3. Communication Flashcards
When should boundary and confidentiality issues be discussed?
At the beginning of session.
What issues should be discussed at the beginning of session?
- What will happen if the client:
- is at risk of harm to self or others
- commits a serious crime
- bumps into you socially
- goes to court and notes are subpoenaed - Fee at clinic
- Cancellation policy
- What will happen at the end of 10 sessions (e.g. when Medicare runs out)
What do you do with angry clients?
If anger escalates, take a break for 5 minutes.
What are 5 positive nonverbal actions that a therapist can employ?
- Maintain eye contact
- Nod head to show listening
- Smile and show interest (never seem bored)
- Lean forward to show speaker you are interested
- Use a tone of voice that matches the message
What are 5 negative nonverbal actions?
- Avoiding eye contact
- Closing eyes or tensing facial muscles
- Excessive yawning
- Using body language that conveys indecisiveness (e.g. slumped shoulders; head down; flat tones; inaudible voice)
- Speaking too fast or too slow
What are the 4 rules of body language?
- Discrete application – don’t push it
- Open posture –invite them in
- Mirroring
- Matching –e.g., when they move arm, you move leg
What is paraphrasing for?
- It checks client’s understanding and makes sure you are both on the same page.
- It builds empathy –so the client knows they have been heard.
What is summarising?
A longer summation than paraphrasing. Used to tie up a section before you move on.
What are the different uses of open and closed questions?
Closed
- Simple information gathering
- Direct flow of conversation –e.g. X or Y
- Easy to answer
- Can discourage patient from speaking openly
Open
- Require longer, more complex answers
- Do not lead the answer
- Promote self-discovery and empowerment
What is the problem with leading questions?
Questioner assumes answer an is seeking confirmation. E.g. How much do you drink?
Discourages the patient from stating their views in their own words – and may lead to false information.
What techniques can be used when English is a second language?
- Speak slowly
- Use basic and the simplest vocabulary possible - Wait patiently for answers
- Repeat Key Words
- But don’t patronise
- Confirm comprehension
- Confirm date arrangements
- Get the person to repeat what has been said back to you to confirm understanding for both parties.
- Never assume “yes” confirms understanding
- Develop cultural competence for each individual you are working with
What cultural differences in communication must a therapist take into account?
- Turn taking –interruptions can be seen as rude, or normal
- Eye contact –honesty in West, but too much can signal aggression, in Asian cultures
- Facial expressions –Japanese smile to mask anger/anxiety
- Gestures –nodding/shaking head for affirmation
- Personal space –some cultures touchier than others
- Posture–folded arms defensive in West, friendly in East
When a client displays strong emotion, what should you do?
Recognise, identify, acknowledge, empathise.
What are 6 signs of anxiety?
- Agitation
- Nervous gestures
- Physical tension
- Fragmented language and posture
- Vocal stress
- Possible physiological arousal (sweating, shaking, redness etc.)
What are 5 UNhelpful ways of dealing with anger?
- Taking anger personally
- Feeding anger back to them
- Defending the system
- Criticising the systems
- Smiling nervously
