Basic Skills for Counselling (Reflections)

The artistic counsellor catches the feelings and emotions of the client. Our emotional side often guides our thoughts and actions, even without our conscious awareness. (Allen Ivey)

As we talked about paraphrasing in the last section, you should know that paraphrasing is used to restate the content part of the message. However the reflections are used to rephrase the affective part of the message. These two might be a little similar but we need to consider that a reflection adds to the message an emotional tone or component that is lacking in a paraphrase.

The Process of Reflection

The Purpose of Reflections:

1. Reflections are used to encourage clients to express their feelings (both positive and negative) about a particular situation, person, idea or whatever. Some clients do not readily reveal feelings because they have never learned to do so; other clients hold back feelings until the helper gives permission to focus on them. Expression of feelings is not usually an end in itself; rather it is a means of helping clients and practitioners understand the scope of the issues or situation.

2. Help clients manage feelings. Learning to deal with feelings is especially important when a client experiences an intense emotion such as fear, dependency or anger. Strong emotions can interfere with a client's ability to make a rational response to pressure. Also, when clients are given permission to reveal and release feelings, their energy and well-being are often increased. For example when a crisis such as earthquake or tsunami or a terrorist attack occurs, people feel overwhelmed by the intensity of their emotions. This feeling can persist for months or even years after the event. Practitioners who help clients in these sorts of  situations do so in part by encouraging them to name, validate and express their emotions in a safe context.

3. A third use of reflection in with clients who express negative feelings about therapy or about the helper. When a client becomes angry or upset with the helper or with the help being offered, there is a tendency for the helper to take the client's remark personally and become defensive. Using reflection in these instances "lessens the possibility of an emotional conflict, which often arises simply because two people are trying to make themselves heard and neither is trying to listen". This lets clients know that the helper understands their feelings in such a way that the intensity of the anger is usually diminished. As anger subsides, the client may become more receptive, and the helper can again initiate action-oriented responses or intervention strategies.

4. Reflection also helps clients discriminate accurately among various feelings. Clients often use feeling words like anxious or nervous that, on occasion, mask deeper or more intense feelings. Clients may also use an affect word that does not really portray their emotional state accurately. For instance, it is common for a client to say "It's my nerves" or "I'm nervous" to depict other feelings, such as resentment and depression. Other clients may reveal feelings through the use of metaphors.  A client may say "I feel like the person who rolled down Niagara Falls in a barrel" or "I feel like I just got hit by a Mack truck". Metaphors are important indicators of client emotion. They suggest that much more is going on with the client than just the "surface expression". Accurate reflections of feelings help clients to refine their understanding of various emotional moods.

5. Feel if reflections are used accurately, they help clients to feel understood. Clients tend to communicate more freely with persons who they feel try to understand them. When understanding is present, clients feel that they have been seen and are no longer invisible, alone, strange or unimportant. At that moment the client begins to perceive the therapist as someone who is different from many others in their livesand possibly as someone who can help.

Feeling Category
Relative Intensity of Words	Anger	Conflict	Fear	Happiness	Sadness
Mild Feeling	Annoyed Bothered Bugged Irked Irritated Peeved Ticked	Blocked Bound Caught Caught in a bind Pulled	Apprehensive Concerned Tense Tight Uneasy	Amused Anticipating Comfortable Confident Contented Glad Pleased Relieved	Apathetic Bored Confused Disappointed Discontented Mixed up Resigned Unsure
Moderate Feeling	Disgusted Hacked Harassed Mad Provoked Put upon Resentful Set up Spiteful Used	Locked Pressured Strained Torn	Afraid Alarmed Anxious Fearful Frightened Shook Threatened Worried	Delighted Eager Happy Hopeful Joyful Surprised Up	Abandoned Burdened Discouraged Distressed Down Drained Empty Hurt Lonely Lost Sad Unhappy Weighted
Intense Feeling	Angry Boiled Burned Contemptful Enraged Fuming Furious Hateful Hot Infuriated Pissed Smouldering Steamed	Coerced Ripped Wrenched	Desperate Overwhelmed Panicky Petrified Scared Terrified Terror-stricken Tortured	Bursting Ecstatic Elated Enthusiastic Enthralled Excited Free Fulfilled Moved Proud Terrific Thrilled Turned on	Anguished Crushed Deadened Depressed Despairing Helpless Hopeless Humiliated Miserable Overwhelmed Smothered Tortured

The table above is a great list which includes many commonly used affect words at three levels of intensity which can be used widely for reflection purposes by counsellors and helpers.

