30 Jun 2021
Owen Atkinson BVSc, DCHP, MRCVS offers advice on how to effectively communicate with farming clients using the magic question game.
Owen Atkinson
Job Title
There is a game that is sometimes used during coaching training. One person thinks of a real problem he or she has, or something he or she would like to do, but has been putting off. The person keeps this secret.
The other players take turns to ask one question each to the problem-holder. The problem-holder doesn’t answer the question, instead giving a rating – 1 to 10 – based on how useful he or she found the question.
After a while, the questioners tune in to the type of questions that get high scores. Pat yourself on the back whenever you score a 9 or 10. Eventually, the problem-holder will say when he or she can see the way to solve his or her dilemma, and this is the end of the game. Skilled players will help people solve their dilemmas in just 10 to 15 minutes.
Very quickly, you will find closed questions score very low. They will either be entirely pointless (for example, “Is it a big problem?”) or degenerate into a futile guessing game (such as “Is the problem something about your work?”); futile because, remember, the problem-holder can’t give you the answer.
As opposed to closed questions, open questions can’t have a “yes” or “no” answer because they usually begin with why, what, how, when, who or where. These will be rewarded with higher scores.
Not all open questions are going to hit the spot, though. “Why is it a problem?”, “Why haven’t you done it?” or “Who is to blame?”, as examples, will probably give moderate scores, maybe a 3 or 4. They help the problem-holder explore the problem a bit more – but they already know it’s a problem, so the usefulness is limited.
Then, you’ll find some high-hitters, such as “Who could help you solve this problem?” or “What is the first step you can take?”. These are solution-focused open questions. They will promote new thought patterns and the problem‑holder is likely to score you higher. When you get a high score, you might be able to follow the thread a bit, such as “What could you do to encourage that person to help you?”
With time, you’ll hit on the really good questions. I’ve played this game quite a lot, and – spoiler alert – you can almost guarantee a 9 or 10 with “How will you feel when this problem has been solved?” Why? Because it is an example of a forward-thinking open question. This type of question takes the problem-holder beyond the immediate hurdles in front of him or her. The person will be accessing the sunny uplands in his or her imagination and unlock trains of thought that help him or her to see ways around those various hurdles.
Try it. Give the problem-holder your full attention. Ask a forward-thinking open question, then wait. Watch the smile slowly creep over the person’s face; see the cogs whirring – he or she will turn to look at you with a light in the eye that wasn’t there before and award 10. Then he or she might add: “Wow! That’s amazing. Thank you!”
This is cognitive behavioural coaching using the principle of unconditional positive regard. It works. The questioners have not been solution-providers; it isn’t possible to give advice in this game. They are behaving as “thinking partners”. They are there for the problem-holder and their sole aim is to ask questions that the problem-holder finds useful. These are ones that help unlock new thought avenues and break old patterns of thinking.
The problem-holder experiences challenge and support – challenge to his or her original way of thinking and support because the other players’ sole aim is to ask questions that will be most helpful to him or her.
Of course, it’s a game. Everyone is relaxed. There is no pressure, and because the problem is never shared, there is absolute confidentiality – the juicy details never leave the problem-holder’s head.
How can real problem-solving work in the same way? And what has this got to do with being a farm vet? I will try to explain.
What exactly is your role as a farm vet when interacting with your farmer clients? Is it to share your excellent knowledge and understanding in veterinary matters? Or is it to coach your client to take the “right” decisions and actions? Well, probably both. This balance needs an exceptional level of skill and flexibility.
We all have our own world views. These are complex, based on our own previous experiences, learning and upbringing, as well as the views of our trusted peers, family and friends, which tend to influence us (think the echo-chamber of social media).
If you try to force your own world view on your client, be ready for disappointment. Hopefully, you will be one of his or her trusted and respected peers, so you can capitalise on this and share your view when asked. If you aren’t asked, you can seek permission: “Is it okay if I tell you something I know about this?”. However, uninvited opinions and lectures, including your own solutions, will antagonise.
Differing world views can be frustrating for the humble farm vet who simply wants the farmer to do the “right thing”. This is where it is useful to have some coaching skills up your sleeve.
The concept of unconditional positive regard was developed by psychologist Carl Rogers. It means demonstrating a basic acceptance and support of a person, regardless of what the person says or does.
It encompasses a person-centred approach – and the central hypothesis of this is that the individual has within himself or herself the ability to alter his or her own attitudes and is able to take responsibility for providing his or her own solutions to problems.
The game described earlier works because the problem-holder is able to think through his or her dilemma.
