[Narrator]

To help understand the differences that good communication skills can make, let's listen to a family's discussion of how to handle a child's need to fit chemotherapy into her life. Angela Neva is 13 years old and has recently been told she has cancer. She lives in the city with her mother, and father. Angela attends a large middle school and has different teachers for each school subject. The whole family has been terribly upset since hearing the diagnosis. Now, they are starting to plan how to work to help Angela get the treatment she needs.

[Mrs. Neva]

OK, Angela, I talked with the nurse this afternoon. She told me about your treatments and what we need to do. Starting next Friday night, we will bring you to the treatment center across town for one night every week for the next three weeks. You will stay overnight while you get your treatment and we will pick you up on Saturday morning. The treatments are very good. They will help you get all better soon. She also told me that some treatments have side effects -- you might feel sick for a few days after each treatment. She will help us get through it. But, that's why your treatments are scheduled for Friday night, so you won't miss too much school.

[Angela]

My friends can't know about this. You can't tell anybody at school either. Nobody can know about this.

[Mr. Neva]

You're right, Angela. It's nobody else's business.

[Mrs. Neva]

No, no, your teachers have to know. Angela, we have to tell them.

[Angela]

Mom, no. Nobody has to find out... we can keep it secret....

[Narrator]

As they continue to argue, you can hear what's going on. Angela and her parents are feeling the stress of not knowing what to do. But, they are not really saying what they mean or how they feel. And, they're not really listening to each other, just sticking to their point of view. What we hear Angela say may mean that she is afraid that people will treat her differently if they know she has cancer. Like every teenager, she wants to fit in, to be treated like other girls her age.

[Narrator]

Mr. Neva is worried about his daughter's health and he wants to help her by taking her side.

[Narrator]

Of course, Mrs. Neva is also worried, but she is thinking about practical matters, like what might happen if Angela misses too much school and nobody understands why. She may fear that this will only put more pressure on Angela.

[Narrator]

What might this same conversation sound like if Angela and her parents used some of the communication skills we have been talking about.

[Mrs. Neva]

…that's why your treatments are scheduled for Friday night, so you won't miss too much school. I'm concerned that if you miss too much at school, it may only make you worry more.

[Angela]

I'm worried about that, too. I don't want to miss out with my friends. But, I'm more afraid that, you know, people will kind of treat me differently... if they know I'm sick.

[Mr. Neva]

I can understand how you would feel that way. I know this is tough on you. We are going to help you every way we possibly can.

[Mrs. Neva]

I know you don't want to miss out on things at school. It's got to be hard, especially with your friends. Your good friends will understand, they will help you through it. But, I am concerned about your teachers. What if they don't know why you might miss some school or can't get assignments done on time? I really feel that we have to let people at school know. That's less for you to worry about....

[Narrator]

Overall, you could hear that there was a lot less stress all around in this second discussion. You heard Angela be assertive, using "I" messages to express her feelings. She was also listening actively to what her mother said. Notice that she checked her mother's concern, thinking that it was about missing out on being with her friends at school. Both of her parents used those same skills to let Angela know how concerned they are about her health and her emotions. You may also have noticed how her mother listened actively to Angela's concerns and corrected a misunderstanding: her mother was not so much worried about Angela missing her friends at school, but about falling behind in her school work. This check allowed her mother to reinforce her point of view and work toward a solution that everyone could be happy with.

[Narrator]

Angela and her parents agreed to write a note to her teachers. It said: "Dear Teachers: Angela is receiving medical treatment at St. Jude's Hospital. She will be missing school for at least one day each month for the next few months for her treatments. It is important to Angela that she try to keep up with her work and fit in with her friends at school. We hope you can help us. Angela will let you know if she needs extra help. If you think she needs extra help or to have a problem solved, please let us know by note or a telephone call. Thank you for your understanding." Good communications skills aren't just for conversations, but can be used in writing, too. The note is assertive in stating what is going on, to the extent that the teachers need to know, and uses a kind of "I" message, in which it is made clear what Angela will be doing.

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