Building therapeutic relationships: choosing words that put people first

Abstract

As health care professionals (HCPs), what we know, do, and say has an impact on people. People with diabetes come to us when they are vulnerable, and our knowledge, actions, and words give us the power to help them overcome their fear and learn what they need to take care of themselves. Unfortunately, the words used in diabetes care often lead to shame instead. When HCPs interact with people who are diagnosed with diabetes, we often use words such as “diabetic,” “should,” “test,” “control,” “noncompliant,” and “morbidly obese.” Although these words have been part of the health care lexicon for years, many people with diabetes find them negative and judgmental and often shut down when they hear them. Negative words are not helping people better manage their disease and may even be hurting them. People with diabetes experience abundant guilt, shame, and blame. Society in general, and HCPs in particular, often refer to diabetes as a “lifestyle disease.” This alone sends a message of judgment. The literature shows that words make a difference in health (1), and some groups have already taken the initiative in changing the language used in specific health-related conditions. It is time for diabetes care professionals to do the same. The messages we send in health care can have an impact on patient-provider communication and, ultimately, relationships. Through messages that empower people with diabetes, we can build trust and rapport. This increases the likelihood that patients will communicate openly and honestly with us and listen to our suggestions. A language movement is not a new concept. Psychologists, health professionals, and even the lay community have been discussing the language of health care for more than half a century. Diabetes Australia published a position statement on language …