Communication Barriers

Read: France & Weikel: Chapters 1, 2, 5

Weikel, K.F. K. (2019). Helping Skills for Human Service Workers: Building Relationships and Encouraging Productive Change (4th ed.). Charles C Thomas Publisher Ltd..  https://mbsdirect.vitalsource.com/books/9780398093044

Chapter 1 INTRODUCTION

Clients in helping relationships make progress when they feel understood and actively work toward goals they care about, as documented by extensive research (Norcross & Lambert, 2018). This book applies those findings by presenting ways for promoting rapport and facilitating desired change. We describe ways to create positive relationships and engage clients in joint efforts that focus on develop-ing adaptive targets to work toward and achieving productive out-comes. There are many approaches one can take when working with clients. Research indicates, however, that regardless of the approach taken, clients improve more when they experience a strong helping bond with the human service worker (Flückiger, Del Re, Wampold, & Horvath, 2018). To better understand that bond, the American Psy-chological Association’s Society for the Advancement of Psychother-apy and Society for Counseling Psychology developed a task force to investigate specific relationship factors associated with productive client change. After rigorous review of extensive research, the task force concluded that strong and consistent research findings docu-ment the effectiveness of several factors in person-to-person human service relationships: developing a helping alliance, demonstrating empathy, collecting and providing client feedback, communicating positive regard and affirmation, and agreeing on goals (Norcross & Lambert, 2018). Those factors are important components of the help-ing skills discussed in this book. We address ways of developing a helping alliance in Chapter 3, with emphasis on conveying empathy and positive regard. We suggest enhancing the helping alliance through collaborative problem solving in Chapter 4 and cooperativegoal setting in Chapter 6. Collecting and providing client feedback regarding progress toward those goals is also a central focus of the material in Chapter 6. The remaining chapters discuss ways to en-hance those fundamental skills. Now that we have looked at the worker’s perspective, let’s consider the client’s point of view. Clients requesting assistance from human service workers often are feeling anxious, low, or combinations of both emotions. There are essential commonalities among anxiety and de-pressive disorders according to empirical evidence reviewed by Barlow, Allen, and Choate (2004; reprinted in 2016 by the same journal). They assert that at the core of those disorders is a sense of being un-able to control events, which results in negative emotions. Emotional disorders can arise out of biological predispositions and early learning experiences, and then intensify during challenging situations in which individuals perceive a lack of control. According to Barlow and his colleagues, successful therapeutic in-terventions focus on building a basic sense of being able to influence events. The development of such confidence can be supported in a number of ways. Possibilities include the following three strategies: (1) logically thinking through things prior to taking on challenging situa-tions (such as realistically estimating both the likelihood of negative events happening and the true nature of negative consequences that actually might occur), (2) actively exploring ways of confronting and dealing with challenging situations, and (3) accepting emotions rather than expending effort trying to avoid them. Consistent with the ideas of Barlow and his associates, the problem-solving approach described in Chapter 4 can be used to help clients control what they are able to influence. We support the following: (1) logically thinking through challenging situations in advance, (2) exploring ways of confronting those situations and dealing with them adaptively, and (3) accepting negative emotions and then addressing their causes via realistic problem solving to bring about environmen-tal change and/or by adaptively modifying the way one views the cir-cumstances. ENCOURAGING CLIENT AUTONOMY AND SELF-EFFICACY Throughout the book we emphasize providing a supportive rela-tionship in which clients can explore their thoughts and feelings, consider options, and make their own decisions regarding changes they might like to implement. In other words, we