CH. 6. Encouraging, Paraphrasing, and Summarizing Active Listening and Cognition

Question 1

Encouraging, Paraphrasing, and Summarizing

Answer 1

INTRODUCTION: ENCOURAGING, PARAPHRASING, AND SUMMARIZING – are active listening skills that are the center of the basic listening sequence and are key in building the empathic relationship.

• When we attend and clients sense that their story is heard, they open up and become more ready for change.
• Active listening is a communication process that requires intentional participation – responding to client conversation.
• When using empathic listening skills, be sure not to mix in your own ideas with what the client has been saying.
  
  • You say back to clients what you have heard, using their KEY WORDS – words that were emphasized by the client in their dialogue.
  • You help clients by distilling, shortening, and clarifying what has been said.

ENCOURAGING – Encourage using short responses that help the client keep talking. These responses may be verbal (repeating KEY WORDS and short statements) or nonverbal (head nods and smiling).

• ANTICIPATED CLIENT RESPONSE – Clients elaborate on the topic

PARAPHRASING – Shorten or clarify the essence of what has just been said, but be sure to use the client’s main words when you paraphrase. Paraphrases are often fed back to the client in a questioning tone of voice.

• ANTICIPATED CLIENT RESPONSE – Clients will feel heard. They tend to give more detail without repeating the exact same story

SUMMARIZING – Summarize client comments and integrate thoughts, emotions, and behaviors. Summarizing is similar to paraphrasing but used over a longer time span.

• ANTICIPATED CLIENT RESPONSE – Clients will feel heard and discover how their complex and even fragmented stories are integrated.

CHECKOUT/PERCEPTION CHECK – Periodically check with your client to discover how your interviewing lead or skill was received.

• “Is that right?”
• “Did I hear you correctly?”
• “What might I have missed?”
• ANTICIPATED CLIENT RESPONSE – these give clients a chance to pause and reflect on what they have said.
• This also gives them the opportunity to correct you.

THEORY OF MIND (ToM) – the way you think about and integrate in your mind what the client is thinking and feeling holistically.

COGNITIVE EMPATHY – understanding others’ emotions and activity.

• We see the world through others’ eyes and understand how they think.

ACTIVE EMPATHY – experiencing emotions vicariously.

MENTALIZING – The goal here is to understand the client’s cognitive and affective worlds, but also integrate them in a way that requires mentalizing—understanding more fully the client’s mental state.

Question 2

Techniques: Encouraging, Paraphrasing, and Summarizing

Answer 2

TECHNIQUES: ENCOURAGEMENT, PARAPHRASING, AND SUMMARIZING:

ENCOURAGERS – are verbal and nonverbal expressions the counselor or therapist can use to prompt clients to continue talking.

• ENCOURAGERS include minimal verbal utterances (“ummm” and “uh-huh”), head nods, open-handed gestures, and positive facial expressions that encourage the client to keep talking.
  
  • Repetition of KEYWORDS can encourage a client and has more influence on the direction of client talk.
    
    • Be careful of your selection of single-word encouraging responses as they may direct clients more than you think.
• RESTATEMENT – a type of extended encourager in which the counselor or interviewer repeats short statements, two or more words exactly as used by the client.
  
  • EX: “The clerk gave you a dirty look.” “You got angry.”
  • Restatements can be used with a questioning tone of voice;
  • Well-timed encouragers maintain flow and continually communicate to the client that you are listening.
• PARAPHRASING – is the most important cognitive empathic listening skill.
  
  • The goal of paraphrasing is to facilitate client exploration and clarification of issues.
  • Paraphrasing covers more of what the client has just said, usually several sentences. Paraphrasing continues to feed back keywords and phrases but catches and distills the essence of what the client has said.
    
    • Paraphrasing clarifies a confusing client story.
• If your paraphrase is accurate, the client is likely to reward you with a “that’s right” or “Yes . . .” and then go on to explore the issue in more depth.
  
  • Once clients know they have been heard, they are often able to move on to new topics.
• An accurate paraphrase usually consists of four dimensions:
  
  1. SENTENCE STEM – sometimes using the client’s name. Names help personalize the session.
     
     • Examples are: “Damaris, I hear you saying . . . ,” “Luciano, sounds like . . . ,”
  2. KEY WORDS – used by the client to describe the situation or person. Include main cognitions, ideas, and exact words that come from clients.
  3. ESSENCE OF WHAT THE CLIENT HAS SAID – in briefer and clearer form. Identify, clarify, and feed back to the client.
  4. CHECKOUT – Here you ask the client for feedback on whether the paraphrase (or other skill) was correct and useful.
     
     • This gives the client a chance to correct any misunderstandings.
• EX: “I’m really concerned about my wife. She has this feeling that she has to get out of the house, see the world, and get a job. I’m the breadwinner, and I think I have a good income. The children view Yolanda as a perfect mother, and I do too. But last night, we really saw the problem differently and had a terrible argument.”
  
