171. Study Notes: Communication Barriers and Defence Mechanisms in CCA Work

The Big Picture

Communication does not always go smoothly. A client may have trouble sending or receiving a message because of hearing or vision problems, cultural differences, distractions, or other barriers.

The support worker’s own behaviour can also block communication. Interrupting, giving advice, dismissing concerns, speaking in a patronizing way, and failing to listen can make it harder for a client to express thoughts and feelings.

People also sometimes protect themselves from uncomfortable feelings without realizing it. These responses are called defence mechanisms, and they can affect communication.

Look for Nova Scotia CCA Notes throughout this page for current provincial guidance.

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Course Notes: Key Ideas You Need to Know

What Is a Communication Barrier?

A communication barrier interferes with sending or receiving a message. It can limit communication or stop it completely.

Some barriers cannot be avoided, so they must be worked around. The support worker must learn special techniques to communicate effectively when hearing, vision, or nervous system problems interfere with communication.

Communication can be affected by:

• hearing problems
• vision problems
• nervous system disorders that limit communication
• cultural differences
• loud noise
• lack of privacy
• distractions

Cultural differences matter because people can give different meanings to verbal and nonverbal communication ⓘ.

CCA action: As much as possible, provide a calm, quiet setting when talking with a client.

Worker Behaviours That Block Communication

Certain behaviours create communication barriers even when the client is able to communicate.

Avoid:

• interrupting
• answering your own questions
• giving advice
• minimizing problems
• using patronizing language
• failing to listen

Interrupting

Interrupting stops communication.

A person may interrupt because they:

• assume they already know what the speaker means
• become impatient with the speaker
• become bored and want a different topic
• feel uncomfortable with the topic
• feel hurried or stressed
• concentrate on the task instead of the person

The key point is to give the person time to communicate instead of taking over the conversation.

Do Not Answer Your Own Questions

Avoid giving the client the answer while asking a question. Also avoid completing the client’s thoughts.

Answering for someone discourages openness. This is especially important when a person takes longer to respond.

For example, asking whether someone slept well and immediately suggesting that the answer was yes gives the person little room to explain. Asking about their sleep without providing an answer gives them more opportunity to describe what happened.

Do Not Give Advice

Support workers should not give advice to clients or family members.

Let clients and family members express their feelings and concerns without offering your opinion.

Avoid: Do not give your personal opinion about what a client should do, even when the client directly asks you for advice.

Giving advice can:

• create confusion
• increase anxiety
• create resentment
• conflict with the family’s wishes
• conflict with physician orders
• conflict with the care plan

Instead, the support worker can suggest that the client speak with a supervisor or case manager.

Do Not Minimize a Client’s Problems

Minimizing means treating a client’s concern as less serious or important than the client feels it is.

Statements that dismiss a problem or tell the client there is nothing to worry about block communication. They can suggest that the client is complaining, exaggerating, or should not feel the way they do.

Minimizing can also make a client feel judged or ridiculed. The client may feel that the worker does not care about their thoughts, fears, or feelings.

A better response recognizes the person’s concern. In the example involving a client who fears surgery, the supportive worker recognizes the fear and uses paraphrasing, which means restating the person’s message in the worker’s own words. The worker also expresses confidence in the health care team and immediately reports the client’s concern to the nurse.

Avoid Patronizing Language

Patronizing language makes another person feel unimportant or inferior. It suggests that the speaker sees themselves as better than the other person.

To avoid patronizing communication:

• Do not call clients names such as sweetie, dude, gramps, love, dear, or honey.
• Do not use a client’s first name without permission.
• Do not call adults “good girl,” “good boy,” or “you guys.”
• Do not say “we” when you mean “you.”
• Do not use baby talk or expressions such as “There, there.”
• Do not talk to family members or co-workers as though the client is not present.
• Do not correct the client’s speech or language.

A worker may intend to sound warm or friendly and still use patronizing language. Good intentions do not change how the words can affect the client.

Listen With Interest and Sincerity

Communication becomes blocked when a worker does not listen with genuine interest.

Pretending to listen is often noticeable. It can communicate a lack of interest or caring.

Poor listening can also cause the worker to miss important information.

Report: Complaints of pain, discomfort, or other abnormal sensations must be reported to the supervisor.

What Are Defence Mechanisms?

Defence mechanisms are subconscious ways of delaying or avoiding uncomfortable feelings such as anxiety, guilt, stress, or embarrassment.

They can last for a short time or a long time. People can use them in positive or negative ways as a means of coping.

A defence mechanism can make communication harder when the client uses it instead of accepting reality or facing a painful truth.

Defence Mechanisms You Need to Recognize

Denial

Denial means being unwilling to accept the truth or a certain reality.

A person with a terminal illness who refuses to believe they are ill is using denial.

Denial can also have different effects. A client awaiting major surgery might tell others that everything will be fine to reduce presurgery anxiety. In another situation, a person might deny having a drinking problem, which can interfere with accepting health teaching and contribute to unhealthy lifestyle choices.

Displacement

Displacement means transferring feelings, usually anger, onto another person or object instead of directing them toward the source of the anger.

For example, a woman who experiences abuse from her partner may direct abuse toward her children instead of dealing with the conflict with her partner.

Fantasizing

Fantasizing means escaping into daydreams instead of dealing with reality.

For example, someone who wants to become a singer may spend time imagining future success instead of practising singing.

Passive-Aggressiveness

Passive-aggressiveness means expressing anger, resentment, or other negative emotions in passive and indirect ways instead of stating feelings assertively ⓘ.

This can include procrastination ⓘ or manipulation.

For example, a student who dislikes an assigned project role may submit their work late, which affects the rest of the group’s grades.

Projection

Projection means blaming someone else for your own behaviour.

For example, a student who did not prepare enough for a test may blame poor marks on a noisy roommate.

Rationalization

Rationalization means explaining a behaviour or action in a way that makes it seem less harmful or hurtful than it is.

For example, a person with a bad cough from heavy smoking may blame the cough on dry air instead of acknowledging the smoking.

Regression

Regression means returning to an earlier developmental stage to escape stress.

For example, a toilet-trained toddler may begin wetting the bed after a new sibling is born.

Repression

Repression is the involuntary blocking of painful memories from the conscious mind.

For example, a person who experienced an assault may have no conscious memory of the assault.

People with repressed painful memories may experience depression or other mental health disorders.

Submissiveness

Submissiveness means showing obedience, meekness, and compliance during conflict or disagreement instead of being assertive.

Suppression

Suppression is a conscious refusal to acknowledge a painful or upsetting situation.

For example, a teenager experiencing the end of a relationship may tell friends that they do not want to talk about it.