Basic Skills for Counselling (Paraphrasing)

A paraphrase is a rephrasing of the client's primary words and thoughts. Paraphrasing requires selective attention to the content part of the message and translating the client's key ideas into your own words.
An effective paraphrase does more than just parrot the words of the client. The rephrase should be carefully worded to lead to further discussion or to increased understanding by the client. It is helpful to stress the most important words and ideas expressed by the client. Look at this example:

Client: I know it doesn't help my depression to sit around or stay in bed all day. 
Helper: You know you need to avoid staying in bed or sitting around all day to help your depression. 

The helper merely parroted the client's message. The likely outcome is that the client may respond with a minimal answer such as "I agree" or "That's right" and not elaborate further, or that the client may feel ridiculed by what seems to be an obvious or mimicking response. Here is a more effective paraphrase:

Helper: You are aware that you need to get up and move around in order to minimize being depressed.


Why do we paraphrase?

It serves several purposes in client interactions:

1. Paraphrasing tells the client that you have understood their concerns and communication. If your understanding is complete and accurate, the client can expand or clarify their ideas.

2. It can encourage client elaboration of a key idea or thought. Clients may talk about an important topic in greater depth.

3. It helps the client to focus on a particular situation or event, idea, or behaviour. Sometimes by increasing focus, paraphrasing can help to get a client on track.

4. To help clients who need to make decisions. Paraphrasing is often helpful to clients who have a decision to make, for the repetition of key ideas and phrases clarifies the essence of the problem. With this skill to emphasize content is also useful if attention to affect is premature or counter-productive.


Paraphrasing Steps:

There are five steps in paraphrasing content:
1. attend to and recall the message by restating it to yourself covertly. "What has the client told me?"
2. Identify the content part of the message by asking yourself: "What situation, person, object or idea is discussed in this message?"
3. Select an appropriate beginning or sentence stem for your paraphrase. It can begin with many possible sentence stems: "It seems like" "It appears as though" "It looks like" "I hear you saying" "From my standpoint" & ...
4. Using the sentence stem you selected, translate the key content or constructs in to your own words, and express the key content in a paraphrase that you can say aloud. Use your voice so that the paraphrase sounds like a statement, not a question.
5. Asses the effectiveness of your paraphrase by listening to and observing the client's response. If it was successful, the client in some way (verbally or non-verbally) confirms its accuracy and usefulness.

Example:

Client, a 40-year-old Asian American woman 
Client: How can I tell my husband I want a divorce? He'll think I'm crazy. I guess I'm just afraid to tell him.
Helper: It sounds like you haven't found a way to tell your husband and you want to end the relationship because of his possible reaction. Is that right?
Client: Yeah--I've decided-- I've been to see a lawyer. But I just don't know how to approach him with this. He thinks things are wonderful, and I don't want to dishonour him by divorcing him.


After paraphrasing we will go through "Reflections"  as another basic skill that we will elaborate more about in later posts.

Basic Skills for Counselling (Clarification)

Because most messages are expressed from the speaker's internal frame of reference, they may seem vague or confusing to the listener. Messages that are particularly likely to be confusing are those that include inclusive terms such as: they and  them. Ambiguous phrases (you know) or words with a double meaning (stoned, trip) may be also confusing. When you aren't sure of the meaning of a message, it is helpful to clarify it. A clarification asks the client to elaborate on "a vague, ambiguous or implied statement." The request for clarification is usually expressed as a question and may begin with phrases such as "Are you saying this" or "Could you try to describe that" or "Can you clarify that".

Purpose of Clarification:

Clarification is usually used to confirm the accuracy of your perceptions about the message. Clarification is appropriate whenever you aren't sure whether you understand the client's message and you need more elaboration. The second purpose is to check out what you heard of the client's message. Particularly in the beginning stages of helping process, it is important to verify client message instead of jumping in to conclusions.
This example may help you see the value of clarification response:

Client: Sometimes I just want to get away from it all. 
Helper: It sounds like you have to split and be on your own. 
Client: No, it's not that. I don't want to be alone. It's just that I wish I could get out from under all this work I have to do. 