support client autonomy. Research has demonstrated that individuals try harder and perform better when changes are more internally motivated and are developed in a nonauthoritarian context, than when change is motivated by the expectations of others (Jang, Kim, & Reeve, 2012; Levitt, Pomerville, & Surace, 2016; Sheldon & Elliot, 1999; Vansteenkiste, Simons, Lens, Sheldon, & Deci, 2004). Consequently, we discourage advice giving and encourage active client involvement in problem solving and in the establishment of targets for change. Clients who actively participate in setting targets for behavior change may experience greater self-confidence or, more specifically, greater self-efficacy regarding their abilities. Albert Bandura (1997) de-fined self-efficacy as belief in one’s ability to successfully execute a par-ticular behavior. He noted that self-efficacy predicts how much effort and persistence one puts into changing a behavior. Clients with high-er self-efficacy regarding coping and behavior change (in other words, clients who believe they actually will be able to cope with difficulties and accomplish desired change) are more likely to persist when faced with obstacles and are, consequently, more likely to successfully bring about desired change. Research confirms that stronger belief in one’s ability to accomplish change is associated with greater success. This effect has been demonstrated in a variety of areas, including the fol-lowing: overcoming phobias, achieving and maintaining weight loss, improving athletic performance, increasing activity level, coping with anxiety, and abstaining from drug and alcohol use (Bandura, 1997; Bandura & Locke, 2003; Evon & Burns, 2004; Kuusisto, Knuuttila, & Saarnio, 2011; Rejeski et al., 2003). Research has also suggested that self-efficacy is associated with in-ternal motivation and helping alliance. For example, one study (Heins, Knoop, & Bleijenberg, 2013) looked at factors influencing fatigue in persons who had participated in treatment for chronic fatigue syn-drome. Lower levels of post-treatment fatigue were associated with higher self-efficacy for controlling one’s fatigue and with the person’s degree of agreement with the therapist on what the necessary steps were to achieve one’s treatment goals. Researchers are now suggesting that increases in self-efficacy may be one of the reasons that helping bond is associated with productive change. Links between helping alli-ance and improved client self-efficacy have been found to be associated with outcomes such as improving diet and exercise following car-diac events (Burns & Evon, 2007) and abstaining from misuse of alco-hol (Hartzler, Witkiewitz, Villarroel, & Donovan, 2011). Given the links among autonomy, self-efficacy, and successful cop-ing, efforts to foster autonomy and self-efficacy seem important. Bandura (1997) identified a number of ways to enhance self-efficacy, including receiving credible verbal encouragement and successfully accomplish-ing what you set out to do. He suggested that performance success, or what he called mastery experience, is a primary way of increasing self-efficacy. From our perspective, both self-efficacy and autonomy are enhanced when the worker encourages productive change by helping clients engage in adaptive coping efforts that foster success in areas which are important to them. Consequently, in this book we empha-size developing rapport and alliance, while also encouraging autono-my and self-confidence through collaborative problem solving and goal setting. REWARDS AND COSTS OF USING HELPING SKILLS Let’s consider some of what you do as an effective human services worker. Since the ultimate goal is for clients to develop insights and to cope more adaptively, you encourage their input and foster their ini-tiative. Using the least amount of authority necessary, you seek to understand feelings, and you encourage the expression of ideas. By sharing responsibility for determining the subject matter and the pac-ing of interactions, you put clients in position to take credit for pro-gress they make, thereby enhancing their self-efficacy and autonomy. The preceding considerations imply both rewards and costs for you. Costs include: • as a student, trainee, or new employee, you must make the effort to learn the art of helping; • as a skilled worker, you will need to allot sufficient time for prob-lem-solving interactions with clients (with about 20 minutes being the minimum for an initial problem-solving discussion).

