply the MBTI type preferences, you can teach your staff to understand the types and how to effectively communicate with clients for a more positive experience in your practice. Don t forget to ask the client in the case of a potential confrontation or misunderstanding. Clarifying what someone means when they say or do something confusing will influence the way you communicate in the future by revealing more about the client personality preference. Course Content Part 18: Personality types and communication Identify your preferred style Determine how you prefer to get energized, take in information, make decisions, and approach life. Part 19: Tune In to the Other Person Understanding other s personality types Notice the way in which the other person talks and determine whether they are extroverted or introverted. Understand the kinds of questions the client is asking. Sense what the client wants from you and what criteria they use to make decisions. See how quickly the client wants to make a decision. Part 20: Adjust Your Approach Learn to be flexible in your style of communication Based on what you learn from the client, learn to communicate with all personality types, including ones that match and do not match your own. Use the four stages of client communication as a model for effective doctor client and staff client communication. Learn to connect with clients with different types to more effectively understand what they want and how you get be flexible to give them what they need. Understand the challenges of flexing your own type and develop skills to overcome that. Part 21: Adherence Encouraging clients to follow your clinical recommendations Meet the goal to communication with clients to promote an informed decision about what is best for the pet. Communicate information in such a way for each preferred style that clients are more likely to adhere to recommendations. When doubtful of how to understand a client s needs, ask questions to understand what they need from you and how you can more efficiently present information. Clarify information for clients and for yourself by asking if you interpreted their point of view correctly. Required materials Required course content is online. Optional and recommended Take the MBTI online Understanding 19 Preferences 20 Client 21 Benefits of Model 22 References

2 MBTI Type & Client By Jeff Thoren, DVM, ACC I m sure the doctor is brilliant, but after leaving my appointment, I was still unclear about what exactly was wrong with my dog and what needed to be done. I just remember being shocked by how much it was all going to cost! Does this sound familiar? The majority of client complaints received in the typical veterinary practice are related to ineffective communication skills, not a lack of clinical competence. What often lingers in the clients mind long after their visit to your hospital is not what you did however skilled but what was said and how it was said. When doctor client or staff client communication goes awry, there s more at stake than dissatisfaction. The client may not follow through with necessary medical treatment or may not fully understand the importance of your clinical recommendations, therefore opting against providing their pet with the care it needs. In either case, the pet s health and the integrity of the human animal bond are put at risk. Personality differences between veterinarians, staff members, and clients may be one of the factors that lead to these breakdowns in communication. If two individuals involved in an interaction differ significantly in their personality preferences, they are likely to be talking on different wavelengths, resulting in potential misunderstandings unless there is some adjustment or flexing of style on someone s part. Therefore, effective communication in veterinary medicine requires that your entire health care team make a concerted effort to tune in to your clients and adjust your individual styles to assure that you arrive at mutual decisions that are truly in the best interest of the client and patient. In this module, we ll explore ways that you can better connect with your clients by applying your knowledge of the Myers-Briggs Type Indicator (MBTI) framework. Specifically, you will: 1. Learn how to use an understanding of each individual MBTI preferences to improve client communication. 2. Discover a four-stage model for effective doctor client and staff client communication that revisits the MBTI Function Pairs learned about in Module Consider the potential relationship between effective client communication and your ability to encourage clients to follow your clinical recommendations (ie, to improve client adherence or compliance). An understanding of psychological type can greatly improve the quality of communication between two people. If we can understand and value different approaches, we may unlock qualities in both ourselves and the other person which will allow us to work more effectively and creatively together. Judy Allen and Susan A. Brock Understanding 19 Preferences 20 Client 21 Benefits of Model 22 References

