Listening, Attending, Responding

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Listening, Attending, Responding
Questioning2012
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Learning outcomes

• Understand the meaning of active listening,
  attending responding.
• Describe some of the barriers to therapeutic
  listening, attending responding.
• Formulate therapeutic questions.
• Identify and give examples of therapeutic
  communication skills

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Therapeutic communication

• A goal-directed focused dialogue between a health
  professional and a client, specifically tailored
  to the needs of the client.

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Listening, attending and responding

• The foundation for a therapeutic relationship is
  based on the concepts of listening, attending and
  responding.
• Rungapadiachy, D. (1999). Interpersonal
  communication and psychology for health care
• professionals theory and practice. Oxford
  Butterworth and Hinemann. Chapter 17 p. 214.

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Establishing a supportive relationship

• Attending Skills
• Active Listening Skills
• Responding Skills
• are skills which are actioned with behaviours of
  empathy, respect and genuineness.
• This is what you will learn to do this Semester.

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Good communication environment

• Private,
• Neutral, colour, furniture, layout
• Comfort, quiet turn off mobile phone
• Seating arrangements Equality (higher/lower,
  barrier, close/far, side by side)
• No distractions, ask to not be interrupted
• Safe privacy, mutual safety

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Listening

• Listening can be defined as the art of capturing
  the true essence of the senders message.
• The word capturing is used deliberately because
  of its implication of being an active process,
  which the listener has to engage in.
• Hearing no effort required.
• Rungapadiachy, D. 1999

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Hearing for a sound
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Listening for a message
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Attending

• The outward, physical manifestation of being
  ready to listen.
• Non-verbally (without voice), Go ahead, you have
  my attention, Im here with you now.
• Non-verbal communication channels body posture,
  eye contact and spatial position.
• Stein-Parbury p. 119

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Non verbal communication (Acronym SOLER)

• Square facing
• Culturally appropriate
• Open posture
• Leaning inwards or outwards
• Eye contact (gaze)
• Relaxed posture
• Stein-Parbury, J. (2009), p. 120

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responding

• Verbal and nonverbal (body language)
• Need to be thought out before spoken. Words are
  said with intention.
• Moves the relationship in a desired and intended
  direction.
• Requires insight and awareness
• Answers the question, What do I need to know
  about this person and why do I need to know it?
• Stein-Parbury, J. (2009) p. 139

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Non-verbal ways of responding

• When we speak to another individual or group,
  the distance our bodies are physically apart also
  communicates a message. 
• Proxemics is the study of such interaction
  distances and other culturally defined uses of
  space.
• Rungapadiachy, D. (1999).

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Body language or Kinesics

• This is the language of gestures, expressions,
  and postures
• The meaning of speech - tone and character of
  voice
• Rungapadiachy, D. (1999)

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Observing

• Provides more information than what is heard.
• Help us notice contradictions or validates what
  we just heard.

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Body Language what are they saying?
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Touch

• Strong carrier of messages
• Need to be aware of how it may be perceived.
• Are we meeting our own needs or theirs?
• What is the other persons culture of touching?
• Reveals the degree of friendliness between two
  people.
• Rules govern use in the medical profession.
• Establishes emotional distanceor not.
• Ellis, Gates Kenworthy 2004, page 9

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Appropriate Touching
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Non-professional Touching
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What does touch do???

• Positives
• Coveys caring and reassurance
• Promotes healing
• Carries a message-friendship
• - - - - Negatives
• Invasion of personal space
• Sign of status (I can touch you, but you can not
  touch me.)
• Carries a message-abuse or harassment
• Arnold, Boggs, 2003 p. 189

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Sowhat makes touch appropriate and safe?

• Necessary (treatment, patient safety)
• Permission
• Respectful
• Professional
• Patient is comfortable --not invasion of personal
  space or cultural norms.

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Attending skills

• SCOLER (square facing, culturally appropriate,
  open, leaning, eye contact, relaxed
• Mirroring-letting the patient hear their own
  words
• Validating So, what I heard you say was.do I
  have that right?
• Stein-Parbury, J. (2009)

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Listening skills

• Silence (what is being conveyed?)
• Body Language (what is being conveyed?)
• Emotions (what is being conveyed?)
• Themes (what is being conveyed?)
• Impressions of what you heard is the message
  being conveyed.

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Responding skills

• Checking for understanding
• Focusing
• Reflecting
• Echoing
• Paraphrasing
• Prompting
• Expressing Empathy

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Therapeutic Questioning
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Questioning skills

• Get information with a question
• Clarify information with a question
• Closed (Yes or No responses)
• Open
• Why? can be an unhelpful question

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References

• Arnold, E. c., Underman Boogs, K., (2007)
  Interpersonal relationships Professional
  communication skills for nurses (5th ed.).
  Sanders Mo.
• Ellis, R. B., Gates, R. J., Kenworthy, N.
  (2003). Interpersonal communciation in nursing
  theory and practice (2nd ed.). Edingburgh
  Churchill Livingstone. Chapter 1.
• Rungapadiachy, D. (1999). Interpersonal
  communication and psychology for health care
  professionals theory and practice. Oxford
  Butterworth and Hinemann. Chapter 16, 17 18.
• Stein-Parbury, J. (2009). Patient Person
  Interpersonal skills in nursing 4th ed. Sydney
  Elsevier.