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The third stage of risk and crisis communication is built around stakeholder engagement and dialog. The publication of the Seven Cardinal Rules of Risk Communication by the EPA in 1988 as an official policy guidance document was an important third‐stage event.¹⁹ Two central premises of the EPA document were that people have a right to participate in decisions that affect their lives, and what people often mean by risk is much more complicated than what technical experts often mean by risk. The document argued that risk communication messages must be based on an understanding of how people obtain information, what values guide their interpretations of information, what role emotion plays in forming perceptions, how people make trade‐offs, and how people arrive at their final attitude and behavior toward a risk.

In the third stage of risk communication, a profound paradigm shift in thinking took place. Risk was seen as consisting of two almost independent, basic elements: technical risk and emotion. Understanding risk required understanding the interaction of these two elements as they intertwined. The advantage of the “technical risk + emotion” concept was that it served to reframe the problem. It allowed risk managers and decision‐makers to consider the many factors included in the public’s definition of risk, such as trust, benefits, voluntariness, control, and fairness. This new, expanded concept of risk also pointed to the need for authentic and meaningful dialog among all interested parties. It led to the then revolutionary idea that the essence of risk communication is not just explaining risk numbers but listening, engaging in constructive dialog, and negotiating in good faith. Third‐stage success requires that it is not enough for risk managers and communicators to acknowledge people’s emotions and concerns by listening to them, they must also actively communicate their understanding that people are entitled to be emotional and concerned, and why.

An excellent example of third‐stage risk and crisis communication occurred in the late 1980s. Medical waste was floating up on the shorelines of the northeastern United States. The public’s response was powerful. In several states, people were told the medical waste did not pose a significant health threat. However, the public kept on insisting that it was still disgusting and frightening. Battles erupted.

In response to public outrage, several states, including Rhode Island, took a different approach. Public health authorities went public and said (in essence): “This is an outrage; this is unacceptable. The people in our communities will not, and should not, tolerate any medical waste or hypodermic syringes washing up on our shores. We are going to do absolutely everything in our power to stop it even though there is a negligible risk to health. We are going to turn our budget priorities upside down if needed.” Many members of the public replied (in essence), “Thank you for your response, for listening, and acknowledging our concerns. Maybe we should wait. If it’s really a negligible risk, how much of our money are you really planning to spend?”

Psychologists call this approach “getting on the other side of the resistance.” When you share, and even exaggerate, people’s concerns and emotions, and acknowledge the legitimacy of their emotions and concerns, it frees them up to feel other things and think the problem through more carefully. Many people came to see that the risk was extremely small and began questioning whether it was worth spending a lot of money to solve the problem.

Revised thinking about risk communication in Stage 3 led many organizations to identify risk communication as a core competency for those involved in risk, high concern, and crisis communications. In a large number of fields, ranging from public health, medicine, and nursing to epidemiology and engineering, a broad consensus developed on the need for risk communication training programs.²⁰ While many professional associations and organizations had long recognized the importance of risk communication skills for high concern situations, they now recognized the need to integrate evidence‐based risk communication principles, strategies, and methods into training and standardized practices.