Health&Care Mediation Training

Dialogues about Dying

Cultural competence, communication and conflict resolution in palliative and end-of-life care

A two-part training programme built on Arabella Tresilian’s Churchill Fellowship research and her practice as a health and care mediator. The full programme is a half-day (about 3 hours, including a break). It can be shortened to fit what your team needs.

Who it is for: healthcare professionals working in adult or children’s palliative and end-of-life care, in hospital, hospice or community settings, who want to build their skills in cultural competence, communication, and preventing and resolving conflict with patients and families.

Format options Length Content
Full programme Half-day, about 3 hours Both parts, with a break, practice and discussion
Two sessions 2 x 1 hour Each part on its own; can run on different days
Single session 1 hour Either part alone, or both condensed into two 30-minute halves

Every session is interactive and is tailored to the setting, the team and the families they work with, using case studies drawn from adult or paediatric practice as needed. It can be delivered in person or online.

Part 1: The 6Rs of Culturally-Responsive Conversations in Palliative & End-of-Life Care

Drawing on 27 interviews in India, South Africa and Peru, this session introduces the 6Rs: Recognise, Respect, Reflect, Relate, Revisit and Restore.

By the end of Part 1, participants will be able to:

  • describe the 6Rs framework and how it supports conversations with patients and families from diverse cultural, faith and family backgrounds
  • recognise how their own assumptions about family roles, authority, spirituality and death shape their conversations
  • use practical questions to explore what matters to a patient and family, rather than relying on assumptions about their culture
  • apply the 6Rs to a difficult conversation from their own practice

Part 2: Preventing & Resolving Conflict in Palliative & End-of-Life Care

A practical session on keeping difficult conversations on track, and knowing what to do when a disagreement with a family starts to harden.

By the end of Part 2, participants will be able to:

  • identify the common causes of conflict between families and care teams, and how these differ in adult and children’s care
  • use three techniques in difficult conversations: translating problems into requests, asking the question underneath the question, and seeking permission before entering sensitive territory
  • hold two futures at once, talking about continued life and possible death in the same conversation without either being heard as a loss of hope
  • explain legal and procedural options to families early, as information rather than threat
  • recognise the signs that a disagreement is escalating, and know when and how to access health and care mediation

About the trainer

Arabella Tresilian

Arabella Tresilian is the founder of Health and Care Mediation. She has been a CEDR-accredited mediator since 2017 and is a CEDR-accredited trainer, registered with the Civil Mediation Council and the International Mediation Institute. She mediates disputes in health and social care, including end-of-life, paediatric and Court of Protection cases, and works with teams up to board level.

As a Churchill Fellow, supported by Marie Curie, she researched how healthcare professionals in culturally diverse settings handle conversations about dying. Her report, Dialogues About Dying (2026), sets out the 6Rs framework on which Part 1 is based. Her work has featured in the Financial Times, on BBC Radio 4’s Inside Health, and with NHS England and the King’s Fund.

To discuss a training session for your team contact: