Berven, N. L., & Bezyak, J. L. (2015). Basic counselling skills. In F. Chan, & K. R. Thomas Counseling theories and techniques for rehabilitation and mental health professionals (2nd ed.), pp. 227-242. Springer Publishing Company.
Basic counseling skills, which are the focus of this chapter, are essentially relationship- building and empathic listening skills, drawing out client stories and concerns in depth, along with the surrounding context. Thus, basic counseling skills serve as the foundation for working collaboratively with clients in understanding and conceptualizing their concerns and problems in ways that can be addressed, along with developing counseling, service, and intervention plans to address the concerns in collaboration with the client. The skills are basic to virtually all theoretical orientations in counseling, which help counsellors conceptualize problems and develop plans for interventions and other services. The goals of this chapter are to facilitate understanding and development of the skills to apply in counseling, regardless of a counselor’s theoretical orientation. Following are the learning objectives to be addressed:
- Develop knowledge of the importance of the counseling relationship and build skills that can facilitate therapeutic relationships and the ability to encourage clients to share and elaborate on their stories and concerns.
- Develop knowledge and skill in applying basic attending behaviors in counseling.
- Develop knowledge of the different ways that questions can be formulated and build skill in using both direct and indirect open questions and follow-up questions in counseling.
- Develop knowledge of and skill in using the active listening responses of encouragers and restatements, paraphrases, reflections of feeling, and summarisations.
- Develop skill in integrating the basic listening skills to structure a counseling session.
Basic Therapeutic Conditions
Virtually all theoretical approaches to counseling and psychotherapy emphasize the importance of strong therapeutic or working relationships with clients. The client-centered approach, now commonly known as the person-centered approach, has been particularly prominent in recognizing the importance of the relationship. Rogers (1942, 1951; Chapter 2 in this volume) hypothesized that the basic therapeutic conditions of empathy, genuineness, and unconditional positive regard are the necessary and sufficient conditions for constructive change through counseling and psychotherapy (Rogers, 1957). However, although virtually all theoretical approaches to counseling and psychotherapy recognize the importance of these conditions in accomplishing constructive change, they are now typically viewed as necessary but not sufficient, thus suggesting that interventions are also necessary that go beyond the basic conditions. The working alliance is a related concept, emphasizing the critical importance of the emotional bond between client and counselor, in addition to agreement between counselor and client on therapeutic goals and tasks to be undertaken in the counseling relationship (Bordin, 1994). There is substantial empirical evidence to support the importance of the therapeutic relationship, with extensive meta-analyses conducted to document the contributions of the relationship to success in counseling across many different types of interventions and treatments (Norcross & Wampold, 2011).
Rogers (1957, p. 99) refers to empathy as a unique type of understanding in the counseling relationship, entering the client frame of reference to understand the perceptions of client experiences from their own frames of reference, to “sense the client’s private world as if it were your own, but without ever losing the ‘as if’ quality.” Rogers (1957, p. 98) refers to unconditional positive regard as nonjudgmental and nonevaluative, as “experiencing a warm acceptance of a client’s experience as being part of that client … neither approval nor disapproval of the client … simply acceptance.” Rogers (1957, p. 97) refers to genuineness on the part of counselors as being “within the confines of this relationship, a congruent, genuine, integrated person … not presenting a façade” and not denying his or her own feelings to him or herself.
Rogers (1957) goes on to point out that the therapeutic conditions of empathy, unconditional positive regard, and genuineness must not only be experienced by counselors but also must be communicated effectively so that clients are able to perceive the empathy and acceptance that counselors feel toward them.
Microcounseling or Microskills
A number of attempts have been undertaken to operationalize the communication of the therapeutic conditions in the form of basic counseling skills. As discussed by Hill and Knox (2013), three of the most visible and researched programs to train counselors in these skills are human relations training (HRT; Carkhuff, 1969), interpersonal process recall (IPR; Kagan, 1984), and microcounseling or microskills (Ivey, 1971). As pointed out by Ridley, Kelly, and Mollen (2011, p. 801), “For more than four decades, the microskills approach has been the dominant paradigm of training in counseling psychology and other mental health specialties, especially for entry level trainees.” As noted in the Intentional Interviewing and Counseling text by Ivey, Ivey, and Zalaquett (2014), now in its eighth edition, the microcounseling or microskills approach has been used in more than 1,000 university and related training programs in counseling. In rehabilitation counseling training programs specifi cally, Dalgin, Bruch, and Barber (2010) noted that 83% of the programs required microskills training prior to practicum, and another 3% reported microskills training as a part of practicum training. A number of textbooks are available to facilitate preparation in basic counseling skills by Ivey and colleagues (e.g., Evans, Hearn, Uhlemann, & Ivey, 2011; Ivey et al., 2014) and by other authors (e.g., Cormier, Nurius, & Osborn, 2013; Egan, 2014; Hill, 2014), all of which cover the basic skills addressed in the present chapter along with other counseling skills.
