Therapist Strategies for Maintaining Patient Engagement

In this episode of Lymphoedema Insights, Maree speaks with Megan Bayliss, a mental health accredited social work supervisor with more than 30 years of experience supporting practitioners, communities, and organisations. Together, they explore why patient engagement can be so challenging in lymphoedema care—and what therapists can do to support it more effectively. 

The conversation moves beyond motivation and compliance to consider the real-world factors that influence engagement, including trust, context, readiness for change, and the pressures patients may be carrying long before they walk into the clinic. Megan shares practical insights to help clinicians navigate complex situations, ask better questions, and identify achievable supports without overwhelming patients. 

This episode offers thoughtful strategies and fresh perspectives on maintaining meaningful patient engagement in long-term lymphoedema management. 

About our guest speaker: Megan Bayliss 

Megan Bayliss is a Mental Health–accredited Social Work supervisor, researcher, and PhD candidate specialising in psychoeducation, bibliotherapy, and lived experience scholarship. She brings over 30 years’ experience as a clinical therapist, working across sexual assault services, relational practice, workforce supervision, and community-based social services in rural, remote, and international settings. 

A recipient of the prestigious CDUDES scholarship, Megan’s doctoral research explores how readers use popular psychology literature to navigate life-changing experiences, drawing on digital methodologies including online book clubs. She has held senior practice, leadership, and program development roles across health, community, and First Nations contexts, and is committed to knowledge translation that supports wellbeing, reflective practice, and community resilience. 

Sponsor: 

This episode of Lymphoedema Insights is proudly supported by OPC Health, a trusted distributor of compression and consumable products for more than 40 years. OPC Health offers a comprehensive range including Juzo, Mobiderm, Jobst, LymphaTouch, and leading bandaging, scar management and wound care products. With a global supplier network, they deliver innovative, evidence-based solutions to support clinicians and improve patient outcomes Australia wide. Their strong commitment to education ensures healthcare professionals have the knowledge and resources needed to provide high quality care. 

Learn more at https://fdl8.short.gy/OPCHealthCompression 

Stay connected with Lymphoedema Education Solutions (LES)
LES offers a diverse range of professional learning opportunities – including online self-paced courses, face-to-face workshops, and accredited training modules – to help you build confidence in your lymphoedema management skills.

🌐 Visit the LES website to explore upcoming course dates and learn more: https://lymphoedemaedu.com/

👉 Subscribe to the LES monthly newsletter for updates, resources, and course announcements: https://lymphoedemaeducation.us10.list-manage.com/subscribe?u=21477ad0021cc388b9c1d508b&id=65df668025 

Transcript

SPEAKER_01 0:06

Today, we're exploring a key question many clinicians face. How do we keep patients meaningfully engaged in their care over time? Welcome to Lymphedema Insights for Health Professionals. I'm Marie O'Connor, physiotherapist at Lymphedema Education Solutions, where we empower health professionals with the tools and knowledge to manage lymphedema confidently and effectively. This podcast is for educational purposes and is intended for health professionals only. It does not replace individual clinical judgment or medical advice, so please consult appropriate guidelines and qualify professionals when making decisions in practice. Thank you to OPC for sponsoring this episode. Engagement is often talked about as motivation or adherence, but in reality it's shaped by relationships, communication, and whether the patient feels the treatment plan actually reflects what matters in their lives. To help us unpack this, we're joined by Megan Bayless, a mental health accredited social work supervisor with more than 30 years clinical experience across social services and workforce supervision. Her work focuses on trauma-informed care, reflective practice, and supporting practitioners and communities to strengthen well-being and resilience. Welcome, Megan.

SPEAKER_00 1:34

Oh, hello, and thank you for having me on, Marie.

SPEAKER_01 1:37

Megan, from your perspective, why is active listening such a powerful tool for maintaining patient engagement?