3 19 Understanding MBTI Preferences to Improve As you communicate with clients, it is important to remember that they may have different preferences than you in the way they take in and evaluate information and the way they are oriented to the world around them. Don t assume that people want to hear what you have to say in the way you want to say it. Effective communication means presenting different kinds and amounts of information in different ways. For example, calm, reasonable communications attract some types (people who prefer Introversion) while others are drawn toward enthusiasm (people who prefer Extraversion). People who prefer to take in practical information (Sensing types) like to hear facts and step-by-step procedures relevant to their current situation. Alternatively, those who prefer Intuition (Intuitive types) need to hear an overview of the information before the facts will become relevant to them. Some people are drawn to personal stories (Feeling types) while others want to be convinced by logic (Thinking types). Some want conclusions and a focus on how to, (Judging types) while others are drawn to explore options and consider possibilities (Perceiving types). There are three simple steps involved in utilizing the eight MBTI preferences to improve your communication with others: 1. Identify your own preferred style of communication. 2. Tune in to the other person s preferred style or current needs. 3. Adjust your approach, if necessary, to match those needs. Let s look at each step in a little more detail... Identify Your Preferred Style Your preferred style of communication will be reflected by your MBTI type, also referred to as your personality type. Four of the eight preferences below (E or I, S or N, T or F, J or P) make up your MBTI type. As you communicate using your type preferences, you naturally exhibit specific communication-related behaviors associated with each preference. The Eight MBTI Preferences How You Prefer to Get Energized Extraversion (E) People who prefer extraversion tend to focus on the outside world and get energy through interacting with people and doing things. Related behaviors: Rapid speech. Appears to think out loud, talk things out. Interrupts. Louder voice volume. Introversion (I) People who prefer introversion tend to focus on the inner world and get energy through reflecting on information, ideas and/or concepts. Related behaviors: Pauses in answering or giving information. Appears to be thinking things through. Quieter voice volume. Shorter sentences, not run-on. Understanding 19 Preferences 20 Client 21 Benefits of Model 22 References

4 19 Understanding MBTI Preferences to Improve How you Prefer to Take In Information Sensing (S) People who prefer sensing tend to notice and trust facts, details, and present realities. They like to take in information through the five senses. Related behaviors: Asks for step-by-step information or instruction. Asks about the present situation. Asks what and how questions. Uses precise descriptions. Intuition (N) People who prefer intuition tend to pay attention to and trust interrelationships, theories, and future possibilities. They are drawn to the big picture. Related behaviors: Asks for the purpose of an action. Asks for current and long-range implications. Asks why questions. Talks in general terms and possibilities. How You Prefer to Make Decisions Thinking (T) People who prefer thinking tend to make decisions using impartial, logical, and objective analysis. They focus on the logical implications. Related behaviors: Appears to be testing you or your knowledge. Weighs the objective evidence. Not impressed by what others decide. Conversations follow a pattern of checking logic, if this, then that. Feeling (F) People who prefer feeling tend to make decisions to create harmony by applying person-centered values. They focus on the impact on people. Related behaviors: Strives for harmony in the interaction. May talk about values. Asks how others have acted or resolved the situation. Matters to them whether others have been taken into account. How You Prefer to Approach Life Judging (J) People who prefer judging tend to like a planned approach to life and are organized, orderly, structured, and decisive. They want closure. Related behaviors: Impatient with overly long descriptions, procedures. The tone is hurry up, I want to make this decision. May make decisions prematurely. Enjoys being done. Perceiving (P) People who prefer perceiving tend to adopt a more spontaneous approach to life and are flexible, adaptable, and like to keep their options open. Related behaviors: Seems to want space to make own decisions. The tone is let s explore, what are some more factors to consider? May decide at the last moment. Enjoys processing.

5 19 Understanding MBTI Preferences to Improve Recalling the team at the hypothetical River City Veterinary Hospital referred to in Modules 2 and 3, you may remember that one of the veterinary technicians, Isabel, had an MBTI type preference of ISFJ. Another staff member, Paul, had a preference for ENTP. Isabel, then, would generally communicate in a thoughtful and succinct manner with an emphasis on specific facts and details, paying particular attention to the impact on others. By contrast, someone with the exact opposite type, like Paul, would be more comfortable processing things out loud, talking about future possibilities, and evaluating multiple options using logical analysis. Once again, remember that we use all eight of the MBTI preferences so, depending on the context, Isabel (the ISFJ) would be perfectly capable of using Paul s ENTP s communication style. Similarly, Paul (the ENTP) could also choose to communicate more like Isabel, using an ISFJ style. However, in reality, some preferences are more comfortable than others and both Isabel and Paul are more likely to behave using a style that s more consistent with their actual MBTI type. So, what s your preferred style of communication? For each of the dichotomies above (E/I, S/N, T/F, J/P), which of the behaviors listed do you naturally and consistently express? You can record your preferred style here: Extraversion (E) Focus: Talk it out Motto: Let s talk this over. Sensing (S) Focus: Specifics Motto: Just the facts, please. Thinking (T) Focus: Logical implications Motto: Is this logical? Judging (J) Focus: Joy of closure Motto: Just do something. Introversion (I) Focus: Think it through Motto: I need to think about this. Intuition (N) Focus: Big picture Motto: I can see it all now. Feeling (F) Focus: Impact on people Motto: Will anyone be hurt? Perceiving (P) Focus: Joy of processing Motto: Let s wait and see. If you re still not sure, observe yourself in action over the next week or two. At least once a day, reflect back over the various interactions you ve participated in and determine which of the behaviors listed above best describe you.

