1. Pace of Conversation
Some cultures (e.g. some American Indian) are comfortable with long periods of silence while others are fast paced. Some consider it appropriate to speak before the other person has finished talking, which would be very disrespectful in other cultures.
2. Physical Distance
Provide patients with a choice about physical proximity by asking them to sit wherever they like. Individuals from some cultures tend to prefer to be about an arm’s length away from another person while those from some others cultures tend to prefer closer proximity or greater distance.
3. Eye Contact
While European Americans typically encourage members to look people in the eye when speaking to them, some others may consider this disrespectful or impolite (e.g., some Asian and Native American groups). Some Muslim groups may consider eye contact inappropriate between men and women. Observe the patient when talking and listening to get clues regarding appropriate eye contact.
4. Emotional Expressiveness
Some cultures value stoicism (e. g. British), while others encourage open expressions of feelings, such as sorrow, pain, or joy. Elders from some backgrounds may laugh or smile to mask negative or other emotions (e.g. Japanese, Filipino).
5. Body Movements
Bodily gestures can be easily misinterpreted based on what is considered culturally appropriate. Individuals from some cultures may consider some types of finger pointing or other typical American hand gestures or body postures disrespectful or obscene (e.g. Filipino, Chinese, Iranian), while others may consider vigorous hand shaking as a sign of aggression (e.g. some American Indian) or a gesture of good will (e.g. European). When in doubt, ask an interpreter or other cultural guide.
While physical touch is an important form of non-verbal communication, the etiquette of touch is highly variable across and within cultures. Practitioners should be thoroughly briefed about what kind of touch is appropriate for cultures with which they work (e.g., especially in cross gender interactions, many Muslim women are not comfortable shaking hands).