Introduction 7 Rewards include: • knowing you can flexibly deal in-depth with a wide range of top-ics; • possessing the skills to create and maintain a productive alliance in which the client eventually emerges as being responsible for positive change. In addition to rewards within the worker-client relationship, learn-ing helping skills has other advantages, including both relationship-building and career-enhancing benefits. Let’s consider some of those, starting with the career side. When CEOs of human service organizations are asked to name the skills they would most like to see in an entry-level staff member, effec-tive interpersonal communication often tops their lists. Consequently, developing the skills discussed in this book will give you very mar-ketable abilities. With regard to relationship building, one of the most universally helpful forms of assistance is appraisal support. This form of assistance means aiding others in understanding and coping with problems. Since facilitating problem solving is a key skill that we will address, learning the material that follows will enhance your ability to provide one of the most valued forms of social support. Of course, when you are with friends, you aren’t always talking about problems, and lighthearted exchanges often have an unfocused quality. But in this book we are concentrating on something different. Compared to social conversation with acquaintances, discussions with clients can be distinguished in several ways. First, the interactions are planned. Second, the focus is on clients’ thoughts and feelings. And third, human service workers do not avoid unpleasant topics. MAKING PROGRESS Since you are reading this book, it’s likely that communicating effec-tively is important to you. And because of your interest, you probably already possess a good set of abilities. But you may be in for a surprise. When trying helping strategies for the first time, individuals often feel awkward and uneasy. And it is common to find that the quality of your skills actually declines during the initial phase of training. Al-though it is not unusual for helping skills students to doubt their abil-ities, results of empirical studies suggest that self-efficacy increases and stress decreases with training and experience (Goreczny, Hamilton, Lubinski, & Pasquinelli, 2015; Lent et al., 2009; Levitt, 2001). Wrestling with the material that follows will be demanding and fre-quently will require a fair amount of trial and error. On the other hand, perseverance probably will lead to an ability level that is far bet-ter than your present one. In order to reach that higher plane, you must develop ways of combining your current skills with what you are about to learn. If you are in a class that teaches helping principles, you will see that students progress at different rates. For those who hit their stride a bit later than some of their classmates, seeing others excel can be exas-perating. But such frustration actually can be productive, if it helps one become more effective in using feedback to make adjustments. When you are responsive to feedback and subsequently are able to improve your performance a bit, your self-efficacy for learning helping skills should increase, and you should feel more motivated to contin-ue practicing the skills. Another way of gaining motivation for sticking with the material is to see how productive it is when used in professional settings. If there are opportunities for you to observe skilled human service workers, take advantage of those possibilities. Such experiences can energize you and can help you perceive the value of the techniques you are learning. Another benefit of such observations is that you can see the professional manner in which veteran human service workers do their jobs. Observing staff members calmly handle difficult situations may help you realize that the pressure of being a novice eventually dissi-pates. Bandura (1997) refers to such observation as vicarious experi-ence, and he notes that it can increase self-efficacy. Unfortunately, you may also observe veteran staff members who dis-play inappropriate behavior. Some persons fail to use the helping techniques in which they have been trained. When bad performance is what you encounter, pay attention to the effects it has on clients. And remember that you can learn how to do a better job than the one you are seeing.

THE ROLE OF PRACTICE This book presents essential content and provides realistic scenarios in which you can apply helping principles. Studying the material and completing the exercises will be useful, but we believe the most important learning will take place when you practice with another person, record the interaction, receive feedback from knowledgeable observers, and then use what you have learned the next time you do a role play. Learning from your critiqued performances may be easier if you maintain your own library of recorded role plays you do. Having your personal copy of interactions allows you to review them at your con-venience and also provides evidence of your improvement over time. If you are a student in a helping skills class, you probably will do role-play interactions as part of the course. But it is also possible to arrange role plays yourself. Such efforts can be worthwhile if you re-cord the interactions and have them critiqued by a person who appre-ciates what you are trying to learn. Doing recorded role plays and being evaluated by others can be