6 19 Understanding MBTI Preferences to Improve Tune In to the Other Person Personality type will impact the effectiveness of communication between many types of people. However, the greater the perceived inequality in a relationship (such as when one person perceives the other to wield more power or authority), the less likely it is that the weaker of the two will demand the kind of information and attitude that they need. This is commonly seen in the exam room where clients look up to the doctor and medical staff and may be hesitant to ask for what they really need in the way of communication. This makes it all the more important that you tune into your clients communication needs. Most of the time this will mean talking with clients in a manner consistent with their preferred communication style, not yours. Now that you ve identified your own style, here are some questions that will help you tune into other people s preferred styles or needs in the moment. For better communication, learn to pick up and respond to the personality type cues that other people are exhibiting. 1What do you notice about the way the other person is talking? Extraverts tend to talk relatively quickly and to think out loud, while Introverts tend to be more sparing in their speech and to pause before answering questions. Cues that you are talking to someone who prefers Extraversion: Eye contact is usually direct and intense; may not review advance materials and, even if he or she did, still wants to hear it from the horse s mouth ; participates freely in conversation and discussions with different team members; may interrupt others frequently; may be challenged by listening skills; interacts with others while in the waiting area. 2 Cues that you are talking to someone who prefers Introversion: Eye contact may be infrequent; will probably have studied any advance materials and come prepared having completed any required paperwork; may pause before they react to a comment; may prefer a one-on-one relationship with a single doctor in the practice; waits quietly for his or her appointment, perhaps reading available literature. What kinds of questions is he or she asking? Clients preferring Sensing are more likely to ask for details and want step-by-step explanations. Clients preferring Intuition are more likely to want to understand the broad implications for the future. Here are some additional cues to watch for related to Sensing and Intuition: Cues you are talking to someone who prefers Sensing: May ask LOTS of detailed questions; asks for facts, concrete examples, and about your experience; uses words like facts, statistics, history, experience, etc; may appear resistant to change; takes a sequential approach to gathering and processing information. Cues you are talking to someone who prefers Intuition: Seems frustrated or bored by detail if there is no big picture ; may have difficulty explaining how they know what they know ; wants to start with cosmic significance then move to detail; becomes irritated at detailed questions; uses words like gut, hunch, intuition, etc.

