Question
What are minimal encouragers and how can respiratory therapists use them to improve patient communication and clinical outcomes?
Answer
Minimal encouragers are verbal and nonverbal cues that signal to a patient or colleague that you are actively listening and that they can continue sharing. Most people use them instinctively without knowing there is a name for them. They foster an environment where patients feel safe to tell their story, and stories yield more clinically useful information than closed-ended yes-or-no questions.
Verbal minimal encouragers include phrases such as "I see," "Go on," "That sounds difficult," "Mhm," and "Tell me more." These signals communicate that you are present, that you hear what is being said, and that the person should continue. The specific phrasing can be adjusted for audience. With a pediatric patient, "That is tough" may feel more natural than "That sounds difficult." The goal is authenticity, not formula.
Nonverbal minimal encouragers include nodding, maintaining eye contact where culturally appropriate, leaning forward slightly, and using facial expressions that convey concern or empathy. I have found in my mental health practice that allowing myself to have genuine reactions, including surprise or visible concern, actually helps patients open up more than a trained neutral expression does. People need to see that you are human.
To illustrate the clinical value: I had a COPD patient, whom I will call Mary, who had been managing well and then was readmitted. Staff described her as non-compliant with her medication regimen. Because I had a relationship with her, I asked open-ended questions. Through that conversation, I learned that her daughter had fractured her femur, was bedridden, and her daughter's husband, overwhelmed by other responsibilities, had not been getting Mary her medications. She was not non-compliant. She did not have access to her medication.
The fix was simple: arrange for the medication to be mailed. But we never would have reached that solution without asking open-ended questions and listening for the story behind the symptom. Minimal encouragers help patients feel heard and understood, promote sharing of critical health information, demonstrate genuine care and attentiveness, and contribute to more accurate diagnoses and treatment plans.
This Ask the Expert is an edited excerpt from the course, Breathing Easy: Building Psychological Safety for Respiratory Therapists and Healthcare Teams, presented by Gabrielle Davis, MPH, MA, RRT, RRT-ACCS, RRT-NPS, TTS, LPC, NCC, FAARC.
