Basic Communication Skills

PSY3960 January 27, 2005

Agenda
Getting Acquainted Exercise: Fantasy Island Lecture and Discussion on Basic Communication Skills Practice/Role Play Questions/Feedback

Attending
Orienting oneself physically and psychological Conveys empathy Encourages the other person to talk SOLER

SOLER
S: Face the other Squarely O: Adopt an Open Posture L: Lean toward the other E: Make Eye Contact R: Be Relatively Relaxed ------------------------------------------------------------- Tone of your voice Rate of speech Tracking the clients topic

Basic Communication Skills

Open-Ended Questions Closed-Ended Questions Paraphrasing Reflection of Feeling Summary

Closed-Ended Questions
Questions that the other can easily answer with a Yes, No, or one- or two-word responses
Are you going to have the test done? Did you drink before you got into the car? Do you drink often? Do you exercise? Do you like your job?

Open-Ended Questions
Questions that clients cannot easily answer with Yes,, No, or one- or twoword responses
Tell me about your family while you were growing up Why is that important to you? How did you feel when that happened? What did you do when she said that? What are your reasons for saying that?

Closed vs. Open

C: O: C: O: Are you scared? How do you feel? Are you concerned about what you will do if the test results are positive? What do you think you might do if the test results are positive? Is your relationship with your husband a good one? Tell me about your relationship with your husband.

C: O:

Purposes of Closed-Ended Questions:

To narrow the topic of discussion To obtain specific information To identify parameters of a problem or issue To interrupt an overtalkative client

Purposes of Open-Ended Questions:

To begin an interview To encourage client elaboration To elicit specific examples To motivate clients to communicate

Paraphrasing
Restatement of a messages content
Example 1
Client: I know it doesnt help my depression to sit around or stay in bed all day. Counselor: You know you need to avoid staying in bed or sitting around all day to help your depression.

Paraphrasing (contd)
Example 2
Client, a 40-year-old woman: How can I tell my husband I want a divorce? Hell think Im crazy. I guess Im just afraid to tell him.

Steps
Recall the message and restate it to yourself covertly Identify the content part of the message
Wants divorce, but hasnt told husband because he will think shes crazy

Paraphrasing (contd)
Select an appropriate beginning (see handout)
E.g., It sounds like, You think, I hear you saying,

Translate the key content into your own words

E.g., It sounds like you havent found a way to tell your husband you want to end the relationship because of his possible reaction. Is that right?

Confirm the accuracy of the paraphrase

Paraphrasing (contd)
Purposes
Tells the client that you have understood what they said Can encourage the client to elaborate Helps the client focus or get back on track Helps the client clarify her or his thinking

Practice
Client 1, a middle-aged graduate student: Its just a rough time for metrying to work, keeping up with graduate school, and spending time with my family. I keep telling myself it will slow down someday.

Practice
Client 2, a 30-year-old woman: My husband and I argue all the time about how to manage our kids. He says I always interfere with his disciplineI think he is too harsh with them.

Practice
Client 3, a 6-year-old boy: I wish I didnt have a little sister. I know my parents love her more than me.

Reflection of Feeling
Restatement of affect Example 1
Client: I dont know. Maybe this marriage isnt worth holding together any longer. Weve already tried just about every option. Counselor: You feel so frustrated and overwhelmed trying to resolve your conflicts without help from your wife. Its as if she had already given up on your relationship and now you are feeling hopeless and helpless.

Reflection of Feeling (contd)

Example 2
Client, a 50-year-old steelworker now laid off: Now look, what can I do? Ive been laid off over a year. Ive got no money, no job, and a family to take care of. Its also clear to me that my mind and skills are just wasting away. [Said in a loud, critical voice, staring at the ceiling, brow furrowed, eyes squinting]

Reflection of Feeling (contd)

Steps
Listen for overt feeling words Watch nonverbal behavior.
What feelings are implied in the clients nonverbal behavior? E.g., disgust, anger, upset, frustration, resentment, disillusionment, discouragement

Verbally reflect the feelings back to the client

What is a good choice of affect words that accurately describe the clients feelings? Anger and discouragement

Reflection of Feeling (contd)

Start with appropriate sentence stem
E.g., I see you, its clear to me that you, or from where Im looking you

Add the context or situation around which the feelings occur

Loss of job, no resources, no job prospects in sight Reflection: From where Im looking, you seem very upset about having your job and stability taken away from you.