The specific skills that are covered here, namely, attending, questioning, minimal encouragers, paraphrases, reflections of feeling, and summarisations, are particularly important in the initial stages of counseling. In the initial stages, the focus of counseling is on building the base of a strong working relationship, in addition to understanding client concerns and stories. In addition, specific types of interviews emphasize these skills, including intake interviews and other types of assessment and clinical interviews (Berven, 2008, 2010). However, the skills can also be useful at subsequent points in counseling, when the focus is on listening; for example, a client may want to report on experiences with a homework assignment, and the counselor attempts to facilitate the telling of the story.
It is important to point out that microskills go well beyond the basic skills to be covered here, including, for example, self-disclosure, interpretation, reframing, and empathic confrontation (e.g., see Ivey et al., 2014). In addition, Ridley, Mollen, and Kelly (2011) have suggested that the range of microskills be expanded to a variety of other counseling competencies, including not only counseling behaviors but also cognitive and affective skills. According to the counseling model proposed by Hill (2014), the microskills covered in this chapter are particularly important in the initial exploration stage of counseling, with the goals of attending, observing, listening, and exploring both thoughts and feelings, prior to the stages of insight and action. In the initial stages of counseling, there is typically an emphasis on listening and attempting to understand as fully as possible the client’s concerns and stories.
Ivey et al. (2014) indicate that microcounseling training has been supported through more than 450 empirical studies to document effectiveness. Both verbal and nonverbal components of communication are emphasized, as the nonverbal component is a major part of communication; in other words, it is not only the words spoken that are important, but also the ways and manner in which those words are spoken. Listening effectively and making an attempt to understand what a client is communicating is at the core of the counseling process, and, because many people are probably better “talkers” than “listeners,” the development and refinement of active listening skills is important. It is certainly important to listen in order to hear and understand client stories. In addition, because many individuals are not particularly good listeners, being listened to can be a refreshing change and a powerful tool in relationship building, showing the client that the counselor cares enough to give undivided attention to hearing and understanding the client’s message.
Attending skills may be defined as the verbal and nonverbal counseling skills that communicate the therapeutic conditions, show clients that counselors are focusing their attention on them and what they have to say, facilitate strong therapeutic relationships, and encourage and reward continued client communication (Hill, 2014; Ivey et al., 2014). As already noted, all interpersonal communication includes both verbal and nonverbal channels. The nonverbal channel is composed of at least two components, kinesic and paralinguistic. Kinesic components include both eye contact and body language, the latter comprising more specific components. Paralinguistic components of communication include the voice qualities of volume, pitch, pace, and fluency. As also previously noted, much of communication occurs through nonverbal channels, particularly the communication of emotion (e.g., a smile, a red face, a raised voice with increased volume). Further, when the verbal and nonverbal components of a message conflict (e.g., a person saying the words, “I am NOT angry,” with a red face, a loud voice, and a shaking finger), the nonverbal message is the more likely to be believed.
Specific Attending Skills
Eye contact is one of the most important attending skills, showing clients that counselors are paying attention and that they are interested in what clients have to say. Failure to maintain eye contact may be interpreted by clients as disinterest, discomfort with the client or the topic being discussed, or distraction or preoccupation with other matters as opposed to what the client is communicating. Facilitative eye contact involves simply looking at the person in a natural way, without “glaring” or “staring.” Some breaks in eye contact are perfectly natural, while still maintaining a focus on the client. Counselors are more likely to maintain eye contact with clients as they are talking, maybe glancing away occasionally as they are collecting their thoughts and responding. One important function of eye contact is the regulation of turn-taking in communication, with the speaker sometimes breaking eye contact, occasionally glancing away while talking, and then looking at the other person when it is his or her turn to talk. Because of the importance of eye contact in communication, it is more common for two people to interrupt one another while talking on the telephone, as opposed to face-to-face conversations, because the absence of eye contact makes it more difficult to effectively regulate turn-taking.