nerve-wracking. As we have noted, however, such nervousness usual-ly decreases with time and experience. During the interaction, try to stay calm. You will feel more relaxed as the novelty wears off. Once you are a veteran with several practice role plays under your belt, the learning cycle will be more familiar. You will become accus-tomed to the process that involves (1) identifying areas needing im-provement, and (2) making appropriate adjustments. It is natural to regret having behaved in ways that led to corrective feedback. But the goal is to learn from your miscues, rather than to become anxious about the fact that you are not perfect. Instead of worrying about your own imperfections, during a role play you should focus on the client. As a worker who is supposed to be assisting that person, the number one priority in your practice in-teractions is to concentrate on the client’s words and nonverbal behav-ior. Keep your focus on the other person. Pay attention to what the individual is saying. While the person is talking, do not think about what you are going to say next. Simply listen. When there is an oppor-tunity for you to speak, gather your thoughts and make an appropriate response. Immediately prior to your comment, a few moments of relaxed silence are perfectly acceptable. You may need to read the preceding paragraph again. As informa-tion from a client begins to accumulate, most novices feel a great temptation to begin planning a response, in order to be ready with a comment when the opportunity arrives. But if you start thinking about yourself, you stop listening to the client. Consequently, the response you make is likely to be out of touch with the totality of what the client has communicated. On the other hand, accomplished human service workers rarely make such gaffs, because they focus on their clients rather than on themselves. In order to assist your efforts at becoming a skilled human services worker, this book presents a number of useful techniques. In general, a set of techniques has value if it provides effective ways of thinking and behaving. Much of the power of these adaptive strategies comes from the self-efficacy you experience once you become proficient with them. When armed with a set of methods that you feel comfortable using, you expend less effort on thinking about your abilities, and you focus more energy on actually getting the job done. Although techniques can be beneficial, it is also possible for them to be counterproductive if they are applied in a rigid or artificial man-ner. Consequently, when employing the strategies described in the chapters that follow, you should always use them with flexibility and common sense. INTRODUCTIONS If you are learning helping skills in a group setting, how you get along with others in the group is more important than interpersonal relationships in traditional lecture-discussion environments. Since most skill-development formats involve giving feedback to one another, par-ticipants and leaders need to feel comfortable with each other and need to share a certain amount of trust. One approach to laying a foundation for group cohesiveness is to begin with an introductions exercise. The activity we recommend is found in Appendix A. If you are in a class that will be using it, you should not read Appendix A be-fore participating in the exercise.

YOUR CURRENT SKILLS In preparation for the next chapter, it is worthwhile to take a base-line measure of your current helping style. A good way to sample your skills is for you to do a role play. If you are in a course, one option is for the instructor to conduct a baseline exercise, which can be struc-tured in the following manner. The class divides into three-person groups. In each group there is an observer, a client, and a worker. The task of the observer is to write what the worker says. (It probably will be impossible to write everything, so just be sure to jot down the first few words of each comment and as much of the rest of it as you can.) The task of the client is to portray a person in need of problem-solv-ing assistance. (Your instructor may provide you with a scenario to role play.) And the task of the worker is to do what you think is appro-priate in such an interaction. The role play need not be long. Gen-erally, three to five minutes is sufficient. The reason for the baseline exercise is to get an indication of your group’s current skills. Consequently, these role plays probably will dif-fer from later ones in two ways. First, there is no feedback after the role play. The intent is to get a sample of everyone’s skills, rather than to change those skills. Second, the observer keeps the observation notes rather than giving them to the worker. Observers retaining their own observer notes allow the workers to remain anonymous as the baseline measures are discussed in class. When processing baseline role plays, remember not to identify indi-viduals who made worker comments that come up for discussion. The purpose of the exercise is not to identify who said what. Instead, the objective is to discover the kinds of responses made by members of the group. Another way of measuring your current skills is to do the dialog exercise in Appendix B. Your instructor may give you directions with regard to the exercise. If that is not the case, you should do it on your own prior to reading Chapter 2. feedback. The purpose of such critiques is for participants to consider their efforts and to modify behaviors that