In this example, the helper drew a quick conclusion about the initial client message that turned out to be inaccurate. The session might have gone more smoothly if the helper had requested clarification before assuming something about the client, as in this example:


Client: Sometimes I just want to get away from it all. 

Helper: Could you describe for me what you mean by "getting away from it all"?

Client: Well, I just have so much work to do. I'm always feeling behind and overloaded. I'de like to get out from under that miserable feeling. 

You can see how it helped both persons to establish exactly what was being said and felt. None of them had to rely on assumptions and inferences that were not explored and confirmed.

Clarification Steps:

There are four steps involved in clarification responses:
1. Identify the content of the client's verbal and non-verbal messages : What has the client told me?
2. Identify any vague or confusing part of the message that you need to check out for accuracy.
3. Decide on an appropriate beginning, or sentence stem, for your clarification such as: Could you describe, Could you clarify, Are you saying ... 
In addition use your voice to deliver the clarification as a question.
4. Remember to assess the effectiveness of your clarification by listening to and observing the client's response. If the client starts to elaborate on the ambiguous part, you'll know that your clarification was useful.

Paraphrasing and Reflections are two other basic skills that we will go through them in later posts.

Basic Skills for Counselling (Active Listening)

To be an effective counsellor you need to know the basic skills required. These basic skills are not mandatory to be used always, but an effective counsellor needs to know about them and how and when  to apply them with great consideration. After learning these basic skills, you will eventually have more experience to be able to use more sophisticated skills which I call them "artistic skills of counselling".


There are many different basic skills which will be elaboretd here in these posts, but here in this place I will mainly focus on the first one of the skills, which is:

Active Listening:

Listening is a prerequisite for all other helping responses and strategies. Listening should precede whatever else is done. When a helper fails to listen, the client may be discouraged from self-exploring, the wrong issue may be discussed or a may be proposed pre-maturely.
Listening involves three steps: receiving a message, processing a message and sending a message. 

Each client message is a stimulus to be received and processed by the helper.  Reception of a message is covert process - that is, we cannot see how or what the helper receives. Failure to receive the entire message may occur when the helper stops attending. Reception of a message may be thought of as contemplative listening. A prerequisite for contemplative listening is the ability to be silent. Interestingly enough the same letters that spell LISTEN also spell SILENT. When we are truly silent, we are not focused on what we are going to say next. Instead we are creating space for ourselves to receive a message and for clients to send a message. Unfortunately because our world is so noisy, true silence is uncomfortable for many of us and must be cultivated with daily practice. Turning off cell phones and pagers and sitting silently with oneself for a few minutes a day is a great way to develop contemplative listening skills.

Once a message is received, it must be processed in some way. Processing, like reception, is covert: it goes on within the helper's mind and is not visible to the outside world except, perhaps, from the helper's non-verbal cues. Processing includes thinking about the message and pondering its meaning. It's important because a helper's cognitions, self-talk and mental (covert) preparation and visualization set the stage for overt responding. Errors in message processing often occur when  helper's biases or blind spots prevent them from acknowledging parts of a message or from interpreting a message without distortion.
Helpers may hear what they want to hear instead of the actual message sent. Processing a message may be thought of as Reflective listening. In this phase of listening, we are listening to ourselves and focusing our attention inward in order to develop sensitivity to our internal voice. Taking a few breaths before responding to a client's message and then, after the breaths, asking oneself, "What wants to be said next?" instead of "What do I want to say next?" is a good way to monitor and practice reflective listening.

The third step involves the verbal and non-verbal messages sent by a helper. Sometimes a helper may receive and process a message accurately but have difficulty sending a message because of lack of skills. Fortunately you can learn to use listening responses to send messages. When sending messages back to our clients, we are engaging in listening that is connective- that is, listening that in some way connects us with our clients.

When we are working with clients who are culturally different from us, understanding may be even more challenging because of cultural nuances in communication and expression. While breakdowns in communication often happen between members who share the same culture, the problem becomes exacerbated between people of different racial or ethnic backgrounds.

To finish this part :
Listening is the art by which we use empathy to reach across the space between us. Genuine listening means suspending memory, desire, judgement and for a few moments at least, existing for the other person.

After this we will go through some verbal listening responses that you can use to send messages to a client and enrich the process of counselling. These are: Clarification, Paraphrasing, Reflection and Summarization.