Implementing Strengths-Based Dialogue to Reframe Clinical Education and Community Engagement.

Purpose: Health care professionals want to solve problems. When health disparities are observed, the solution often rests on expanding access to clinical services. However, what are the varied paths that persons with communication disorders might take to access speech, language, and hearing care? Where are these paths successful and where does a well-intended initiative have an absent or limited effect in altering disparities? Multiple, complex factors affect access to health care in underserved communities. However, current practice tends to frame the goals and metrics of outreach programs in terms of access to health care services, which risks privileging the perspective of the providers who want to increase the volume of services accessed over the voices of the community members for whom access to health care is only part of the larger course of their lives. Solutions that do not reflect those community strengths outside the service provision framework likely yield minimal impact on quality of life, since the community members are less likely to fully embrace the solution. Method: In this clinical focus, we describe a community-informed strengths-based framework for clinicians and clinical researchers whose work is designed to reach underserved communities by employing mutual trust, empathy, active listening, and patient-centered care planning. Through case scenarios, we exemplify key tenets of the framework. Conclusions: The community-informed strengths-based framework detailed in this clinical focus supports a paradigm shift from a biomedically-informed strengths-based framework to a model of health care service provision that focuses on individual or community strengths. Eliciting guidance from those receiving care and framing the totality of encounters in terms of the process of responding to community strengths can build a collaborative and sustainable path forward toward achieving health goals.