Basic Counselling Skills

The most important thing in communication is to hear what isn't being said.

Peter Drucker

To help participants understand the concept and importance of counselling

To help participants understand the process of counselling

To impart the skills of counselling To help participants to be more aware of

using counselling techniques appropriately and effectively

Purpose of Presentation

Listening is not passive. It is important to indicate that the person is being heard

Good counselling skills means listening before acting to solve problems

Basics of Counselling

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

Basics of Counselling

Using good verbal listening skills, you increase the chances that: You will understand what the other is saying

and they will understand you You will create a situation where you will be

able to develop a helping relationship

Listening Skills

Looking Like You're Listening is Not Enough

Ask open and closed questions Use “encouragers” Paraphrase what you have heard Reflect on feeling Summarize

Listening skills

Open questions Generally start with “what”, “how”, “why” or

“could “ Questions serve to:

Gather lots of general information Encourage discussion

Open Questions

Counsellor: “How has the baby been eating?”

Counsellor: “What is the bedtime routine?” Counsellor: “Could you tell me about giving

the baby medicine in the morning?”

Example: Open Questions

Generally start with “is”, “are”, or “do” Serve to:

Gather lots of specific information quickly Tend to close down discussion

Closed Questions

Counsellor: “Are you giving the medicine every day?”

Counsellor: “Is the baby able to tolerate the medicine in the morning?”

Example: Closed Questions

Ex: “Yes, I understand” or repeat a word or two of what was said

Serves to: Encourage further discussion

Encouragers

Patient: “I missed my appointment last week because of transportation problems.”

Counsellor: “Transportation problems…?”

Example: Encouragers

Understanding whether: Is the person is asking for information OR is the person is expressing concern?

Ex: Patient: “My baby vomited the medicine this morning”

Counsellor: “Are you worried the baby is sick?”

Differentiating

Briefly summarize the content of the discussion

Reflective listening Check your understanding Show that you heard what was said

Acknowledge and accept feelings without judging

Paraphrasing

Patient: “I am worried that the medicine is making my baby sick”

Counsellor: “It sounds like you are worried about how the baby is reacting to the medicine.”

Example:Paraphrasing

Focus on feelings (stated and unstated) Serves to:

Communicate understanding of emotions

When combined with a paraphrase, confirms the accuracy of understanding (“Check out” the the other person)

Encourages discussion of feelings

Reflection of Feelings

Patient: I don’t see many changes in the baby since I started the medicine”

Counsellor: It sounds like you are worried that the medicine is not helping the baby get better”

Example: Reflection of Feelings

Succinctly pull together ideas from a an interview

Serves toOrganize the structure of the interview

Check the accuracy of understanding,

Summarizations

Counsellor: “During the time we have had together we have talked about issues with giving the baby medicine, problems with transportation, and your worries about the baby reacting to the medicine and getting better. Is that right?”

Example: Summarizations

Increase awareness of nonverbal communications (yours & theirs)

Notice body language – a person’s stance, posture, physical tension

Acknowledge what you observe – be open and candid

Attend to Nonverbal Communication

Counsellor: “You appear a little uncomfortable. Is there something I can do about that?”

Discussion point: What other examples of non-verbal communication can you identify

Example: Nonverbal Communication

Remember culture and contextMost nonverbal behaviors have multiple meanings

Some nonverbal behaviors have different meanings in different cultures

Non Verbal Communication

Maintains eye contact Makes few distracting movements Leans forward, faces speaker Has an open posture Allows few interruptions Signals interest with encouragers and facial expressions

What are other examples of good listening?

A Good Listener

Makes little eye contact Makes distracting movements Faces away from speaker Has a closed posture (ex.: arms crossed) Interrupts speaker Does too many other things while listening Has a flat affect, speaks in a monotone,

gives few signals of interest What are other examples of a bad listener?

Bad listening

Get into a group of three people One person begins by talking about a

troublesome situation. Be brief but allow your partner opportunities to practice listening skills.

Listening partner: Provide at least three different types of listening responses as your partner talks

Third person is the Observer: Use checklist to identify different listening skills

Switch roles so that each person has a chance to fill each role

Listening Practice Scenarios

Remember the goals of listening skills Help the speaker feel understood Keep the speaker talking

Think carefully about the thoughts and feelings the individual stated or implied

Try to imagine yourself in their place in order to understand their message

Make a brief verbal statement communicating what you heard No questions No opinions

Check to see if you are correct

Listening Practice Scenarios

Influencing or Changing Behavior

Directives Reframes and interpretations Advice Feedback Logical consequences

Influencing or Changing Behavior

Tells a person what to do (can be direct or indirect)

Works best if clear and concrete Serves to:

Move a person to take a specific act

Directive

Patient: “I am not sure when to take my medicine”

Counsellor: “You should take your medicine once in the morning and once in the evening”

Example: Directive

Attempts to replace an old, maladaptive response with a newer, more useful (usually positive) one

Serves to Increase insight and understanding Shift emotional or intellectual response

Reframing and Interpretations

Patient: “There is so much going on I don’t think I can take my medicine”

Counsellor: “Sometimes you feel overwhelmed and you are not sure that you can get everything done so you can take your medicine”

Example: Reframing and Interpretations

Provides information to help client make a decision. Can be very directive or less so

Serves to: Share information that would be relevant for a

person’s decisions, actions, or understanding Disadvantages of advice

It’s often disempowering (You can’t solve this on your own)

People may say (but not really mean) that they want advice

Advice

Counsellor: “Try stirring the medicine in milk and then giving it to the baby”

Counsellor: “Let me show you how to swallow the pill”

Counsellor: “Marking a calendar is a good idea for keeping track of giving medicine, and it will help you feel good about giving every dose”

Example: Advice

Gives information about how the person is experienced by others

Serves to: Help client see self more objectively (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

Feedback

Patient: “Last week I gave almost all of the doses of the medicine”

Counsellor: “You have really worked hard to make improvements in giving the medicine. Let’s think about how we can help you so that you can give all of the doses of medicine”

Example: Feedback

Focuses on the logical consequences of a person’s behavior, actions, thoughts, or feelings

Serves to: Increase awareness of consequences

Logical Consequences

Patient: “It is really hard to start the medicine, and the side effects are really hard for the baby”

Counsellor: “If you can make it thorough the first few weeks of taking the medicine than the side effects will get better and the baby will start to improve”

Example: Logical Consequences

The goal of counselling is to help a person tell their story

With effective listening skills you can assist a person in communicating their thoughts and feelings

When you understand where a person is starting from, it is easier to help them reach their goal

Counselling