Engaging the Patient

This page is part of an overall training activity provided by Clinical Tools, Inc. Our ImpactObesity training activity provides skills training for primary care providers.
Please refer to the ImpactObesity homepage to sign-up and begin the activity!

When engaging the patient to start a discussion of their weight, which is a sensitive topic for many people, first build rapport and ask permission to avoid setting up patient resistance.

Build Rapport

Establishing rapport decreases defensiveness and increase openness to the possibility of change. Expressions of acceptance and affirmation are important parts of building rapport (Rollnick et al., 2008). Make sure to:

  • Be reassuring: Reassurance that you are not going to insist on immediate and drastic lifestyle changes — you just want to talk — may also help.
  • Use non-threatening body language: Pay attention to your body language. Adopt open, non-authoritarian body language. For example, sit at the same level as the patient, maintain regular eye contact, keep your chest and hands open, and do not cross your legs. Be relaxed while professional -- the demeanor will likely be contagious.

Ask Permission

Asking permission engages patients by getting them to "buy-in" to the process. This approach helps the patient realize the they have a say in what happens.

(Rollnick et al., 2008)

Examples of Developing Rapport and Asking Permission

I appreciate the way you check in with me every year. That way, if there are any health problems or potential health problems, I can work with you to address them early. [Building rapport using affirmation]

Sure, I think it's important to get checked out regularly.

One thing we could work on together that is likely to improve your health, now and down the line, is your weight. Can we talk about that? [Asking permission]

Yes, I know I'm a little out of shape.

Practice Tip

When giving factual advice, asking patients their response to it helps engage them.

View ReferencesHide References
Rollnick S, Miller W, Butler C. Motivational interviewing in Health Care. Guilford Press: New York. 2008. Available at: http://books.google.com/books?id=njcm0V_IprEC&dq=Using+motivational+interviewing+in+routine+care&lr=&source=gbs_navlinks_s Accessed on: 2014-12-16.