CH: IV - SKILLS IN

COUNSELLING
CONTENTS
• ATTENDING BEHAVIOR
• OBSERVATIONAL SKILLS
• SKILLS OF ACTIVE LISTENING
• REFLECTIVE SKILLS
• INTEGRATIVE SKILLS
• INFLUENCING SKILLS
• CAPACITY FORMING SKILLS
• ELICITNG AND REFLECTING SKILLS
• When someone really hears you without passing judgment on you,
without taking responsibility for you, without trying to mould you, it
feels good. When I have been listened to, when I have been heard, I
am able to re-perceive my world in a new way and go on. It is
astonishing how elements that seem insoluble become soluble when
someone listens. How confusions that seem irremediable become
relatively clear flowing streams when one is heard. —Carl Rogers
Attending Behavior
 ATTENDING BEHAVIOR/ SKILLS

• Attending behavior, essential to an empathic relationship, is defined

as supporting your client with individually and culturally appropriate
verbal following, visuals, vocal quality, and body language/facial
expression.
“3 V’s 1 B”

• 1. Visual/eye contact. Look at people when you speak to them.

• 2. Vocal qualities. Communicate warmth and interest with your voice. Think
of how many ways you can say, “I am really interested in what you have to
say,” just by altering your vocal tone and speech rate. Try that now, and
note the importance of changes in behavior.
• 3. Verbal tracking. Track the client’s story. Don’t change the subject; stay
with the client’s topic.
• 4. Body language/facial expression. Be yourself—authenticity is essential to
building trust. To show interest, face clients squarely, lean slightly forward
with an expressive face, and use encouraging gestures. Especially critical,
smile to show warmth and interest in the client.
SOLER

• S – S stands for sitting squarely. So you sit and face the person that you are talking to. We
should sit attentively at an angle to the person, so that we can look at them directly and
show that we are listening to them and paying attention to them.
• O – O stands for having an open posture. Do not cross your arms as this can make us
appear anxious or defensive.
• L – Lean forwards to show we are interested in what the person is talking about. It also
means that the person can lower their voice if they wish to, if they are talking about
personal issues, for example.
• E – E stands for eye contact. Maintaining eye contact again shows that we are interested
and listening to what the person has to say. It doesn't mean stare at the person as this
can make them feel uncomfortable, but maintain good, positive eye contact.
• R – R stands for relaxed body language. This shows the person that you are not in a rush
to get away, but are letting them talk at their own pace.
Listening Skills
Basic Listening Sequence
• The basic listening sequence (BLS) will enable you to elicit
empathically the major thoughts, feelings, and behaviors of the client.
Through the use of questions, encouragers, paraphrases, reflection
of feelings, and summaries, you will draw out and understand the
way clients see their issues.
• Listening lights up the brain; the basic listening sequence facilitates
organization and the potential for a creative new integration.
A. QUESTIONS
• Questions help a session begin and move along smoothly. They assist
in pinpointing and clarifying issues, open up new areas for discussion,
and aid in clients’ self-exploration.
• Exercise: How do you feel when you are questioned? Do you feel
threatened? Do you feel free?
• Questions reduce talk time (of the therapist) – a client who stopped
going to a therapist as the therapist spoke volumes on the harms of
cutting)
• Client’s risky behavior with men – questions only to clarify what she
went through at that time
1. Open questions
• Open questions are those that can’t be answered in a few words.
They tend to facilitate deeper exploration of client issues. They
encourage others to talk and provide you with maximum information.
Typically, open questions begin with what, how, why, or could/
would.
• For example, “Could you tell me what brings you here today?”
2. Closed questions
• Closed questions enable you to obtain specifics and can usually be
answered in very few words. They may provide useful information,
but the burden of guiding the talk remains on the counsellor. Closed
questions often begin with is, are, or do. For example, “Are you living
with your family?”
What are the USES of Questions?

• In Some Situations Questions Are Essential: “What Else?”

• Clients do not always spontaneously provide you with all necessary
information, and sometimes the only way to get at missing data is by asking
questions.
• For example, the client may talk about being depressed and unable to act.
The open question “What is happening in your life right now or with your
family?” might bring out information about an impending separation or
divorce, a lost job, or some other issue underlying the concern.
• Client revealing mother had schizophrenia only when questioned after several
weeks. Only when therapist asked if there has been a diagnosis.
• Client revealing childhood trauma only when questioned. Otherwise
continued to express how low and unemotional she is feeling.
What are the USES of Questions?

