Objectives

At the end of this topic, you will be able to:

• discuss some therapeutic aspects of reflection of content and reflection of feeling and meaning
• discuss some disruptions to the responding process
• synthesise knowledge and skills to effectively respond to client feelings
• reframe clients statements into more positive orientations
• recognise the difference between helpful action-oriented therapeutic responses and disempowering directiveness
• apply this knowledge to demonstrate beginning skills in responding.

Introduction

We have now learned how to attend, observe with all our senses and really listen to our clients and how to ask respectful and appropriate questions. We have taken the opportunity to practise these skills and through this process will have already used responding skills with our clients. This topic will now extend our understanding of the microskill of responding – indeed without a supportive response to the thoughts, feelings and behaviours which our clients share with us, the therapeutic alliance may not make sufficient progress towards our client’s goals and hopes for the future. Suitable responses are integral components of the counselling process. No doubt you will already be aware that you have naturally used some clarifying and supportive responses in your practice sessions – let us now refine this practice with the assistance of more knowledge!

Observing and listening

Generally, ‘observation’ refers to client non-verbal behaviour whereas ‘listening’ refers to what is actually said and how it is said. The two overlap and are interrelated. Whilst listening to the words, the non-verbal messages are vitally important to observe. It should also be noted that the skills of listening and observing, whilst mainly focused on the client, also apply to the counsellor. What this means is that whilst listening to the client, it is equally important to check your own responses to their story. It may help you clarify what is happening, and at the same time, whilst listening you are also giving ‘messages’ to the client. If that sounds confusing, remember, that listening involves many levels of activity.

Egan (2004: 80–89) points out four different levels of listening, which include:

• listening to the words, the story
• listening to the non-verbal and body language
• listening for meaning
• listening to your own reactions to the stories.

We probably pay attention to the first three levels automatically, when we really listen to someone. As a counsellor you need to do that with awareness, so you can pick up discrepancies, new perspectives or even solutions the client is volunteering.

Listening to verbal messages

The first level relates to the actual words, the stories our clients tell us. First of all let us look at the difference between active and passive listening skills.

Passive listening

This does not serve a positive function, but it is important to be aware of the possibility that we all slip into this mode at various times – we are not perfect! … when we are not fully in tune with the person.

This occurs when we are not on the same wavelength as the person with whom we are interacting – for example, we may be waiting our turn to talk, or busy thinking about what we are going to say and lose track of what the other person is talking about. It also occurs as a process of ‘selective deafness’. I’m sure we all know people who are good at this, particularly when there is a difficult or unpleasant topic needing to be covered. Adolescents seem to have fined-tuned this particular skill! The other way we can be passive in our listening is in fact to do too much talking ourselves! Remember, it is the client who has come to do the talking, not you!

We look at some of these issues again when we go on to talk about good and bad listening habits.

Active listening

Focusing on the story

Active listening is taking in what is said and responding appropriately and meaningfully to what the client is saying. When actively listening, the counsellor is directing attention to what is said, how it is said and what the client may mean when using those words. In responding, the counsellor puts his/her understanding of what is said into his/her own words and feeds that back to the client for verification. The main purpose is to communicate to the client that you are following their story with interest. However, I would like to add that playing back a story line often increases the client’s awareness of their situation. This in itself is often a relief … ‘Oh, that is how it really is’ or … ‘I have never given it much thought …’

Active listening responses and skills

What are some of the skills involved in active listening? Bearing in mind that this is a process of responding to the client, of observing and interacting in a constructive way, let us look at a few important points:

1. Body language: Observe the body language of the client, but also be aware of one’s own. The counsellor should maintain a relaxed, open and friendly posture.
2. Make non-verbal acknowledgments such as nodding your head, smiling and making eye contact.
3. Use minimal encouragers such as ‘mmm’ and ‘yes’.
4. Do not jump to premature conclusions about what the client is saying. Allow and ask the client to clarify and explain more fully by saying such things as: Are you telling me? Did I hear you saying that? Can you tell me more about that?
5. Demonstrate to the client that you want to understand. Do not look bored or slip into non-attending behaviours.
6. Be non-judgmental and accept what the client is saying. This does not necessarily mean agreeing with the client, but it does allow the free flow of communication by not creating ‘blocks’. This respects the client’s need not to be judged but to be understood and to receive help.

