Lesson 6 — Speaking Up: Self-Advocacy in a Care Visit

Summary

Learners turn their rights into words: they prepare a before/during/after question list for a care visit, learn the assertive middle path between passive and aggressive, and rehearse asking clearly — including when to bring a support person or translator and when to seek a second opinion.

Objectives

• Prepare for a care visit and use assertive self-advocacy to make sure one’s needs are heard. (D03.S4.11.01)

Connection

Most people have felt it: the visit ends and you realize you never understood the answer, or forgot the question you meant to ask. Speaking up in a care setting is a skill, not a personality — it can be planned before you walk in, and practiced until it feels natural. Being heard is not about being loud or rude; it is about coming prepared and asking directly, clearly, and without apology.

Materials

• Care-visit question sheet
• Role-play scenario cards

Preparation

• Copy the question sheet and scenario cards.
• Retrieval: from Lesson 5, the three rights (understand, agree, privacy). Today we put them into words.
• Prepare a worked example of one full before/during/after script to model.

Facilitator note

This lesson is written to the learner (“you”). The ideas to land: self-advocacy is a prepared skill — before (write what you want to know; bring a support person or translator), during (ask directly: “can you explain again,” “what are my options,” “what are the risks,” “what if I wait”), after (restate the decision in your own words; know the next steps). The communication frame: assertiveness is the middle path — expressing your own needs directly and respectfully, distinct from passive (suppressing them) and aggressive (trampling others’) (S-405); the “I” statement and needs-based asking come from the same tradition (S-148). Discussion moves like “can you restate that?” and “help me understand” support clear asking (S-238). Model one script explicitly (worked example), then guided role-play (S-011).

The social-emotional lens: speaking up sits on self-awareness and regulated confidence, and it is harder in a second language or under authority — normalize that. The critical-thinking lens: learners choose questions that actually get the information they need. Honor cultural differences in how directly needs are stated (S-405 note); the lesson teaches one effective register, not the only right one. Preview: Lesson 7 turns to the information side — reading health claims and deciding together.

Procedure

1. Recall (5 min). From Lesson 5, what are your three rights? Today: how do you actually say them in a visit?
2. Meet the three styles (8 min). Three ways to speak up: passive (stay quiet, swallow the question), aggressive (demand, blame, raise the voice), and assertive (ask directly, clearly, respectfully). Assertive is the middle path — you state your need without trampling anyone else’s (S-405).
3. Build your question list (12 min). Before: write what you want to know, and who could come with you to help you listen — a support person or translator is always allowed. During: “Can you explain that again?” “What are my options?” “What are the risks?” “What happens if I wait?” After: restate the decision in your own words and name the next steps. Keep your sentences in the “I” form: “I still don’t understand — could you say it another way?” (S-148).
4. Model the visit (8 min). Watch one full script: a learner who comes prepared, asks two “during” questions, and ends by restating the plan. Notice the tone — calm, clear, unhurried (S-011).
5. Rehearse (12 min). In pairs, role-play a visit from the scenario cards — a rushed clinician, an explanation you cannot follow, a language gap. Practice your three “during” questions and one “after” restatement. Swap roles.
6. Know your exits (6 min). You can always ask again, bring someone next time, or seek a second opinion — a different clinician’s view. That is not disloyalty; it is part of advocating for yourself.
7. Close (4 min). Write one sentence you now feel ready to say aloud in a real visit, and say it to your partner.

Differentiation

• Support: Practice one clear ask (“please explain that again”) until it feels natural, and rehearse bringing one support person by name.
• Extension: Write and rehearse a response for a harder moment — being talked over, offered something you do not understand, or needing an interpreter — and refine it with a peer.

Assessment

• Formative (peer + self + performance): Can the learner produce a before/during/after question list and rehearse an assertive ask with a support-person or second-opinion plan?
• Portfolio artifact (unit): The completed question sheet, folded into the unit’s health-care plan.

Home connection

Rehearse your “during” questions once with someone at home, and ask them to name one question they would add. Note what they add.

Resources

• On assertiveness as the middle path between passive and aggressive: Alberti & Emmons, Your Perfect Right (S-405).
• On needs-based “I” statements: Rosenberg, Nonviolent Communication (S-148).
• On discussion moves that keep asking clear and respectful: Michaels & O’Connor, Accountable Talk (S-238).
• On worked examples and guided practice for a communication skill: Kirschner, Sweller & Clark (2006) (S-011).