CLINICAL INTERVIEWING PART 2 - Listening and relationship development

3 - Basic Attending, Listening and Action Skills

Difference between positive and negative attending behaviours

How ethnocultural background and diversity can affect how clients respond to attending and listening behaviours

How and why therapists use nondirective listening behaviours, including: silence, paraphrasing, clarification, relfection of feeling, and summarization

The natural inclination many therapists have toward reassuring clients


Therapists should use reflective, empathic listening regularly, whereas reassurance should come in carefully considered, small doses.

How and why therapists use directive listening behaviours, including: interpretive reflection of feeling, interpretation, feeling validation, and confrontation.


  • Client-centered directives: focus in on exactly what the client is talking about, but are aimed at a deeper level.
  • Therapist-centered directives: typically move clients away from what they're talking about and toward what the therapist deems important.

4 - Directives: Questions and Action Skills

5 - Evidence-Based Relationships

Silence

Paraphrase (or Reflection of Content)

The Simple Paraphrase

The Sensory-Based Paraphrase

The Metaphorical Paraphrase

Intentionally Directive Paraphrases

Clarification

Several forms of clarification:

  • a restatement of what a client said and a closed question, in either order.
  • a restatement imbedded in a double question (an either/or question including 2 or more choices of response for the client
  • clarification used when you don't quite hear what a client said and you need to recheck

2 general guidelines for clarifying:

  1. Admit your confusion over what the client has said.
  2. Try a restatement or ask for clarification, repetition, or illustration. Asking for a specific example can be especially useful.

Reflection of feeling

Summarization

Guidelines: be informal, collaborative, supportive and hopeful.

Feeling Validation

Interpretive Reflection of Feeling

Interpretation

Psychoanalytic or "Classical" Interpretations

Reframing

Confrontation

Section 1: Using general and therapeutic questions

The benefits and liabilities of using questions with clients

How asking some questions can be inappropriate and how asking other questions can be unethical

Guidelines for using questions in an interview

Several different theory-based assessment and therapeutic questions

Section 2: Using directive interviewing behaviours

Why directives and action skills are more or less effective with different clients

A range of different directives and action skills, including explanation, suggestion, agreement-disagreement, approval-disapproval, advice, self-disclosure, and urging

The many general questions available to therapists, how to use them, and their usual effects (and side effects)

The nature and use of directives and action skills

Open questions

Closed questions

Swing questions

Indirect or implied questions

Projective questions

1. Prepare your clients for questions

2. Don't use general questions without nondirective listening

3. Make your questions relevant to client concerns and goals

4. Use questions to elicit concrete behavioural examples and positive visions of the future

5. Approach sensitive areas cautiously