Body language and facial expression represent another component of attending behavior. Facilitative body language typically includes facing a client directly and leaning slightly toward the client, with a comfortable posture and arms unfolded, not slouching and not ramrod straight. Natural physical gestures are consistent with facilitative body language, consistent with the content and flow of the conversation, not sitting totally still and stiff. Smiles and head nods, again not overdone, and facial expressions conveying attention and concern are also components of facilitative body language.
Paralinguistics or vocal qualities are also components of attending behavior, including volume, pitch, and pace or speed of talking. Facilitative communication is characterized by volume that is moderate, not too loud and not too soft; pace or speed of speaking that is moderate, not too quick and not too slow; and pitch that is appropriately modulated according to the words and ideas being communicated, as opposed to flat and monotone.
One of the most important components of paralinguistics is latency in responding, which refers to the delay from the time that a client finishes speaking until the counselor begins a response. Latency can vary from a very long delay to a very short or even nonexistent delay, jumping in before the client has actually finished speaking and interrupting the client. Interruptions and short delays in communication may often be perceived as aggressiveness, whereas very long delays may be perceived as passivity. In addition, if counselors frequently interrupt clients or demonstrate very short response latencies, they may be perceived as more concerned with what they themselves have to say than what the client has to say, and clients may then see the counselor as not truly listening and paying attention. Longer latencies in responding may be particularly important with clients who tend to speak slowly, with long pauses, perhaps pondering before speaking, as a counselor may miss additional important things that the client has to say when jumping in too quickly.
Attempts to lengthen latencies in responding may be difficult for counselors who tend to typically communicate in a fast-paced manner, but doing so may be very helpful in improving listening and attending skills, getting more important information from clients in interviews, and building rapport.
Silence can be anxiety provoking in conversation, both for counselors and clients, and counselors may rush in to fill the silence and respond too quickly. Sometimes, particularly when clients look like they are thinking or contemplating what they might say, it is often important to wait until the counselor perceives that the client has finished talking. In addition, when counselors are thinking about what they are going to say next, which can often occur, especially with beginning counselors, this can be a major distraction from listening to all that a client is communicating. It is typically beneficial to try to focus total attention on what a client is communicating and then taking a moment to reflect on what has been communicated in order to think about what to say in response, accepting that a few moments of silence will be okay.
Verbal tracking is one of the most important of the active listening skills and is also one of the most difficult to master. Verbal tracking occurs when counselor responses follow from client leads, continuing on the same or a related topic that follows directly from what the client is communicating, as opposed to introducing new topics. Verbal tracking leads to more organized interviews as opposed to interviews that seem to “bounce around” from topic to topic. One of the benefits of verbal tracking is that clients will likely perceive counselors as listening to what they have to say, as verbal tracking can only be accomplished if the counselor hears what the client is communicating. In addition, verbal tracking can serve to facilitate understanding of client stories by exploring what the client is communicating in greater depth, not leaving topics until they are more fully explored. Thus, verbal tracking can produce many important benefits in counseling and are basic to some of the other microskills yet to be discussed in this chapter.
General Considerations on Attending
If counselors do not actually experience a sense of warmth, caring, and interest toward a client, it is difficult to convince the client otherwise. However, clients may not always perceive these qualities on the part of the counselor, even when the counselor experiences them, and basic attending skills may serve to communicate those qualities to clients. Basic attending skills can demonstrate that counsellors care enough to pay attention to clients and what they are communicating, also helping to build a strong working relationship or rapport (Ivey et al., 2014). Attending skills help to “grease the wheels” and help clients to open up and tell their stories in greater depth. From a behavioral perspective, attending skills can be viewed as reinforcing client communication, with counselor attention serving as the reinforcer.
