CLINICAL PSYCHOLOGY – PSY 323A

CHAPTER 3: SKILLS AND TECHNIQUES IN 5) Speech tone/rate – non-monotonous and appropriate

to the topic of discussion.
COUNSELING (MICROSKILLS IN
COUNSELING EMPATHY) 6) Time – varies, some like to talk and extend, others are
bottom-line type and want to finish fast.
MICROSKILLS IN COUNSELING
7) Facial expression – match the client’s mood: smile or
• Microskills are the basic foundational skills involved in laugh when client does; serious when client is serious.
effective helping relationships.

• They help to create the necessary conditions from which UNDERSTANDING BODY LANGUAGE
positive change can take place.
What types of body language give a negative impression?
• They provide the client with such alliance building
Bored/disinterested body language
constructs as empathic understanding, genuineness and
acceptance, and will greatly facilitate the development of • Checking the time
a safe therapeutic environment. • Inspecting fingernails/split ends
• They will aid in establishing rapport with clients. • Leaning away
• Not directly facing the person you are addressing
ATTENDING IN COUNSELING • Poor posture
• Attending is a counseling skill. • Propping your head up with your hands
• Tapping fingers/feet
• Being attentive means the counselor is giving the
client their full focus, paying attention to what the Angry body language
client is saying, doing, the tone of voice used and body
• Standing too close
language.
• Hair pulling Squinting
• Attending is the first skill a trainee counselor learns. It • Lowering and spreading the body
is the base that other skills can be built on and used. • Making fists

• Good attending will show the client that they are • Jutting chin
respected and encourage them to talk about their • Gritted teeth
thoughts and feelings.
Resistant body language
• It also shows they are being listened to and taken
• Holding objects in front of your body
seriously.
• Touching your face during a conversation
• This will make the client feel more relaxed about • Nose
disclosing personal information about their emotions, • Mouth
feelings and thoughts. • Fake smile

ATTENDING SKILLS: Nonverbal/Listening • Crossing arms

Dr. Villar listed micro skills which she found helpful for Nervous body language
counseling Filipinos
• Fidgeting
1) Eyes – direct eye contact with natural blinks to convey • Scratching head or neck
attentiveness. • Fixing your collar/clothes
• Increased blinking rate
2) Posture – trunk slightly inclined toward the client to show
• Slouched shoulders
interest.
• Crossing your hands over your groin
3) Head – nodding every now and then to convey “I am • Wiping your hands on your clothes
listening”. • Sitting on the edge of your chair
• Shifting body language from foot to foot
4) Space – diagonal sitting position with distance enough for
the client to see the face and upper body of the counselor.

