The Importance of a Therapeutic Relationship: Beyond Helping a Patient Master Use of their Device, Part 2

by Brian Taylor

“Signal & Noise” is a bimonthly column by Brian Taylor, AuD


The Importance of a Therapeutic Relationship


Brian Taylor, AuD

Hearing aid owners who participated in the study noted the importance of an effective working relationship between the clinician and the hearing aid user. Traits of a good therapeutic relationship with their clinician, such as awareness, understanding, knowledge and a willingness to help were valued by hearing aid owners. On the other hand, patient traits, like proactive, help seeking behavior, knowing when to ask questions to the clinician, being comfortable divulging personal information, and asking for help contributed to a strong working relationship between patient and clinician.

The work of Bennett and colleagues serves as a reminder that successful long-term hearing aid use by patients has two distinct components: mastery of the device and independent problem-solving skills.


To teach patients about these two components require clinicians possess both effective technical skills and interpersonal counseling skills. A careful reading of Bennett’s work suggests clinicians need to excel at both: many clinicians focus too much of their attention on the technical aspects of the device at the expense of building a strong therapeutic relationship with the person.


Finally, the results of these studies show that a clinician’s role is much more than providing verbal instructions on how to handle and maintain hearing aids – one of the main topics covered during hearing aid follow-up appointments. It is equally important to establish whether patients have learned skills that allow for mastery of their device and self-managed problem-solving skills. Clinicians who are proficient at teaching patients both skills, especially in a changing market where patients might purchase hearing aids on-line, and then seek professional guidance, offer a professional service that cannot be duplicated by lower skilled technicians or machine learning algorithms.

Using Bennett’s work as a foundation, here are 4 things clinicians can cover during routine follow-up appointments to ensure patients are getting the most from their hearing aids:


  1. Empowerment. Help patients recognize and independently solve communication problems. The process of empowerment can be facilitated by getting patients involved in decision making and supporting their treatment choices. The use of easy-to-understand, visually appealing decision aids that present patients with a range of treatment options and tips for independently solving common communication breakdowns can be used to help patient’s feel empowered.
  2. Avoid Information dumping. Convey technical information in ways that are easy for patients to understand. Provide them with concise printed materials that they can refer to after the appointment.
  3. Break appointments into smaller chunks. To ensure patients understand all aspects of successful hearing aid use, consider bringing the patient back more often for follow-up appointments, or better yet, use Skype and other forms of video conferencing to relay information to the patient in smaller chunks. Utilize support personnel whenever possible in the follow-up care and support process to ensure your clinic operates efficiently.
  4. Break the hearing aid check and other similar follow-up appointments into “knowing how” and “knowing when” buckets. “Knowing how” refers to physical, hands-on skills patients must acquire to be successful hearing aid users. “Knowing when” skills are more abstract and require clinicians teach patients more complex tasks that require higher level cognitive awareness and skill, such as knowing when to use a remote microphone, recognize a challenging listening situation that requires some modification of listening behavior, or know how to be a more assertive, proactive listener.


Beyond adjusting the acoustic parameters of hearing aids and assisting patients with the hands-on skills needed to use their hearing aids, there are an abundance of person-centered skills that are too often overlooked by clinicians, but desired by patients. The work of Bennett and her colleagues lays the groundwork for how knowledge, skills and tasks can be conveyed to patients in a meaningful way, thus enabling them to be independent, self-managers of their communication.


Brian Taylor, AuD, Brian Taylor is the director of clinical audiology for the Fuel Medical Group. He also serves as the editor of Audiology Practices, the quarterly journal of the Academy of Doctors of Audiology, and editor-in-chief of Hearing News Watch for HHTM. Brian has held a variety of positions within the industry, including stints with Amplifon (1999-2008)  and Unitron (2008-2015). Dr. Taylor has more than 25 years of clinical, teaching and practice management experience. He has written and edited  six textbooks, including the third edition of Audiology Practice Management (Thieme Press) which will be published in 2018. He lives in Minneapolis, MN and can be reached at


*feature image courtesy of Cambridge in Color

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