SPEAKER_00 1:46

Aha. This is an excellent question. And I could talk about this forever and ever. Amen. But basically, the reason we have two ears and one mouth is because it's twice as hard to listen as it is to speak. But as practitioners, many of us make the mistake of we must speak, we must share this knowledge that we have. So we're going to share it this way. We forget to listen. Now, active listening is an active process. And I did hear somewhere once upon a time, and I don't know how robust this is, but I have repeated it many times over 80% of the glucose level in our blood is used up when we're either learning something new or holding back emotion. Now, as practitioners, we are always managing our own emotion. We're always holding it back, and we are always learning new information by listening to our clients. So that is the emphasis on the active part of listening. And engagement skills are all about actively listening to people. So active listening is a micro skill of counseling. Now, lots of physiotherapists might not be trained as counselors, but then there's lots of you who will have done some counseling units during uni, and active listening is a wonderful way to practice all of those skills. So active listening has a number of things that have to be done. And I talked about this on your webinar recently for effective attending. It is so important. Now, effective attending has three steps that you need to do every single time you're with a client, not just the first time, but this is what keeps people engaged is when you display effective attending. So the first step is to understand your own geo-socio-political standpoint. And that is what makes you who you are as a practitioner? Yeah. What is it that's about your geography, your social situations, your political situations that informs your thinking and your assessment of what it is that you're hearing? And then the second step is to understand the geo-socio-political position of the person you're talking to. They could be from Rwandra or from Bangladesh. And you need to understand something about that person's customs. It could be the conflict that they've come from, it could be the respect they do or don't give to medical professions. So you need to understand that. And then the third step is solar, S-O-L-E-R. Now, this is one of the tricks that I talked about the other night that absolutely keeps people engaged. So the S is to sit square on so that you can at least see the person's eyes. You don't have to be, you know, knees touching and you know staring, but sitting so that you can see each other. O is to uh have open body language. L is to lean slightly forward, not so far forward that you look like a you know a duck balancing on the fence, uh, but certainly slightly forward to tell the other person that you are engaged with them and only them. S-O-L E is um eye contact, so you must be able to make eye contact. This is a little bit different to sitting square on, where you can make eye contact, but we use eye contact purposely to let somebody know, I'm really interested in what you're saying. Yeah. And then the R is relax, to relax. So, as listeners, rather than you know, listening intently to work out what's the next thing we're going to say, relax, baby, and listen to what your client is saying, to what your patient is saying, so that you can then pick up on the other counseling skills of active listening to let the person know that you have heard what they're going to say. And you do that every single time you're with that person. This is what makes it active. This is not passive, this is active, and it's exhausting. Yeah.

SPEAKER_01 6:01

Just thinking about the positioning whilst you're talking about that, you know, your room set up when you're seeing someone. Some people say to me, Oh, you should have your desk so that you're you're then turning towards the person rather than having them in front of them. But if that's the case, you wouldn't get that so much. Which is the best position?

SPEAKER_00 6:20

Correct. Well, I pay a lot of attention to room set up because I'm a therapist. It's a little bit different for me. But the room setup actually aids communication, it will add to or take away from. So I would leave my desk and go and sit near the client because that is the way you absolutely show respect. You don't have to be typing all the time. We've all got neurons. Well, after PhDs, we might not have any left, but we have neurons that we should be able to remember information that after the client has left, that we can go and write that information down. So my preference is always to leave the desk, don't have anything in between you. Unless, of course, it's a violent person. And then you're going to know that through your notes, but also by looking at the geo-socio-political stance of the other person, you're going to know what the risk factors are and what triggers might be. So then I pay particular attention to how that room is set up, including where's the door if I need to escape.

SPEAKER_01 7:25

Yeah, for sure. In regards to memory and stuff like that, I suppose sometimes when we're collecting a lot of stuff like comal, but it is in bits and pieces. I suppose it's pretty much easy. You could just say, hang on, my brain's not so good. Just let me just jot that down.

