Communicating effectively with
Aboriginal and Torres Strait
Islander people
This information sheet provides a general guide forcommunicating effectively with Aboriginal and Torres Strait
Islander people. Further information for communicating in theclinical context can be found in the Aboriginal and Torres Strait
Islander Patient Care Guidelines.
https://www.health.qld.gov.au/atsihealth/documents/patient_care_guideline.pdf

Demonstrating understanding
The negative impacts of racial and economic disadvantage
and a series of past government policies, including
segregation, displacement and separation of families has
contributed to the mistrust held by Aboriginal and Torres Strait
Islander people towards government services and systems.
In today's Western dominant society, Aboriginal and Torres
Strait Islander people continue to be a marginalised andsocially disadvantaged minority group. Compared to other
Australians, Aboriginal and Torres Strait Islander people
experience significantly varied outcomes related to health,education, employment and housing. Discrimination, racism
and lack of cultural understanding mean that Aboriginal andTorres Strait Islander people still experience inequality andsocial injustice.
People's cultural beliefs, values and world-views influence
thinking, behaviours and interactions with others. It is importantto reflect without judgement before, during and after interactingwith people whose beliefs, values, world-views andexperiences are different to your own.

Some general tips to overcome langauge barriers may include:
Avoid using complex words and jargon.
•Explain why you need to ask any questions.
•Always check you understood the meaning of words the•person has used and vice versa.
Use diagrams, models, dvds and images to explain•concepts, instructions and terms.
Be cautious about using traditional languages or creole•
words unless you have excellent understanding.
If required, seek help from local Aboriginal and Torres Strait•
Islander staff.

TimeIn Western culture, emphasis is placed on time to meetdeadlines and schedules. Time is percieved differently inAboriginal and Torres Strait Islander cultures, as more value isplaced on family responsibilities and community relationships.
Consider allocating flexible consultation times.
•Take the time to explain and do not rush the person.
•Non-verbal communicationSome non-verbal communication cues (hand gestures, facialexpressions etc.) used by Aboriginal and Torres Strait Islander
people have different meanings in the Western context. Be
mindful that your own non-verbal communication will beobserved and interpreted. For example, feelings of annoyance
may be reflected by your body language and are likely to benoticed.

Personal space
Be conscious about the distance to which you are standing
near a person. Standing too close to a person that you are
unfamiliar with, or of the opposite gender, can make a person
feel uncomfortable or threatened.

TouchPersonal communication

Always seek permission and explain to the person reasons
why you need to touch them. Establish rapport first to makeperson feel comfortable.

RapportSilence

In many traditional cultures, a high sense of value is placed onbuilding and maintaining relationships. Taking a 'person before
business' approach will help form this relationship and buildrapport.
Introduce yourself in a warm and friendly way.
•Ask where people are you from, share stories about•
yourself or find other topics of common interest.

In Aboriginal and Torres Strait Islander cultures, extended
periods of silence during conversations are considered the‘norm’ and are valued. Silent pauses are used to listen, showrespect or consensus. The positive use of silence should not
be misinterpreted as lack of understanding, agreement or
urgent concerns. Observe both the silence and body language
to gauge when it is appropriate to start speaking. Be respectful
and provide the person with adequate time. Seek clarificationthat what was asked or discussed was understood.

Language
Many Aboriginal and Torres Strait Islander people do not
speak English as their first language. Some also speak English
in different dialects such as Kriol, Aboriginal English andTorres Strait Creole.

Cultural Capability Team September 2015

Eye contact
For Aboriginal and Torres Strait Islander people, avoidance ofeye contact is customarily a gesture of respect. In Western
society averting gaze can be viewed as being dishonest, rude

or showing lack of interest. Some (but not all) Aboriginal andTorres Strait Islander people may therefore be uncomfortablewith direct eye contact, especially if unfamiliar. To make direct
eye contact can be viewed as being rude, disrespectful oreven aggressive.To convey polite respect, the appropriate
approach would be to avert or lower your eyes in conversation.
Observe the other person's body language.
•Follow the other person's lead and modify eye contact•
accordingly.
Avoid cross-gender eye contact unless the person initiates•
it and is comfortable.

TitlesIn Aboriginal and Torres Strait Islander cultures, the terms‘Aunty’ or ‘Uncle’ are used to show respect for someone older
than you. This person does not have to be a blood relative ornecessarily an Elder.
Only address people with these titles if approval is given•
and/or a positive relationship exists.

Shame‘Shame’ (deeply felt feelings of being ashamed orembarrassed) for Aboriginal and Torres Strait Islander people
may result from sharing private or personal information,
cultural beliefs and from breaches of confidentiality.
Take a discrete approach and avoid discussions in open or•
public spaces.
Build trust and rapport to help people feel safe and•comfortable with you and in their surroundings.
Ensure confidentiality and consider Men’s and Women’s•
Business.

Listening
Explaining may take time because of narrative communicationstyle or due to linguistic differences. The person may be
struggling to communicate what they are trying to get across.
Avoid selective hearing and ensure you are ‘actively’•
listening.
Paraphrase by summarising and repeating what the person•
said. This will help with clarification and signal you havebeen listening.
Show empathy, be attentive and avoid continually•interrupting or speaking over the person.

Questioning
In Aboriginal and Torres Strait Islander cultures, indirectquestioning is the approach most preferred. Direct questioning
may lead to misunderstandings, discourage participation andmake it difficult to obtain important information, particularly
when a person is communicating in non-Standard English.
Use indirect, 'round about' approaches (e.g. frame a•question as a statement then allow time for the answer tobe given).
Clarify if the person understood the meanings of your words•
or questions and that you understood their answers.

••••

Avoid compound questions (e.g. "how often do you visit
your GP and what are the reasons that you don’t?").
Use plain words (e.g. say ‘start’ rather than ‘commence’).
Do not ask the person to continually repeat themselves
Avoid using hypothetical examples.

‘Yes’
Aboriginal and Torres Strait Islander people have a tendency
to agree with the questions even when they do not understandor agree, and may answer questions the way they think others
want. People may say "yes" to questions to end theconversation so they can leave, to deal with other priorities, orbecause they simply feel uncomfortable.
Take the time to build rapport to make the person feel•
comfortable.
Explain at the beginning how long the appointment will take•and give the person the opportunity to ask questions.
If a person repeatedly says ‘yes’ immediately after a•question, ask with respect what they understood from thequestions and/or to explain reasons for their decision.

Clear instructions
It is critical to provide clear and full explanations so that theperson fully understands your instructions. For example, tosimply say “take until finished” - this may be misunderstood as“take until you feel better” rather than “take until all the tablets
are finished”.

Provide options and ownership
When people are given choices and ownership over managing
their health, the likelihood of medical compliance is increased.
Provide options for care; for example, explain how some•medications can be taken orally or by injection.
Ensure that any options are practical and realistic.
•Do not make promises that you cannot deliver as this may•create mistrust.

Making decisions
Due to family kinship structures and relationships, decisionmaking usually involves input by other family members.
Check with the person if their decisions requires•
consultation with family.
Allow time for information to be clearly understood .
•Be respectful if you are asked to leave the room or the•meeting for matters to be discussed in private by the family.

Communication assistance and cultural support
Build relationships within the local community and learn
suitable and generally accepted words. Your local Aboriginal
and Torres Strait Islander staff may be able to assist with
cultural knowledge and interpreting information. They may also
advise you of the best ways of distributing information throughthe community.