show room for improve-ment. But, as results of empirical research have demonstrated (Daniels & Larson, 2001), being told that one has made mistakes can evoke strong reactions. Since feedback is helpful only if the recipient uses it, here are some guidelines for productive evaluations. Focus on what the worker actually did. To the best of your ability, describe what the worker said or did, then state what you liked or did-n’t like about it. Since there are many correct ways of handling any situation, it generally is not productive to concentrate on “should haves,” “would haves,” or “could haves.” Wide-ranging discussion of alternative responses can take place after feedback to the worker is over, but not as part of commentary on his or her performance. Be succinct. We all have limits on how much criticism we can absorb. Oversaturation is not productive. Consequently, think about the points you want to make, communicate them to the person, and then stop. If there is an instructor or trainer who gives feedback, pay attention to how that person delivers both positive and corrective feedback. Over time, feedback you give will become increasingly more like that of the leader. As we have said, for all but the baseline role plays, there should be written feedback on every training interaction you do. There are a variety of formats for arranging written comments; Appendix C con-tains the approach we use. Just as there are different ways of providing written feedback, there are also various approaches to structuring a helping skills course. In Appendix D, you will find one set of possibilities regarding class orga-nization. SUMMARY When used effectively, helping skills engage clients in an alliance intended to promote effective coping. Once you become a skilled worker who schedules sufficient time for interactions, you will be able to facilitate flexible contacts that leave clients feeling responsible for Introduction 13 productive changes that take place. In addition, learning the art of helping can increase your professional marketability, as well as enhance your effectiveness in offering social support. Learning helping skills typically involves practicing, making mis-takes, and using feedback to do better the next time. The trauma of role playing usually lessens with repetition, and performance general-ly improves when workers focus on their clients rather than on them-selves. Initial tasks in a helping skills course include taking measures of your current skills and becoming comfortable with the persons who will be giving you feedback. When you are the one providing feed-back, you should succinctly focus on actual behavior displayed by the worker.

Chapter 2 FIVE WAYS OF RESPONDING

Take a look at the dialog exercise (Appendix B) and see where your slash mark is for option A. Since the dread being felt by the client is discounted by that response, it is an insensitive comment. Hopefully, you were dissatisfied with the statement and placed your mark toward the left end of the line. But if your mark is on the right portion of the line, and you still believe the comment is a good one, you should dis-cuss the item with a knowledgeable person, such as your instructor or your supervisor. Option A functions as a litmus test. Its purpose is to verify that we share a common starting point for viewing responses as being helpful or detrimental. Now let’s begin to make some finer distinctions. David Johnson (2014) has asserted that when one person is trying to be supportive of another, most comments from the would-be helper can be categorized according to five modes of response. Each of these modes has a different objective, and each has its own effects on the interaction. ADVICE The purpose of advice is to tell others what to do. Results of empir-ical research suggest that such direct guidance is often associated with interactions that workers subsequently view as being shallow and of little value, and that clients subsequently see as being rough and unpleasant (Friedlander, Thibodeau, & Ward, 1985). Advice provides ready-made courses of action, rather than encour-aging individuals to generate their own solutions. When you bypass others’ own decision-making capabilities, you communicate the belief that you are in a better position than them to decide what should be done, and you may damage their self-esteem by implying that your ideas are superior to theirs. Your clients’ agreement or disagreement with your high opinion of yourself will be reflected in one or more of the following basic consequences that can follow advice giving. • Rejected. If you tell a client what to do, the person may reject the advice. When that happens, the individual may also have come to believe that you do not really understand the problem, since you made such an inappropriate suggestion. Consequently, reject-ed advice often is a sign of poor rapport, which can hinder sub-sequent efforts at relationship building. • Accepted. The client may accept the advice. That probably is what you wanted when you made the suggestion. But there still may be trouble ahead, since there are additional possibilities. • Failed. Having accepted your advice, the client actually tries it. The result, however, is a miserable failure. Circumstances now may be worse than they were before, and the client may blame you for the mess. Such finger pointing can occur even if the advice was good and the problem actually was with the client’s implementation of your recommendations. • Worked. This