Many counselors may engage in note taking during counseling, either jotting down handwritten notes or entering information by computer during a counseling session. Such note taking can detract counselor attention from clients and what they are communicating. Thus, to the extent possible, it may be beneficial to minimize note taking during counseling or interviewing sessions, perhaps allowing a few minutes after a session to then make notes while information is still fresh in the mind of the counselor. If counselors have forms to complete or other information to obtain from clients in an initial interview or at other points in counseling, it may be helpful to first allow clients to talk and express what they have to say, and later in the session say something like, “Before we get back to talking, there are some forms that we have to complete, so maybe we can take care of that at this point.”
As previously discussed, verbal tracking is probably the most difficult of the attending skills to master, because tracking requires listening and perceiving what clients are communicating. Often counselors may be thinking about what they are going to say next while the client is talking, detracting from listening to the client. Alternatively, counselors will typically benefit by devoting their full attention to what clients are communicating, waiting until they have finished, and then thinking about what the client has communicated and formulating a response to follow that topic or to switch to a new topic. As is true in any conversation, counselors may be at a loss as to what to say at any point in a counseling session. As noted previously, counselors can get back on track by taking a moment of silence to think about what the client has communicated and what part of that communication may be helpful to follow up.
Basic attending skills can influence perceptions of counselors on the part of clients in positive ways, and these skills can help clients open up and tell their stories and elaborate on their concerns. In addition, these skills can be readily learned, although verbal tracking may be more challenging to master, and Ivey and colleagues (e.g., Ivey et al., 2014) have developed procedures to teach these skills with documentation to support their effectiveness.
Questions are essential in interviewing and counseling, as they are in all human interaction. However, counselors vary in the extent to which they rely on questions, as opposed to other types of responses, and also in the ways in which questions are formulated, both of which can infl uence client responses, in addition to client perceptions of the counselor and relationship or rapport building (Ivey et al., 2014).
Open-Ended and Closed-Ended Questions
Closed-ended and open-ended questions represent two general ways of formulating questions. Closed-ended questions can be answered with one or a small number of words (e.g., “Do you like school?”), whereas open-ended questions request more elaborate responses (e.g., “What things do you most like about school?”). It is important to note that some questions, which are technically yes– no questions, actually function like, and can be considered to be, open-ended (e.g., “Can you tell me about school?” is technically a yes–no question, but the response requested is clearly not a yes–no response).
Open-ended questions may be further divided into direct and indirect open-ended questions. Direct open questions would be clearly seen as questions ending with a question mark (e.g., “What is school like for you?”). In contrast, indirect open questions do not end with a question mark, although they function like questions (e.g., “Tell me about school” or “I’m interested in knowing more about what school is like for you”). Open questions, whether direct or indirect, can be open to different degrees (e.g., “What is school like for you?” vs. “What do you enjoy about school?” vs. “What is the single thing that you enjoy most about school?”). Sometimes a client may not be able to handle the degree to which a question is open. For example, a counselor may say, “Please tell me about yourself” to which the client may reply, “Well, what do you want to know?” indicating that he or she is having difficulty answering, so the counselor may follow up with a less open alternative, “Well, I’m interested in knowing about your family.”
Closed-ended questions tend to provide very specific direction to a client and are thus highly efficient in getting specifi c information sought (Cormier et al., 2013); for example, it is much more efficient to learn a client’s age by asking “How old are you?” as opposed to “Please tell me about yourself” and hoping that age will be a part of the response. Because of the efficiency provided by closed-ended questions, a great deal of specific information can be obtained in a short amount of time. In addition, for some clients, closed-ended questions from counselors are less threatening because the counselor assumes more responsibility for the interaction, with the client simply giving short answers to direct, specific questions. Finally, closed-ended questions give the counselor greater control over the interaction and the responses that are likely to come from the client; because of the control given to the questioner, attorneys conducting a cross-examination will frequently use closed-ended questions (e.g., “Is it not true that you disliked Mr. Jones, the victim of this crime?”).
Open-ended questions also have advantages. Although closed-ended questions may sometimes produce a longer client response than a simple “yes” or “no,” open-ended questions generally tend to produce much longer and more elaborate responses than closed-ended questions. Thus, open-ended questions will typically elicit more extensive and detailed information, which can then be followed up by the counselor, and clients will tend to do more of the talking and counselors less (Ivey et al., 2014). Open-ended questions also put more of the control for the interaction in the hands of clients, giving them more freedom to tell their stories. Because of the more elaborate responses that open-ended questions produce, attorneys conducting a direct examination of their own witnesses will often use more open-ended questions (e.g., “Please tell the court about your relationship with Mr. Jones”).
