“LEAP” Method of Communication
From Xavier Amador’s book, “I Am Not Sick, I Don’t Need Help”
1. Listen. Walk in the other person’s shoes to gain a clear idea of his experience of the illness and treatment. Think of yourself as a scientist trying to unravel a mystery. Listen for his (1) beliefs about having a mental illness, (2) attitudes about treatment, (3) concepts of what he can/cannot do, (4) hopes and expectations for the future.
- Set aside the time for listening
- Agree on the agenda
- Listen for beliefs about the self and the illness, and hopes for future
- Don’t react or correct
- Let chaos and delusions be
- Echo what you’ve heard
- Ask permission to write it down
2. Empathize. “If you want someone to seriously consider your point of view, be certain he feels you have seriously considered his. Quid pro quo”
- Empathize with frustrations, fears, discomfort, desires.
- Convey your empathy by using reflective listening: - reflecting back statements about feelings in the form of questions.
3. Agree. Find common ground and stake it out. Your focus is on making observations together, identifying facts that you can ultimately agree upon.
- Whenever you see an opportunity to convey your observations and opinions, always begin with something our loved one already acknowledges and believes.
- Couch your opinion in a question – you want to collaborate, not pontificate.
- Normalize the experience (“I’d feel the same if I was in your shoes.”)
- Discuss only perceived problems/symptoms (Statements such as, “I can’t sleep at night. The landlord changed my windowsills,” reflect insomnia and paranoia stemming from a delusion. However, the words insomnia and delusion need never be mentioned.)
- Review the loved one’s perceived advantages and disadvantages (rational and irrational) of his goals, and of treatment and of his current situation without it
- Correct only particular misconceptions (antipsychotics are not addictive; serious mental illness is not caused by anything the person did, including using of illicit drugs)
- Reflect back perceived benefits (“So if I have it right, you’re saying that when you were on the medication you slept better and felt calmer?” “It sounds like you really want to go back to work. What helped you succeed at your last job? What do you need for success now?”)
- Agree to disagree (whenever areas of disagreement are brought to the surface.)
4. Partnership. “Collaborate on accomplishing the goals agreed on. You and your loved one make an explicit decision to work together and to become teammates in arriving at a treatment agreement. Try to agree on goals that are reachable.”