Creating Accountability and Engagement

Written by Kim Poyner

April 20, 2022

Creating accountability and engagement in your patients

All general practice consultations are an opportunity for you to cultivate patient awareness about health so that they are more open to the possibility of change.

Following a process of building awareness and insight will transform your client interactions to being more empowering and create value for you and the patient.

Knowing and applying some straightforward skills of creating awareness will allow your patients to take greater ownership of their health and reduce the impact on you and even the possibility of eventual burnout.

Awareness of what needs to happen always precedes any action or goal setting.

What are the key skills?

Create the Environment

To help your client get the most out of their session you should always be:

  • Mindfully present
  • Distraction free
  • Attentive to the person directly in front of you

Taking just a few seconds to acknowledge to yourself the distractions which are tugging at you and note them for later attention can assist here.


An environment built on trust and rapport supports the patient in part by activation of the Parasympathetic Nervous System (PNS – the “rest and digest” response), which helps them to gain the most from your interaction.

PNS activation can help the client more readily to think, listen, learn, problem solve and strategise during the session.  This can result in a productive and fulfilling experience that focuses on strengths and the excitement of experiencing something new.

Check In

  • Validate the stage of readiness to change the client is currently at.
  • Validate the emotion the client is currently experiencing.
  • Allow the client to explore options without racing to a quick solution
  • Understand barriers to change and support your client to “sort barriers” (what gets in the way of change) from smallest to biggest barrier

Demonstrate Understanding

  • Notice body language
  • Notice what is and what is not being said
  • Ask permission before giving advice
  • Reflect what you are hearing so the client knows you’re listening and that you understand
  • Go at the pace of the client’s readiness to change
  • Stay with the client’s agenda

Facilitate Change

  • Observe, reflect and allow the client to learn more about themselves from the experience.
  • Allow them to speak their thoughts and feelings – particularly concerns and fears about changing.
  • Questions that create awareness are open ended and reflective. They often convey the possibility of transformation. Some examples of questions you might use follow. If these look or sound foreign to you, that’s ok – the more you use the language, the more it will sound familiar to you.


  • Now you know this ….. what is your next step?
  • How do you feel…?
  • When you experience that ….. how do you feel?
  • What need do you feel is being met here?
  • What do you now know about yourself that you didn’t know before?
  • How are you different now after today’s session?
  • What have you learnt about yourself today?
  • What are you now more aware of?
  • What just happened there?


Behaviour change is a gradual process for all people, and people will start motivating themselves to change when they understand a compelling reason to do this. Remember you don’t need to motivate anyone. But you can support them to uncover what really matters to them and why – the basis for motivation to change.

Kim Poyner

[email protected]


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