Uses and Types of Open-Ended Questions
Opening New Topics of Discussion
Open questions are typically used to open an interview (Ivey et al., 2014), whether an initial interview (e.g., “What brings you in to see me today?” or “Please tell me about yourself” or “I’m interested in knowing what’s on your mind, so where would you like to start?”) or a subsequent interview (e.g., “What has been happening with you since we last talked?” or “At the end of our last interview, you were all set to follow up on that job lead that you were excited about, and I’m interested in knowing all about it”). Open-ended questions are also typically used to open a new topic of discussion in an interview after transitioning from the previous topic (e.g., “Tell me about the role that your sister might be playing in these difficulties that you’ve been having” or “How about the relationship with your other boss?”).
Obtaining Information
Who, what, where, or why questions elicit specific facts or information (e.g., “In the office where you work, who seems to take the major responsibility for getting those types of things done?” “What responsibilities in your office would you most like to have?”). “Why” questions can sometimes come across as challenging and may thus provoke defensiveness, and this can be due to the experiences that we have had with “why” questions dating back to our childhood (e.g., “Johnny, why is your room always such a mess?” or “Johnny, why can’t you be nice to your little sister?” or “Johnny, why do you persist in tormenting me?”). “Why” questions (e.g., “You’re unhappy with your work situation, so why don’t you do something about it?”) can easily be rephrased as “what” questions (e.g., “You’re unhappy with your work situation, so what do you see as your options to deal with it?”), so the use of “why” questions can be minimized relatively easily, avoiding their possible disadvantages (Cormier et al., 2013).
Following Up on Client Communications to Explore Topics in Greater Depth
Questions can be used for verbal tracking to stay with a topic and explore it in further depth. Some very simple open-ended follow-up questions can be used t accomplish this purpose (e.g., “Could you tell me more about that?” or “Please tell me more” or “Can you go a little further with that?”).
In contrast to these more general follow-up questions seeking elaboration, other follow-up questions can attempt to obtain greater detail in understanding client stories and communications (e.g., “Can you tell me more specifically what you mean?” or “When you say that she is sometimes combative, can you tell me what you mean by ‘combative’?”). A particularly helpful type of follow-up question asks for specific examples (e.g., “Can you give me an example of a typical day at work for you?” or “Can you give me a specifi c example of a time when he said something that specifically bothered you in that way?”). Asking for specific examples can be extremely helpful in more fully understanding a client’s story and communications (Ivey et al., 2014).
Consistent with the attending skill of verbal tracking, follow-up questions can be used to stick with topics and explore them more fully. Leaving topics and moving on to new topics more quickly may provide a more superficial picture of client stories, and counselors may often not explore topics in sufficient depth. Following is an example, beginning with no follow-up and, instead, moving on to a new related topic:
- Co: Have you been looking for work?
- Cl: Yes, every single day I have been looking and working hard at it, but I haven’t been able to find anything.
- Co: That’s got to be really frustrating. How is the money holding out after being unemployed for so long?
Following is an alternative, following up on the client’s last response:
- Cl: Yes, every single day I have been looking and working hard at it, but I haven’t been able to find anything.
- Co: I’m interested in knowing more about your job hunt. … Can you tell me more about it?
- Cl: Well, like I said, it’s every single day … a real grind?
- Co: Well, let’s take yesterday as an example. Perhaps you can tell me specifically what you did yesterday in your job hunt.
- Cl: OK, yesterday. … It was pretty much like all of the days … I got my cup of coffee and sat down with the newspaper first thing in the morning and looked at the job ads and, just like all or the other days, there was absolutely nothing worthwhile, so I went on with my day.
The counselor follow-up in this alternative interchange brought out a more specific picture of the client’s job hunt, much different from the picture from the first interchange, showing the value of following up and not leaving topics too quickly.
Building Skills in Formulation and Use of Questions
Closed Versus Open-Ended Questions
An interview that is composed almost entirely of questions may sound much like an interrogation rather than a counseling or interview session (Ivey et al., 2014). This is particularly true if the questions are predominantly closed-ended, tending to elicit “yes–no” or other very short client responses to the counselor questions; a preponderance of closed-ended questions will also typically reduce the proportion of talk time on the part of the client versus the counselor, making it more difficult to get a thorough and in-depth understanding of client stories. Closed-ended questions tend to be commonly used in day-to-day communication because of their efficiency in getting some information and then moving on. Thus, people generally tend to be more skilled in asking closed rather than open-ended questions and tend to automatically phrase questions in a closed-ended format, so work is needed to build skill in using open-ended questions as a part of the repertoire of questioning skills.
