Active Listening

• Ineffective listening - is one of the most frequent causes of misunderstanding.
• Empathic resonance - is the ability (and willingness) to crawl inside someone else's skin and to know what he or she is experiencing.  Another part to this is your ability to communicate to the other person your understanding of what you hear/see/sense/feel in such a way that the person doesn't feel quite so alone.
• Active Listening -
• Paying Attention
• Gathering Information
• Paraphrasing & Reframing
• Clarifying
• Summarizing

SEVEN ACTIVE LISTENING TECHNIQUES

1. Minimal Encouragements

Sounds made, especially on the phone, to let one person know the other is there and listening. Such as, "Oh?", "When?", and "Really?". They are questions, comments, or sounds that do not interfere with the flow of conversation, but do let the subject know that he/she is being heard. They help build rapport and encourage the subject to continue talking.

2. Paraphrasing

A summary in your own words of what you were told. Demonstrates listening, creates empathy and establishes rapport because it is evident that you have heard and understood. Usually, paraphrasing begins with the words, "Are you telling me..." or "Are you saying..." Paraphrasing also clarifies content, highlights issues and promotes give and take between you and the subject. It tends to make the subject a better listener.

3. Emotion Labeling

This is often the first active listening skill to be used in a crisis communication incident. It is important to be attuned to the emotion behind the words and facts. Commonly, we all want to get into problem-solving too early. Too early an approach to problem solving is doomed to failure because the subject is often not ready to reason and you have not listened enough to get all of the information you need to assist in problem solving. Common phrases for you to use are, "You sound...", "You seem..." , "I hear..." (emotion heard by you). You do not tell people how they are feeling, but how they sound to you as if they are feeling.

Do not be concerned about making a mistake in labeling emotions. The subject will correct you and will often appear grateful for the attempt. Be aware of missing emotions and listen for conflicts in the feelings expressed, especially if they appear inappropriate to the situation.

4. Mirroring (or Reflecting)

This is the technique of repeating the last word or phrase and putting a question mark after it. This provides very exact responses because you are using the subject's own words. Reflecting or mirroring asks for more input without guiding the direction of the subject's thoughts. It is an effective way to let the subject know that you are listening and for the subject to "hear" what he/she is saying.

5. Open-Ended Questions

The primary use of open-ended questions is to help a subject start talking. Asking open-ended questions encourages the person to say more without actually directing the conversation. They are questions that cannot be answered with a single word such as "yes" or "no". Open-ended questions get information for you with fewer questions, those that usually begin with how, what, when and where. Note that "why" questions are not asked directly. "Why" questions tend to steer the conversation toward blame and shut down communication. "Why" questions also tend to pass judgment.
Closed-end questions can give a feeling of interrogation that makes rapport building difficult. They also can prevent any additional information from being shared organically.

6. "I" Messages

"I" messages let the subject know how he/she is making you feel, why you feel that way, and what the subject can do to remedy the situation. This is a non-threatening approach and does not put the subject on the defensive. "I" messages can be effective when communication is difficult because of the intense emotions being directed at you.

7. Effective Pauses

Silence can be very effective on a number of levels. Most people are not comfortable with silence and will fill it with talk. It is to your advantage to keep the subject talking. Silence can also be used to emphasize a point. You can use silence just before or just

Stages of Change

Five stages of change have been conceptualized for a variety of problem behaviors. The five stages of change are precontemplation, contemplation, preparation, action, and maintenance.

Precontemplation is the stage at which there is no intention to change behavior in the foreseeable future. Many individuals in this stage are unaware or under aware of their problems.

Contemplation is the stage in which people are aware that a problem exists and are seriously thinking about overcoming it but have not yet made a commitment to take action.

Preparation is a stage that combines intention and behavioral criteria. Individuals in this stage are intending to take action in the next month and have unsuccessfully taken action in the past year.

Action is the stage in which individuals modify their behavior, experiences, or environment in order to overcome their problems. Action involves the most overt behavioral changes and requires considerable commitment of time and energy.

Maintenance is the stage in which people work to prevent relapse and consolidate the gains attained during action. For addictive behaviors this stage extends from six months to an indeterminate period past the initial action.

Joseph

Joseph is a 70 year old Jewish-American gay male who wants to meet with you to discuss low income housing options for him and possibly his partner. Your supervisor tells you that she is concerned that Joseph is in a violent relationship with his partner, Marcus, and wants you to assess how safe he feels living with Marcus at this time. Joseph appears very thin and you can see bruising on his forearms. This is your first meeting with Joseph and Marcus is not present.

LaShonda

LaShonda is a 32 year old African American female who was put on a 5150 hold last night after overdosing on pills. LaShonda was diagnosed with depression six months ago after being let go from her job. LaShonda told her group therapist this morning that she was forced to leave her job because she was black. She feels hopeless she will ever be able to work again because of her racial identity. She states because she cannot change the color of her skin, she wants to die.

Mr. Fahza

Mr. Fahza is a 87 year old Iranian Muslim male who is being treated for end stage liver cancer. He does not speak English and his son stays at the bedside. His son has indicated that he wants to relay all the health information to his father directly and refuses to have a translator. His physician is concerned that the patient is not aware that he is dying and would like to know if the patient wants to remain on chemotherapy or be placed on hospice to die peacefully at home. His son insists his father wants to stay on chemotherapy and "keep fighting". You are asked to speak with the son and have a translator assist you and assessing the patient's wishes without interference.

consider the following questions in the engagement strategies:

1. What is (are) the major obstacle(s) in engaging this client?

2. What "pushes your buttons" (know clinically as countertransference) in working with this client? Please use the first person tense for this section.

3. What does the literature say about working with this client?

4. What is your strategy to engage this client considering all your answers above?