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Crucial Conversations

Crucial Conversations

Author: Sophia Tutorial

Crucial Conversations

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what's covered
This lesson will introduce the principles of crucial conversations. Specifically, it will cover:
  1. Crucial Conversations
  2. Principles of Crucial Conversations
    1. Get Unstuck
    2. Start With Heart
    3. Learn to Look
    4. Make It Safe
    5. Master My Stories
    6. State My Path
    7. Explore Others’ Paths
    8. Move to Action
  3. Reflect

1. Crucial Conversations

Crucial conversations happen when there are opposing opinions, strong emotions, and high stakes. In order to effect a change and thereby the result, one must have the communication (crucial conversation) as a means, not an end. The goal of crucial conversations is dialogue and avoiding violence and silence. In crucial conversation there are facts that we need to consider:

  • Think safety first
  • When it matters most, we often do our worst
  • When the conversation turns crucial, we become blind to our own role in the problem, our motives degrade and we limit our choices

2. The Principles of Crucial Conversations

The principles of crucial conversation include:

  1. Get unstuck
  2. Start with heart
  3. Learn to look
  4. Make it safe
  5. Master my stories
  6. State my path
  7. Explore others’ paths
  8. Move to action
Let’s learn to apply the principles of crucial conversation to achieve change and result.

2a. Get Unstuck
How do you spot the conversations that are keeping you from what you want? By developing the following skills. You must identify where you are stuck and unbundle with CPR (content, pattern, and relationship). Content is described as a single instance of a problem. If the action or consequences are the issue, this is a content process. If it is creating a pattern, that means a recurring problem has developed into a behavior over time. Relationship is about how the problem is affecting a working relationship between employees.

2b. Start With Heart
Stay focused on what you really want. This means that it is about “me,” about what you think and feel. Stay focused on what you really want and get results. The skills needed for this heart principle are to admit your role and re-engage your brain.

2c. Learn to Look
It is important to notice when safety could be at risk. Be sensitive to the signs and symptoms during your conversation. The signs of silence are masking, avoiding, and withdrawing. For violence, look for controlling, labeling, and attacking.

2d. Make It Safe
Make it safe to talk about almost anything. When things go wrong in crucial conversations, we assume the content of our message is the problem, so we begin to water it down or avoid it altogether. People usually feel unsafe—not because of the content, but the intent. If your intent is pure, you can talk candidly. If not, you can’t. There are two conditions for “safety”—mutual purpose and mutual respect.

“Purpose” returns us to the goals discussed earlier. If people feel they are being manipulated, that you’re trying to win or look good, you want to punish them, etc., you can forget honest dialogue. What you’ll get is silence or violence. One strategy to get to mutual purpose is to commit, recognize, invent, and brainstorm (CRIB).

  • Commit to seek mutual purpose—verbally agree to arrive at a solution that is mutually acceptable.
  • Recognize the purpose behind the strategy. Focus on real purposes.
  • Invent a mutual purpose. If you can’t agree on a mutual purpose, invent one that has a higher, more encompassing long-term goal.
  • Brainstorm new strategies.
“Respect” is one thing most of us feel we would NEVER violate. Are there people you don’t have respect for? How do you build respect for someone you don’t respect?

2e. Master My Stories
How does one stay in dialogue when angry, scared or hurt? The following skills are related to this principle:
  1. Separate facts from stories. Facts refer to information that can be validated and stories come after facts that involves judgment, conclusions, and attributions.
  2. Watch for clever stories. What are these? Victims’ stories say it's not their fault, I am innocent. Conversely, the villains’ stories are that it is your fault. The emphasis is on others. Helpless stories are about having one’s hands tied—I cannot do anything.
  3. Tell the rest of the story. Change your story from a victim-focus to a contributor focus—from being helpless to being able. In mastering one’s story, it is important that one identifies unhealthy motives from motives of dialogue. Unhealthy motives are to be right, look good, save face, win, punish/blame, and avoid conflict. The motives of dialogue are comprised of learning, finding the truth, producing results, and strengthening the relationship.

2f. State My Path
Learn how to speak persuasively, not abrasively. Think about a path to action–how do we create our own stories?