It is relatively easy to rephrase a closed question into an open-ended format (e.g., “Do you want to go to the technical school?” can be rephrased as “What are your thoughts about going to technical school?”). So, skill in formulating questions in an open-ended format can be developed through practice in regular day-to-day conversations, taking a moment to think about the question that you are about to ask, determining whether it is closed or open-ended and, if closed-ended, rephrase it in an open-ended format. One possible goal of such practice is to work toward the point of being able to carry on a conversation, say for 20 minutes, without asking a single closed-ended question. Working toward this goal is not meant to imply that closed-ended questions are “bad,” but rather to become as skilled in formulating questions in an open-ended format as in asking closed-ended questions; as this skill is established in the repertoire of questioning skills, open-ended questions can be readily formulated whenever they are judged to best serve a purpose at any point in an interaction. In addition, using more indirect open questions, as opposed to direct open questions, can also make a difference in the tone of an interview or counseling session, making it soundless like an interrogation, and the use of indirect open questions can be practiced in a similar manner, consciously reformulating direct open questions into an indirect format.
Using Follow-Up Questions
Again, because there is often an emphasis on efficiency in day-to-day communication, little follow-up may often occur. In interviewing and counseling, depth of understanding may often be more important than efficiency, and more extensive follow-up will be critical in accomplishing greater depth of understanding (Ivey et al., 2014). As with open-ended questions, it is possible to practice listening to what a person has to say in a conversation and using follow-up questions to get more specific information (e.g., “Can you tell me more about that?” or “When you say that he can be difficult to deal with, can you tell me more specifically what you mean?” or “Can you give me an example when he seemed difficult to deal with?”).
Active listening responses provide alternatives to questions, facilitating follow-up and verbal tracking. Nearly all active listening responses focus on some aspect of what the client has communicated and indicate what you have heard in the client’s message. Active listening responses may focus on the content of a client response or on the affective component of what the client has communicated. Because they require that the counselor listen in order to respond to the client’s message, active listening responses show the client that the counselor is paying attention and listening (Ivey et al., 2014). In addition, they provide alternatives to questions, reducing the reliance on questions as a general type of counseling response.
Encouragers
Head nods and “uh-huhs” represent minimal nonverbal and verbal encouragers (Ivey et al., 2014). Unlike other active listening responses, they do not feed back to clients what the counselor has heard them say. However, they reinforce client communication and increase the likelihood of continued talk about whatever immediately preceded them. Other verbal encouragers involve the simple verbatim restatement of a key wrd or phrase in a client communication. For example,
Cl: The things he says make me really, really angry!
Co: The things he says?
Alternatively, the counselor might focus on another part of this brief message.
Co: Really angry?
If stated by the counselor in a definitive tone of voice, rather than a questioning tone of voice as indicated in the aforementioned alternative responses, the client is likely to say in response something like, “Yes, the things he says,” or to the second alternative, “You bet I get angry!” However, if stated in a questioning tone of voice with a rise in pitch at the end of the response, the client is likely to expand on “the things that he says” in response to the first alternative or to expand on feelings of anger in response to the second alternative, even though the counselor response has been only minimal.
In other words, the restatement type of encouragers that are used with a questioning tone of voice can serve to invite the client to expand on the part of the previous response that is restated by the counselor. Thus, a restatement of a word or phrase can substitute for a question (e.g., “What kinds of things does he say?”), eliciting a similar response on the part of the client as a question might do. A restatement of a key word or phrase in the content part of a message will facilitate expansion of that content, whereas a restatement of a key word or phrase in the affective or feeling part of a message will facilitate further talk and expansion regarding the affect communicated. In fact, it is possible to conduct an interview that is quite productive in facilitating client communication and the telling of a story, relying primarily on encouragers. The use of restatements depends on listening to a client response, identifying a key word or phrase that may be worth following up and expanding on, and then restating that key word or phrase, typically using a questioning tone of voice.
