Listening and Responding: Skills and a Framework for Helping People Change



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Listening and Responding: Skills and a Framework for Helping People Change J. Scott Yaruss, Ph.D., CCC-SLP Assistant Professor, University of Pittsburgh Clinical Research Consultant, Children s Hospital of Pittsburgh Co-Director, Stuttering Center of Western PA 1

My philosophy of teaching Do I have a philosophy? 2

My philosophy of teaching Do I have a philosophy? Yes! I guess I do 3

My Teaching Goal Students will develop the skills they need to help clients achieve their goals in treatment Counseling is an integral part of the therapeutic process in communication disorders, regardless of the specific nature of the disorder All speech-language pathologists need to develop counseling skills 4

My Teaching Goal Students will develop the skills they need to help clients achieve their goals in treatment Understand basic theories of counseling Humanistic Person-centered Gestalt Existentialist Behaviorist Rational Emotive Cognitive Restructuring 5

My Teaching Goal Students will develop the skills they need to help clients achieve their goals in treatment Understand basic principles of counseling Attending Listening Valuing Probing Challenging Summarizing 6

My Teaching Goal Students will develop the skills they need to help clients achieve their goals in treatment Understand how counseling relates to the scope of practice in communication disorders What is the boundary between speech-language pathology and counseling psychology? 7

Accomplishing the Goal Students will develop the skills they need to help clients achieve their goals in treatment Students need time to PRACTICE their counseling skills if they are going to be able to use them in clinical settings Many students are uncomfortable (at first) talking about the issues that may come up in treatment for communication disorders 8

Step One: Learning to talk about stuff Feelings our clients have Challenges our clients face Unpleasant things that happen to people Situations we wouldn t want to face ourselves Clinicians need their counseling skills to help their clients with the issues that the clients couldn t handle on their own 9

How my teaching has evolved Well, it still hasn t had time yet I have moved more and more toward giving students the opportunity to DEVELOP their microskills for counseling rather than just being taught them 10

Organizing principles for my class AND my own clinical interactions Learning Counseling Microskills Understanding the Importance of Change 11

Counseling Microskills I What does it take to be an effective counselor?!? How does a student develop good listening skills?!? LISTENING the ability to Attend to what the client is saying Convey through verbal and nonverbal means that you understood the client s experiences, behaviors, and feelings PRACTICE 12

Learning to Listen Some people are born listeners most of us have to develop the skill Students develop attending and listening skills by practicing with each other Role-playing interview scenarios Observing each other while listening and providing feedback about their classmates Practicing common listening mistakes then attempting to correct them 13

Counseling Microskills II What does it take to be an effective counselor?!? RESPONDING the ability to Let the client know you can understand his perspective Provide feedback that helps clients make changes in their lives How does a student develop good responding skills?!? PRACTICE 14

Learning to Respond It is not enough to understand what a client is saying, we also have to let him know that we understand Empathetic responses let clients know we have heard and respected their message Probes help clients consider their situation more deeply and lead to new insights Challenges encourage clients to examine their assumptions and consider new perspectives Summaries help clients integrate experiences 15

Learning to Respond It is not enough to understand what a client is saying, we also have to let him know that we understand Students may be uncomfortable, at first, with these types responses, so they need lots of time to practice 16

Learning to Respond It is not enough to understand what a client is saying, we also have to let him know that we understand Students may be uncomfortable, at first, with these types responses, so they need lots of time to practice We spend a lot of time in role-plays practicing different responses to scenarios and evaluating which response is better 17

The Importance of Change Any counseling interaction should be focused on the goal of treatment to help the client make changes that move them to their desired outcome to help the client solve problems that stand in the way of these changes It is not enough to have a good talk Clinicians must have a plan in mind that will help the clients achieve change 18

A Blueprint for Change (Egan, 2002) (The Skilled Helper model) Stage I: Current Scenario Stage II: Preferred Scenario Stage III: Action Strategies Helping the client tell his or her story Identifying possibilities for the future Identifying possible courses of action Identifying "blind spots" in the client's perspective Setting and agenda for change Determining which action provides the "best fit" Leverage: Determining which issues should be addressed Making a committment to the process Formulating a plan for achieving the client's goals ACTION leading to the desired outcomes 19

A Blueprint for Change (Egan, 2002) (The Skilled Helper model) Stage I: Understanding the current scenario where are you now? Stage II: Identifying the preferred scenario where do you want to go? Stage III: Developing action strategies how are you going to get there? Action Arrow: The whole point is to help the client achieve goals in therapy 20

A Blueprint for Change (Egan, 2002) (The Skilled Helper model) Using this model, students learn that the point of counseling is to help the client move in a specific direction that counseling involves more than just talking to the client and active listening how to identify roadblocks to change that affect the client s success in therapy And they can develop the confidence they need to develop an effective partnership with their clients 21

Summary Counseling is an integral part of the therapeutic process for all communication disorders Students not only need to understand the goals and processes of counseling; they must also practice the microskills necessary for helping clients make the changes to achieve their treatment goals 22