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Intentional Interviewing and Counseling: Facilitating Client Development in a Multicultural Society 9th Edition

Allen E. Ivey

Mary Bradford Ivey

Carlos P. Zalaquett

Chapter 6

Encouraging,

Paraphrasing,

and Summarizing:

Active Listening and Cognition

Chapter Goals and Competency Objectives (slide 1 of 2)

Awareness and Knowledge

Value active listening in the communication process.

Identify the role of intentional participation, decision making, and responding to client conversation.

Chapter Goals and Competency Objectives (slide 2 of 2)

Skills and Action

Help clients talk in more detail about their issues of concern and help prevent the overly talkative client from repeating the same facts. Clarify for the client and you, the interviewer, what is really being said during the session.

Check on the accuracy of what you hear by saying back to clients the essence of their comments and providing periodic summarizations.

Develop cognitive empathy and facilitate client cognitive understanding for clearer decision making and more effective action.

Introduction: Encouraging, Paraphrasing, and Summarizing (slide 1 of 6)

Encouraging, paraphrasing, and summarizing are active listening skills at the cognitive center of the basic listening sequence and are key in building the empathic relationship.

When we attend and clients sense their story is heard, they open up and become more ready for change.

Leads to more effective executive brain functioning, which in turn improves cognitive understanding of issues and decision making.

Introduction: Encouraging, Paraphrasing, and Summarizing (slide 2 of 6)

Active listening is a communication process that requires intentional participation, decision making, and responding to client conversation.

Accurate listening leads to client understanding and synthesis, providing clients with a clearer picture of their own stories.

Active listening is central in facilitating our brain’s executive functioning—cognitive understanding and making sense of the emotional underpinnings of the story.

Introduction: Encouraging, Paraphrasing, and Summarizing (slide 3 of 6)

Encouraging: Encourage with short responses that help clients keep talking. They may be verbal, (repeating key words and short statements) or nonverbal (head nods and smiling).

Anticipated Client Response: Clients will elaborate on the topic, particularly when encouragers and restatements are used in a questioning, supportive tone of voice.

Introduction: Encouraging, Paraphrasing, and Summarizing (slide 4 of 6)

Paraphrasing (also known as reflection of content): Shorten or clarify the essence of what has just been said, but be sure to use the client’s main words when you paraphrase. Paraphrases are often fed back to the client in a questioning tone of voice.

Anticipated Client Response: Clients will feel heard. They tend to give more detail without repeating the exact same story. They also become clearer and more organized in their thinking. If a paraphrase is inaccurate, the client has an opportunity to correct the interviewer. Paraphrasing of client statements is important in cognitive empathy.

Introduction: Encouraging, Paraphrasing, and Summarizing (slide 5 of 6)

Summarizing: Summarize client comments and integrate thoughts, emotions, and behaviors. Similar to paraphrasing but used over a longer time span.

Anticipated Client Response: Clients will feel heard and often learn how their complex and even fragmented stories are integrated. A summary helps clients make sense of their lives and will facilitate a more centered and focused discussion. Secondarily, a summary also provides a more coherent transition from one topic to the next or a way to begin and end a full session. As a client organizes the story more effectively, we see growth in brain executive functioning and better decision making.

Introduction: Encouraging, Paraphrasing, and Summarizing (slide 6 of 6)

Checkout/Perception Check: Periodically check with your client to discover how your interviewing lead or skill was received. “Is that right?” “Did I hear you correctly?” “What might I have missed?”

Anticipated Client Response: Interviewing leads such as these give clients a chance to pause and reflect on what they have said. If you indeed have missed something important or distorted their story and meaning, they have the opportunity to correct you. Without an occasional checkout, it is possible to lead clients away from what they really want to talk about.

Awareness, Knowledge, and Skills: Encouraging, Paraphrasing, and Summarizing

A client, Jennifer, enters the room and starts talking immediately.

