Chapter 3 Attending and Empathy Skills

3 V's + B

"3 V's + B" 1. Visual/eye contact. Look at people when you speak to them. 2. Vocal qualities. Communicate warmth and interest with your voice. 3. Verbal tracking. Track the client's story. Don't change the subject; stay with the client's topic. 4. Body language/facial expression. Be yourself: authenticity is essential to building trust. The 3 V's + B reduce counselor talk time and provide clients with an opportunity to tell detailed stories. Increase awareness of clients' attending patterns. Note clients' patterns of eye contact, changing vocal tone, body language, and topics to which your clients attend and those they avoid. Note individual and cultural differences in attending. Attending behavior and listening are essential for human communication, but we need to be prepared for and expect individual and cultural differences. Listen before you leap! Avoid trying to solve clients' difficulties too soon. Clients developed their concerns over time. It is critical that you slow down, relax, and attend to clients' stories. Use the 3 V's + B to understand clients' concerns and build rapport.

Listening

-the core skill of attending behavior and is central to developing relationships and making real contact with clients. - more than hearing

Awareness, Knowledge, and Skills of Attending Behavior and Empathy Skills

Attention is the connective force of conversations and empathic understanding. We are touched when it is present. We know when someone is not attending to us. Attending behavior is the first and most critical skill of listening. It is a necessary part of all interviewing, counseling, and psychotherapy. Sometimes listening carefully is enough to produce change.

Talk Time

Clients can't talk while you do. Review your sessions for talk time. Who talks more, you or your client? With adults: Client > Counselor. With less verbal clients or children, you may expect: Client < Counselor.

Action: Key Points and Practice of Attending Behavior and Empathy Skills

Central Goals of Listening Four Aspects of Attending Attending Behavior Listening and Individual and Multicultural Differences Attending Behavior Research Empathy The Neuroscience of Active Listening and Empathy Training as Treatment Practice Is of the Essence

Anticipated Result

Clients will talk more freely and respond openly, particularly about topics to which attention is given. Depending on the individual client and culture, eye contact, vocal tone, completeness of story, and body language will vary. Clients will feel understood and be more engaged in exploring their issues. Empathy is best assessed by a client's reaction to a statement and his or her ability to continue the discussion in more depth and, eventually, with better self-understanding.

Additive empathy: Level 3

Counselor's responses add to or link to something the client has said earlier, or a response may be a congruent idea or frame of reference that helps the client see a new perspective.

Basic empathy: Level two

Counselor's responses are roughly interchangeable with those of the client.

Subtractive empathy : Level one

Counselor's responses give back less or distort what the client has said

Neuroscience and Empathy

Empathy is identifiable through functional magnetic resonance imaging and other key technologies. Key to this process are the mirror neurons, which fire when humans or animals act and when they observe actions by another. When listening skills are not successfully implemented, empathy falls apart. Listening and empathy are not just abstract concepts: they are measureable and make a difference in people's lives.

Empathy

Experiencing the client's world and story as if you were that client; understanding his or her key issues and expressing them accurately, without adding your own thoughts, feelings, or meanings. This requires attending and observation skills plus using the important key words of the client while distilling and shortening the main ideas.

The Samurai Effect, Magic, and the Importance of Practice to Mastery

Intentional practice is the magic! Recognize and enhance your natural talents. Greatness only happens with extensive practice. Practice is the breakfast of champions. Skipping practice means mediocre performance. 1. Practice changes your body. Both the brain and body change with practice. 2. Skills are specific. Each skill must be practiced completely before it can be integrated into superior performance. 3. The brain drives the brawn. Changes in the brain are evident in scans. Areas of the brain relating to finger exercises or arm movements show brain growth in those areas. Expect the same in your brain as you truly master communication skills. 4. Practice style is crucial. One can understand attending behavior intellectually, but actually practicing the specific skills of attending makes the difference. 5. Short-term intensity cannot replace long-term commitment. You will want to take what you learn about counseling skills and use it regularly. 6. Practice provides a continuous feedback loop, which leads to even more improvement. In addition, feedback from colleagues on your counseling style and skills is especially beneficial.

Body Language: Attentive and Authentic

Like eye contact, body language patterns differ according to culture. Maintain culturally appropriate distance. Note client's movements in relation to you. Note your own body language patterns in the session. Maintain authenticity in the client relationship.

Implications for your practice

Many clients can benefit from training and education in listening skills.

Visual/Eye Contact

Observe cultural differences in appropriate amounts of eye contact. Maintain and break eye contact as needed for specific results. Observe clients' pupils for dilation. Use specific body language to achieve desired results.

Training as Treatment: Social Skills, Psychoeducation, and Attending Behavior

Social skills training is training in a specific set of psychoeducational strategies oriented toward teaching clients an array of interpersonal skills and behaviors. These skills include a wide range of behaviors, such as listening, dating behaviors, drug refusal skills, assertiveness, mediation, and job interviewing procedures. Virtually all interpersonal actions can be taught through social skills training. Training as treatment is a term that summarizes the method and goal of social skills training. Implications for your practice: Many clients can benefit from training and education in listening skills.

The Usefulness of Silence

Sometimes the most useful thing you can do is to support your client silently. Search for a natural break in the client's speech and attend appropriately. The auditory cortex in the brain remains active when you are attending to silence.

The Value of Redirecting Attention

There are times when it is inappropriate to attend to client statements. For example, a client may talk insistently about the same topic over and over again. Through failure to maintain eye contact, subtle shifts in posture and vocal tone, and deliberate jumps to more positive topics, you can facilitate the interview process. Redirect the conversation to focus on positive assets.

Attending Behavior: The Foundation Skill of Listening

When you use the microskills, you can anticipate how a client is likely to respond. Attending behavior has predictable results in conversations with clients. These predictions are never perfect, but research has shown we can generally expect specific results from various types of helping interventions (Daniels, 2010). If your first attempt at listening is not received well, you can intentionally flex and use a different skill.

Verbals: Following the Client or Changing the Topic

Verbal tracking is staying with your client's topic to encourage full elaboration of the narrative. Selective Attention Selective attention is central to interviewing, counseling, and psychotherapy. Clients will talk about what counselors are willing to hear. How you attend determines the length of the session and whether the client will return. Observe the selective attention patterns of both you and your clients. What do your clients focus on? What topics do they seem to avoid? Ask yourself the same questions..

Accents

What are your reactions to the following accents: Australian, British English, Canadian, French, Pakistani, Castilian Spanish, New England, Southern United States? Avoid stereotyping people with accents different from yours

Attending and Empathy in Challenging Situations

You may think that attending skills are simple and obvious, and may be anxious to move to the "hard stuff." Cognitive learning through reading and study does not mean one has the skills and is really able to listen to clients empathically. Effective listening takes time, commitment, and intentional and deliberate practice.

Training as treatment

a term that summarizes the method and goal of social skills training

Attending behavior

supporting your client with individually and culturally appropriate verbal following, visuals, vocal quality, and body language/facial expression.