SPEAKER_00 7:39

And that's a lovely way to do it because it's got to be genuine. Yeah. And I used to be a child therapist when I was a very young social worker. I trained as a child therapist. And I would say to the kids, Oh, I'm so old I can't remember things. I need to write this on the picture that you're drawing. So I would write, you know, some pertinent information or whatever. And the kids had a ball with that. Then they'd copy my writing or they'd tell me that I spelt something wrong or you know, whatever. You make it fun, you make it part of your interactions to stay engaged with a particular person.

SPEAKER_01 8:15

Staying engaged is obviously listening, letting them um speak, but sometimes, sometimes, is some people can wrap it on so much that you think this could take, you know, like it's not always necessarily relevant. Do you know what I mean? For us anyway, but maybe that's we're seeing it the wrong way, but who knows? How do you, what sort of words would you use to bring it perhaps back on track without you know making them feel offended?

SPEAKER_00 8:46

I I would be genuine and honest. I would say, oh, I would so love to sit and have this cup of tea with you and chat about X, Y, and Z forever, but I've only got 20 minutes left and we've got to cover this, this, and this. So let's do that really quickly and then let's have a chat. Right. That's so it's I let them know that I have things to do. Uh, and I I also want to talk to them, but I make sure I come back to say, now that conversation that we were having, that was really juicy. Blah, blah, blah.

SPEAKER_01 9:17

Yeah. And sometimes they can be doing this while we're doing other things. Do you know what I mean? Because, you know, for instance, often as a lymphedema practitioner, or any practitioner, I suppose, is you'll do an assessment, you'll ask them about their history, their comorbidities, medications, blah, blah, blah. You get a good feel of where they are right now. And then you actually have to look if it's swelling in the legs, you actually have to look at it. So during that process, there's a lot of time where you're just doing things. It may be an opportunity where they can sort of continue on, so to speak, but you keep doing some other things as well.

SPEAKER_00 9:50

Absolutely.

SPEAKER_01 9:51

Yeah.

SPEAKER_00 9:51

But then you're also going to have people that don't want to engage because they're disengaged to start with. So, what I would do in that situation is while I was doing, say, the bandaging or the stuff that's unpleasant, uh, I would have already done a bit of assessment by looking around at what they're naturally interested in. Um, or if you're doing it in their home, what have they got in their home that displays their interests? And I'll ask them an open-ended question about that. Now, open-ended questioning is another of the micro skills of counseling. So, a closed question is a, as you as you know, it's a question that can be answered with a yes or a no, but engagement is all about evoking something from the person who's sitting in front of you so that you're able to get more information about something.

SPEAKER_01 10:41

For sure. Often we like to set goals. I think we're getting better at this for our clients, patients, um, whatever you might like to the terminology. But how can clinicians shift from setting goals for patients to co-creating goals for them?

SPEAKER_00 11:00

Yeah, okay. It's a mindset in all of us. Now, I operate from a trauma-informed perspective, and I never come across as the expert, even though I might hold some expert knowledge. I'm really fortunate that I went to university and that I've had 30 years of practice. But the person in front of me is the expert of their own life. So, in my head, I come from that, and I use questioning, I use curiosity to draw out of them their own expert knowledge so that I'm not coming across as the know-it-all, and I'm helping that person to co-create what they want. There's there is um a style of questioning called the magic wand questioning, where I will often say to a client, and this is from narrative therapy, if I was to give you a magic wand, what would you do with your health care? What would you create? So, this is co-creation. You're learning from this person who might want to say, I never want to see your face again. You do nothing but hurt me, like you hurt my arms, you hurt my legs, I can't afford to have the air conditioning off on. Do you know how hot these things are? Uh so that becomes co-creation. You know straight away what's in the head and ways you might be able to get around this. Can we put a fan in front of you? Um, do you need somebody to go and buy you a fan for your lounge room? Yeah. So it's it's co-creating that way through curiosity and engagement questions.

