Key concepts: the seven C’s

We use seven core concepts to communicate the essentials of our approach. We call these the seven C’s:

Conversations. Effective conversations don’t just describe reality, they create new understanding of it. Whatever the setting or the purpose of the encounter, conversations can be seen as interventions in their own right. Through the judicious use of questions, they create opportunities for people to rethink and redefine their realities.

Curiosity. This is the common factor that turns conversations from chatter into something more substantial. It should be friendly but not nosey. Curiosity invites people to reframe their stories. An essential aspect of curiosity is neutrality (to people, to blame, to interpretations, to facts.) Curiosity should also extend to yourself. How can you stop being bored, critical, impatient?

Contexts. This is what it is most effective to be curious about. Important contexts for patients and clients are their personal histories, families, belief systems and values.  These are what people want to talk about and make their conversations come alive. Similarly, important contexts when talking with colleagues are their teams, networks and organisations.

Complexity. Life can be seen as an evolving dance of interactions in which each conversation plays a part. Introducing a sense of complexity into the conversation gets away from fixed ideas of cause and effect, unchangeable problems, and over-concrete solutions.

Challenge. Any conversation is an opportunity for challenging someone to explore and create a better account of reality than the present one: a story (a narrative) that makes better sense of what they are going through.

Caution. You need to balance challenge with confirmation. Also, remember you’re not doing therapy – on colleagues or on patients! If people want straightforward advice, be prepared to give that too, while being aware of its limitations).

Care. None of the other ideas will work unless you are respectful, affectionate and attentive. Every professional encounter needs to be grounded in moral commitment.

These published articles describe different aspects of CIC:

Effective clinical conversations: the art of curiosity

Digging holes and weaving tapestries

Is taking a history outmoded? Why we should listen to stories instead

The Yin and Yang of medical consultations

Teaching and facilitating groups online: adapting to the COVID-19 pandemic

Whatever happened to silence?

Interprofessional supervision

Complexity made simple

Why metaphors matter: the semantic determinants of disease