is the best possible outcome. You give advice, it is accepted, and it works. When faced with a new and equally dif-ficult decision, what is the client going to do? Having successful-ly implemented your advice in the past, the person may again turn to you for guidance. If that happens, you may be fostering dependency, rather than encouraging independent problem-solv-ing abilities. Recognizing the risks of advice, there are times when it is appro-priate. The most crucial occasion for advice-giving is during life-threatening situations. For example, with a suicidal person it is always appropriate to say (if you mean it), “I don’t want you to kill yourself.” Although this is telling the individual what not to do, preserving life is worth the risk of dependency. In the dialog exercise, option B is an example of advice. Take a look at where your slash mark is. Next, if you did the baseline role plays, check your observer notes for examples of advice. Compare what you and your peers thought of advice before, to what you think of it now. ANALYSIS When you analyze, you describe your opinion of how things got to be the way they are. As with advice, the emphasis is on what you believe, instead of on what the client thinks. Sometimes analysis comes in the form of general observations about life. These are truisms that you think are applicable. For instance, you might say, “Most people feel uneasy at first. It takes time to get to know someone.” Clients may or may not see such pro-nouncements as being relevant to their situations. And, as with all analysis, general observations about life put the focus on your beliefs rather than on your clients’ thoughts. Consequently, it is best to avoid such comments. There are occasions when analysis is appropriate. For example, dur-ing initial interviews with new clients, psychotherapists often negoti-ate goals for the intervention, and then provide a rationale for how counseling can facilitate progress toward those objectives. By identify-ing potential helping strategies, therapists also imply the existence of certain causative factors, as in the following scenario. “You have select-ed ‘understand my children better’ as one of your goals. In order to improve that understanding, we will do some role-playing exercises, and eventually you will have homework assignments in which you try out communication skills that we develop in our sessions.” The analy-sis implied in this rationale is that the client’s lack of sufficient com-munication skills has contributed to the problem. Although there are some situations that call for your analysis, such as when providing a rationale for a recommendation you make, we encourage you to use this response sparingly. As much as possible, the focus should be on the client’s interpretation and understanding of events. In the dialog exercise, option C is an example of analysis. Look at the location of your slash mark. Also check your observer notes for the baseline role plays and see if you find any examples of analysis. Now consider whether you have changed your opinion of this response mode.

SYMPATHY/REASSURANCE When laypersons try to be supportive, two of the most commonly used responses are sympathy and reassurance. Sympathy seeks to communicate concern by saying how you feel about the other person’s difficulties, and reassurance is intended to calm the individual by offering some type of guarantee. If you are in a relationship that typically involves self-disclosure of personal information about yourself, it may be entirely appropriate to say how you feel about the other person’s difficulties. But if the rela-tionship does not involve you regularly revealing your personal thoughts and emotions, then sympathy probably is inappropriate. When communicated in a professional relationship, sympathy can be perceived as pity or can be seen as being insincere. In either case, it is likely to hinder rather than to enhance rapport. The appropriateness of reassurance depends on the worth of its guarantee. In order for a statement of reassurance to be believable, there must be evidence to support it. For example, an auto accident victim goes to the emergency room with an injured arm and has X-rays taken. The E.R. physician receives the report of the radiology consult and then says to the patient, “The X-rays show no signs of any broken bones.” Such a statement is an example of appropriate reas-surance because the speaker has evidence to back up the assertion. In order to consider another kind of reassurance, let’s continue the hospital scenario. Imagine the accident victim is a friend, and you are with her in the E.R. examining room. While waiting for the radiolo-gy report, you say, “I’m sure everything will be fine.” Although you are seeking to calm her, this statement may have the opposite effect. She may believe that you don’t appreciate the severity of the situation, and she may belittle your future efforts to be helpful. There is no value in false reassurance. Its guarantee is worthless. (Rather than signifying a response mode, the term “reassurance” can also mean an emotion experienced by the client. Used in this manner, reassurance might describe unpleasant feelings being relieved or pos-itive expectations being strengthened.) In the dialog exercise, look at where your slash mark is for option D. In addition, check your observer notes for examples of sympathy and reassurance. Think about the appropriateness of these two fre-quently encountered responses.