Paraphrases
Paraphrases summarize or reflect the content in a client response, as opposed to the affective or feeling component of the message, using the counselor’s own words to summarize or rephrase what the counselor has heard the client say (Ivey et al., 2014). Unlike an encourager, which repeats verbatim a word or phrase that the client has stated, a paraphrase does not “parrot” what the client has stated, but rather states the essence of what the client has communicated using new words that often will clarify the client’s message and the thoughts underlying that message. The purpose of a paraphrase is to both show the client that the counselor is listening and to encourage the client to expand on the content of what has already been communicated. In addition, in highlighting the most important parts of the client’s communication, without some of the peripheral parts of the message, a paraphrase can help clients clarify their thoughts.
A paraphrase of a client response is composed of several components (Ivey et al., 2014). First, the counselor must be paying attention and listening to what the client is communicating, including key words used by the client. The counselor must then think about and process what has been heard in order to formulate a paraphrase. A paraphrase always includes a summary that captures the essence of what the client has communicated, using the counselor’s own words, which is the defining characteristic of a paraphrase. However, a paraphrase often also includes one or more of the client’s own key words. In addition, the paraphrase may, although not always, include a stem (e.g., “So you seem to be saying …” or “So it looks to you like …” or “It sounds like you’re thinking that …”). Finally, a paraphrase may have a check for accuracy (e.g., “Am I hearing you correctly?” or “Have I got that right?”).
A paraphrase may attempt to be all-inclusive in summarizing the essence of an entire client response, even a lengthy response. Alternatively, a paraphrase of a client response, particularly a lengthy one, may focus only on a part of the response, encouraging the client to expand on that part that the counselor might see as useful to explore (Cormier et al., 2013). For example:
Cl:I don’t know what to think. Sometimes the possibility of taking this new job sounds really good to me, but on the other hand, the job that I have is OK, I’m doing a good job, and I know that I can stay there as long as I want, and I know that I will never have to move away, and I know that my wife really likes living here.
Co: So there are some things about the new job that really sound good to you.
This paraphrase would encourage the client to talk more about and explore some of the specific things about the new job that are attractive to him. Alternatively,
Co: So staying put in your current job has some advantages, too.
This paraphrase would encourage the client to talk more about and explore things about the current job that are appealing. Yet another possibility:
Co: So your wife has some thoughts about this decision, too.
Another option might be to summarize the alternative sides of the decision to be made.
Co: So on the one hand the new job has some big advantages, but there are some good things about your current job, too, and your wife also has some thoughts about this, too.
Paraphrases may stick closely to what has been explicitly communicated by a client or may go beyond what the client has stated explicitly to infer what the client seems to be saying implicitly. For example,
Co: So there is some risk in moving into this new job, where your current job offers you a great deal of security.
If a paraphrase is accurate in capturing an implicit message being communicated by a client, it can stimulate a greater depth of exploration. However, even if the paraphrase accurately captures an implicit message, but is too far ahead of a client’s awareness, the client may deny the accuracy of the paraphrase in the next response or may even respond defensively.
Paraphrases can produce a number of benefits in counseling. As just noted, a client response can be accurately paraphrased only if the counselor is listening carefully to what the client is communicating, so the paraphrase is a clear indication that the counselor is paying attention and listening. Further, the perception of a client that the counselor is listening and attempting to understand can contribute substantially to the development of a good working relationship or rapport. In addition, a paraphrase can serve as an alternative to questions in helping clients to explore and talk about their concerns, the context surrounding their concerns, their thoughts and, more generally, expanding on and telling their stories in greater depth. Finally, because paraphrases highlight the essence of what has been communicated, they may help clients clarify their thoughts.
Reflections of Feeling
In contrast to paraphrases, reflections of feeling focus on the affective component of client responses, encouraging the exploration of feelings as opposed to the content (Ivey et al., 2104). Because the communication of feelings often occurs through nonverbal channels, the verbal components of a client response may or may not explicitly state the feeling being communicated, and a client may not be fully aware of the feelings being expressed (Cormier et al., 2013). The exploration of feelings is often a major component of counseling, as feelings may play important roles in concerns brought to counselors. For example, clients may often talk about needing to “sort out” their feelings in attempting to resolve a conflict or make a decision, and reflections of feeling may play an important role in understanding those concerns and the surrounding context. In addition, dysfunctional feelings, such as fear and anxiety, can pose major barriers to pursuing and achieving goals and may even be primary concerns brought to counselors.