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ATTENDING SKILLS: Verbal
1) Open Question – gathering question through a question
which requires elaboration.
2) Closed Question – asking questions answerable by “yes”
or “no” to obtain specific data quickly and directly or to
regulate over-talkative clients.
3) Encourager – repeating a few of the client’s words to
encourage more specific and concrete explanation on
content shared (restatement).
4) Paraphrase – repeating the main points presented by the
client through combining own words with the main words
of the client (clarification). Your feedback to the client is the
essence of what has just been said.
Sample Client Statement
“I’m really concerned about my wife. She has this feeling that
she has to get out of the house, see the world, get a job. I’m the
breadwinner and I think I have a good income. The children
view her as a perfect mother, and I do too. But last night, we
really saw the problem differently and had a terrible
argument.”
COUNSELOR RESPONSE
• Key word encouragers: breadwinner, terrible argument,
perfect mother
• Restatement Encourager: You’re really concerned about
your wife, you see yourself as the breadwinner, you had a
terrible argument.
• Paraphrase with Check-out: 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?
• Empathic communication – stating the unstated feelings
observed from the client’s language and behaviors and
linking them to some possible sources to show
understanding of what the client is really going through
(reflection of feelings).
• Summarization – organizing the facts, thoughts and
feelings presented by the client to clarify what the problem
is, what factors are operational, and if already discussed,
the decisions or solutions arrived at.
EXAMPLE OF REFLECTION OF FEELINGS:
When I get home in the evening, my house is a mess. The kids
are dirty… My husband does not care about dinner...I do not feel
like going home at all.
You are not satisfied with the way the house chores are
organized. That irritates you.
EXAMPLE OF SUMMARIZING
We discussed your relationship with your husband. You said
there were conflicts right from the start related to the way
money was handled, and that he often felt you gave more
importance to your friends. Yet on the whole, things went well
and you were quite happy until 3 years ago. Then the conflicts
became more frequent and more intense, so much so that he
left you twice and talked of divorce, too. This was also the time
when your drinking was at its peak. Have I understood the
situation properly?
Yes, that is it!
BASIC LISTENING SEQUENCE (BLS)
BLS SKILLS USAGE
Open Questions Begin the session
Closed Questions Clarification
Encouragers Evoke Details Throughout
Paraphrase Reflects essence of client talk
Reflection of Feeling Examines Key Emotions
Summary Reviews and Closes
INFLUENCING SKILLS
Ivey, Ivey and Simek – Downing (1986) are convinced that
clients can benefit and grow through the mere use of
attending skills. However, they also admit that the process
may be slow and difficult. To help it along, they also suggest
some influencing skills.
• Interpretation – presenting another frame of reference
from which the client may view the situation and produce
changes in feelings, thoughts or behaviors.
• Directive – presenting a simple suggestion on the action
that may be taken to give the client a starting point.
• Advice – instructing or prescribing homework on how to
think or act to help indecisive or confused clients to do
something concrete and helpful.
• Information – giving an explanation or more information
that can be used as basis for decisions and actions.
EXAMPLE OF INTERPRETING
You said, you had difficulty in getting along with your boss.
Once you mentioned that sometimes you simply broke the rules
for the sake of breaking them. You also said that you are always
late, even when your husband had everything ready for the
children. In the past, you said it was because of the negative
behaviour of your boss. This time you blamed your husband. Is
it possible that your problems at work, like being late, are
related to your alcohol use?
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I always thought I could control it.
• Self-Disclosure – sharing of related past personal
experiences or present reactions to client’s input.
• Feedback – sharing of one’s perception of client to enable
him/her to see himself/herself in another light.
• Logical Consequences – explanation of the logical
outcome of the client’s thinking and behavior to enable
him/her to see their effects on him or her and his/her
progress.
• Influencing Summary – synthesis of what has happened
in the interview, with special focus on what the therapist
has said to ensure generalization from the session to real
life.
CLASSIFICATION
1. Strategies that build rapport and encourage client dialogue
2. Strategies that aid in data gathering
3. Strategies that add depth and enhance the relationship
1. STRATEGIES THAT BUILD RAPPORT AND ENCOURAGE
CLIENT DIALOGUE
• Attending (L.O.V.E.R.)
• Encouraging (smiling, nodding)
• Restating (repeating exact words of client)
Client: I don’t know why I do these dumb things. It’s as if I did
not want a relationship
Counselor: You don’t know why you do dumb things. It maybe
you don’t want a relationship
• Paraphrasing (repeats thoughts and feelings, but uses
own words)
Client: I do not want a relation but each time a get close I seem
to do everything in my power to destroy it.
Counselor: You are very sure that you want a relationship, but
each time you have the opportunity, you sabotage your
chances.
• Reflecting Content (what is the client’s thinking based on
his statements)
Client: When you don’t have a college degree, people look
down on you.
Counselor: A college degree is important so that people will
look up to you.
• Reflecting Feeling (what is the client’s feeling based on
his statements)
Client: If I don’t finish a college degree even if get rich people
will look down on me.
Counselor: You are afraid that people will not accept you in
society if you did not finish a college degree.
• Clarifying – enable a counselor to ask the client to define
or explain words, thoughts, or feelings
• Perception checking – request confirmation or correction
of perceptions he has drawn regarding the words,
thoughts. Or feeling he has expressed
Client: If what you say is true, I’m a real jerk. What chance do I
have to be happy if I run away every time, I get close to
someone else?
