Communication and Engagement Skills

What makes a good conversation?

Think of someone you like talking to. What makes those conversations enjoyable? Maybe you trust them. Maybe they listen carefully. Maybe they give good advice or calm you down when you're upset. These are the things that make people good at communicating — and they're the things CHWs need to do, every day.

As a CHW, you're an important member of the care team. Building relationships with patients helps the care team understand and address patients' needs. This lesson covers three foundational skills: rapport, active listening, and responding to challenging statements.

The importance of good communication

If a CHW can't build a good relationship with their patient and the care team, they will not be able to help the patient much. Effective communication is an essential part of healthcare.

No matter how knowledgeable a clinician might be, if they are not able to open good communication with the patient, they may be of no help.

Building rapport

Building rapport creates trust, confidence, and participation. Rapport starts from the very beginning of the relationship and continues throughout.

Steps to build rapport

Steps in building rapport

Three techniques: empathy, curiosity, patience

Technique #1: Empathy

Empathy is the ability to sense others' emotions and imagine what they might be thinking or feeling. CHWs use empathy to feel alongside patients — not just feel sorry for them. People often don't want a magic fix; they want a connection. Empathy helps people feel less alone.

• Show genuine interest
• Put yourself in the other person's shoes
• Avoid being judgmental
• Listen carefully
• Recognize emotions in others you've felt before
• Let the person know you understand how they're feeling

Phrases to show empathy

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Technique #2: Curiosity

Being truly curious is another way to build rapport. People often avoid showing too much interest to seem polite — especially in the US, where privacy is highly valued. But as a CHW, stay genuinely curious. Curiosity shows you're listening and interested in patients' experiences. That demonstrates patients are heard and valued — and builds trust. Being fully present in conversations is a key part of effective help.

Technique #3: Patience

Healthcare is fast-paced. Patients may take their time to get to the point or go off on tangents. It's normal to feel frustrated — but slow down and empathize. Giving the patient time to share their experiences, thoughts, and needs uncovers valuable information and builds trust. If you feel frustrated, take a deep breath and practice empathy.

Active listening

Active listening means really paying attention to what the client is saying, understanding it, responding to it, and remembering it. Pay attention to tone, behavior, and body language to understand the whole message. It tells the client they're being heard.

The three pillars of active listening

The three pillars of active listening

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Tips for active listening

The four elements of active listening

The four elements of active listening

Using silence

Sometimes the best way to connect is to stay quiet. Silence gives both the CHW and the client time to think. It can help patients share tough information by giving them space.

• Don't rush to fill silence (especially on the phone).
• Make sure you're not talking more than the client.
• Try silently counting to 15 before speaking again.

Watch: Sitting in silence

A client says: "I waited twenty minutes and someone budged in front of me — I've just been so tired this week." Which response is the best example of reflection?

Match each element of active listening to what it does.

Responding to challenging statements

Sometimes patients, caregivers, or coworkers may say things that are challenging — untrue, offensive, or expressing anger. CHWs are good at respecting other people's experiences and feelings. But disagreements happen.

Strategies

Use reflections and open-ended questions:

• "I can hear you are feeling upset and angry."
• "Help me understand your thinking."

Buy time to think:

• "Let me pause for a moment — I need to think through what you just said."

What people in difficulty actually need

Research shows that people experiencing difficulties benefit from three things:

1. Feeling safe and connected to others
2. Having access to social, physical, and emotional support
3. Feelings of self-efficacy and autonomy

These are all things CHWs can promote. Your presence and empathy are powerful in ways you might not appreciate.

Empathy has no script. There is no right way or wrong way to do it. It's simply listening, holding space, withholding judgment, emotionally connecting, and communicating that incredibly healing message of 'You're not alone.'

Which three techniques does this lesson identify for building rapport with a client?

When a coworker or patient says something challenging, which responses fit the strategies in this lesson? Select all that apply.

Putting it together: Meet Joe

Joe is a 62-year-old man with type 2 diabetes, hypertension, and COPD. Last week, his toe was amputated due to unmanaged diabetes. You're concerned he isn't taking his health seriously — he hasn't answered your calls. You've decided to show up at his home unannounced.