What topics does this cannabis study cover?

This study covers research on: Mental Health, Endocannabinoid.

Where was this research published?

Published in Patient education and counseling on May 19, 2026.

Mental Health Endocannabinoid

How doctors' words can trigger shame in sensitive health conversations

Clinician communication and patient shame during chronic condition management visits.

Patient education and counseling • May 19, 2026 • Moderately Relevant

🤖

AI Summary

This qualitative study examined how clinician communication affects patient shame during conversations about sensitive health topics, particularly cannabis use in chronic condition management visits. Researchers observed 18 patient visits across five clinical settings and interviewed patients about their experiences. The key finding emerged from comparing two cases where patients disclosed marijuana use: one patient felt judged and became reserved after the clinician used minimal acknowledgments and suggested the cannabis use was problematic, while another patient felt comfortable and open when the clinician used encouraging language and validated their experiences without judgment.

The research highlights an important but often overlooked aspect of healthcare communication: how doctors respond to patient disclosures can either create or prevent shame. The study found that clinicians who used brief acknowledgments ("okay") while immediately pivoting to assessment or questioning may inadvertently trigger shame responses, even if that's not their intention. In contrast, clinicians who used continuers (encouraging words that invite more discussion) and focused on understanding rather than immediately evaluating the patient's behavior created a safer environment for honest communication. This distinction is particularly important for sensitive topics like cannabis use, where patients may already feel stigmatized or fear judgment.

The researchers conclude that creating trust and connection before suggesting health behavior changes may help clinicians navigate sensitive conversations more effectively. This finding has significant implications for healthcare providers working with patients who use cannabis, as shame-inducing communication could discourage future honest disclosure and harm the therapeutic relationship. The study suggests that clinicians need training in communication techniques that validate patient experiences while still addressing health concerns in a nonjudgmental way.

📄 Original Abstract

Identify clinician communication that could elicit or avoid eliciting potential patient shame in the context of a chronic condition management (CCM) visit. This study involved a multi-qualitative method observational design. We recorded 18 CCM visits in three internal medicine clinics, one family medicine clinic, and one psychiatry clinic. Patients were interviewed after CCM visits about their interpretations of clinician communication. Interviews were analyzed using deductive content analysis to explore if patients felt shame. Talk in CCM visits that could generate shame were analyzed using conversation analysis. One out of the eighteen patients expressed feelings of being judged and becoming reserved after disclosing marijuana use during the CCM visit: indications of a shame response. We present a single case analysis of this patient case alongside a parallel case of a patient who also disclosed marijuana use but did not indicate shame. In the first case that indicated shame, the clinician consistently used "okay" that merely acknowledged receipt of information from the patient and moved to ask more questions or close discussion. The clinician also suggested the marijuana use was problematic and should be reconsidered. The clinician in the second case used continuers to encourage the patient's talk about cannabis and acknowledged their experiences and concerns without providing any assessments or recommendations. It is possible that clinician communication may influence patient shame, especially in instances of patient disclosures of sensitive information. Further exploration of the influence of anticipatory shame on patient interpretations of clinician communication is warranted. Clinicians must navigate the challenge of addressing sensitive topics. Creating connection and trust may be useful prior to suggesting health behavior change.