7 19 Understanding MBTI Preferences to Improve 3What criteria is he or she using for making decisions? What do you sense he or she wants from you as a human being? In decision-making, clients with a preference for Thinking naturally lean toward logic, cause and effect reasoning, and objective evidence. They also tend to prefer an objective, impersonal approach and may be irritated by what they see as being too touchy-feely. Clients preferring Feeling will favor the implications for themselves and those close to them when making decisions and will tend to want some kind of personal connection. They will also value attempts to understand how they are feeling. Here are some additional cues to watch for related to Thinking and Feeling: Cues you are talking to someone who prefers Thinking: Asks about the logic of your recommendations and decisions; can appear distant; wants to be clear about your policies and procedures; uses words like logical, fair, defensible, etc; has relatively low need for praise and/or acknowledgement; uses phrases like I think, or that makes/doesn t make sense. Cues you are talking to someone who prefers Feeling: May have a soft quality to eye contact; interested in honoring other people s values and priorities; may be uncomfortable around and avoid conflict; conveys an interpersonal warmth that draws others; uses phrases like my feeling is or I feel that 4 Flex Your Approach Being aware of type provides a useful framework for recognizing your own individual preferences and also points to specific strategies for effective communication with others. Although it can sometimes be challenging to communicate even with clients who share type preferences that are similar to your own, the real challenge comes when a client s preferred communication style differs significantly from yours. It s at these times that having the ability to adjust to meet the client s needs and speak their language can make all the difference. Here are some communication strategies to use when you want to flex your own style to connect with clients with differing type preferences: How quickly does he or she want to make a decision? Clients who prefer Judging are more comfortable when everything is decided, will tend to decide quickly, and focus more on the outcome. Those who prefer Perceiving are likely to ask for more information, be reluctant to decide, may change their minds, and are more interested in the process. Here are some additional cues to watch for related to Judging and Perceiving: Cues you are talking to someone who prefers Judging: Expresses concern over schedules, timetables, and follow-through; wants to know who will be doing what; may rush to make decisions; becomes frustrated if things begin or end late; will learn from your experience and advice; communicates update information frequently; wants things planned. Cues you are talking to someone who prefers Perceiving: Relatively unconcerned about when things start and end; wants to defer decisions; wants to explore every possible option and gather more and more information; seems to prefer talking to action or doing; will learn from doing things on their own; communicates on a need-to-know basis. Communicating with Extraverted Clients Let s talk this over. Project energy and enthusiasm. Use nonverbal behavior effectively (eg, lean forward, nod, smile, and maintain eye contact). Respond immediately to questions, comments, etc. Emphasize action. Allow plenty of discussion time for thinking out loud and to help get past any initial resistance to an idea.

8 19 Understanding MBTI Preferences to Improve Communicating with Introverted Clients I need to think about this. Allow them advance notice and time for prior thought if possible. Don t expect an immediate reaction give them time to reflect and consider things. Practice active listening skills. Don t be unnerved by pauses before they respond to something you say or ask. Above all, resist the urge to interrupt them, to rush in while they are pausing, or to complete their sentences. Think before speaking or let them know that you are thinking out loud. Communicating with Sensing Types Just the facts, please. Go into detail, give plenty of facts and evidence, and don t skip over things. Begin with an explicit statement of the problem or issue and have a definite plan of action. Emphasize tangible results (especially near-term as opposed to far in the future). Don t become frustrated or see it as resistance when they ask lots of questions and want lots of detail. Remember that errors of fact will destroy your credibility. Communicating with Intuitive Types I can see it all now. State the main idea first know what your main point is. Begin with the big picture, then proceed to the details. Get their attention with the broad implications and longterm possibilities. Emphasize concepts and general ideas and avoid getting bogged down in too many details. Discuss any novel, unusual, or innovative approaches that could be considered. Communicating with Thinking Types Is this logical? Get straight to the point; be as brief and concise as you can and support your recommendations with logical reasoning and clear thinking. Focus on clear goals and objectives and demonstrate your competence. Present advantages and disadvantages, including all known pros and cons. Use logical, not emotional, arguments; play to the head, not the heart. Demonstrate how your clinical judgment is consistent with similar cases and show the fairness and even-handedness of your policies and procedures. Communicate with Feeling Types Will anyone be hurt? Take time to get to know them and develop rapport. They will be most amenable to guidance and influence if they like you as a person. Use personal anecdotes and examples, and let them know some personal details about you. Avoid critiquing and evaluating when you are listening. Include their needs and values as criteria in making recommendations. Remember that you cannot logic them into submission. Communicating with Judging Types Just do something. Be prompt and punctual. Be sure you are well-organized in your presentation; let them know your plan, and follow it; be sure to begin at the beginning and end at the end. Be decisive, not wishy-washy; draw conclusions. Emphasize schedules, deadlines, and timetables (but remember you will be held to them). Follow through on your commitments or you will lose credibility. To Communicate with Perceiving Types Let s wait and see. Present things in tentative, modifiable form; present options. Let them draw the conclusions. Avoid deadlines if possible, and don t press them for an immediate decision unless absolutely necessary. Follow up, since they are not always proactive with updates and may need a gentle nudge once they ve had plenty of time to make up their minds. Be flexible listen for new information and be prepared to change your plan if warranted. Remember that they lose interest if they are simply talked at and aren t involved.