• Questions Can Help Begin the Session

• Open question facilitates free discussion and leaves plenty of room to talk.
Here are some examples: “What would you like to talk about/ work on
today?” “Could you tell me what prompted you to see me?” “How have
things been since we last talked together?”
What are the USES of Questions?

• Open Questions Help Clients Elaborate and Enrich Their Story

• To help the session start again and keep it moving, ask an open question on a
topic the client presented earlier in the session. “Could you tell me more
about that?” “How did you feel when that happened?”
• What is your relationship with your parents? (atleast 10 -15 mins talktime)
What are the USES of Questions?

• Questions Can Reveal Concrete Specifics from the Client’s World

• As counsellors, we are most often interested in specific feelings, specific
thoughts, and specific examples of actions. One of the most useful of all open
questions here is “Could you give me a specific example of . . . ?”
• Relationship counselling – “he traumatized me – I cant take it” – could
be physical abuse, could even me something as simple as he doesn’t
take the garbage out.
• Cient’s explanation of rough play – specifics reveal actual violence
B. CLIENT OBSERVATION SKILLS

• Through observation you get to know the client and what is conveyed
by his or her verbal and nonverbal behavior. Clients’ intentions,
needs, meanings, and underlying emotions are often conveyed not
only with words, but also through nonverbals.
How keen is your observation - video
• In counselling, you may be so focused on a single issue you note in
the client that you are missing the underlying meanings.
• Don’t be too quick to identify….you may miss other cues. Example..
College example, girl with puncture marks
1. Nonverbal Behaviour

• As we listen to a client’s story, we need to be constantly aware of how

he or she reacts to what we say— both verbally and nonverbally.
• If a client breaks eye contact and/or shifts hands or body,
“something” is happening. Client who hugged herself and curled her
legs when talking about childhood
• Saying we love someone and shaking our head negatively
• Your ability to observe will help you anticipate and understand what is
happening with your client, but be careful to watch for individual and
cultural differences.
2. Facial Expressions

• When it comes to observing the client, here are some things to

notice: The brow may furrow, lips may tighten or loosen, flushing may
occur, or a client may smile at an inappropriate time. Even more
careful observation will reveal subtle color changes in the face as
blood flow reflects emotional reactions. Breathing may speed up or
stop temporarily. The lips may swell, and pupils may dilate or
contract.
3. Body Language

• Couples who come in – notice their body language

• Often people who are communicating well mirror each other’s body
language.
• Mirror neurons in the brain enable counsellors to become empathic
with their clients. When empathy is at a height, client and counsellor
may unconsciously sit in identical positions and make complex hand
movements together as if in a ballet. This is termed movement
synchrony.
C. ENCOURAGING, PARAPHRASING, AND
SUMMARIZING

• Encouraging, paraphrasing, and summarizing are active listening skills

are key in building the empathic relationship.
• Active listening requires intentional participation, decision making,
and responding to client conversation.
• When a client shares with us a lot of information all at once and talks
rapidly, we can find ourselves confused and even overwhelmed by the
complexity of the story.
• We need to hear this client accurately and often slow the story down
a bit. Our accurate listening, in turn, leads to client understanding and
synthesis, providing clients with a clearer picture of their own stories.
• Encouraging, paraphrasing, and summarizing are basic to empathic
understanding and enable you to communicate to clients that they
have been heard.
• When using empathic listening skills, be sure not to mix in your own
ideas with what the client has been saying. You say back to clients
what you have heard, using their key words
Encouragers
• Encouragers include minimal verbal utterances (“ummm” and “uh-
huh”), head nods, open-handed gestures, and positive facial
expressions that encourage the client to keep talking.
• Silence, accompanied by appropriate nonverbal communication, can
be another type of encourager.
Paraphrasing
• Paraphrasing covers more of what the client has just said, usually
several sentences. Paraphrasing continues to feed back key words and
phrases, but catches and distills the cognitive essence of what the
client has said.
• Paraphrasing clarifies a confusing client story.
• Client who was so hurt in his relationship spoke so much, with no
pause – sometimes no chance of paraphrasing as that would mean
interrupting the flow
• 1. Let the client know that you are listening and understand what they
are saying
• 2. clarify confusing content
• 3. highlight issues by stating them more concisely
• 4. check out the accuracy of your perceptions as the counselor.
• Client: "I don't know about her. One moment she's really friendly, and
the next time 1 see her she's totally cold.“
• Counselor: "You haven't experienced her as being very consistent."
• Client: "Every moment there is something new to do. There must be ten
different things going on at the same time!"
• Counselor: "There are a lot of activities for you to chose from."
• Client: "He's really crummy. His degree is from a non-accredited school.
He's had very little training, and he has a: poor relationship with his
wife."
• Counselor: "You don't think he's very competent."
Summarizing

