Hearing Care Blog

3 simple tools to explore the needs and motivation of people with hearing loss

Reading Time: 5 min.

Three easy-to-use hearing loss counselling tools help understand your clients’ motivations and adjust your counselling approach on the go to achieve better counselling outcomes.

Here’s a familiar scenario for many hearing care professionals: A new client comes in for a hearing test. The test shows that the client is a good candidate for a hearing aid, but they are not receptive to the news.

The client then brushes off the results of the hearing test and leaves your hearing clinic – with a still-untreated hearing loss. Or they passively accept a hearing aid that will probably end up in a drawer.

These outcomes – which stem from your clients ambivalence – are very unsatisfactory for both you and your clients. How can you overcome this ambivalence? By understanding the client’s motivation.

Understanding and nurturing the client’s motivation can make a big difference in achieving successful counselling outcomes. This is because it can help you provide them with more responsive hearing care that is tailored to their current needs and desires.

Understand the motivations of people with hearing loss

So how can you as a hearing care professional understand what a client really wants from an appointment?

You need to understand the client’s motivation for coming to you in the first place.

Have they been thinking about getting a hearing aid for a while? Are they uncertain whether they have a hearing loss and just want more information? Did a family member pester them into making the appointment?

Each person with a hearing loss will respond differently to your recommendations according to what they perceive their needs to be – and not necessarily what the audiogram says.

To help you uncover these hidden needs, the Ida Institute has developed three tools that help explore the motivation behind hearing loss treatment.

The purpose of these tools is to help guide your conversation with clients in order to unlock their individual needs. The tools have the potential to unlock things that the client may not have thought of themselves, or that the hearing care professional didn’t think to ask, during the initial interview.

Tool #1 – The Line – Is my client ready for hearing aids?


The Line is a quick way to assess a person’s readiness to take action, such as getting hearing aids. It also assesses their confidence with using hearing technologies. The Line is based on two simple questions:


Question 1:

“On a scale of 1 to 10, how important is it for you to improve your hearing?”

Question 2:

“On a scale of 1 to 10, how confident are you in your ability to wear and use hearing technologies?”


You then discuss your client’s replies and ask follow-up questions about why they placed themselves on The Line where they did (“Why are you at 7 and not at 3?” or “How can I help you move from 5 to 8?”). This enables you to gain insights into the client’s motivation and adjust your counselling accordingly.

For instance, a person with low motivation is better served by information than technology. Tell them about their hearing loss and send them home with reading material. This way, a new client won’t feel pressured and will feel they were listened to during your initial appointment and that you are sensitive of their readiness to move forward or not. They are consequently more likely to come back to you when they’re ready to be fitted with hearing aids.

Similarly, someone who is motivated to improve their hearing but apprehensive about the practicalities of using technology needs a different sort of support. This could be a tutorial to help them, or a family member to sit in on the appointment.

The Line is very efficient when used as part of establishing a new client’s history. Some clinicians even incorporate The Line into their patient intake forms.

Tool #2 – The Box – How can I motivate my client with hearing loss to act?


The Box is a cost-benefit analysis of taking action, which makes it useful for resolving ambivalence in clients. The Box is built around two sets of questions:


Question 1:

"What are the advantages and disadvantages of taking action?”

Question 2:

What are the advantages and disadvantages of staying as you are today?”


The questions help narrow down the source of your client’s ambivalence, allowing you to offer tailored advice, information and support.

The Box can be used in an initial appointment if the client seems ambivalent, or if their score on The Line falls somewhere in the middle.

Using this tool, professionals can demonstrate how they value the client’s perspective and priorities, a cornerstone of PCC.

The Box can also be helpful when talking to clients who are dissatisfied with using hearing technology. By weighing the advantages and disadvantages, you can get a clearer idea of why they are dissatisfied with their hearing aids or other technology. Then, you can make adjustments to improve their experience – either by trying a different hearing device or by changing their settings.

Tool #3 – The Circle – Where is my client on the hearing care journey?


All people with hearing loss go through different phases on their hearing care journey, from when others notice that they have difficulty hearing, to getting their hearing tested, to seeking advice from a hearing care professional, to finally purchasing and using hearing technology.

Use The Circle as a personal reflection tool to assess where your client is on their hearing care journey and what interventions make the most sense at the time of the appointment.

You can also use The Circle with a client to explain the different phases of the hearing care journey and to illustrate how far they have progressed on their path to better communication.

9 stages that your clients experience on their way to better hearing

All of these simple tools are easy to integrate into your counselling and take only minutes to use. And they have the potential to offer better outcomes for both potential and more experienced clients.

All Ida Institute tools are available free of charge from the Ida Institute website

Improve your counselling with Oticon’s interactive solutions

If you wish to enhance your counselling and rehabilitation processes, Oticon Counselling can help you.

You can motivate clients and their relatives and provide them with a valuable insight into the benefits of using a hearing solution.

Explore the benefits of Oticon Counselling