I really need to talk to you. I don’t know where to start. I just got my last exam back and it was a disaster—maybe because I haven’t studied much lately. I was up late drinking at a party last night and I almost passed out. I’ve been sort of going out with a guy for the last month, but that’s over as of last night. . . . [pause] But what really bothers me is that my mom and dad called last Monday and they are going to separate. I know that they have fought a lot, but I never thought it would come to this. I’m thinking of going home, but I’m afraid to. . . .

Jennifer continues for another 3 minutes in much the same vein, repeating herself somewhat, and seems close to tears. At times, speech is so fast that it is hard to follow her. Finally, she stops and looks at you expectantly.

Basic Techniques and Strategies of Encouraging, Paraphrasing, and Summarizing (slide 1 of 3)

Encouraging

Encouragers are verbal and nonverbal expressions the counselor or therapist can use to prompt clients to continue talking.

Head nods and positive facial expressions

Open gestures

Minimal verbals – “Ummm” or “Uh-huh”

Repetition of key words from last statement

Silence with appropriate nonverbal behavior

Basic Techniques and Strategies of Encouraging, Paraphrasing, and Summarizing (slide 2 of 3)

Paraphrasing

Paraphrasing is the most important cognitive empathic listening skill.

An accurate paraphrase usually consists of four dimensions:

A sentence stem that may include the client’s name.

The key words used by a client to describe the situation or person.

The essence of what the client has said in briefer and clearer form.

A checkout for accuracy.

Basic Techniques and Strategies of Encouraging, Paraphrasing, and Summarizing (slide 3 of 3)

Summarizing

Summarizing pulls together and organizes client conversation, supporting the brain’s executive functioning.

Summarizing is key to Theory of Mind (ToM) and your ability to “mentalize” the world of the client.

Attend to client’s verbal and nonverbal comments.

Selectively attend to key concepts.

Restate key concepts to the client accurately.

Check for accuracy at the end.

Observe: Listening Skills and Children (slide 1 of 2)

Listening skills are used with children in much the same way as they are used with adults.

Children generally respond best if you seek to understand the world as they do.

Smiling, warmth, and the active listening skills are essential.

Questions can put off some children but remain one of the best ways to obtain information.

Seek to get the child’s perspective.:

Observe: Listening Skills and Children (slide 2 of 2)

Reflection Questions

What do you think about the interview with Damaris conducted by Mary Bradford Ivey?

What did you notice that the interviewer did well?

Did listening skills help to bring out Damaris’s story?

What can you expect if you use these same skills with an adult?

Did Mary focus on strengths?

Multiple Applications: Additional Functions of the Skills of Encouraging, Paraphrasing, and Summarizing

When we attend to clients and use the active listening skills, we facilitate executive functioning and the development of new neural networks that become part of long-term memory in the hippocampus.

Executive functioning is also critical for emotional regulation.

Cognitions may be defined as language-based thought processes underlying all thinking activities.

Therapies focusing on changing cognitions to achieve client change: cognitive behavioral therapy (CBT), rational emotive behavioral therapy (REBT), and dialectical behavior therapy (DBT)

Multicultural Issues in Encouraging, Paraphrasing, and Summarizing

Language is one of the important issues related to the listening skills.

Building trust requires learning about the other person’s world.

Involve yourself in the cultural communities and activities.

Discuss cross-cultural differences early in the interview.

When you are culturally different from your client, self-disclosure and an explanation of your methods may be helpful.

Consider gender differences.

Practice, Practice, Practice

Encouraging, paraphrasing, and summarizing are central skills to effective counseling and psychotherapy, regardless of your theory of choice and natural style.

Intentional competence in these skills requires practice.

Every client needs to be heard, and demonstrating that you are listening carefully makes a real difference.

Achieving intentional competence takes time and practice.

Dr. Amanda Russo highlights the rewards of practice (p. 147).

Action: Key Points and Practice of Encouraging, Paraphrasing, and Summarizing

Purpose of Listening Skills

Encouragers

Paraphrases

Summarizations

Active Listening, Cognition, and Executive Functioning

Diversity and Active Listening

A Word of Caution