Counselor: You say you want to be happy. What does “happy”
mean to you? (clarifying)
Client: I would be happy If I could let someone care for me, get
to know me, want to spend time with me, and allow me just be
me and stop pretending.
Counselor: Let me see If I’m understanding you. Your view of
happiness is having someone who cares enough about you to
spend time with you and to allow you to be yourself. Am I
correct? (Perception checking)
Summarizing
Example
Counselor: We’ve talked about many things today. I’d like to
review some of this and make plans for our next meeting. The
parts that stick out in my mind are your loneliness, boredom,
and desire to have a lasting relationship, your behaviors that
drive you away from building such relationship, and your need
for caring and the freedom to be yourself. Am I missing
anything?
2. STRATEGIES THAT AID IN DATA GATHERING
Includes all of the active listening Strategies plus three
strategies designed to extract specific information and gain
greater depth of information in areas that are significant in the
client’s statements.
• Questioning – use open ended questions
• Probing – specific area of client’s present concern
• Leading – encourage the client to respond to specific topic
area
Clor: I want you to be more specific about this “voice”. Whose
voice, is it? (probing)
Clor: You told me whose voice it is, but you didn’t tell me what
the voice says. Would you talk about this? (leading)
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3. STRATEGIES THAT ADD DEPTH AND ENHANCE THE
RELATIONSHIP
• Used to open up deeper levels of communication and
strengthen the relationship patterns that have been
established
• Counselors who use these strategies usually model types
of behaviors they wish their clients would emulate such as
risk taking, sharing of self, demonstrating trust, honest
interaction
Self-Disclosure
• Counselor shares with the client his feelings, thoughts and
experiences that are relevant to the situation presented by
the client
• Must be carefully used for it has both positive and negative
impact on the helping relationship
Confrontation – enables counselor to:
1. Provide client with direct and honest feedback in which
discrepancies are presented an honest and matter – of –
fact manner.
2. Identify differences between client’s words and behaviors
3. Challenge the client to put words and ideas into action
4. Provide client with insight as to how he is perceived
Responding to Non – Verbal Cues- enables the counselor to:
1. Go beyond client’s words and respond to the messages
that are being communicated by the client’s physical
actions
2. Look for patterns that either confirm or deny the truth of
the client’s words and share these with the client
Client should confirm or deny such perception
EMPATHY
• Empathy requires congruent counselor behavior. The
paralanguage – tone, modulation, pause and nonverbal
signals – eye contact, facial expression, and posture –
should be congruent with the language.
FIVE LEVELS OF EMPATHY
Level 1 - low level (little or no awareness of feeling).
✓ Counselor fails to attend to client’s words or body
language and responds in a way that disrupts client
sharing, discounts the information, or attacks the client.
“Perhaps you would not have failed had you paid attention to
your parents‟ warnings.”
Level 2 - moderately low level (some awareness).
✓ This is more subtle as the counselor overtly tries to be
helpful but fails to respond to the true feeling.
“That’s truly sad. Maybe you should apologize”
Level 3 - reciprocal level of empathic responding (accurate
reflection of client's message reflected at the level in which it
was given - paraphrasing with the appropriate feeling word).
✓ At this level, what the counselor say is interchangeable
with what the client is saying.
“You feel very sad because you failed your subjects.”
Level 4 - moderately high level of empathic responding
(reflecting not only the accurate feeling but the underlying
feeling).
✓ The counselor is accurately empathic as he/she goes
beyond making an accurate paraphrase or reflection of
feeling by adding a mild interpretation that not only
catches the deeper meanings of the client, but facilitates
growth and exploration.
“You feel angry with yourself because you have given your
parents a chance to say, I told you so”.
Level 5 - high level of empathic responding (accurate reflection
of feeling, plus underlying feelings in greater breadth and
depth (also for some interpretation such a deep disappointment
or long-range goals).
✓ This additive level communicates a full understanding of
the deep feelings and concerns of the client and challenges
the client to go beyond what he/she is experiencing.
“You feel angry with yourself because in addition to having
failed, you have given your parents a chance to prove that you
are wrong and they are right. What do you think you can do
about this?”
COUNSELING ROOM IDEAL SET-UP
Confrontational Seating
Seating which is directly opposite is regarded as being
confrontational as eye contact is direct. This can be threatening
to the client. If there is a desk or table between the chairs this
can be an additional barrier to effective communication.
Cooperative Seating
The cooperative seating arrangement is a seating arrangement
with not too much distance between two chairs. It allows both
parties to mutually focus on what is in front of them, usually at
a table.
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Side By Side

Sitting 'side by side' but with some distance between two

chairs is conducive to private study tasks and not counselling.
Both parties are not in direct contact but can be in contact
should they wish.

The Counselling Set Up

The chairs or seating are at a right angle to each other, maybe

a small coffee table just in front.

It feels comfortable, allowing the client to look past the

counsellor without turning their head away. There is no
confrontation or threat with this way of seating.

What makes an inviting counseling room?

• Counseling rooms that have framed prints, rugs to throw

over sofas, cushions, bean bags, art materials, plants are
welcoming.

• Counseling rooms that use natural light are inviting.

• Counselling rooms that use lamps to soften the room

provide a soothing place to be.

• Ensure that you can observe facial expressions, gestures

and other expressions of emotion (especially if you're
counselling at night).

• Allow sufficient space between chairs so that there is no

sense of intrusion on personal space.