Minimal encouragers

As we are aware, we attend to our clients with all of our senses. The use of minimal verbal responses when responding to our clients when they are telling their story is an important tool to allow the session to progress. These verbal responses are known as ‘minimal encouragers’ and include such utterances as ‘yes’, ‘mmm’, ‘uh-huh’. Minimal encouragers are also included in non-verbal communication and include nods of the head, facial expression, use of body position and appropriate eye contact. Skilful application of minimal encouragers is a basic counselling microskill which helps our clients story to unfold in a safe, supportive environment.

Parroting

When reflecting content (paraphrasing) counsellors do not just repeat the exact words the client has said – this is called ‘parroting’ – and any good parrot can do it. We need to develop skills in repeating what the client has told us in our own words. This demonstrates to the client that we are interested in what they have to say, ‘there’ with them in the therapeutic alliance and listening wholistically (using body, brain and spirit) to the client’s message. There are many examples of how to apply this counselling microskill in your textbook (see p. 51) and other literature from the counselling field, but probably the best way to develop expertise in this area is to practise repeating verbal messages you have heard. You can practise these skills with a role-playing colleague (and then reverse the roles), on family or friends, or even news reports on TV. Some of us find written practice is also very constructive in developing this microskill.

Restatements

Contrary to parroting, using a restatement is a valuable technique which emphasises a certain aspect of the client’s conversation and directs the therapy away from or towards a certain cognitive or affective process. Consider the following example:

Client: ‘I have been worried for about two years now about my adult daughter’s inability to concentrate on one career.’

Counsellor: ‘worried?’

or:

‘adult daughter?’

or:

‘inability to concentrate?’

The first restatement invites the client to explore their own affective responses to this situation and allows the counsellor to assess the level of anxiety and/or depression. The second response may encourage discussion of theories of life-span development, issues of changes in relationship from parent to young child and adult child, or even gender issues. The third response is centred more around issues observed by the parent in the daughter – again this raises diverse trains of thought which may or may not be encouraged by the counsellor’s type and level of response to the client’s disclosures.

Without vigilance, it is possible to reflect content whilst adding our unconscious judgments of what our client is telling us, which can result in the client losing control of the session. We will lose our collaborative framework and direct the therapy in the direction in which we think the client should be heading. To avoid this, use a ‘check in’ phrase at some time in your paraphrase to ensure you are understanding the client’s meaning and not just assuming. You can check in at the beginning of your paraphrase:

or at the ending of the paraphrase:

Distortions in reflection of content

As well as reflecting content with our own judgments attached, in listening and responding to our clients, we can commonly find ourselves subject to distortions. Milner & O’Byrne (2004) alert us to the following distortions:

Selective attention

• More weight given to negative information and less to positive.
• Clients with more perceived intelligence and verbal fluency will be heard and assessed differently to less verbal clients.
• Apportioning different values to traits e.g. black physicality has more trait value than white physicality.
• Primacy effects take precedence over recency effects.
• Vivid or startling information is given more attention than less unexpected client disclosures.

Stereotyping

• Information given by clients is categorised according to the counsellor’s perceived stereotypes.
• Using stereotypes discounts a person’s uniqueness.
• Allocating persons to categories perpetuates myths about social class, race and gender.
• Stereotyping produces negative self-fulfilling prophecies.

