Active Listening Skills

DEFINITION : “Listening is the attending, receiving, interpreting, and responding to messages presented aurally” (Prout & Watkins, 2014, p. 132).

In the counseling field, listening requires much more than simple comprehension of the verbal messages receive from our clients.  As therapists, we must capture the meaning of the messages communicated the client, utilize this to develop an understanding of our clients and form a plan for therapy.  In other words, our ability to listen requires the skills of effective communication, empathetic understanding & attending skills (Drab, n.d.)   One interesting comment from my textbook, includes the need to act as an “authentic chameleon” (Prout & Watkins, 2014, p. 133), by adjusting our interactive style to the needs of the client.  Also of interest is a review of three key types of listening in everyday life discussed in research:

  1. MARGINAL LISTENING:  “individuals are hearing but not paying attention to the other person.  The listener may be distracted or involved in formulating the next response, and this inattention is likely to lead to a less than ideal interaction.”  (Prout & Watkins, 2014, p. 133)
  2. EVALUATIVE LISTENING: “involves concentrating intently on what is being said, but this type of listener focuses only on the literal meaning of the words and does not acknowledge subtle verbal cues or nonverbal communication.”  (Prout & Watkins, 2014, p. 133)
  3. ACTIVE LISTENING: “entails receiving verbal and nonverbal messages from others, processing them and responding in a way that encourages further discussion.”  (Prout & Watkins, 2014, p. 133)

Therapeutic Listening: Skills Required…

The above-listed types of listening (marginal / evaluative / active) come from research on forms of listening in everyday relationships.  What are some unique considerations for listening as a counselor? Prout & Watkins (2014), note that “people who are new to counseling are frequently preoccupied with learning what to do to help clients, instead of focusing on how to be – the facilitative condition for being able to enact those specific counseling strategies.” (p. 138). What follows are random insights from my textbooks that provide “food for thought” as I consider “how am I being” while I see my clients???

Empathy, Genuineness & Unconditional Positive Regard…

“Genuineness, unconditional positive regard and empathy are the key components of Rogers’s…facilitative conditions of therapy…[they] create an environment that allows clients to grow and change” (Prout & Watkins, 2014, p. 134).  These qualities are essential to truly understand the meaning in what the client express and appreciate their lived experiences more fully (Prout & Watkins, 2014).  This is easier said than done when in the midst of a counseling session.  Thus far, I’ve noticed that counseling practice, requires us to think on our feet as we follow our gut, education, and lived experience while “making things up as we go along”.  People are complicated and there are no exact recipes for success.

For example, there are times, when I’ve entered a counseling relationship and find struggling with a nagging uncertainty as I realize that there I don’t have many common experiences to draw upon.  In this case, personal education and supervisory consultation are critical.   There are other situations in which I find myself relating to the client’s situation very well.  At such times, I become concerned that my understanding of their situation reflects more my own past experience, than their current reality.  In this case, I’m aware of the potential risk of transference issues. So what is the solution here?  Empathy, is a two-fold process that involves accuracy of perception and effectiveness of communication.  Therefore, “active empathetic listening” (Prout & Watkins, 2014, p. 134) involves a conscious effortful attending by the counselor that communicated effectively to the client.  

My course textbook breaks down the process of active empathetic listening into three stages:

  1. FIRSTLY, we must be able to pick up on all the verbal and nonverbal communication.
  2. SECONDLY, we must be able to understand the meaning & content of what is expressed.
  3. FINALLY, We must process this information, my textbook describes two types of processing that occur while we listen “top-down” & “bottom-up”  Since, I didn’t like the definitions provided in my textbook, I found this video to help clarify things:

Affect Tolerance & Mindfulness….

Listening within counseling is unique since the therapeutic relationship is inherently imbalanced.  What makes the relationship between therapist and client so unique is its one-sided nature.  In fact, the ACA (2014) code of ethics prohibits dual relationships where a counselor provides services to a friends, family members or significant others.  What follows is a description of the counseling relationship from the ACA Code of Ethics Manual

“Counselors facilitate client growth and development in ways that foster the interest and welfare of clients and promote formation of healthy relationships. Trust is the cornerstone of the counseling relationship, and counselors have the responsibility to respect and safeguard the client’s right to privacy and con dentiality. Counselors actively attempt to understand the diverse cultural backgrounds of the clients they serve. Counselors also explore their own cultural identities and how these affect their values and beliefs about the counseling process” (American Counseling Association, 2014, p. 4).