  • Key word encouragers: “: “Breadwinner?” “Terrible argument?” “Perfect mother?”
  • Restatement encouragers: “You’re really concerned about your wife.” “You see yourself as the breadwinner.” “You had a terrible argument.”
  • Paraphrase: “You’re concerned about your picture-perfect wife who wants to work even though you have a good income, and you’ve had a terrible argument. Is that how you see it?”
• SUMMARIZING – Summarizing encompasses a longer period of conversation than paraphrasing and often includes feelings and emotions as well.
  
  • • The summary essentially puts together and organizes client conversation, forming the foundation for further exploration.
• Summarizing is key to Theory of Mind (ToM) –(Mentalizing) and your ability to mentalize the world of the client.

Question 3

Observe: Listening Skills and Children

Answer 3

OBSERVE: LISTENING SKILLS AND CHILDREN –

• Children generally respond best if you seek to understand the world as they do.
• Frequently paraphrase or restate what they have said, using their important KEY WORDS.
• Talk to children at their eye level whenever possible; avoid looking down at them.
• Be prepared for more topic jumps with children; use attending skills to bring them back to critical issues.
  
  • They may need to expend excess energy by doing something with their hands;
• Avoid leading questions, which may bring out false memories.
• Use short sentences, simple words, and a concrete language style.
• Break down abstract questions into concrete and situational language,
  
  • USE a mix of closed and open questions as represented by the ABC-TF framework for questioning:
    
    • “Where were you when the fight occurred?” “What was going on just before the fight?” (Antecedents)
    • “Then what happened?” (Behavior)
    • What happened next?” “What happened afterward” (Consequence)
    • “What were you thinking through all this?” (thoughts/cognitions)
    • “How were you feeling at each point?” (Feelings/emotions)

Power of the positive asset search and positive psychology – Positive stories and identified strengths weaken the negative cognitions while simultaneously building executive functioning.

• Note that cognition here is reinforced by positive feelings. Thinking is often not enough – the FEELING has to be present in order to think positively and actually believe it.
• If someone hassles or bullies us, this enters our thoughts and cognitions—and over time can interfere with executive functioning.
  
  • Adult bullying is beginning to be recognized as a significant personal issue for clients.

Question 4

Encouraging, Paraphrasing, and Summarizing (Part II)

Answer 4

ENCOURAGING, PARAPHRASING, AND SUMARIZING –

• POWER of LISTENING – the very act of listening can lead to restorying – the generation of new and better ways of thinking.
  
  • That new story leads to more effective executive functioning (thinking) and behavior.
• Cognitions – language-based thought processes underlying all thinking activities.
  
  • EX: analyzing, imaging, remembering, judging, and problem-solving.
  • Cognitive theories of counseling that focus on changing cognitions (thoughts) to achieve client change.
    
    • Cognitive-Behavioral Therapy (CBT)
    • Rational Emotive Behavioral Therapy (REBT)
    • Dialectical Behavior Therapy (DBT)

Question 5

Multicultural Issues in Encouraging, Paraphrasing, and Summarizing

Answer 5

MULTICULTURAL ISSUES IN ENCOURAGING, PARAPHRASING, AND SUMMARIZING – work cross-culturally is to discuss differences early in the interview.

• For example, “I’m a White European American and we may need to discuss whether this is an issue for you. And if I miss something, please let me know.”

Question 6

SUMMARY

Answer 6

PURPOSE OF LISTENING SKILLS – The purpose of the listening skills is to hear the client and feed back what has been said.

• Clients need to know that their story has been heard.
• Active and accurate listening communicates that you have indeed heard the client fully.
  
  • It also communicates your interest and helps clarify relevant issues for both the client and you.

ENCOURAGERS – Encouragers are a variety of verbal and nonverbal means the counselor can use to encourage others to continue talking.

PARAPHRASES – Paraphrases are key to cognitive empathy. ey feed back to the client the essence of what has just been said

SUMMARIZATIONS – Summaries provide the basis for mentalizing. They may be used to begin an interview, for transition to a new topic, to provide clarity in lengthy and complex client stories, and, of course, to end the session.

• Cognitive and affective empathy are typically shown in summaries and represent both large and small aspects of mentalizing

EXECUTIVE FUNCTIONS – Executive functions are the cognitive mental processes that regulate human behavior.

• Cognitive skills help clients become aware of their emotions and regulate their emotional reactions. Cognitive-based counseling and therapy focus on changing clients’ cognitions (thoughts) in order to achieve change.
• Theory of Mind (ToM, or mentalizing) can be called “the working of the mind” and involves a holistic cognitive view of clients. We attribute mental states to others (their intentions, beliefs, and cognitive/emotional perspectives).

DIVERSITY AND ACTIVE LISTENING – cross-culturally more participation and self-disclosure on your part may be necessary.

• Trust building occurs when you visit the client’s community and learn about cultures different from your own.