Learning to Listen

Week 3

Bastyr Communications

Basic Counseling Skills

The most important thing in communication is to hear what isn't being said.

Purpose of Presentation

To help participants understand the concept and importance of counseling

To help participants understand the process of counseling

To impart the skills of counseling

To help participants to be more aware of using counseling techniques appropriately and effectively

Basics of Counseling

Listening is not passive. It is important to indicate that the person is being heard

Good counseling skills means listening before acting to solve problems

Basics of Counseling

Verbal listening skills

Show interest

Gather information

Encourage speaker to develop ideas

Communicate our understanding of ideas

Request clarification of understanding

Build the therapeutic alliance

Listening Skills

Using good verbal listening skills, you increase the chances that:

You will understand what the other is saying and they will you

You will create a situation where you will be able to develop a helping relationship

Looking Like You're Listening is Not Enough

Listening skills

Ask open and closed questions

Use “encouragers”

Paraphrase what you have heard

Reflect on feeling

Summarize

Open Questions

Open questions

Generally start with “what”, “how”, “why” or “could “

Questions serve to:

Gather lots of general information

Encourage discussion

Example: Open Questions

EAMP: “How has the baby been eating?”

EAMP: “What is the bedtime routine?”

EAMP: “Could you tell me about giving the baby medicine in the morning?”

Closed Questions

Generally start with “is”, “are”, or “do”

Serve to:

Gather lots of specific information quickly

Tend to close down discussion

Example: Closed Questions

EAMP: “Are you giving the medicine every day?”

EAMP: “Is the baby able to tolerate the medicine in the morning?”

Encouragers

Ex: “Yes, I understand” or repeat a word or two of what was said

Serves to:

Encourage further discussion

Example: Encouragers

Patient: “I missed my appointment last week because of transportation problems.”

EAMP: “Transportation problems…?”

Differentiating

Understanding whether:

Is the person is asking for information OR is the person is expressing concern?

Ex: Patient: “My baby vomited the medicine this morning”

EAMP: “Are you worried the baby is sick?”

Paraphrasing

Briefly summarize the content of the discussion

Reflective listening

Check your understanding

Show that you heard what was said

Acknowledge and accept feelings without judging

Example:Paraphrasing

Patient: “I am worried that the medicine is making my baby sick”

EAMP: “It sounds like you are worried about how the baby is reacting to the medicine.”

Reflection of Feelings

Focus on feelings (stated and unstated)

Serves to:

Communicate understanding of emotions

When combined with a paraphrase, confirms the

accuracy of understanding (“Check out” the the other person)

Encourages discussion of feelings

Example: Reflection of Feelings

Patient: I don’t see many changes in the baby since I started the medicine”

EAMP: It sounds like you are worried that the medicine is not helping the baby get better”

Summarizations

Succinctly pull together ideas from a an interview

Serves to

Organize the structure of the interview

Check the accuracy of understanding,

Example: Summarizations

EAMP: “During the time we have had together we have talked about issues with giving the baby medicine, problems with transportation, and your worries about the baby reacting to the medicine and getting better. Is that right?”

Attend to Nonverbal Communication

Increase awareness of nonverbal communications (yours & theirs)

Notice body language – a person’s stance, posture, physical tension

Acknowledge what you observe – be open and candid

Example: Nonverbal Communication

EAMP: “You appear a little uncomfortable. Is there something I can do about that?”

Discussion point: What other examples of non-verbal communication can you identify

Non Verbal Communication

Remember culture and context

Most nonverbal behaviors have multiple meanings

Some nonverbal behaviors have different meanings in different cultures

A Good Listener

Maintains eye contact

Makes few distracting movements

Leans forward, faces speaker

Has an open posture

Allows few interruptions

Signals interest with encouragers and facial expressions

What are other examples of good listening?

Bad listening

Makes little eye contact

Makes distracting movements

Faces away from speaker

Has a closed posture (ex.: arms crossed)

Interrupts speaker

Does too many other things while listening

Has a flat affect, speaks in a monotone, gives few signals of interest

What are other examples of a bad listener?

Listening Practice Scenarios

Get into a group of three people

One person begins by talking about a troublesome situation. Be brief but allow your partner opportunities to practice listening skills.

Listening partner: Provide at least three different types of listening responses as your partner talks

Third person is the Observer: Use checklist to identify different listening skills

Switch roles so that each person has a chance to fill each role

Listening Practice Scenarios

Remember the goals of listening skills

Help the speaker feel understood

Keep the speaker talking

Think carefully about the thoughts and feelings the individual stated or implied

Try to imagine yourself in their place in order to understand their message

Make a brief verbal statement communicating what you heard

No questions

No opinions

Check to see if you are correct

Influencing or Changing Behavior

Influencing or Changing Behavior

Directives

Reframes and interpretations

Advice

Feedback

Logical consequences

Directive

Tells a person what to do (can be direct or indirect)

Works best if clear and concrete

Serves to:

Move a person to take a specific act

Example: Directive

Patient: “I am not sure when to take my medicine”

EAMP: “You should take your medicine once in the morning and once in the evening”

Reframing and Interpretations

Attempts to replace an old, maladaptive response with a newer, more useful (usually positive) one

Serves to

Increase insight and understanding

Shift emotional or intellectual response

Example: Reframing and Interpretations

Patient: “There is so much going on I don’t think I can take my medicine”

EAMP: “Sometimes you feel overwhelmed and you are not sure that you can get everything done so you can take your medicine”

AdviceProvides information to help client make a decision. Can be very directive or less so

Serves to:

Share information that would be relevant for a person’s decisions, actions, or understanding

Disadvantages of advice

It’s often disempowering (You can’t solve this on your own)

People may say (but not really mean) that they want advice

Example: AdviceEAMP: “Try stirring the medicine in milk and then giving it to the baby”

EAMP: “Let me show you how to swallow the pill”

EAMP: “Marking a calendar is a good idea for keeping track of giving medicine, and it will help you feel good about giving every dose”

FeedbackGives information about how the person is experienced by others

Serves to:

Help client see self more objectively (as others see him or her)

Feedback works best when

It is requested or desired

It is concrete

It is positive

If negative, it addresses something changeable or controllable

Example: Feedback

Patient: “Last week I gave almost all of the doses of the medicine”

EAMP: “You have really worked hard to make improvements in giving the medicine. Let’s think about how we can help you so that you can give all of the doses of medicine”

Logical Consequences

Focuses on the logical consequences of a person’s behavior, actions, thoughts, or feelings

Serves to:

Increase awareness of consequences

Example: Logical Consequences

Patient: “It is really hard to start the medicine, and the side effects are really hard for the baby”

EAMP: “If you can make it thorough the first few weeks of taking the medicine than the side effects will get better and the baby will start to improve”

Counseling

The goal of counseling is to help a person tell their story

With effective listening skills you can assist a person in communicating their thoughts and feelings

When you understand where a person is starting from, it is easier to help them reach their goal

Finally:

Keep your ears open!