Assessment The first step in working with individuals in these communities is assessing what level of information they would like and the timing of providing diagnostic information. "I think you have to assess individuals. You can't approach it in the same way each time. You have to make that assessment: How much is this patient willing to deal with it? Is it going to be, 'You don't talk about it'? And if that's what it is, then you may have to go with that" (p. 93).

Preparation Before disclosing any potentially upsetting information or making intervention suggestions, it is important to build a trusting relationship, facilitate involvement of family, warn patients about the nature of the discussion, and facilitate the involvement of traditional healers if the patient would like. “It is very important because if you just tell the patient right of the bat without setting the stage, the patient might get very upset and angry and then withdraw. He may not want to talk to the doctor, nurse, or social worker anymore” (p. 93). “Information can scare, or startle, or make things worse. I recommend having prayers before going to the hospital to prepare them and protect them from the information” (p. 94)