SPEAKER_01 12:41

This episode of Lymphedema Insights is proudly supported by OPC Health, a trusted distributor of compression and consumable products for more than 40 years. OPC Health offers a comprehensive range including JUSO, MobiDerm, JOPEST, Lymphatouch, and leading bandaging, scar management and wound care products. With a global supply network, they deliver innovative, evidence-based solutions to support clinicians and improve patient outcomes Australia-wide. Their strong commitment to education ensures healthcare professionals have the knowledge and resources needed to provide high quality care. Learn more via the link in the podcast notes. Are there any better ways, like you might your initial appointments you might say, look, let's look at some goals? Do you know what I mean? For the and you know, you you do what you've just been talking about. So how do you touch base? Because goals can change over time, can't they? So how do you navigate to keep them uh what we call on track, I suppose, to get the best for them, I suppose. Um what's your suggestion?

SPEAKER_00 13:59

Look, I use scaling questions. So on a scale of one to ten, what is the most important thing for you to tell me, or for you to have me do, or for you to tell the doctors? So that's how I work out what's really important to them, scaling questions. And it could also be things like on a scale of one to five, how deep is your pain today? Because pain actually impacts the way a person communicates. So if we know that straight up, we know that we have to change the way we are co-creating with that person. The biggest thing though is I've mentioned it before, mindset. We've got to go in knowing that the other person is actually in control of their own health. And there's we can't make them do something if they don't want to. We can suggest, we can try, we can control, we can help, but at the end of the day, it is that person's decision. And we need to be able to respect that because that is also part of client-centered care. Yeah, if they if they refuse, there's nothing that we can really do except psychoeducate by telling them, look, I get that you don't want this, I get that it's painful, I get that it's hot, but this is what might happen, uh, and I'm leaving it to you. In mental health, there's a really nice saying that goes something like, uh, nothing about me without me. So that's the person with the mental health issues who's very clearly saying, You can't discuss anything to do without me, without me being there. Thank you. Nothing about me without me. And I've drawn that into all of my practice to try and remember that that's what I've got to do. The client's voice and the client's perspective and the client's choices are so important. Nothing about me without me.

SPEAKER_01 15:52

How do you also establish realistic goals? Because it depends on the person that might walk through the door. So give I'll let I'll give you a scenario. Is you might have someone that's had swelling in their legs for a long, long, long time, and their goal is to fit their shoes on. So they're not telling me I want it to be completely gone. Do you know what I mean? I just want to have to be able to wear normal shoes so I can, you know, whatever. Or it might be that I want to get out of the house or whatever. So the goal then is to get that it not necessarily reduced completely, which it probably won't, but to get it under control so they can do that. So that that makes sense to me. Sometimes we will have some people under after cancer, um, where they get swelling following cancer. So it's a blow, another huge blow because they're dealing with mortality, and now they've got this swelling that reminds them of the fact that they dealt with dealing with mortality. Sometimes, even when they get an exacerbation, they think, is it the cancer back? But also because it's gone from nothing to whatever in a short period of time, they want it fixed, they want it to cure. Now, in some instances, we can reduce it considerably, but in some times we can't. How do we, without giving them not giving them hope, um, how do we address that? What sort of words could we use?

SPEAKER_00 17:21

Okay, so this is um the miracle question um and trying to motivate somebody to do something themselves towards reaching that miracle. I use motivational interviewing questioning, and I provided to you all that um um chapter 10 with 1001 questions in it. It's brilliant. So, a question that I might ask that person who wants to just put their shoes on, I'd say, what's the smallest thing that you could do to help me get your shoes on? Because it's actually not up to me, but I'm not about to say, well, sweetheart, it's it's totally up to you. But what's the smallest thing you could do to get your shoes on? What's the smallest thing you could do today to help you leave the house? Another thing that I do, but it depends on the client. Uh, it's I gamify it. And do you know the game um Hangman? Yes. Okay, so I'm a nonviolent practitioner, so the game I play is don't hang the man. And and I make a really long sentence, so it's impossible for them to hang themselves. But the sentence would be something like, To make your goal come true, there are some things that you must do. Right? So I will draw that out and we play this game together. And then I draw a staircase with their goal at the top. So the goal is to be able to wear beautiful red shoes uh next week to the party, right? Yeah, big ass, but yeah, okay, so that's your goal. And this staircase, let's let's fill in the little things that we might have to do. Nothing big here, just really small things. What are the steps that would have to happen for you to be able to put those shoes on? And a lot of people get really engaged in that and they keep it on their fridge. So I've done lots of home visits. I know that you guys do lots of office visits, but mine was often going out and meeting people in their home.