• Summarizing encompasses a longer period of conversation than

paraphrasing; at times it may cover an entire interview or even issues
discussed by the client over several interviews
Summarizations are frequently used when:
• 1. You wish to structure the beginning of a session by recalling the
high points of a previous session.
• 2. The client's presentation of a topic has been either confusing or
just plain lengthy and rambling.
• 3. A client seems to have expressed everything of importance to her
or him on a particular topic, and summarizing provides closure so you
can move on.
• (parents – friend – client’s feelings)
• 4. Plans for taking the next step in counseling require mutual
assessment and agreement on what has been learned so far.
• Client: "I really feel guilty about marrying her in the first place. It wasn't really for love.
It was just the convenient thing to do. I feel like I've messed up her life, and now I feel
obligated to her. Starting a family and having children has always been important to
me and at my age I feel like I should get started soon. I don't want to be in my
seventies before my children graduate from high school. Everything in my life feels so
unsettled right now. I just started this new job and it won't start paying good until I get
a promotion. In order to get a promotion I know that I'll have to work overtime and
travel frequently. I just don't think that I can handle all of these responsibilities at the
same time.
• Counselor: "There are a number of areas in your life which make you feel
overwhelmed with responsibility. So far you've indicated that your dissatisfaction with
your marriage, the pressure you feel to start a family, and your new job each
contribute to the stress you feel. Each area is related to the others by the degree of
responsibility you feel and your ability to cope with those responsibilities."
D. REFLECTION OF FEELINGS

• Reflection of feelings involves observing emotions, naming them, and

repeating them back to the client.
• It involves constant awareness and observation of emotions and
feelings as clients show them explicitly through words in their
conversation and nonverbally through their patterns of eye contact,
facial expression, and body language.
The Skill Dimensions of Reflection of Feeling

• Sentence stem. Choose a sentence stem such as “I hear you are

feeling . . .,” “Sounds like you feel . . .,” “I sense you are feeling . . .”
• Feeling label. Add an emotional word or feeling label to the stem.
Example: “Angelica, you seem to feel sad about . . .,” “Looks like
you’re happy,”
• Context or brief paraphrase. You may add a brief paraphrase to
broaden the reflection of feelings. For example: “Angelica, you seem
to feel angry about all the things that have happened in the past two
weeks”.
• Tense and immediacy. Reflections in the present tense (“Right now,
you look very angry”) tend to be more useful than those in the past
(“You felt angry when . . .”).
• Checkout. Check to see whether your reflection of feelings is
accurate. This is especially helpful if the feeling is unspoken (“You
really feel angry and frustrated today—am I hearing you correctly?”).
• Bring out positive emotional stories and strengths to counter the
negatives and difficulties. If you only focus on fearful, angry, sad
emotions, you may find yourself reinforcing negative cognitions as
well as negative emotions.
Influencing Skills
Focusing
H. Focusing
• Beginning counsellors often focus
on problems instead of the
people in front of them.
• Naming the client is important,
as client feels important.
• Client centred therapy/
psychoanalytic psychotherapy is
always about the client.
• However, it is invaluable to
broaden the focus of the session.
Different focuses
Client focus
• “Suzanne you feel confused and
lonely, you are unsure of what
you want to do”
• Maybe culturally inappropriate
to focus on the individual alone
• Tends to ignore gender/ family
issues
Other focus
• “Tell me more about your
husband”
• This will tell us about the
situation, but not much about
the reaction of Suzanne to the
situation.
• But this focus may relax the
client in the early stages
Different focuses
Family focus
• Family history and family
interactions are very important.
• “Does Joss bullying someone in
the playground reflect on
something happening at home”
Problem focus
• In times of crisis, its more
important to focus on solving
the problem.
• Getting the husband into AA.
• If the wife is being abused, then
getting her into a shelter.
Different Focuses
Interviewer focus
• Self disclosure may help the
client feel greater rapport with
the counsellor.
• “ I also grew up in an alcoholic
family, I know how you must be
feeling”
• Do not overdo this. The
counselling is for the client and
not the counsellor.
“We” focus
• “Right now we seem to be
getting somewhere; lets work
something out to help you reach
your goal”
• More egalitarian relationship.
• Useful when the client is more
or less your age
Cultural/ environmental/ contextual focus
• “This is a concern facing many women, society doesn’t make things
easy”
• Makes you feel your are not alone.
Case discussion using influencing skills and
confrontation
• Interpretation/ reframing
• Directive
• Advice/ information
• Self-disclosure
• Feedback
• Logical consequences
• Influencing summary