Assess the effectiveness of your reflection

Reflection of Feeling (contd)

Purposes
Helps clients feel understood Encourages clients to express more feelings Helps clients manage feelings Helps clients discriminate among various feelings

Practice
Client 1, an 8-year-old girl: Im telling you I dont like living at home anymore. I wish I could live with my friend and her parents. I told my mommy that one day Im going to run away, but she doesnt listen to me. [Said in level, measured words, glancing from side to side, lips drawn tightly together, flushed face]

Practice
Client 2, a middle-aged man in marital therapy: As far as Im concerned, out marriage turned sour last year when my wife went back to work. Shes more in touch with her work than me. [Said in a soft voice tone with downcast eyes]

Practice
Client 3, an adolescent: Now look, we have too damn many rules around this school. Im getting the hell out of here. As far as I can see, this place is a dump. [Said in loud, harsh voice]

Summary
A collection of two or more paraphrases or reflections that condenses the clients messages or the session

Summary (contd)
Example- Client, a 10-year-old girl
At the beginning of the session: I dont understand why my parents cant live together anymore. Im not blaming anybody, but it just feels very confusing to me. [Said in a low, soft voice with lowered, moist eyes] Near the middle of the same session: I wish they could keep it together. I guess I feel like they cant because they fight about me so much. Maybe Im the reason they dont want to live together anymore.

Summary
Steps
Recall key content and affect messages
Key content: wants parents to stay together Key affect: feels sad, upset, responsible

Identify patterns or themes

She is the one who is responsible for her parents breakup

Use an appropriate sentence stem and verbalize the summarization response

e.g., I sense, or You are feeling

Summarize
e.g., Earlier today you indicated you didnt feel like blaming anyone for whats happening to your parents. Now Im sensing that you are feeling like you are responsible for their breakup

Assess the effectiveness of your summarization

Summary (contd)
Purposes
To tie together multiple elements of client messages To identify a common theme or pattern To interrupt excessive rambling To start a session To end a session To pace a session To review progress To serve as a transition when changing topics

Practice
Client 1, a 30-year-old man who has been blaming himself for his wifes unhappiness: I really feel guilty about marrying her in the first place. It wasnt really for love. It was just a convenient thing to do. I feel like Ive messed up her life really badly. I also feel obliged to her. [Said in low, soft voice tone with lowered eyes]

Practice
Client 2, a 35-year-old woman who focused on how her life has improved since having children: I never thought I would feel this great. I always thought being a parent would be boring and terribly difficult. Its not, for me. Its fascinating and easy. It makes everything worthwhile. [Said with alertness and animation]

Practice
Client 3, a 27-year-old woman who has continually focused on her relationships with men and her needs for excitement and stability:
First session: Ive been dating lots and lots of men for the last few years. Most of them have been married. Thats great because there are no demands on me. [Bright eyes, facial animation, high-pitched voice] Fourth session: It doesnt feel so good anymore. Its not so much fun. Now I guess I miss having some commitment and stability in my life. [Soft voice, lowered eyes]

Role-Playing
Designed for practicing new counseling skills Valuable in the beginning stages of learning Can be uncomfortable at first Think of the experience as a play Should NOT be used as an opportunity to resolve personal problems Present realistic problems Do not overdo being a difficult client

Suggestions for Giving Feedback

Person receiving the feedback should be in charge Focus on strengths Concrete and specific Non-judgmental Lean and precise Well-timed Checked to insure communication