Empathic Communication

Question 1

Components of a Client’s Message

Answer 1

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)

Question 2

How Each of these dimensions of experience can be evoked by specific skills?

Answer 2

• 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”

Question 3

What is Empathic Listening?

Answer 3

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

Question 4

What is reflective listening?

Answer 4

Another term for Empathic Listening

Question 5

Empathic Listening Involves:

Answer 5

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

Question 6

How to Listen Empathically?

Answer 6

• 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 7

Question 1: How do I encourage my client to speak?

Answer 7

Using Invitational Skills

Question 8

What are the type of Invitational Skills?

Answer 8

• Non-verbal skills

* Opening skills

Question 9

What are the non-verbal skills?

Answer 9

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

Question 10

Give example for each nonverbal skill below:

1 eye contact

Answer 10

Direct eye contact with occasional breaks for client comfort

Question 11

Give example for each nonverbal skill below:

2 Facilitative body position

Answer 11

“Open” attentive body position, squarely facing the client

Question 12

Give example for each nonverbal skill below:

3 appropriate use of silence

Answer 12

Allowing the client to fill in the “voids” in the conversation

Question 13

Give example for each nonverbal skill below:

4 voice tone

Answer 13

Using a voice tone that reflects the client’ s and is appropriate in volume and rate and shows warmth and support

Question 14

Give example for each nonverbal skill below:

5 Gesture

Answer 14

Encouraging the client to open up with appropriate gestures and head nodding

Question 15

What are opining skills?

Answer 15

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

Question 16

What are the verbal listening cues/ Encouragers?

Answer 16

Minimal encouragers and Door openers:

Question 17

Example of Minimal encouragers?

Answer 17

verbal listening cues
I see…
Oh…
Hmmm…
Really?...
Interesting…

Question 18

Example of Door openers?

Answer 18

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!

Question 19

What are the questions skills? what are they used for

Answer 19

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.

Question 20

Give an example of an opened question and closed question?

Answer 20

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?

Question 21

Why therapist have to reflect?

Answer 21

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

Question 22

How do I reflect what my client expressed?

Answer 22

• Remember the “onion”?
• Reflecting content
• Reflecting feelings
• Reflecting meaning

Question 23

Reflecting content:

Answer 23

-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

Question 24

How do you reflect content? steps

Answer 24

2 steps:
o Listen carefully – use door openers, minimal encouragers, open/closed questions
o Feedback - paraphrase

Question 25

What are the common problems in paraphrasing?

Answer 25

• Parroting – list exactly what the client said
• Distractions – mental noise & worrying about what to say next
• Taking the client side
• Judging the client

Question 26

Reflecting feelings

Answer 26

identify and verbalize the personal significance of the client’s story
Recognize client’s feelings and feedback them

Question 27

How do you reflect feeling? steps

Answer 27

• 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

Question 28

Reflecting meaning

Answer 28

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

Question 29

Why therapist have to reflect meaning?

Answer 29

o Awareness
o Empathic bond
o Opening/disclosure
o Deeper issues

Question 30

Tips to boost Reflecting meaning

Answer 30

Tip: avoid closed questions and an interrogating attitude

Question 31

How do you reflect meaning?

Answer 31

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

Question 32

What the type of summarizing?

Answer 32

• Beginning of a session: Focusing summaries
• Middle of a session: Signal summaries + Thematic summaries
• End of a session: Planning summaries

Question 33

Beginning of a session summary

Answer 33

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)

Question 34

Middle of a session summary

Answer 34

• 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

Question 35

End of a session summary

Answer 35

Planning summaries – conclusion of a session: progress, important points discussed, plans