Breaking bad news: the S-P-I-K-E-S strategy

The S-P-I-K-E-S protocol described in this article provides a simple, easily learned strategy for communicating bad news and suggests ways to assess the situation as it evolves and respond constructively to patients.

Abstract

Breaking bad news to patients is one of the most difficult and demanding tasks that oncologists face—and one for which they are often poorly trained and emotionally ill equipped. The S-P-I-K-E-S protocol described in this article provides a simple, easily learned strategy for communicating bad news and suggests ways to assess the situation as it evolves and respond constructively to patients. Showing empathy, exploring the patient’s understanding and acceptance of what he or she has just learned, and validating that patient’s feelings can provide muchneeded support to the patient, an essential psychological intervention for managing distress and helping the patient face the treatment decisions ahead. Although breaking bad news will never be easy, having a plan of action and knowing that you can support your patient through a difficult period should help considerably. Psychosocial Oncology