• Nick Hicks

Understanding the Four Elements of Trust

Updated: Jun 5, 2019



This is the second in a 5-part series. Building and maintaining trust with patient groups and advocates is an essential part of any patient advocacy and engagement programme.


Trust is divided into four different categories; understanding these and applying this knowledge can greatly improve patient group relationships.

Nick Hicks: : You've split trust into four different elements.


Libby Robinson: Well, I think sometimes people think is trust is something inherent in a person. He's either trustable or not trustable. And we at Integral, like to make distinctions, sort of subcategories, that help people distinguish. So distinction is just to be able to distinguish, different pieces of a quite complex and sometimes amorphous conversation about trust.


Libby Robinson: The four elements or distinctions or categories, they're sort of overlapping categories and separate. And the four categories are this, I'll give them to you quickly: Competency, reliability, sincerity, and care. So let me just talk very quickly about each of the four.


Libby Robinson: Competency is just exactly what you think it is. Am I competent at the thing that I'm promising you? So, do I have the skill base, do I have the knowledge, the background, whatever I need. And that seems very obvious, and most people can get that.


Libby Robinson: Sincerity is: Is my public conversation, what I say to you Nick, or what I say to the public, same as what I'm thinking, or what I'm saying to my private group of friends or colleagues, or things like that. People can very easily pick up on, if I'm just trying to be marketed to, and the person in front of me doesn't really believe what they're saying. It's kind of a , we would call it an incongruence between walking their talk.


Libby Robinson: Reliability, this also probably makes sense. Is it, do I show up when i say I will show up when I actually promise on time, when I say I'm gonna call, call, do I do the things that I'm gonna do on time, consistently. So, sometimes people are competent, they're sincere, but it might be as simple as not letting people know that a meeting's been canceled, or not showing up on time, if the standard is to be right exactly on time. Reliability has to do with shared standards.


Libby Robinson: And then the final one, which often people miss is the category of care. Which is: I might be competent, I might be reliable, I might be sincere, but if I only ... If I am the person with you, and I only feel like you're doing this to get something out of it, you need me, but you don't really care about me, I'm just patient X. It's also gonna come through in your actions and in the words in the way you speak.


Nick Hicks: Okay, so that's really interesting. So these four different elements, is there like a hierarchy between them? Is one more important than the other?


Libby Robinson: Sure. So it's really interesting what you're saying. Just first of all, there's no hierarchy. They're all necessary conditions for creating trust, and hopefully everybody has all of those, but in different domains. For example, I'm very competent as it relates to coaching, I'm a master certified coach. I'm not very competent in cooking. So you can see depending on the domain, I may or may not be trustable, right? So that's an important thing. There's different domains of trust.


Watch previous episodes of If Medicines could Talk by clicking here

©