SHLD 530 Counseling

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SHLD 530 Counseling Communication Disorders

• Class 5
• February 13, 2009

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Interviewing and Therapy MicroskillsWhat are
microskills?

• Verbal and nonverbal encouragers
• Asking questions
• Paraphrasing and reflections
• Clarifications
• Reframing or relabeling
• Interpretations
• Suggestions
• Use of silence

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Verbal and nonverbal Encouragers

• Verbal encouragers are prompts used by the
  clinician to try to elicit more information
  (uh-huh, yes, hmmm, and repetition of a word that
  the individual has said)
• Nonverbal encouragers also elicit more
  information (smiling, eye contact, leaning
  forward, open body posture and head nodding)
• Beware of therapist noises (Wachtel, 1993) -
  words that are overused that can begin to sound
  like cliches (interesting, hmmm)

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Questions

• Use questions to understand how the individual
  makes sense of his /her experience.
• Use questions to encourage the individual to
  think about his/her experience in a new light.
• Caution when asking question - Do not
  bombard/grill ask multiple questions ask
  leading questions

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Questioning and Cultural/Individual Differences

• Western cultures tend to use rapid-fire
  questions.
• Men tend to ask more questions than women. Women
  comment on what is said.
• Children may be intimidated by questioning.

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Kinds of Questions

• Closed Questions - eliciting a yes/no or brief
  response
• Open Questions - encouraging longer more
  detailed, less leading responses
• Who, what, when , where - lead to factual
  info
• How - helps individual think about
  process/strategy
• Why - leads to reasons or causes and can be
  intimidating.

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The art of gentle inquiry

• Turning a question into a declarative statement
• Using words such as can, will, could
  would as swing questions
• Using open-ended questions about experiences
  (What does that mean to you? Can you tell me
  about that? What are some reasons you think
  that may be happening?)

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Kinds of questions, contd

• Funneling questions - guiding the conversation
  from general to specific helping the individual
  narrow the focus.
• Requests for Clarification - checking for
  understanding (Let me try to clarify When you
  say.what does that mean?)
• Comparison questions - helping to clarify
  symptoms

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Kinds of questions, contd

• Counter questions - answering with a question
  important in understanding the individuals
  feelings, and for the clinician to avoid being
  hooded into answering a question that the
  individual may already have made a decision
  about.
• Broken record - Technique of repeating a word or
  statement until you get the individuals
  attention.

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Observing and Listening Techniques

• Paraphrasing - assuring the individual that you
  have accurately heard the meaning of their
  message and providing opportunity for the
  individual to hear how someone else perceives
  them.
• Reflection (echoing) - reflecting back the last
  few words (or stated feelings) the individual has
  said in order to encourage her to say more or to
  develop the story.
• Silence - used to encourage the individual to
  talk or reflect on the discussion.

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Selective Feedback- Providing new positive
interpretation

• Reframing or relabeling - helping the individual
  focus on the positive by relabeling the behavior
  or situation.
• Normalizing - Helping the individual see that
  what they are experiencing may be typical (It is
  common that It is understandable)
• Suggestion- helping individuals see new ways of
  looking at old problems. This is not advice, but
  specific to intervention and treatment
• Direct instruction - Teaching specific aspects of
  the intervention process

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Selective Feedback- continued

• Interpretations ( Linking statements) - require
  clinician to be attentive to individual's
  comments for an extended time goes beyond
  paraphrasing and may present new information (I
  wonder if Is it fair to say that )
• Confronting - this is an advanced microskill that
  is used to facilitate change - sensitively
  helping the individual see discrepancies of which
  they may be unaware.