Many people feel uncomfortable asking others about their stress reactions. We know how to have casual conversations with peers, but when it comes to discussing personal issues or emotions, people often don’t know where or how to start. Another common barrier to accurate assessment is the almost automatic denial of experiencing any stressors, distress, or changes in functioning.
One tool that can be effective in overcoming these obstacles is “OSCAR” communication—a mnemonic (memory device) for the five steps of:
Observe: Actively observe behaviors; look for patterns or changes that are consistent with the warning signs.
State Observations: Using words that reflect the behaviors you have seen; not attitudes, motivations, or thoughts; state what you have seen.
Clarify Role: In our professions, we are required to adhere to a code of conduct and have role bound expectations. Peers, supervisors, trainers, spouses, parents, friends are bound by the roles we share with others. There are times that we have more that one role with coworkers. You and they need to understand where you are coming from.
Ask Why: A is not for assume. Seek clarification; try to understand the other person's perception of the behaviors. An excellent way to ask why is to start with, "Help me understand..."
Respond: Telling someone what they should do or giving unrequested advice rarely works out. Provide Guided Options. (Do you want to talk with Cindy at EAP or our supervisor Jack?) Clarify concern if indicated; discuss desired behaviors and state options in behavioral terms. The idea is that we want to assist the person to expand their support resources and their options. Stress injuries heal best when additional resources are available.
There is also the B.E.G.I.N. FRAMEWORK
The BEGIN Framework is based on research on interpersonal dynamics. The way we respond to someone usually draws a particular type of response in turn. For example, if we respond to an angry and hostile person with anger ourselves, that tends to escalate the situation further. Another example: If we respond to someone who is being domineering with passivity or silence, they are likely to continue with this stance and go on being domineering or bullying.
Our aim is to respond verbally and non-verbally in a way that pulls or draws a more positive or neutral response from the person so that we can move on with the goals of care. Getting to neutral is a way to have a new beginning in a dialog or relationship.
Here are the steps of BEGIN:
Breath! A slow deep breath promotes calming and gives your thoughts a chance to catch up to your emotions. It is rarely a good idea to simply launch. Take a moment to calm yourself and to be thoughtful about how you will respond. Suspend judgment.
EMPATHY: This is where you start. Acknowledge that being in the situation is hard. “It must be really tough to situation (to balance all of these demands).” “I know that it has been very stressful for you since you situation (a really dedicated to good patient care).”
STATE THE GOALS, THE VALUES: “We work as a team to take to provide care, and each member of the team has an important role.” “We treat each other and our patients with respect as we face challenges together.”
INQUIRE: Try to find out what is going on that is driving the biased behavior. “So help me understand why you are so upset” “Tell me what is going on.” “Are there questions I can answer?”
ENGAGE TOWARD THE COMMON GOAL: “So let’s get started on something that we can change or make a little better.” Bystander– “What can we do to ensure this will not happen again?”
Focus on the behavior and not the person. These steps of BEGIN are designed to draw the person back into a more productive or neutral dialogue and space.