Attributional bias

• Inferences about a person or their behaviour are made on the basis of irrational biases (Nisbett & Ross, 1980, cited in Milner & O’Byrne, 2002).
• Successes are attributed to our own efforts and failures to factors outside our control. In assessing others, the opposite applies. As counsellors, if other people are considered personally responsible for their misfortunes, then the same fate cannot befall the observer – we have protected ourselves through fundamental attribution error.
• We have an inbuilt tendency to prefer counselling interventions that locate the problem within our client. It is easier to ‘work on’ the ‘victim’, rather than to locate the problem within social constructs.
• Attributional biases contribute to the perpetuation of an ‘us’ and ‘them’ mentality.
• Counsellors need to adopt a reflexive process to ensure that they are not operating from an internal position of self-righteous superiority (Jenkins, 1996, cited in Milner & O’Byrne, 2002).

Sensory distortions

• We make positive and negative inferences about our clients on the basis of how they look, smell and speak. Positive personality traits are attached to good-looking people.
• The cultural norms reflected in speech affect our responses to our clients. A masculine tone reflects the voice of authority. Gender and ethnic biases occur in listening to our clients. Many will present with voices quieter or more shrill than usual, and certainly lacking in authority – this is the result of stress.
• Responding appropriately to clients requires careful listening to the words used so that reflection occurs without sensory distortion by using language similar to that used by the client.

Erich Fromm (1994) suggests that counsellors should take care in ensuring we always use the truth. He suggests that if we encourage a person by minimising the depth of the problem, we are complicit in stopping the eruption of emergency energy which is innate within the person as he/she strives for health. Fromm took the attitude that the more clearly and even severely the issues were reflected to the client, the closer the client is brought to the realisation of the possibility of rejuvenation. We can probably all recount examples of people rising above dire situations with powers they had no idea they possessed.

Summarising

One of the skills of reflection of content is the ability to summarise the content of the session. Summaries frequently occur at the end of the session but can also occur at the beginning of the session to review what occurred in the previous session. They are also sometimes employed during the session to:

• clarify what has happened so far
• emphasise the important points covered
• bring clients back on track if they have become confused or lost
• knit together threads of information, and to integrate the cognitive and affective aspects presented to complete a comprehensive whole picture
• allow the client to see how the counsellor is understanding the presented information
• provide a lot of information in a concise manner which then allows the client to see his/her issues much more clearly. This can precipitate decisive action.

Note: In your 10-minute assessment item, you will not have time to undertake several summaries throughout your session – use your knowledge of paraphrasing to respond to your client to confirm understanding. You will need to include a brief summary at the end. In longer sessions you will have the opportunity to summarise more frequently.

The role of silence

All that we have learned up to now and all that is still coming needs to be understood in the light of the importance of silence. A good question, and a good reflection, a focus on feelings; they all need time and space for quiet reflection. In other words, these microskills are useless unless you schedule some silence in.

Our society promotes chitchat and noise to fill vacuums – silence, however, does have a function. It allows people time to think, to centre and ground themselves. We are often uncomfortable in silence, but do remember that silence in counselling is not rude. Beginning counsellors often feel the need to ensure that talking occurs all the time and therefore feel afraid of silence. Silence gives both people time to reflect, think and absorb what has been said. It can be good to pause, perhaps when stuck, good to have a change of pace, or to break a pattern that is not particularly productive (see the role of non-attending behaviour below). It gives us all a time to collect our thoughts and feelings. Silence is particularly useful and valuable in grief situations as it is very difficult to find useful and appropriate verbal responses.

Similarly we do not have to be constantly making creative and meaningful comments during a counselling session. The ‘ums’, ‘mmms’ and ‘ah hahs’ made famous by Carl Rogers have an extremely useful place. These ‘minimal responses’ as they are known, punctuate the session and if expressed with meaning can show the client that the therapist is staying with them and feeling alongside them.

Summary

Here we have looked at the importance of and practice of reflecting content within the counselling interview. This allows the client to feel heard and valued and allows the counsellor to check they have got it ‘right’. Alongside this skill lies reflection of feeling, to which we now turn.