Week 2: Social History Taking Flashcards
What is a social history?
▪ Part of the assessment process
▪ Method of gathering data from the patient during consultation
▪ Generally first ~10 minutes of an initial individual outpatient/ private
practice consultation
▪ Fits in ‘client history’
What’s the Aim of social history?
▪ Getting to know your client
▪ The start of a shared journey
▪ Build rapport
▪ Through demonstrating interest in the client
▪ Allow the client to feel comfortable with you as a practitioner
▪ Put them at ease for the rest of the consultation
▪ Gather data that informs the overall assessment you will make of the person
▪ Which informs the plan of action
Key elements of social history:
▪ Who they live with ▪ Who shops/plans the meals/ cooks ▪ Food accessibility ▪ access, preparation, support ▪ Caring responsibilities ▪ Employment/ study/ volunteer activities ▪ Routine ▪ Affordability of food ▪ Physical activity/ sitting time ▪ What activities, how often ▪ Assess current level at work ▪ Incidental/ planned ▪ Recreational activities ▪ Hobbies/ interests ▪ routine, ways of increasing PA ▪ Social support – friends, group involvement ▪ Smoking & alcohol
What does active listening mean?
Active listening is the ability to focus completely on a speaker, understand their message, comprehend the information and respond thoughtfully. Unlike passive listening, which is the act of hearing a speaker without retaining their message, this highly valued, interpersonal communication skill ensures you’re able to engage and later recall specific details without needing information repeated.
What is reflecting and how to do it?
Labelling a client’s verbal and non-verbal emotion
This allows clients to feel understood, facilitating self-acceptance and self-understanding
Steps in reflecting:
Correctly identify the feeling being expressed.
Reflect on the feeling you have identified to the client.
Match the intensity of your response to the level of feeling expressed by the client.
You should respond to the feelings of your client, not to the feelings of others.
What are closed questions?
▪ Closed questions invite a short-focused answer
▪ Answers to closed questions can often (but not always) be either right or wrong.
▪ Closed questions are usually easy to answer - as the choice of answer is limited
▪ Can be effectively used early in conversations to encourage participation
▪ Can simply require a ‘Yes’ or ‘No’ answer,
▪ ‘Do you smoke?’, ‘Did you feed the cat?’, ‘Would you like a cup of tea?’
▪ Can require that a choice is made from a list of possible options,
▪ ‘Would you like beef, chicken or the vegetarian option?’, ‘Did you travel by train or car today?’
▪ Can be asked to identify a certain piece of information, again with a limited set of answers,
▪ ‘What is your name?’, ‘What time does the supermarket open?’, ‘Where did you go to University?’
What are open questions?
Open Questions
▪ Open questions allow for much longer responses and therefore
potentially more creativity and information.
▪ They allow a client to talk about what they feel is most relevant.
▪ There are lots of different types of open question
▪ some are more closed than others!
What is Leading or ‘Loaded’ Questions?
▪ A leading question, usually subtly, points the respondent’s answer in a certain
direction.
▪ Prompts the person to answer a certain way
▪ Leading questions may not obtain an accurate answer
▪ Examples:
▪ ‘Do you use white bread’?
▪ ‘Was that a small coffee?’
▪ Children are particularly susceptible to leading questions and are more likely to take the
lead for an answer from an adult.
▪ Examples:
▪ ‘Did you have a good day at school?’
▪ points the child towards thinking about good things that happened at school.
What are Recall Questions?
▪ Require something to be remembered or recalled
▪ Example: ‘What is your mother’s maiden name?’
▪ This requires the respondent to recall some information from memory,
a fact.
▪ A school teacher may ask recall questions of their pupils,
▪ ‘What is the highest mountain?’
What are Process Questions?
▪ Require some deeper thought, analysis and/or a sharing of opinion
than recall questions.
▪ Examples
▪ ‘What skills can you bring to this organisation that the other
applicants cannot?’
▪ ‘What are the advantages and disadvantages of asking leading questions to children?’
What is funnelling?
▪ We can use clever questioning to essentially funnel the respondent’s answers
▪ That is ask a series of questions that become more (or less) restrictive at each step, starting with open
questions and ending with closed questions or vice-versa.
▪ For example:
▪ “Tell me about your most recent holiday.”
▪ “What did you see while you were there?”
▪ “Were there any good restaurants?”
▪ “Did you try some local delicacies?”
▪ “Did you try the Clam Chowder?”
▪ The questions in this example become more restrictive, starting with open questions which allow for very
broad answers, at each step the questions become more focused and the answers become more
restrictive.
What is a distorted response?
Distorted answers to questions based on perceptions of social norms, stereotypes and other forms of bias. Different from lying. Exaggerate in some way to come across as more ‘normal’ or successful. Respondents may not realise answers are influenced by bias.
What is paraphrasing?
▪ Demonstrate your understanding of what the patient is saying
▪ Use as a way of summarising
▪ For example: “What I hear you saying is….”
▪ Remember:
▪ Keeping the language clear and simple.
▪ Not everything needs to be paraphrased (that would be distracting, interrupting).
▪ The focus should be on critical information that must be understood and often leads to the disclosure
of additional information.
▪ Paraphrasing can be used to assess the patient’s understanding,
▪ For example “Can you explain to me, in your own words, how you will plan your meals?“
▪ Can be used to lead into new questions or topics or refer back to a previously missed cue
▪ Especially if multiple points were raised at the same time and you want to go back and explore these
▪ For example: “you previously mentioned…” or “You said before…