In other words, while healthy relationships are two-sided in nature, the therapeutic relationship is one sided: focused specifically on “client growth and development” (American Counseling Association, 2014, p. 4).  In order to facilitate the development of a relationship like this good attentive listening skills are required.  “Counselors must be able to hear, and perhaps tolerate vicariously experiencing distressing emotions that may occur during counseling” (Prout & Watkins, 2014, p. 138). My course textbook provides two suggestions:

  1. AFFECT TOLERANCE:  Counselors must “Develop affect tolerance to respond empathetically to client’s experiences of distress without overly identifying with it or avoiding it.  Affect tolerance has been described as being willing and open to experiencing feelings” (Prout & Watkins, 2014, p. 136).
  2. MINDFULNESS:  “suggested as a practice that can help counselors train their minds to attend fully to their clients…defined as…paying attention in particular way: on purpose, in the present moment and nonjudgmental” (Prout & Watkins, 2014, p. 136).

Observational Skills…

“In working with [clients[, if you miss those nuances…if you don’t notice when their emotions, gestures, or tone of voice doesn’t fit what they are saying, if you don’t catch the fleeting sadness or anger that lingers on their face for only a few milliseconds as they mention someone or something…you will lose your [clients]” (Ivey, et al, 2010, p. 123).

Observational skills are a critical tool in determining how the client interprets the world.”  (Ivey, et al, 2010, p. 141).  In discussing observational skills, there are two points I’d like to touch on:

#1: What are we supposed to observe?

    1. CONFLICT:  Much of the time spent in therapy centers around working through the conflict, stressful situations, ambivalence, and incongruence (Ivey, et al, 2010).  Are there discrepancies between a client’s actions and words?  Does the client hesitate or resist talking about certain subjects?  Are there discrepancies between the client’s inner world and external situation:?  What conflicts exist in the client’s relationships?
    2. NONVERBAL BEHAVIOR:  What sort of nonverbal communication does the client display?  What do you notice about their facial expressions and eye contact?  How about the client’s body language and mannerisms?
    3. VERBAL BEHAVIOR:  “Noting patterns of verbal tracking for both you and the client is particularly important.  At what point does the topic change and who initiates the change?  Where is the client on the abstraction ladder?…Is the client making I or other statements?” (Ivey, et al, 2010, p. 141).

#2:  How can we improve our observational skills?

  1. TIP ONE – AWARENESS:  “Looking at your way of being an be equally important as, or more important than observing your client.  Start by taking brief inventory of your own nonverbal style” (Ivey, et al, 2010, 134).
  2. TIP TWO – MULTICULTURAL SENSITIVITY: “Note individual and cultural differences in verbal and nonverbal behavior…Use caution in your interpretation of nonverbal behavior (Ivey, et al, 2010, p. 141).

Reflective Listening

Once the skills of paying attention, empathy, and observation are in place, it is possible to begin developing advanced listening skills defined in my course textbook as reflective interviewing (Prout & Watkins, 2014)

types of reflective statements:

  1. SIMPLE REFLECTIONS: “made by repeating or rephrasing the client’s statements” (Prout & Wadkins, 2014, p. 139).
  2. COMPLEX REFLECTIONS: “When making a complex reflection, a mental health professional is making an interpretation of ta client’s statement by substituting a word or making a guess at unspoken meaning.” (Prout & Wadkins, 2014, p. 139).

Tips for reflective listening…

Mirroring the client’s affect is a useful way of showing empath.   Using the client’s vocabulary is Often more useful than the uh-huh’s and academic language I use frequently.   At times, directing the subject matter to ensure the client stays on topic can allow for a more in-depth discussion of matters.  Finally, listening requires us to uncover the underlying themes and/or bigger picture as we utilize these insights to determine our best course of action..

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References

American Counseling Association (2014). ACA Code of Ethics. Alexandria, VA: Author.
Drab, K. (n.d.) The top ten counseling skills. Retrieved from: http://www.people.vcu.edu/~krhall/resources/cnslskills.pdf
Ivey, A.E; Bradford Ivey, M; & Zalaquett, C.P. (2010). Intentional Interviewing and Counseling.  Belmont, CA:  Brooks/Cole.
Prout, T.A. & Wadkins, M.J. (2014).  Essential interviewing and counseling skills.  New York, NY: Springer Publishing Company.

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Basic Attending Skills

I realize it might seem ridiculous to devote a blog post to “paying attention” as counseling skill….

After all, shouldn’t it be obvious?  Can you imagine a therapist falling asleep or becoming distracted during a session, nothing would be more painful, angering, or infuriating.  Keep in mind, one of the many purposes of this blog is to create a resource of information that can aid in my ongoing professional growth.

Learning to become mindful in my interactions with clients has been crucial for me thus far.  During weekly sessions with my supervisor, I’ve become aware of two things:

#1.  I use more counseling skills than I am aware of.

#2.  There is definitely room for growth.

What is Attending Behavior?