But there is more to it than that. The game also works because the participants are not threatening each other’s self-esteem. The environment is very “safe” and non-judgemental (it is impossible to judge if you don’t know either the problem or the answers to the questions).
The principle of unconditional positive regard runs through the core of cognitive behavioural coaching, of which motivational interviewing is an example.
Consider a dairy farmer and lameness in his or her herd. Your world view may include that too many lame cows exist and that this is a problem – for the cows’ welfare, for their fertility and for the farm’s profitability, for example.
The farmer’s world view might be that, firstly, he or she isn’t aware of the number of lame cows in the same way you are. And then he or she may not recognise it as a problem in the same way that you do. He or she might have alternative reasons for needing to reduce lameness (“because the supermarket contract says I’ve got to have less than 10 per cent”) or ways by which to go about this task (“Can’t you just say we have less than 10 per cent lame? That will sort the problem”).
Let us imagine that, rather than trying to persuade the farmer towards your own world view by way of your logic and reasoned argument, you take the opportunity to practise some coaching skills instead. In simple terms, that means to ask some questions, then listen.
You might try some motivational interviewing. The process includes helping people to explore and resolve ambivalence to a problem. Be careful here, because “ambivalence” is not the same as “doesn’t care about”. Ambivalence is that we tend to hold in our minds pros and cons for every situation or action.
Take ale, for example. I have ambivalence towards ale – and that certainly doesn’t mean I don’t care about beer. My ambivalence is that, on the one hand, I enjoy a beer and I like socialising with friends while doing so. On the other hand, I don’t like feeling tired and hungover the next day if I drink too much.
For the farmer and his or her lame cows, the ambivalence “pros and cons” might be expressed by change talk and sustain talk. Change talk might include:
All of these are internal motivations to reduce lameness.
Sustain talk might include:
All of these are internal motivations to accept the current level of lameness.
How to proceed? You want the farmer, not you, to voice the change talk. Take this imaginary conversation:
“Farmer: I don’t have as many lame cows as people make out I have (sustain talk).
You could respond: But lame cows cost you money (change talk).”
You have fallen into the righting reflex trap. The righting reflex is natural – but damaging – and means that when you hear one side of the argument, you will feel compelled to express the other side. The effect, when it is you who voices the change talk, is that the farmer balances this with sustain talk:
“Farmer: Those supposed lame cows still produce lots of milk, and I am making plenty of money as a good farmer with a great business, thank you very much (sustain talk).”
Before you know it, you are in a game of ping-pong where you voice all the change talk and the farmer voices all the sustain talk – reinforcing his or her resistance to change.
Far better, then, to roll with resistance. Hold your counsel; reflect what the farmer has just said to honour his or her difficulty, to show respect and to demonstrate you are listening. Then ask an open question:
“Farmer: I don’t have as many lame cows as people make out I have (sustain talk).
You respond: I see it isn’t pleasant for you when people say you have too many lame cows. What bothers you about lame cows? (Validating farmer’s concern followed by an open question).
Farmer: I don’t like to see lame cows – they depress me (change talk).”
Notice a simple open question has been met with change talk by the farmer. Now, follow up with:
“Vet: Lame cows are sure depressing! They cost a lot of money, too. Would you like me to discuss more about this with you? (Validating farmer’s response, expanding slightly and then asking permission to give further information).
Farmer: They cost me a lot to treat, I know that! How else do they cost me?”
…and so on. If you get into the groove, you can help the farmer develop discrepancies himself or herself whenever you hear change talk. Such as:
“Farmer: I don’t like cows going lame.
“Vet: I wonder how you’d feel if you had fewer lame cows?”
This is a forward-thinking open question. Don’t waste these. Use them when the dynamic feels good and when you have demonstrated you are really listening. Then you will see the cogs moving, the slow smile creep across your client’s face and – maybe – when he or she turns to face you, you notice a light in the eye that wasn’t there before.
Finally, use some questions to support the farmer’s self-sufficiency:
“Vet: You did great last month – booking the foot trimmer to blitz treat the herd for digital dermatitis was a fantastic success! What would you like to do next?”
The game described at the start is exceptionally simple. I would suggest you start simple, too, when trying out cognitive behavioural coaching. Try not to overthink it.
Be there for your client – really there, not just physically; be in the moment; relax; have respect. Think: “This person is capable of solving his or her own problems, and I‘d like to help him or her.”
Ask open questions. Come from a place of curiosity: if he or she has a different world view to your own, seek to understand why he or she thinks that way.
Then listen. The power of change and persuasion comes from being heard.
Enjoy being a “thinking partner” and remember to spend more time listening than talking.
It really is that simple.