SPEAKER_01 19:24

I like that because in my mind, I've got a person already sitting in my mind with swollen legs, is to get them to put the shoes on, we have to reduce, we need to reduce the swelling somewhat, otherwise it won't go on. So to do that, there's a few things that they'll need to more than likely need to do is wear compression. So I suppose they would, if I said, what are the you know, those situations, they'd probably say, Well, I need to get my the swelling down so I can get my shoes on. So I suppose that's where you could use the steps. Well, how about I often say it's a work in progress. Yeah. And I'll say, let's, you know, maybe do some exercise for the next little while and and and see how much does that help? Do you know what I mean? You know what I mean? So then we know. So they they will say, okay, it doesn't work that well with that. How about we go the next step? Um and then that could be, I like that visual. I really like that visual of the steps.

SPEAKER_00 20:19

Yeah, it's worked really well with all ages of people that I've worked with, from children to adolescents to adults. Uh, people seem to appreciate it and it's fun. Yeah, and they cannot hang themselves and they try, but it is so long with so many letters in it that they can't do it.

SPEAKER_01 20:37

Yeah.

SPEAKER_00 20:38

Yeah. And that's and that's important. They've got to have a win.

SPEAKER_01 20:41

Yeah, a win. That's it. I say that to clinicians when I'm doing training. Do not set them up to fail. Because sometimes what they do is they will put them on into perhaps a garment that you know is not right, may cut in whatever else, and then the person will never wear anything again. Anything. So aren't you better off going for what you believe is true that it's going to work and work towards that, rather than sidestep and then end up with nothing? So you need a win. Yeah. Yeah. Yeah. One of the other scenarios that's difficult, I know, for many practitioners who will be listening to this is the cancer patient, where they say to you, is this going to go away? Um, they want you to say yes. In some instances, it might be, we don't know. So I'm honest. I say, actually, I don't know. I don't know. Well, you know, you you've had your system really impacted and it's it's just overloaded. We need to to roll look at how it, you know, it rolls out with this. But some we know it won't go away. What's the best way of handling that?

SPEAKER_00 21:48

What I use is psychoeducation. So I educate the person on and and their family around them on the reality. But it's actually not me that's educating, it's what I'm using. So it's a book. Uh, it's something else that they can read that when it's just too much, they can put it down again. But I'm I am a person who likes to tell the truth. I'm very genuine in my practice. Uh, so I loved what you just said. Look, I don't know. That's what I would say too. I don't know. But here's all of the information. Um, and actually, you like to read. So here's a novel, and I would have already researched about, you know, a cancer survivor or uh a person who is terminal and in palliative care and give that to the client. I would leave it for them, or I would recommend it. You know, it might be on audiobooks, so they can look it up on audiobook uh and they can sit in their chair or lie in their bed and and listen to it. But yeah, we need to be able to be compassionately truthful. Yeah, there's nothing worse than somebody says, Oh, of course you're going to get better, because that's about us, and we're trying to avoid that difficult conversation.

SPEAKER_01 23:04

Yeah. And then if someone else tells them it, they'll say, You lied, and therefore the relationship's completely gone.

