I've been working with my colleague Bill Dupre on designing and delivering a workshop entitled, "Managing Through Conflict to Success."  It focuses primarily on interpersonal conflicts and challenges. One of the main premises is that preparing for a conversation that you think might be challenging increases the likelihood of a positive outcome.  We both like the phrase coined by the Crucial Conversations authors, "Work on me first."  We've assembled a variety of strategies that help in preparing for a difficult conversation, some drawn from the Crucial Conversations work:

1.  Clarify what the conversation needs to be about:  Write out some of the history, background, and context. Think through really carefully what you want to bring up. In Crucial Confrontations, the authors point out that difficult conversations are rarely simple. Therefore, it's helpful to be clear about what aspect of a situation you want to focus on.  One way to figure out what the conversation needs to be about is to use the acronym "CPR." The first time the issue comes up, focus on Content (C): describe just what happened at the level of event. The next time the issue comes up focus on Pattern (P): What has been happening over time?  As the problem continues, focus on Relationship (R): What is this doing to us?  How is it impacting on our relationship?

2.  Ask yourself, "What do I want? What do I not want?":   Being clear about your hoped-for outcomes and their opposite can be a valuable touchstone.  Do you want to win?  Get the other person to do what you want them to do?  Have an open and honest dialogue?  Feel that you've been heard and respected?  Part of this reflection also involves considering whether you actually want to have the conversation at all. Perhaps you had a bad experience with someone that you will never have to interact with again. Is it really worth engaging in this difficult conversation?  Or maybe you determine that the potential costs of speaking up are likely to be greater than the costs of keeping quiet. Keep in mind that we often overestimate the costs of speaking up in relation to the costs of keeping silent. Does your conscience keep bothering you but you have kept quiet until now because you're worried about the consequences?  What is the cost of your silence?

3.  Ask yourself, "Why would a reasonable person behave this way?":  This allows you to put yourself in the shoes of the other person and explore some legitimate reasons for the behavior that may have led to the need for this conversation.

4.  Explore your own assumptions about the conversation: As you continue your preparation, pay attention to why you believe this conversation is going to be difficult and what actual evidence you have that this will be the case. Often, our expectation that a conversation is going to be difficult contributes to the difficulty because we feel tense, defensive or angry. When we can approach a potentially difficult conversation with curiosity, openness and modest expectations, the emotional "cloud" that surrounds the conversation often dissipates.

5.  Familiarize yourself with your own triggers and "hot buttons" and develop strategies to minimize the likelihood of this happening:  The conversation will probably not go well if you find yourself in the midst of a fight or flight situation, and knowing what sets you off and how to address this beforehand is good preventive medicine.

6. If possible, find someone to practice the first minute or two of the conversation with:  Many of us put off having these conversations because we just don't know how to get started.  Actually, the first minute or so is the greatest predictor for how well the rest of the conversation will go, so it's a good idea to practice.

No one truly enjoys having these kinds of conversations but with preparation and successful practice you can actually come to experience these as stepping stones toward enhancing positive relationships rather than experiences to be avoided at all costs.

• Each year, one in twenty inpatients in hospitals will be given a wrong medication.
• 3.5 million people will get an infection from someone who didn't wash his or her hands or take other appropriate precautions.
• 195,000 people will die because of mistakes made while they're in the hospital.
   

What does this have to do with communication?  "Every day, many healthcare workers stand next to colleagues and see them cut corners, make mistakes, or demonstrate serious incompetence.  But only a small percentage speak up and discuss what they have seen-even though they're standing only a few feet away."

The article describes seven kinds of conversations that people in healthcare regularly avoid that likely add up to unacceptable error rates, low morale, turnover, and poor quality and productivity. These include: Broken rules, mistakes, lack of support, incompetence, poor teamwork, disrespect and micromanagement.  Although set in the healthcare field, these seven conversations will be familiar to people working in many kinds of organizations.

In a companion article, the authors describe approaches to each of these seven conversations that are designed to produce positive results and lead to environments where open communication is the norm rather than the exception. 

You can access the articles by clicking on dialogueheals

I found this study to be particularly interesting because I've been conducting a communication assessment within a healthcare organization.  The themes described in the article are consistent with my findings.  It's encouraging to know that with commitment and practice organizations can begin to turn around a culture where these important conversations are avoided into one where people skillfully speak up in a way that gets results without provoking defensiveness.

If you'd like to know more about what we're up to, please contact me at deborah@reidyassociates.org or 413-536-9256.