GREAT & LAURS

Communication in healthcare is not neutral. What clinicians say — and how, when and in what context they say it — can influence attention, expectation, anxiety, pain, trust and the patient's experience of care.

GREAT and LAURS are complementary frameworks designed to help clinicians communicate more therapeutically. They provide practical language structures that can be incorporated into everyday clinical interactions and can help optimise patient care.

GREAT — creating the conditions

G — Greeting

A greeting begins the process of establishing safety, orientation and relationship. Acknowledging the patient and engaging with them as a person can influence everything that follows.

R — Rapport

Rapport involves joining the patient in their experience, with attention to language, tone, pace, body language, emotional state, concerns, cultural context and what appears important to the individual patient.

E — Expectations

Patients arrive with expectations derived from previous experiences, stories, culture, family, healthcare professionals and imagination. Exploring expectations can identify beliefs that may help or hinder the experience — and expectations can also be created unintentionally by clinicians.

A — Addressing concerns

Addressing concerns means finding out what matters to the patient rather than assuming we already know, then responding with appropriate information, reassurance, reframing, practical assistance or therapeutic suggestion.

T — Tacit agreement

Tacit agreement refers to developing sufficient shared understanding for the interaction to proceed in a collaborative way.

LAURS — working therapeutically with the patient's experience

L — Listening

Listening comes before intervention. The patient's words may reveal fear, expectations, previous experiences, metaphors, personal resources and clues about how the patient's experience can be improved.

A — Acceptance

Acceptance means acknowledging the patient's present experience rather than immediately contradicting it. It creates an opportunity for change because the patient no longer has to defend the validity of what they are experiencing.

U — Utilisation

Utilisation asks: How can this be used? A sound, movement, metaphor, interest or even anxiety may become part of a therapeutic response. Use what is already present.

R — Reframing

Reframing changes the meaning attached to an experience without denying the experience itself. It should remain credible and help the patient discover another possible way of understanding what is happening.

S — Suggestion

Suggestion is present throughout healthcare. Clinicians routinely influence expectations through their choice of words. Hypnotic communication makes that process more deliberate while supporting the patient's own capacities and resources.

GREAT + LAURS

GREAT asks: What conditions will help this communication work?

LAURS asks: What can I therapeutically do with what the patient gives me?

Listen first, second, third — and continually throughout an interaction.

Conversational hypnosis

GREAT and LAURS are not in themselves hypnotic. They do, however, provide a practical communication structure within which hypnotic principles can be utilised and integrated into a normal patient interaction — including building rapport, directing attention, aligning expectations and using suggestion.

Ethics and autonomy

Therapeutic communication should not be confused with manipulation. The ethical use of suggestion requires respect for autonomy, truthfulness, the legal and ethical requirements of informed consent, patient preference and the patient's right to decline.