Talking About Feelings - Are You Hiding Behind The Audiogram?

By guest contributor: Andrea Hillock Dunn, AuD, PhD, CCC-A

Have you ever felt your heart rate increase, breath grow shallow, or room grow warm when informing a patient or family of a hearing loss? Learning of a hearing deficit or decrease in hearing can be intensely emotional for the unprepared patient or family. This experience can also be emotional for the professional delivering such news, especially those with limited experience or skills for most effectively responding to the patient’s needs at that time. The way in which you share that information, react to the patient’s and family’s emotions, and provide ongoing emotional support and counseling can have a major impact on patient and family well- being and satisfaction with care.

Although audiologists reportedly recognize the importance of emotional or “adjustment”
counseling (Sexton, 2015), and patients and families value this support from hearing healthcare
professionals (Fitzpatrick et al., 2008), unfortunately it appears to be lacking. In a recent survey of parents of children with hearing loss who use hearing aids (ages birth through 3 years), only roughly half reported that their audiologist gave them adequate time to talk about and understand their emotions (Muñoz et al., 2014). Moreover, a survey from The Care Project, a nonprofit organization supporting children with hearing loss, families and professionals, showed a dichotomy between the perceived importance of adjustment counseling and professionals’ preparedness. Survey respondents (comprised of attendees at a sensitivity training course) unanimously reported that emotional counseling was important (15%) or very important (85%), but fewer than half were trained to provide adjustment counseling to children and parents (Sexton, 2015). Likewise, only 45% indicated that they were comfortable providing such counseling to families.

In the classroom and clinic, we become exceedingly prepared in diagnostics and rehabilitation
(e.g., technology), but is the role of adjustment counseling adequately recognized as an integral part of patient care and rehabilitation? Are we hiding behind the x’s and o’s on the audiogram because we’re uncomfortable, or unprepared to effectively respond to patient emotions surrounding hearing loss? How does adjustment counseling fit within our scope of practice and more practically speaking our clinic schedules?

Audiologists are not trained or licensed to act as therapists, but perhaps effective adjustment counseling in audiology starts with active listening and probing questions. When patients or families are presented with potentially devastating news, actively listening can allow audiologists to more sensitively respond to the patient or family’s pressing questions and needs. While information and knowledge about the nature of hearing loss is an essential part of the grief journey and hearing loss acceptance, it is also imperative that we offer support for families on more a more personal and emotional level. This allows us to potentially recognize the need for referrals to other healthcare providers and to answer unanticipated questions. Using active listening to tailor counseling to a specific patient or family needs, not only embodies the spirit of family-centered care, but may be a critical part of supporting our patients or families on their journey toward hearing loss acceptance.