How to approach a struggling colleague

By Christina J. Wong, M.A. Clinical Psychology

How should I go about approaching my colleague?

It has come to your attention that one of your colleagues may be struggling. This may elicit all sorts of emotions in you. You may feel afraid to reach out to respect his/her privacy. You may doubt your own ability to handle the confidence that your colleague shares with you. What should you do next? 

The very first thing is to ensure that you have the right setting: approach them in a relaxed and private space. Here are some steps you may also consider when reaching out to them:

ASK – Approach the conversation with curiosity., Be specific about what you have been seeing, and ask open-ended questions.

The more descriptive you are descriptive about specific instances you have observed that have caused concern, the less you can misinterpret what has been happening. This shows that you are coming to the conversation non-judgmentally. You are not telling the other person how they feel, but rather you are initiating an opportunity for them to address the change.

Don’t say: 

“I notice you’ve been struggling; is everything okay? (this makes a non-specific reference to “struggling” with a closed ended question that could be answered with, “I’m fine.”)

Say instead:

“I notice you’ve come late to shift a few times. I’m wondering what’s been going on for you?”

“I’ve noticed you’ve been extra fatigued lately. Tell me about how you’ve been doing and if I could give you some help and support.”

“I’ve heard you being harder on yourself these days, like when you said X, I’m wondering how you are.”

LISTEN – Make active listening and being present your priority.

Demonstrating understanding and care through listening is the core goal of a peer support interaction. Physicians are trained to fix whatever issue they are presented with, but that may come at the expense of active listening. For this approach, it is important to suspend the desire to problem-solve or give advice. The situation is likely complex and not fully understood and resolved in one conversation. Simply listening can help someone begin the critical step of gaining perspective in their situation.

Tips to listen actively:

• Do not become preoccupied with what you are going to say, because it can be a significant distraction from showing empathy. Even if you sit in silence, your facial expressions and body language will convey your empathetic reaction. Validate that their situation is painful. This demonstrates that you are actually burdened together.
• Reflect their experience using specific adjectives describing how you understand they are feeling (e.g. exhausted, conflicted, burdened, overwhelmed, daunted, unsettled). The more specific the better. 
• Make use of non-verbal minimal encouragers (nodding, leaning forward slightly, open posture, facial expressions that convey understanding)

ENCOURAGE – Reinforce that you are looking out for them, and care about them as a member of the team. 

Some things you might say to encourage:

“You deserve to feel better.”

 “You deserve to care for yourself.”

“I know these feelings will pass.”

“I get why you’re feeling this way.”

“I don’t have answers but I want you to know I’m here and I care about you.”

“Seeking help for your own problems can help improve the care you give your patients.”

REFER – Encourage your colleague to enlist other support.

People in difficulties often isolate themselves. Emphasize that seeking help is not a sign of weakness or failure but a sign of health. Reassure them that they can find a way to function with less anguish.

• It may be helpful to ask them about the resources they already have such as their support network and from whom else they could seek support.
• If appropriate, encourage them to identify their next steps.

FOLLOW UP – Checking in again can instill confidence that your concern for their situation is genuine. Do not insist on knowing what has happened, but instead let them know that you are still available to listen and help.

Proactive peer support can both alleviate stigma surrounding physician mental health and burnout and can promote a culture of care and safety around vulnerable conversations. The above steps should hopefully give you the confidence to approach a struggling colleague. Your concern could make a world of difference for your peer.