9 20 Four Stages of Client A model for effective doctor client and staff client communication As we ve seen, to be effective with their clients, veterinary practitioners and health care team members must first discover their own preferred style of communication. Next, they need to determine what their patients prefer. Then, they adjust their approach, if necessary, to match those client preferences. This three-step approach can be readily applied at each stage of a model for health care communication developed by Judy Allen and Susan A. Brock. According to Allen and Brock, what transpires during doctor-client and staff-client communication can be analyzed as a four-stage process: 1. Initiating the interaction 2. Investigating needs 3. Suggesting action 4. Next steps or closing. According to MBTI estimates provided by the Center for Applications of Psychological Type, 45% 53% of the general U.S. population prefer Extraversion, while 47% 55% prefer Introversion. Let s look at each of the stages Stage 1: Initiating the Interaction At the start of the interaction, the preferences that likely make the most difference are Extraversion and Introversion. Extraverts tend to talk first, while Introverts are more likely to listen. Clients are likely to be most at ease when they feel the health care practitioner is tuned in to them on this dimension. Similar to the tips outlined in the previous Adjust Your Approach section, here are some communication strategies to try during this stage of the interaction: If your client prefers Extraversion In your own way, show energy and animation in your face, voice, and body. Allow enough time for the client to talk it out. Ask open-ended questions, then listen for and summarize the main points as they emerge. If your client prefers Introversion Use calm body movements. Allow for and use a slower verbal pace to allow for the client to think things through. Listen after asking a question and don t fill the pauses. Stages 2 & 3: Investigating Needs and Suggesting Action As the exchange proceeds, the client will show a preference for how information is taken in and how decisions are made. Sensing and Intuition are the preferences used for taking in information. Some patients want facts and specifics (Sensing). Others want to know the wider options and possibilities (Intuition). Thinking and Feeling are the preferences used for making decisions. Clients with a preference for Thinking may first weigh the logical options, while those with a Feeling preference may first consider the personal impact of decisions. How clients prefer others to communicate with them during stages 2 and 3 depends most on their particular combination of function pairs Sensing/Intuition and Thinking/Feeling. The function pairs ST, SF, NF, and NT are aptly named because they say so much about how people prefer to function in life. They also play a key role in determining the focus of the information and how we interact when communicating. On the other hand, the Extraversion/Introversion and the Judging/Perceiving dimensions affect the pace of the interaction and the approach to concluding it. Understanding 19 Preferences 20 Client 21 Benefits of Model 22 References

10 20 Four Stages of Client How Can You Identify Clients with Preferences for ST, SF, NF, and NT? What do each of these preference pairs looks like? Here are some behavior cues to watch for that can tip you off to your client s preferred way of gathering information and making decisions. For a review of the four MBTI function pairs, how they affect practice team dynamics, and tips for communicating with colleagues and coworkers with differing function pairs, refer to section 16 in MBTI Type and Teams Module 3. Also included is the estimated prevalence of each of the functional pairs in the U.S. population,which provides interesting insight into the preferences that clients are most likely to display. ST Specifics/Logical Implications (estimated 30% of the U.S. population) Values factual information Gives the facts in a logical order Has a practical, let s get the task done approach Interested in tried and trusted methods with data-back-up How they might prefer to hear bad news: - I don t want to hear all sorts of irrelevant stuff, I just want the straightforward facts, no fuzzy prelude. - When my last pet died, they kept asking me how I felt. It felt intrusive and wasn t helpful. Please don t expect me to open up before I know you are trustworthy. SF Specifics/Impact on People (estimated 43% of the U.S. population) Seeks personalized service, a caring relationship Asks for facts rather than theory Wants a warm and friendly approach Interested in whatever worked for others How they might prefer to hear bad news: - The blunt way the doctor broke the news made it so much worse to bear; what helped was how the technician actually related to me as a person. - The worst thing was hearing the news alone, I wished my partner was with me. But it really helped me to have the doctor s full concentration, and not to be hurried so I could get all my questions answered. NF Big Picture/Impact on People (estimated to be 17% of the U.S. population) Sees their situation as unique Needs to be valued as a person Interested in new methods of treatment and perhaps non-traditional approaches How they might prefer to hear bad news : - I hated being treated like a number, just another person with a sick cat. I really wanted to have more time to talk about different treatment options. - I immediately thought of my family, especially the kids, and how they would take the news. NT Big Picture/Logical Implications (estimated to be 10% of the U.S. population) Asks for logical options Tests the health care providers competence Interested in cutting-edge methods How they might prefer to hear bad news: - I just wanted the truth, an understanding of the whole situation, the prognosis and what options there are. - If I have a serious decision to make that might affect my pet s life, I want to be sure I am dealing with someone who knows what is going on, not an amateur.

