When can SAGE & THYME help in a conversation?

Nurse talking to a patient

The skills taught in the SAGE & THYME workshop are universally applicable and helpful.  

For this reason, we refer to them as ‘foundation level’ skills.

The SAGE & THYME structure can be used in many conversation involving emotions, worries or upset.

The SAGE & THYME structure can be used in situations such as

I'm being misunderstood

I feel tired and low and scared

Will I lose my mind?

What have I done to deserve this?

I worry about my family - it's too much

I can't face more of this

The finances feel like a mess

I don't feel very brave

Will my partner still want to be with me?

I feel as though I am letting everyone down

I feel out of control of my whole situation

I feel that I am losing my independence

Complex situations when the SAGE & THYME structure does not apply

Diagnosing an anxiety state

Challenging undesirable behaviour in a colleague

Working with denial

Diagnosing depression

Breaking bad news

Handling irreversible loss

Assessing suicidal risk

The withdrawn patient

Requests for euthanasia

Discussing resuscitation or the limits of treatment

"Patient told me that she had walked out of a fog following our brief consultation [using the SAGE & THYME model].  She worked out for herself what it was she needed to do to solve her problems.  The model really fitted well in a really limited time scale."

Kathryn Arrowsmith, Associate End of Life Care Facilitator, Royal Bolton Hospital NHS Foundation Trust

Why can using the SAGE & THYME structure in a conversation help staff?

When we asked a number of staff in a lung cancer directorate how they feel when they are in contact with a patient/relative who gets upset, they said they felt:

Upset

Empathetic

Helpless

Sad

Stressed

Emotional

Worried

Sympathy

Awkward

Concerned

Anxious

Frustrated

Without guidance and training, staff tend to give too much advice too quickly and ignore the emotions of patients because they are unsure how to respond to emotional distress.

After staff have been trained in just three hours, they say that:

  • Instead of avoiding such conversations, they feel confident in speaking to people with worries.
  • Instead of trying to fix problems, they have learned to hold back on advice and let the person think and speak.
  • Instead of feeling helpless, they feel satisfied and in control of these conversations (improves their wellbeing).
  • As well as being kind and empathic, they can use evidence-based listening skills.
  • As well as being caring and well-meaning, they can empower people to find their own solutions to their worries.

“I felt I had fulfilled my role much more than previous. I often avoided conversations around prognosis and death as I found it difficult to conduct a conversation. Now I feel satisfied. I am confident to lead a structured interview.”

S&T foundation level workshop participant

“I used SAGE & THYME with one of our NVQ candidates. She came to see me, very upset and crying, not wishing to complete her NVQ. 2 months after our conversation, she has completed her NVQ!”

S&T foundation level workshop participant