Reflections of feeling also have several components (Ivey et al., 2014). As with paraphrases, reflections of feeling require that the counselor listen to what the client is communicating and to process and think about what has been heard, considering both the verbal and nonverbal components of a client response, as nonverbal channels are particularly important in the communication of affect. A reflection of feeling always includes a feeling label, which is the defining characteristic of this type of response (e.g., “You are angry” or “You are feeling very discouraged”). In addition, because the focus of the exploration of feelings in counseling may be in the present rather than the past, often termed “the here and now,” reflections of feeling often use the present verb tense (e.g., “You feel angry about what he said” as opposed to “You felt angry when he said that”). A reflection of feeling may also provide a context for the feeling reflected (e.g., “You are feeling __________ about ____________” or “You are feeling _____________ because ____________”). In addition, as with a paraphrase, a stem may be included, and a check for accuracy may also be included. Finally, because conflicting feelings are often important in counseling in sorting out those conflicting feelings, reflections may highlight those conflicting feelings (e.g., “So, on the one hand you are feeling ____________________ but at the same time you are also feeling _____________________.”).
Reflections of feeling encourage clients to continue talking and exploring the feelings communicated in greater depth. As with paraphrases, reflections of feeling may have different degrees of inference in the extent to which they go beyond the feelings explicitly communicated in the words spoken by clients, but perhaps communicated through nonverbal channels. Going beyond what has been communicated explicitly may facilitate greater depth of exploration and, as indicated for paraphrases, clients may not accept the refl ections or may even react defensively, particularly if they are not aware of the feelings they are communicating implicitly, or if the reflection is not particularly accurate. Also, as true for paraphrases, refl ections of feeling can serve as alternatives to questions in encouraging exploration of feelings. Finally, clients may not be accustomed to being listened to, particularly when they are communicating feelings, and reflections can thus communicate caring and attempts to understand, facilitating the development of working relationships with clients.
Summarisations
Summarisations are also listening responses, similar to paraphrases and reflections of feeling, and they may focus on content or feelings communicated by clients or both (Ivey et al., 2014). The difference from paraphrases and reflections of feeling is that, rather than focusing on an immediately previous client response, they focus on a more extended series of client responses. Summarisations can have several important uses in counseling. They can be used at the end of an interview, summarizing what has occurred in the interview and highlighting the things that counselors may particularly want clients to remember and reflect on prior to the next interview. Similarly, summarisations may be used at the beginning of an interview, summarizing what occurred in the previous session or sessions and then using this summary to move into the current interview. Summarisations may also be used to summarize an extended interaction of a topic just discussed in an interview before transitioning into another topic. Such a use of summarisations can also occur when a client seems to be rambling, to wrap up the topic and transition into a new one. Summarisations are, of course, active listening responses and clearly demonstrate to a client that a counselor has listened and heard what has been communicated and also show that the counselor is attempting to understand what the client is communicating.
A General Interview Strategy
Active listening responses can be organized into a general strategy for organizing and conducting interviews, particularly in the early stages of counseling, which tend to focus on developing an understanding of client concerns and surrounding context and facilitating the telling of client stories. An interview can begin with an open question or open invitation to talk, perhaps preceded by a summarisation of what the counselor recalls from previous information received about the client (e.g., a referral source) or communicated by the client. The counselor then uses follow-up questions, encouragers, paraphrases, and reflections of feeling to explore in greater depth what the client is communicating. When it is time to move on to the next topic, the counselor summarizes what has been communicated and then transitions into the next topic with an open question.
As is true of conversations in general, counselors may sometimes be at a loss as to what to say next, particularly less experienced counselors who may also be uncomfortable with silence. In those instances, one strategy is for counselors to give themselves a moment to think about what a client has communicated previously and identify a specific aspect on which to follow up. This strategy not only allows the client to elaborate on an important topic, but it also provides further clarification for the counselor, which will prompt the counselor to use one of the responses previously discussed to continue the interview. Another strategy for the counselor is to remain silent and use the amount of time necessary to collect his or her thoughts and continue the interview. It is important to remember that a brief period of silence will not halt the flow of the interview, and it will likely improve the counselor’s next steps.
