Before a Difficult Practice Conversation, Ask These Five Questions

You can rehearse a difficult conversation for days and still be unsure what you are asking for. Start there. What needs to be clearer, decided, or changed? Then work out who can respond, what you need to say, and which next step you can take even if the conversation does not go as you hope.

This worksheet is for professional conversations in practices, supervision, and teams. It is not a substitute for safety planning, legal advice, human-resources review, clinical consultation, or protected reporting processes.

Before drafting the message, write down the situation:

1. What do I need this conversation to accomplish?

Finish one sentence:

After this conversation, I need greater clarity about ________, a decision about ________, or a change in ________.

You may want an apology or hope the other person finally understands. Those wishes can matter a great deal, but you cannot make them happen in one conversation. Write down the action or decision you can ask for, separately from the response you hope to receive.

2. Is this the right person and route?

Ask:

• Does this person have the information or authority to respond?
• Is there a required supervision, management, HR, compliance, ethics, or safety route?
• Does a power difference change how the concern should be raised?
• Is a support person, documentation, or formal process appropriate?

Taking the concern to someone who can act on it gives the conversation a better chance of producing a useful result. Follow any required reporting or support route.

3. What is the clearest accurate message?

Draft three parts:

1. Observation: What happened, stated as specifically as possible?
2. Impact or concern: Why does it matter to the work, client care, role, or agreement?
3. Request or question: What response, decision, or next step are you asking for?

Take out guesses about motives, unrelated grievances, and claims you cannot support. Give enough context to be understood, and say the main point clearly.

4. Which format supports participation?

Consider whether this needs a conversation in person, by video or phone, in writing, or in more than one step. Choose with the situation in mind: its complexity and urgency, accessibility, privacy, documentation, power differences, and whether each person can participate.

If strong emotions are making it hard to participate, pause when safe and permitted. You can practice the message aloud, bring notes, ask for an agenda, or use the appropriate support process. Asking someone to regulate their emotions must not place all responsibility on the person raising a legitimate concern.

5. What boundary or decision follows?

Write the next step for three possible outcomes:

• Agreement: Who will do what, by when?
• Uncertainty: When and how will the issue be revisited?
• No resolution: Which boundary, escalation, documentation, or decision becomes necessary?

Be specific about what you will do or which process you will use. A boundary can guide your next action; it cannot guarantee that the other person will change.

Evidence note

APA guidance on difficult conversations emphasizes curiosity, respect, empathy, avoiding personal attacks, and recognizing when a discussion may need to end. Those principles are useful but do not replace a practice’s reporting, supervision, safety, or employment obligations.

Sources

• American Psychological Association: Managing conversations when you disagree
• American Psychological Association: Effective Communication in the Evolving Policy Landscape

Completion state

You have prepared enough for this step when you know the purpose, correct route, main message, format, and what follows. You do not need a perfect response planned for every possibility. Schedule the conversation or use the formal route you identified.