11 20 Four Stages of Client According to MBTI estimates provided by the Center for Applications of Psychological Type: 66% to 74% of the general U.S. population prefers Sensing, while 26% 34% prefers Intuition 40% to 50% of people prefer Thinking, while 50% to 60% prefer Feeling. Note that the Thinking/Feeling dichotomy is the only MBTI preference pair where a significant gender bias is evident. While 65% to 76% of females prefer Feeling, only 33% to 45% of males assess with a Feeling preference. So, the data suggest that, if veterinary clients are simply a subset of the general U.S. population, then there is a 66% to 74% likelihood that any random client would have a preference for Sensing and up to a 60% likelihood of a client preferring Feeling, unless the client is female in which case there is a 65% to 76% likelihood that she has a Feeling preference. What does this data mean? If you play the odds, you can guess that many clients preferred communication styles will be represented by the SF function pair. However, you ll still want to tune in to each individual client and be prepared to adapt to their communication needs in the moment. Exercise Identifying Client Preferences Let s check your understanding and see how you do at identifying the following client statements. Match each group of statements with the appropriate function pair. A = ST B = SF C = NF D = NT 1. I need to know that the person talking to me has my best interests at heart. I need someone to spend time with me talking over the treatment options and possible long-term outcomes. I want to be confident in the treatment that is recommended and understand why it has been chosen. 2. I just want the facts, as much information as I can take in. I don t want a lot of sentiment or personal stuff. I want to know the pros and cons from someone who really knows what they are talking about. 3. I need to know the reason for the recommended treatment, the full extent of its effect, both good and bad. I m not just going to act on faith on this. I want someone I respect to give me the information, but not necessarily all the details. I need to be confident in their competence. If I have it, I ll pretty much do what I m told. 4. I need to trust the person who is providing the information and have confidence in them. I want individual attention and the other person s full concentration. And I don t want a whole lot of wild options and alternatives. I like to be channeled into the right solution. Answers: 1. C; 2. A; 3. D; 4. B

12 20 Four Stages of Client How Can You Connect With Clients with Preferences for ST, SF, NF, and NT? The MBTI function pairs make the greatest difference in how patients want information and interaction from members of the veterinary health care team. With this in mind, here are some specific things you can do to ensure that you are communicating most effectively with each client. ST (Sensing/Thinking): The Facts with Practicality Approach Typically, clients with a preference for Sensing and Thinking desire fact-based interaction with their veterinary practice. Specific to do s for ST s include: Be brief, give concise facts. Be straightforward, honest, and realistic. Be competent and pay attention to detail. Present information in a logical way; do not go off on a tangent. Know the facts about their pet s condition and expect to be questioned on them. Give them information on the specific treatment options so they can weigh them. Do not treat their pet without first giving them all the facts and relevant details. Give them factual written information about their pet s condition and treatment. Have relevant data available for comparison and review. SF (Sensing/Feeling): The Personal Service Approach Clients with a preference for Sensing and Feeling want a warm, personal connection with their veterinary health care professional. Specific to do s for SF s include: Listen carefully to them, give them your time and complete attention. Be warm, friendly and cheerful. Give them factual information honestly, but with a personal touch; for example, remember what you ve already told them. Strive for harmony in the interaction, find points of agreement. Provide practical information and examples about their pet s condition. Tell them about similar cases and what other pet owners in the same situation have done. Explain any options clearly and allow them time to decide. NF (Intuition/Feeling): The Supporting Their Vision Approach Those with a preference for Intuition and Feeling want personalized support that respects their values and considers the implications of their situation on others and for the future. Specific to do s for NF s include: Treat them with respect, involve them in the decisionmaking process, and value their unique perspective. Be honest, kind, and sincere. Listen to and acknowledge their concerns. Provide bottom line solutions an overview without too many details. Get to know them as a person. Be open to discussing alternate or complimentary treatments with them. Be consistent in words and actions. NT (Intuition/Thinking): The Logical Options With Competence Approach Clients with a preference for Intuition and Thinking want the veterinary health care team to offer logical options and will often test the competence of the doctor and perhaps even the staff. Specific to do s for NT s include: Respect their intelligence and their need to understand. Demonstrate your competence and show that you continually update your knowledge. Do not expect or assume a personal relationship that will be built when competence is shown. Answer their questions in an honest, open way; do not hide anything. Share multiple options and involve them in decisions. Listen to their views and ask before giving advice. Be informed about new, innovative treatment options.