SPEAKER_00 23:11

Yeah, correct. Yeah, yeah. Um, Maria, another thing that I use a lot is called uh mental status exam. And a mental status exam uh works out somebody's um cognitive and psychological state, and I use it as baseline. So I run a mental status exam with somebody every time I see them. Uh, and what made me think of this is the cognitive ability of somebody to be able to take in really bad information. Like, is this going to get better? I just need this to get better, or I may as well go and kill myself now. Right. So I use that mental status examination on purpose every single time, so I'm able to tell where the client is at, how their pain is, how their thinking is. Um, some people are really spiritual, some people are not. And when you get spiritual people who just want to give up, you know, we know we've got a problem. Yeah, so we might need to put more supports in place for them.

SPEAKER_01 24:14

Would you get that person to fill it in before they come into the room or whilst you're there? Because I'm just thinking of us, we're really busy. Do you know what I mean?

SPEAKER_00 24:22

Yeah, it's a visual thing. Um, so it's something that mental health practitioners use all the time, right? Yeah. So you're checking out um are they talking differently to the way they were before? Um, what's their clothing like? Uh, are they disheveled or are they really neatly dressed like they really are? There's a whole heap of things that you just run through visually. And then in my case notes, I used to always note it at the end of the case notes for my own information so that I knew that when I went, when I go to see that person next time, this is what they looked like and what they were talking about and what they were doing last time I saw them. Uh, so anybody can access the questions, the reflective questions for the mental status examination online. You just put in mental status examination, it will tell you what to look for.

SPEAKER_01 25:14

Fantastic.

SPEAKER_00 25:14

But it's it's very helpful.

SPEAKER_01 25:16

Yeah, that's great. So when we're looking at our patients' clients in the long term, which I mean to really keep on track, because it's not easy for them to continue to wear the garments. You know, we tell them why they should wear the garments, we tell them what happens if they don't wear the garments potentially. Um, I know I have some patients who will say, Look, I get to four o'clock and look, that's it. Do you know what I mean? I I need to stop. I've had enough. Do you know what I mean? And that's fair enough. If those that just are not consistent, and so they are getting the up and down and getting frustrated, so they're sort of blaming it on management, so to speak, but it's really because they haven't been consistent. What besides me saying, Listen, you know, Megan, you're just not doing your job. Do you know what I mean? That's why you're not getting the results. What's another approach that I can do for that long-term sustainability?

SPEAKER_00 26:15

Okay, always connection over comparison. So the comparison would be: look, um, Sally down the road, she wore her bandages all the time, and look, now she is wearing her red shoes. So don't compare ever. So connect with the person, find out why. Dig into what's happening at four o'clock in the afternoon, what else is going on in the household? Uh is it because you want to get up and walk to the kitchen and have a vodka? Yeah, what else is what else is going down? And connect with the person, treat them as a person, understand that this is their choice, but you need to connect with them to help them over that to get the bandages back on.

SPEAKER_01 27:03

What about the ones? And this doesn't happen all the time, but what about the ones that you know they're not doing it? Because it just doesn't make sense. Do you know what I mean? Honestly, and they say, Oh, yeah, I'm doing it, but it's just not working, but you know, there must be something they're not doing.

SPEAKER_00 27:19

Yeah.

SPEAKER_01 27:20

How do you handle that? Because they're saying, Well, this is not working. You think, come on.

SPEAKER_00 27:25

I put that back onto myself. I go, Oh, I just don't know what I'm doing wrong. I must be doing something wrong for you. I can't work it out. I'm keeping myself awake at night looking at this, and most people, well, they'll say something or they'll have a sly little smile or whatever. Um, but again, it's about motivational questions and evoking change questions by moving somebody from uh a complainant to or sorry, a visitor to a complainant to a customer. So they're the questions that I set out in that chapter 10. Yeah. Yeah. So asking those questions, having them in your pocket, these are tools and they're really powerful tools. Yeah. So ask those questions in those situations. Like, oh what? And what am I doing wrong? Gosh, I can't work out why it's not working for you either.

