Empathic Communication Flashcards
Components of a Client’s Message
Like an onion:
1 Fact and thoughts: the crust
The client’s understanding of the facts and his/her thoughts (a cognitive level)
2 The client’s feelings : Inside (an emotional level)
3 Hidden meaning: Deep inside (existential level)
How Each of these dimensions of experience can be evoked by specific skills?
• Facts and thought
Paraphrasing (reflection of content) e.g. “this week has been difficult, both at home and at work”
• Feelings
Reflection of feeling e.g. “You felt discouraged about your job and sad about the problems at home”
• Hidden meaning
Reflection of meaning e.g. “You are beginning to look at yourself as a failure because neither your job nor your home life are fulfilling at the moment”
What is Empathic Listening?
Begins with the skills we call active listening, reflective listening or paraphrasing but goes beyond these skills to real understanding
Empathy – putting yourself in another’s shoes; feeling or thinking what they feel or think
What is reflective listening?
Another term for Empathic Listening
Empathic Listening Involves:
1Attending to the words, gestures, tone of voice, eye movements and…
2Reflecting and summarizing the speaker’s words or feelings in your own words to convey acceptance and understanding
How to Listen Empathically?
- Identify the content, feelings or meanings
- Reflect – say back in your own words
- Listening doesn’t always require words
- Silence is a good therapeutic tool
- Minimal interventions to help client continue to talk (door openers, minimal encouragement).
Question 1: How do I encourage my client to speak?
Using Invitational Skills
What are the type of Invitational Skills?
- Non-verbal skills
* Opening skills
What are the non-verbal skills?
are the use of attentive silence, eye contact, appropriate voice tone, appropriate use of silence, body position and nonverbal encouragers such as head nodding or hand gestures that invite the client to talk
Give example for each nonverbal skill below:
1 eye contact
Direct eye contact with occasional breaks for client comfort
Give example for each nonverbal skill below:
2 Facilitative body position
“Open” attentive body position, squarely facing the client
Give example for each nonverbal skill below:
3 appropriate use of silence
Allowing the client to fill in the “voids” in the conversation
Give example for each nonverbal skill below:
4 voice tone
Using a voice tone that reflects the client’ s and is appropriate in volume and rate and shows warmth and support
Give example for each nonverbal skill below:
5 Gesture
Encouraging the client to open up with appropriate gestures and head nodding
What are opining skills?
are verbal encouragers. They ask the client to explore a little deeper but are not very invasive. They also reassure the client that you are following the story.
Includes verbal listening cues/ Encouragers and question
What are the verbal listening cues/ Encouragers?
Minimal encouragers and Door openers:
Example of Minimal encouragers?
verbal listening cues I see… Oh… Hmmm… Really?... Interesting…
Example of Door openers?
More explicit listening cues Tell me more about it I’d like to hear about it Tell me more I’d be interested in your point of view Would you like to talk about it? Tell me the whole story!
What are the questions skills? what are they used for
They are closed and opened question that are used to prompt the client to say more.
Have to be used with caution: when the therapist asks a question, she/he takes the lead on the conversation and guides the client to where the therapist thinks the conversation should go.
Give an example of an opened question and closed question?
Open:
“Could you tell me what has been going on?” or “how” or “what questions such as “how did that happen?” or “what led you to that conclusion?”
Closed:
Are you working outside the home?
Why therapist have to reflect?
o Verbal way of communicating empathy
o Feedback allows the person to confirm or correct the image he/she is giving
o Stimulates further exploration (opening effect)
o Captures important aspects of the client’s message that might remain hidden
How do I reflect what my client expressed?
- Remember the “onion”?
- Reflecting content
- Reflecting feelings
- Reflecting meaning
Reflecting content:
-Paraphrasing
paraphrase what the client just said
Use your own words to feedback the content of client’s message that restates the important facts and thoughts in a non-judgmental way
How do you reflect content? steps
2 steps:
o Listen carefully – use door openers, minimal encouragers, open/closed questions
o Feedback - paraphrase
What are the common problems in paraphrasing?
- Parroting – list exactly what the client said
- Distractions – mental noise & worrying about what to say next
- Taking the client side
- Judging the client
Reflecting feelings
identify and verbalize the personal significance of the client’s story
Recognize client’s feelings and feedback them
How do you reflect feeling? steps
- Asking the client “How do you feel?”
- Waiting too long to reflect. Better to reflect inaccurately, than never to reflect at all – similar to letting the client ramble
- Reflection as a question
- Add a question after the reflection
- Focusing on the wrong person/topic
- Confusing the words “feel” and “think”
- Undershooting and overshooting
- Parroting – using the same words
- Too long/rambling - letting your reflection go on and on
Reflecting meaning
identify and verbalize the personal significance of the client’s story
Recognize client’s meaning system, how they see themselves, others, and the world and feedback it
Why therapist have to reflect meaning?
o Awareness
o Empathic bond
o Opening/disclosure
o Deeper issues
Tips to boost Reflecting meaning
Tip: avoid closed questions and an interrogating attitude
How do you reflect meaning?
o Understand client’s worldview
o Using: invitational skills, paraphrasing, and reflecting feelings
o Same elaborated formula used in reflecting feelings: “You feel… because…” (you add the meaning, instead of the content – reflecting feelings+meaning/value)
o Or
o You can even combine the 3 reflecting skills: reflecting feelings+paraphrasing+meaning
What the type of summarizing?
- Beginning of a session: Focusing summaries
- Middle of a session: Signal summaries + Thematic summaries
- End of a session: Planning summaries
Beginning of a session summary
Focusing summaries – focus the conversation before it begins (i.e.: remind clients about their goals from previous sessions or summarize what is known to a new client)
Middle of a session summary
- Signal summaries – summarize a topic a gives client a signal that they can move to another topic
- Thematic summaries – used to identify a recurrent pattern/theme/topic
End of a session summary
Planning summaries – conclusion of a session: progress, important points discussed, plans