13 20 Four Stages of Client The Challenges of Flexing Your Style Flexing your style to connect with your client will be most challenging when the client s preferred communication style is exactly opposite to yours. Take, for instance, Dr. Jung, the INTP practice owner at River City Veterinary Hospital (RCVH). Dr. Jung s natural communication style, considering his NT function pair, is to get straight to the point and present treatment options in a logical and fairly impersonal way. He would typically share the pros and cons of each potential approach at a fairly high level, without providing much in the way of specific detail. When attempting to communicate with an SF client, Dr. Jung s style could easily get in the way. The SF client would first want to feel like Dr. Jung cared about him or her as a human being. Then, they would need a lot more detail about the how to s related to each approach and what would be required of them in the way of home care, etc. In the same way, RCVH s practice manager, Jean, with an ESTJ type preference, would be challenged to adapt her normally short, crisp, businesslike style to meet the needs of an NF client who had lodged a complaint about the hospital s billing policy. With a little practice, though, every member of your practice team can develop the skills needed to flex and connect with clients with different communication styles. Try the following exercise to help you reflect and learn from your daily client communication experiences. Exercise Develop Your Skills Exercise Think of two recent client interactions that you were involved in: one where the outcome was good and one where it was unsatisfactory from your perspective. Describe each one using the following headings: What was the situation? Who was involved? What did you think, feel, or want to do in this situation? What did you actually do? What was the outcome? Then consider these questions: 1. Looking at the functional pairs in particular, what type mode would best describe you in this interaction? ST Specifics/logical implications SF Specifics/impact on people NF Big picture/impact on people NT Big picture/logical implications 2. How would you describe the clients type mode? 3. In what ways did your mode match the clients mode? In what ways did you perceive a mismatch? 4. For the instances where your behavior cues matched those of your client, what were the positive outcomes, what were the negative outcomes? 5. For the instances where your behavior cues did not match those of your client, what were the positive outcomes, what were the negative outcomes? 6. What insights are coming up for you that could inform how you can be more effective in the future? What do you want to do differently next time?

14 20 Four Stages of Client Stage 4: Next Steps or Closing The next step is to move to closure. The Myers-Briggs Judging/Perceiving dimension is most evident as the conversation ends. Some patients (those preferring Judging) are eager to achieve closure. Others seem to enjoy gathering information and considering their options and may delay closure (those preferring Perceiving). Clients in a J mode may seek to control the situation as much as possible. They may want: To reach a decision and move quickly on to the next steps: What treatment does my pet need? How soon can it be scheduled? No loose ends: Is that everything? When do I need to schedule the next appointment? Clients in a P mode usually like to have options and information. They may want: To examine the options: What are the treatment options? Can we review them again? To stay open until the last minute: I d like to consider all of this before deciding what to do. I need time to do a little more research. Similar to the tips outlined in the previous Adjust Your Approach section, here are some communication strategies to try during this stage of the interaction: If your client prefers Judging Clarify the client s goals and when they want to achieve them. Provide a timetable and stick with it. Expect a push to get it done. Ensure that the client does not make decisions prematurely. If your client prefers Perceiving Clarify the client s direction, then be ready to make action easy when they make a decision. Make actions fit the client s timetable if possible. Expect the client to take action at the last minute and follow-up with them as appropriate. Support the client in gathering the information they need to make a decision. Note: according to MBTI estimates provided by the Center for Applications of Psychological Type, 54% 60% of the general U.S. population prefers Judging, while 40% 46% prefers Perceiving.

