Communication Flashcards
What is MI?
Client centered, directive style that targets the client’s ambivalence about change, naming it and resolving it.
What are the goals of MI?
- Change behavior.
- Develop an ongoing relationship.
- Resolve ambivalence.
- Develop discrepancies.
- Get a commitment to change.
What is OARS?
Open-ended questions, affirmations, reflective listening, and summaries.
Open-Ended Questions
Invites the client to go beyond one-word answers and actively engage in the therapeutic process.
Affirming
Affirming the client encourages ongoing communication, disclosure, and growth in the process.
Reflection
Directs the client toward areas for change or exploration of an issue. Roll with resistance, don’t confront it.
Summaries
A form of reflective listening, allows for feedback of a bigger picture of the client situation as it is understood by the practitioner in the session, giving space for the client to further clarify and gain insight.
6-Steps for an effective relationship with a nonvoluntary voluntary client
- Name the circumstance under which the meeting occurs.
- Validate legitimate concerns.
- Identify non-negotiable portions of the intervention.
- Identify what is and is not negotiable as part of the assessment and tx process.
- Negotiate a tx plan that includes the mandatory requirements of the referring authority, but also includes the client’s interests.
- Identify criteria for measuring progress toward the agreed-upon plan and tx goals.
Precontemplation stage
Individual does not even consider a change in his or her situation. Denies they have a problem.
Contemplation
Ambivalence toward change. Considering costs and barriers to change.
Preparation
Individual is experimenting with small changes, considering what it will be like when full change occurs.
Action
Person takes definitive steps to alter the behavior.
Maintenance and relapse prevention
Maintain new behaviors over the long term, preventing a return to using substances and embracing new and healthy habit.s
Close-Ended Questions
Responder is asked for specific, discrete information, such as identifying information. Good for self-administered questionnaires, quantitative research, and interview schedules.
Scaling Questions
Used in solution-focused brief therapy, used to track differences and progress in the client.
Strengths-focused questions
What have you done to get to this (higher score?)
Exception Questions
Have you ever been higher on the scale? What is different on the days when you are one point higher on the scale?
Future-focus questions
Where on the scale would be good enough for you?
(Diagnostic Interviewing Technique) Reflection
-Restate the client’s cognitive or emotional material.
-Identify and feedback the underlying emotional experience.
-Demonstrate empathic understanding.
(Diagnostic Interviewing Technique) Restatement/Paraphrasing
Rephrase what the client says, demonstrates you are actively listening. Provides a check on the accuracy of the perceptions of the session.
(Diagnostic Interviewing Technique) Encouragers
Brief responses such as head nods, uh-huh, and single words.
(Diagnostic Interviewing Technique) Clarification
Accompanied by other techniques such as questioning, paraphrasing, and restating.
(Diagnostic Interviewing Technique) Confrontation
May be used to call a client out on discrepancies, breaks denial or rigid defenses
(Diagnostic Interviewing Technique) Self-Disclosure
The sharing of personal experiences by the therapist to the client relative to the session with the purpose of helping the client understand.
(Diagnostic Interviewing Technique) Silence
Provides both the client and therapist time to process what is being understood, timing is essential.
(Diagnostic Interviewing Technique) Exploration
Therapist tests the limits of what the client is willing to process, can be used to determine the client’s level of insight.
(Diagnostic Interviewing Technique) Reframing or Cognitive Reframing
Allows for a different perspective. Used to challenge negative self-concepts and harmful thinking patterns. Leads to behavior change.
(Diagnostic Interviewing Technique) Summarization
Overall feedback of longer statement.
Five Interview Stages
- Accentuate the positive.
- Be careful of only seeking war stories.
- Be careful of rescuing.
- If the therapist avoids hard issues, so will the client.
- Focus on the positive.
Empathy
See, feel, and hear as the client does
Cultural Empathy
Understanding the impact of a multicultural world.
Goals of Initial Interview
- Establish rapport
- Discover problems and expectations of client
- Ascertain what therapy goals should be completed and create a contract with those in mind.
Attending
Listen closely to the client, sitting forward and make eye contact.
Paraphrasing
Take the statement the client has made and restate it in more condensed terms and in different words. Does not include emotional aspects of the statement.
Reflecting
Restate the affective section of the client’s message. Demonstrate emotional awareness of the content so client feels understood.
Clarifying
Define vague or perplexing words clients use in their conversations. Assists client in better understanding the actual meanings of statements.
Leading
A response method whereby the counselor encourages the client to discuss a specific aspect of himself or an experience by directly or indirectly inviting a verbal response.
Summarizing
Connects several topics and feelings, centers on themes the client mentions more than once. Brings focus to a counseling session.
Supporting
Demonstrates the counselor has listened to what the client has said and does not believe the thoughts, feelings, or behaviors to be odd.
Approving
Reinforces concrete and ideal alterations in a client’s feelings and behaviors.
Confronting
Demonstrating to a client discrepancies found in single verbal message.
Interpreting
Deals with implicit components of a client’s statement.
Informing
Giving a client important information regarding alternatives, decisions, or plans the client is considering.
Instructing
Enables client to identify behaviors suitable for certain circumstances. Can be useful when a client is striving to meet a goal or when they need to learn an adaptive reaction. Often done through role-playing.
Assigning tasks and contracting
Formal or informal written or spoken contract, encourages the client to implement changes in real life that have been learned in counseling sessions.
Two Categories of Client-Counselor Communication Barriers
- Communication that has immediate negative impact on counseling, resulting in inherently damaging verbal responses.
- Increasingly frequent communications that result in counterproductive patterns of verbal response.
Moralizing and Sermonizing
Counselors who use should or ought messages to give their clients advice.
Premature Advice
Advice given to a client before the client knows the counselor well enough tot take the advice given.
