| The empathy stamp | “I’m sorry to hear that” after every difficult statement. | Respond specifically or sometimes simply pause. |
| ICE interrogation | Three stock ICE questions regardless of what the patient has already told you. | Use cues and natural follow-up questions. |
| The management lecture | Two uninterrupted minutes of information. | Chunk, check and adapt. |
| Option dumping | Listing choices without helping the patient compare them. | Relate options to priorities and offer a professional view. |
| Fake choice | “What do you want to do?” when one option is clearly unsafe. | Explain your concern and negotiate within safe boundaries. |
| Premature reassurance | Reassuring before understanding the fear. | Explore first, then reassure proportionately. |
| Psychosocial tourism | Asking about home/work without using the answer. | Only explore what helps understanding or planning. |
| Judgement disguised as advice | Language that implies blame. | Use neutral, curious language. |
| Ignoring the second agenda | Finishing the clinical problem while the real concern remains untouched. | Return explicitly to the patient’s agenda. |
| Safety-net dump | A generic warning list at the end. | Make it specific and meaningful. |