15 21 What are the Benefits of Applying the Four-Stage Model? Veterinary health care practitioners and team members can definitely learn how to recognize and respond to client differences. Applying the simple fourstage process outlined here can improve quality of doctor client and staff client communication, client satisfaction, client follow-through, and actual pet health outcomes. Adherence: for Committed Action Encouraging clients to follow your clinical recommendations The subject of adherence (more commonly referred to as compliance within the veterinary profession) has been a hot topic recently. The use of the term adherence is more commonly used in human health care to refer to communicating with patients for committed action. While compliance has enjoyed more widespread use within veterinary medicine, in some circles the term adherence is preferred. The reason? It is not our intent to persuade or manipulate clients to comply passively with whatever we think might be good for their pet. Our goal is to communicate with clients in such a way as to promote an informed decision that the patient can own. This ownership and resulting commitment contribute to a greater chance that our clinical recommendations that are in the best interest of both the pet and client will be followed. Poor communication is costly on many fronts and it contributes to the less-than-optimal levels of adherence identified in veterinary practice. Wasted medication, continuous need for medical intervention, a tendency to wait until emergencies arise versus taking a preventive approach these are all symptoms of low adherence. Most importantly, as a result, our patients may not achieve the fullest possible recovery from disease states or surgical interventions and their quality of life (as well as that of the client) is negatively impacted. Improving Adherence Using the MBTI Framework An understanding of personality type can help veterinary professionals partner with clients and provide information which will help them to reach informed decisions decisions to which they are more likely to adhere. Essentially, better client communication using the lens of MBTI personality type is one key that can help ensure committed action and followthrough on the part of the client. Understanding 19 Preferences 20 Client 21 Benefits of Model 22 References

16 21 What are the Benefits of Applying the Four-Stage Model? Guidelines for Improving Client and Adherence When encouraging clients to adhere with any recommendation, be it a prescription diet or a course of antibiotics, they are more likely to respond positively if they receive the information in a type mode which reflects their own. So, thinking about what s already been covered in this module, always remember to: Follow the three simple steps involved in utilizing the eight MBTI preferences to improve your communication with others: 1. Identify your own preferred style of communication. 2. Tune in to the other person s preferred style or current needs. 3. Adjust your approach, if necessary, to match those needs. Practice using the four-stage model for effective doctor-client and staff-client communication outlined earlier in this module. The to do lists for each MBTI function pair (ST, SF, NF, NT) provide clear guidance for influencing clients most effectively. When in Doubt, Ask the Client! There may be times when you just can t get a lock on what the client s preferred communication style is at the moment. In those instances, follow this simple rule: When in doubt, ask the client! Simply ask the client a few questions to uncover their needs and find out what they want from you in the way of communication. Here are a few examples: Would you like me to focus on the details or the big picture? What other information would be helpful for you right now? What criteria will you be using to arrive at a decision? What do you need from me/us to help you move forward? What lingering questions do you have that I/we haven t adequately answered? What options or steps are you considering? Checking it out simply means to ask the client what they meant when they said, did, or failed to do something. When asked in a curious and sincere manner, checking it out is neither offensive nor confrontational. Here s what to say When you said (or did), I interpreted that to mean. Did I get it right? Many things can affect the way in which clients receive information and advice. Pet health care issues can often be emotive and this in itself may lower the client s ability to assimilate information and make sound decisions. Therefore, it is even more important to match our communication-related behaviors to the patient and their needs. Additionally, one of the greatest benefits that comes with understanding personality type is an improved ability to differentiate between intentional and misunderstood messages. Many misunderstandings are based on differences in personality types, not the result of intended confrontations or slights. So, how can you prevent misunderstandings? Once again, ask the client. Always check it out when you experience a client interaction that seems confrontational or otherwise catches you off guard.

17 22 References Suggested Reading Books 1. Health Care Using Personality Type. Allen J, Brock S. Routledge, Introduction to Type and. Dunning D. CPP, MBTI Manual: A Guide to the Development and Use of the Myers-Briggs Type Indicator, 3rd ed. Myers IB, McCaulley M, Quenk N, Hammer A. CPP, Articles 1. strategies with people of different psychological types. Carskadon T. Mississippi State University Psychology Department, freshmanseminar. appstate.edu/fs_students/com_strategies.htm. 2. Doctor-patient communication. Houghton A. BMJ Careers, Guessing another person s type without them telling you. mbticlub.com. 4. Personality differences between doctors and their patients: Implications for the teaching of communication skills. Clack GB, Allen J, Cooper D, Head JO, Med Educ 38: , Tailoring the message. Allen J, Brock SA. Minnesota Medicine, Vol. 83, May Understanding 19 Preferences 20 Client 21 Benefits of Model 22 References