SPEAKER_01 28:21

Could you flip it back and say, gosh, you know, I mean, I don't know why it's not working. Let's have a think about this. The last two weeks, when did it work? There must be, was it any time where it actually worked? What were you doing?

SPEAKER_00 28:32

Excellent, excellent questions, yes. And they're um um problem, not problem saturated, they're um the opposite, they're solution-focused questions, which is absolutely fantastic because that's what these people want. They want solutions. They know that they're in pain, they know that they're not doing something, so let's go for some solutions. And questions like that are fantastic at moving them along. So well done to you.

SPEAKER_01 28:57

Thank you. Lastly, is practitioners do want the best for their clients. They want it reduced, or they want them to meet their goals, and sometimes it doesn't happen for whatever reason. We've talked about in the webinar to keep engaged, but sometimes you really feel bad. Do you know what I mean? I suppose that's where you need to be able to not disassociate, but you know, separate out. What's your suggestions for those people? Look for the practitioners?

SPEAKER_00 29:33

Yes, the until it's relying on your peers. So social workers and psychologists have monthly supervision with an experienced peer who can help them work through issues like this. Now, these are issues that lead to burnout if they're not addressed. So even um peer drinks down the pub on a Friday night, uh, where you're able to all speak the same language as long as nobody else is over here in you. You know, it's got to be has to be private. Uh, but being with people from your own discipline and sharing the highs and the lows, seeking out supervision, talking and mentoring with uh a more experienced practitioner who's they've had this before, but this is not about the individual practitioner. This is something that goes with working with people with chronic pain and chronic illness. So we've all experienced uh experienced it. So hanging out with people like us to say it's okay. This is not about you being a bad practitioner. This is part of the process of getting people to change.

SPEAKER_01 30:39

And I think it's really, really important because you spend a lot of time with the person. And to many ways, we as lymphedema practitioners do the same because we're not like your normal physio or OT or nurse that may be quick in and out, you know, let's treat the wound 20 minutes out. We are there for a long period of time. They can dump a lot on us during that period of time, so we learn a lot about that person, and it is a bit like we need to be able to let go of some of that so it doesn't become like this bottled up whatever. Absolutely.

SPEAKER_00 31:15

Yeah, bottling it up leads to burnout, and we don't need to lose people from the profession, we need to keep people in the profession, right, with those particular skills. So, supervision and mentoring, coaching, they're all fantastic things. But also, this comes back to that um the step in effect of attending of understanding your own um geo-socio-political standpoint. What is it that you like to do? But have you got your own supports? How do you debrief? And there is a particular communication style and formula around debriefing that when when we're all trained in it, we can do it to our friends and colleagues because bad things happen to good people and it's it's not their fault. You know, these bad things get stuck in their head or get stuck in their heart. We're in this profession, damn it, because we care. And when when other people are hurting, it affects us. So being able to debrief over that and having psychoeducation around others have also felt this way. Um, it's a really good thing to do. The best therapist that we have is sitting on our bookcase. Yeah, we have so many books that we can be reading at home to continually re-feed our souls. Uh, we identify with characters in a book. Uh, it's cathartic for us because we're able to see, oh, that's how that person dealt with it. And oh gosh, uh, that's worked really well. Uh, and and we know that we're not alone. Yeah, we realize that other people are going through this stuff as well.

SPEAKER_01 32:52

We need to spend time for ourselves too to do that. Oh, we get we're the usually the last people, as they say, who you know, we need to look after ourselves. So thank you, Megan. It's been a powerful reminder that maintaining engagement isn't about persuading patients to follow a plan. It's about listening, understanding, and working together to create goals that truly matter to them and to look after ourselves as well, so that we don't burn out for the long term for us and for for them. Thank you, Megan. Thank you, Marie. Stay tuned for future podcasts to empower you with the tools and knowledge to manage lymphedema and chronic edema confidently and effectively. Until next time, keep supporting your clients with evidence-informed care.