For this blog post, I dug up my very first course textbook for this graduate program.  It reviews essential counseling skills and describes attending behavior as an essential component in conversation:

“Attention & Consciousness are the foundations on which create an understanding of the world.  Together they form the ground upon which we build a sense of who we are.  [Attention and consciousness enable us to] define ourselves in relation to the myriad off physical and social worlds we inhabit.  They are also the basic foundations that give rise to ‘the mind'”. (Ivey, et al, 2010, p. 62)

Kranz & Sanders (2006) add that in the counseling field…”all that we do is determined by our attentiveness” (p. 107).  “Well-developed skills assist…in two ways. First, they help…demonstrate that [we] care and are involved.  Second, they enable counselors to observe unspoken messages and respond more appropriately to immediate client needs.” (Ivey, et al, 2010, p. 62).  Effective communication achieves the following goals: “communicates interests; sets a climate of respect, motivates self-expression in others; assists concentration; establishes a base for constructive exchanges; prepares on to access information accurately”  (Kranz & Sanders, 2006, p. 107).

The Basics of Paying Attention.

What follows below, is information from an array of resources that describe the essential skills involved in basic  attentive behavior.  (Again, I realize it may seem obvious, however starting with the basics at this point is the most effective cure to my feelings of incompetence).  

Key Aspects of Attentive Behavior – (Kranz & Sanders, 2006).  

Basic attentive behavior involves both verbal and nonverbal communication.  It stays on topic, focus on the client, while maintaining eye contact, and an attentive posture, with silences when appropriate. (www.uccs.umn.edu, n.d.).  Kranz & Sanders, (2006) discuss three elements of attending behavior:

  1. Contextual Attending:  involves preparing the setting in which the interaction is supposed to occur and preparing in advance with arrangements necessary for positive interaction, (Kranz & Sanders, 2006).  To the issue of contextual attending, I would like to add that this should include any necessary preparatory work prior to first meeting.  This can include, understanding the client’s reason for seeking therapy, and any relevant background information.  The sociocultural background and specific concerns determine how one can best prepare in advance.
  2. Postural Attending: (Kranz & Sanders, 2006) define postural attending as an awareness of how you communicate an interest in the client.    Do you have any distracting behaviors?  What about your eyes contact and nonverbal messages?
  3. Psychological Attending:  “psychological attending occurs when a sense of ‘one-ness’ is experienced between those involved….[it] can be observed by noting the congruity of ‘presence’ between counselor and client.” (Kranz & Sanders, 2006, p. 123).

“The 3 V’s + B of Listening” (Ivey, et al 2010).

“The first interviewing skill of the microskills hierarchy is attending behavior which consists of four dimensions and is critical to all other helping skills” (Ivey, et al, 2010, p. 65) and includes the following:

  1. Eye contact (visual)
  2. Speech (Vocal quality)
  3. Listening (Verbal tracking)
  4. Body Language….

Nonattention & Silence

Two final comments regarding the issue of attending behavior are worth noting.  Firstly, there are times when it is useful or appropriate to not attend to specific things a client says.  For example, a client recently discussed that she didn’t feel she was progressing very far in recovery.  However, it was clear that she was being hard on herself, and simply not aware of the how far she had come.  In such an instance, Ivey, et al, (2010) note that, “non attending may be useful.  Through failure to maintain eye contact, subtle shifts in body posture, vocal tone and deliberate jumps to more positive topics” it can be possible to switch the interview to another lien of discussion.    My course textbook concludes by noting briefly the utility of silence and its relevance in the coursing process.  “Counseling and interviewing are talking professions. But sometimes the most useful thing you can do as a helper is to support your client silently.” (Ivey, et al, 2010, p. 76).

ADDENDUM:  Improving my capacity to pay attention

In another textbook I found the following comment: “Counselors must be able to hear, and perhaps tolerate vicariously experiencing distressing emotions that may occur during counseling.” (Prout & Wadkins, 2014, p. 136).  There are skills all counselors must develop:

  1. AFFECT TOLERANCE: “to respond empathetically to client’s experience of distress without overly identifying with it or avoiding it” (Prout & Watkins, 2014, p 136).
  2. MINDFULNESS: “paying attention in a particular way: on purpose, in the present moment, and nonjudgmental.” (Prout & Watkins, p. 136).
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References

Kranz & Sanders, V. (2006).  A compendium of roadworthy skills for counselors. Australia: Quest Partners.
Ivey, A.E; Bradford Ivey, M; & Zalaquett, C.P. (2010). Intentional Interviewing and Counseling.  Belmont, CA:  Brooks/Cole.
Prout, T.A. & Wadkins, M.J. (2014).  Essential interviewing and counseling skills.  New York, NY: Springer Publishing Company.
www.uccs.umn.edu (n.d.) Basic counseling skills. Retrieved from: http://www.uccs.umn.edu/Training/docs/Basic%20Counseling%20Skills.pdf

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