Unit on empathy and listening skills

Slide 1: What are Rogers’ necessary & sufficient conditions of therapy?

• Communication of accurate empathy
• Genuineness
• Unconditional positive regard

Slide 2: How do these affect therapy?

• Experience being prized
• Drop defensive facades
• Accept self
• Develop unconditional + SELF-regard
• Experience self as an individual with self-actualizing potential

Slide 3: Focus on empathy

• How is empathy different from sympathy?
• How is empathy different from caretaking?

How is it different than simply agreeing with a client?

Slide 4: What does empathy involve?

• Understanding, an ability to walk in client’s shoes
• How can you build this?
• Acceptance -- even of the unacceptable
• Hopefulness about client and client’s future
• Communication of this experience

But your words and their feelings should be similar in tone...

Slide 5: Which therapists are seen as most empathic?

• Experienced therapists > novice therapists
• Behavior therapists > other therapists

Slide 6: What is bad listening?

• Little eye contact
• Distracting movements
• Faced away from speaker
• Closed posture
• Interrupts speaker
• Little development of ideas
• Flat affect, monotone, few signals of interest

Slide 7: Good listening

• Maintains eye contact
• Few distracting movements
• Forward lean, faced toward speaker
• Open posture
• Few interruptions
• Develops ideas
• Signals interest with encouragers and facial expressions

Is looking like you're listening enough?

Slide 8: But -- remember culture and context

• Most nonverbal behaviors have multiple meanings
• Some nonverbal behaviors have different meanings in different cultures

Slide 9: Verbal listening skills

• Show interest
• Gather information
• Encourage speaker to develop ideas
• Communicate our understanding of ideas
• Request clarification of understanding
• Build the therapeutic alliance

Slide 10: Listening skills

• Open and closed questions
• Encouragers
• Paraphrases
• Check outs
• Reflections of feeling
• Summarizations

Slide 11: Open questions

• Generally start with what, how, why or could
• Avoid why questions
• Serve to:
• Gather lots of general information
• Encourage discussion
• What else is happening in your life?

Slide 12: Closed questions

• Generally start with is, are, or do
• Generally begin with is, are, or do
• Serve to:
• Gather lots of specific information quickly
• Tend to close down discussion
• Are you planning on graduate school next semester?

Slide 14: Encouragers

• Often uh huh or repeats a single word or two of speaker
• Serve to:
• Encourage discussion of specific ideas repeated
• Graduate school?

• Relatively briefly summarize the content of a discussion
• Serve to:
• Communicates understanding
• When combined with a check-out, they confirm the accuracy of this understanding
• Sounds like you’ve had a difficult time choosing a direction, but you’re feeling on track now.  Is that right?


Sometimes we must read between the lines...

Slide 16: Reflections of feeling

• Focus on feelings (stated and unstated)
• Serve to:
• Communicate understanding of emotions
• When combined with a check-out, they confirm the accuracy of this understanding
• Encourage discussion of feelings
• Stem + feeling + (context) + check out
• Sounds like you’ve been feeling helpless and alone since he left.  Does that feel right?

Slide 17: Summarizations

• Succinctly pull together ideas from a longer segment of an interview
• Over the last hour we’ve been exploring the ways that your thoughts leave you depressed and powerless, but we’ve also identified ways to challenge this pattern.
• Serves to:
• Organize the structure of the interview
• Check accuracy of understanding, when combined with a check out

Slide 18: Influencing skills

• Each of these are relatively high on the interpersonal influence dimension
• Directives
• Reframes and interpretations
• Self-disclosures
• Advice
• Feedback
• Logical consequences

Slide 20: Directives

• Tells a person what to do, can be direct or more indirect.  Work best when clear and concrete.
• Close your eyes and find a place where you feel comfortable.  Breathe in & out.  Or, I want you to monitor your thoughts and feelings this week...
• Serves to:
• Move client to take a specific action

Slide 21: Reframes and interpretations

• Attempts to replace an old, maladaptive story with a newer, more useful (generally positive) one.
• I’m wondering if your lateness to our session reflects your ambivalence about therapy.
• Serves to:
• Increase insight and understanding
• Shift affective or intellectual view

Slide 22: Self-disclosures

• Shares part of the therapist’s experiences, thoughts, feelings
• Applying to graduate school was very difficult for me too.  It was both the best and worst of times.

Slide 23: Advantages of Self-disclosures

• Increase client’s understanding of the therapist and create the “safety” to work in therapy
• Decrease feelings of isolation
• Normalize a person’s experience
• Suggest possible solutions to a problem

Slide 24: Disadvantages of self-disclosures

• Can divert therapy from the client to therapist
• Can suggest that there are “right” and “wrong” solutions
• Can be disempowering because it implies that the therapist knows better
• May be unnecessary for the client and the course of therapy

Slide 25: Advice & information

• Provides information to help client make a decision.  Can be very directive or less so.
• If I were you… Or, Many women have difficulty trusting others after a rape.
• Serves to:
• Share information that would be relevant for a person’s decisions, actions, or understanding of a situation

Slide 26: Disadvantages of advice

• It’s often disempowering: You couldn’t solve this on your own...
• People say they want it, but often don’t.

Slide 27: Feedback

• Gives client information about how the therapist sees or feels about a client
• When you come late to a session, I feel like you aren’t committed to what we’re doing here.
• Serves to:
• Help client see self more objectively (i.e., as others see him or her)
• Feedback works best when:
• It is requested or desired
• It is concrete
• It is positive
• If negative, it addresses something changeable or controllable

Slide 28: Logical Consequences

• Focuses on the logical consequences of a person’s behavior, actions, thoughts, or feelings
• If you use dichotomous language (always, never), you are more likely to feel angry and hopeless in this situation.
• Serves to:
• Increase awareness of consequences

Slide 29: Possible leads

• Open question
• Closed question
• Encourager
• Paraphrase
• Reflection of feeling
• Summarization
• Directives
• Reframes and interpretations
• Self-disclosures
• Advice
• Feedback
• Logical consequences

Page by jms
URL= http://psy1.clarion.edu/jms/CPTlisteningpp.html

Last modified September 10, 2001.