Path to Action


Let’s follow the direction of this diagram as we read this example: You are working on a report and your manager keeps on following up with you about the progress and continually offers unsolicited advice. What type of story do you think you are telling yourself? You concoct a story that your manager questions your capabilities, she does not believe that you can finish the job, and much worse, she thinks you are incompetent. Of course, you feel hurt and become defensive and now you’re angry. As a result of this behavior, you hold a grudge against your manager, and you ignore her. Does this resonate with you? Did you have this kind of experience? The stories we tell ourselves can hold us hostage. Why? Because we guess, we are quick to respond, and we’re our own worst enemies.

In this principle, there are five skills (STATE):

  • Share your facts
  • Tell your story
  • Ask for others’ paths
  • Talk tentatively
  • Encourage testing
Below is a table that can help you figure out how tentative talk is done.

Is it too forceful? Is it too tentative?
“The fact of the matter is...” “In my opinion…”
“That’s a dumb idea.” “Maybe it would make more sense to…”
“The only reasonable option is to…” “I believe that what we should do is…”
“If I agreed with you, then we would both be wrong.” “I’m wondering if that example applies to us.”

2g. Explore Others’ Paths
How do you listen when others blow up or clam up? Understanding this concept helps fill your pool of meanings. The pool of meanings includes yours and others’ opinions, thoughts, ideas, culture, bias, and much more. The pool of meaning should contain not only your meanings but also others' meanings as well. The more meanings you have in your repertoire, the better decisions you make. Your goal is to fill your pool of meaning so that you can make an educated decision. In this principle, use the ask, mirror, paraphrase, prime (AMPP) skill.

AMPP Skills Description
Ask to get things rolling "What's going on? I would like to hear your opinion, let me know if you see things differently."
Mirror to Confirm Feelings Hint that emotions are inconsistent with words. "You seem ___."
Paraphrase to acknowledge the story "Is it that you're feeling ___ because of ___?"
Prime when you're getting nowhere Pour meaning into the pool so others will do the same.

2h. Move to Action
How do you turn crucial conversations into action and results? through accountability and responsibility! Simply—you need to follow-up.

Video Transcription

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Crucial conversations involve opposing opinions, strong emotions, or high stakes. They're particularly common when discussing issues with patients and families, working out problems with other nursing staff, or discussing hiring more staff with human resources. In order to master these conversations, there are several principles.

First, it's important to get unstuck. To do that, think of content or a single instance of a problem, pattern, meaning a recurring problem that develops, and relationship or how the problem affects your ability to work with others.

Another principle is starting with the heart, meaning starting by clarifying your motives and then staying focused on that. It's also important to learn to look for signs that others feel unsafe in the conversation like silence and violence.

The most common forms of silence are masking, which refers to selectively showing opinions, avoiding, meaning not addressing the real issues, and withdrawing or exiting the conversation. Violence can present as controlling, labeling, or attacking others.

The sooner you notice these, the sooner you can make it safe. People feel safe when there's a mutual purpose and mutual respect. To achieve mutual purpose, commit to seek a common outcome. Recognize the real purpose behind the strategy. Invent a mutual purpose. And brainstorm new ideas.

For mutual respect, it's important to master your stories. To do that, separate objective facts from stories which involve judgment or associations. Next, watch for clever stories. These include victims stories like saying it's not my fault, I'm innocent, villain stories like it's all your fault, and helpless stories like I can't do anything. To turn these into useful stories, just tell the rest of your story.

Another important principle for mutual respect is stating your path. For this, share your facts. Tell your story. Ask for others' paths. Talk tentatively. And encourage testing or opposing views.

Next, explore others' paths by asking others to tell their stories. A nice way to do that is, please let me know your opinion on this. Mirroring to confirm feelings that are inconsistent with words is also useful. An example is, you say you're OK, but by your tone of voice, you seem upset. Paraphrasing to acknowledge others' stories can be done by saying something like, let's see if I got this right. You're upset because I voiced my concerns about your reliability. And if nothing else works, prime or pour meaning into the pool so others will do the same.

Finally, to turn crucial conversations into action, ask who, and assign a name to each responsibility, does what to define the exact responsibility, by when, establish the deadlines, and how will you follow up-- schedule a follow-up conversation.

3. Reflect

Knowing that a conflict is at hand, it is beneficial to know how you manage your stress so that you can be objective in handling that situation and have a chance to improve your skillset. Crucial conversation has a self-assessment that assesses your style under stress. This will be an excellent activity for you to know how you are at handling stress.

Complete the self-assessment to know how you are at handling stress.

Authored by Solimar Figueroa, PhD, MSN, MHA, BSN, RN, P-PCA


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