INTERROGATION If you ask questions or specify the topic to be discussed, you are interrogating—a mode of response that has been the focus of several classic empirical studies. When evaluating interactions that contain high levels of such information seeking, workers subsequently have viewed them as being shallow and of little value, and clients subse-quently have seen them as being rough and unpleasant (Friedlander et al., 1985). Ongoing clients have been shown to feel less understood and less supported when the intent of the worker was to interrogate (Hill, Helms, Spiegel, & Tichenor, 1988). And for both brief interac-tions and ongoing contacts, questioning has been found to be nega-tively related to clients feeling understood (Elliott, James, Reimschuessel, Cislo, & Sack, 1985). Given those findings, it is not surprising that trainees tend to ask their clients fewer questions at the end of their training than they did at the beginning (Kivlighan, 1989). As this research implies, interrogation is a powerful and directive technique. But there are degrees of control you can use, as we will see. Open Probes and Questions One area of worker control in interrogation is whether an inquiry is open or closed. Open probes (statements that specify the area to be discussed) and questions give the client considerable freedom in choosing what to say. Open questions usually begin with the word “What” or with the word “How.” Open probes often start with phras-es such as “Tell me” or “Describe.” Here are several examples of open interrogation. • How are things going? • What is on your mind? • Tell me about your efforts since our last meeting. • Describe some of the feelings you’ve been having. A number of researchers have compared the effects of open and closed questions. (Closed questions are discussed below.) Hargie (1984) summarized the findings and noted the following research con-clusions. When responding to open questions as opposed to closed questions, individuals engage in higher levels of self-disclosure, convey information that is more accurate, and provide longer replies. In addition, they perceive the worker to be more empathic. Most open questions provide some degree of direction. When that is the case, it generally is more effective for the initial focus to be on current issues. If you want to explore other topics, such as experiences from the past, that can come later. In the dialog exercise, take a look at where your mark is for option E. Also examine your observer notes for examples of open interroga-tion. We believe that, “How have you tried to deal with your fears?” is an example of a productive open question. Likewise, the open probes and questions you find in your observer notes may have had positive effects on the interaction. Closed Probes and Questions Closed questions and probes can be answered with a small bit of information or with a simple “Yes” or “No.” There are many phrases that can begin closed questions, including “Do you,” “Are you,” “Is it,” and “Have you.” The following responses are examples of closed interrogation. • Did you talk to Mr. Richards? • Have you told him what you think? • When did you go to see him? • Tell me his phone number. Closed questions and probes are appropriate when you would be satisfied with receiving just the specified information. But, in reality, clients often ignore the fact that the question is closed, especially if you are working with cooperative middle-class adults. For instance, “Have you told Mr. Richards what you think?” may result in a long description of interactions between the client and Mr. Richards. Sometimes, though, clients take you at your word and only answer the question you actually asked. If that is the case, the reply to, “Have you told Mr. Richards what you think?” is only a “Yes” or “No.” Such minimal responses are most likely to come from children, uncooper-ative individuals, persons highly respectful of your authority, and members of lower socioeconomic classes. With uncooperative clients, there is one particularly problematic question format that can help you paint yourself into a corner. This sticky form of interrogation begins with phrases such as “Would you,” “Could you,” “Will you,” and “Can you.” When asking one of these questions, you usually are seeking agreement or cooperation, but the phrasing of your request sets you up for a different answer: “No.” Consequently, if you are looking for an affirmative reply, do not ask “Would you,” “Could you,” “Will you,” or “Can you” unless you are certain of getting a positive response. Let’s say you are working with a teenager who is viewed as a disci-pline problem. You say to the young person, “Could you tell me what happened yesterday?” And the reply is “No.” You can cope with that response in a number of ways, but they all are time consuming and all require some backtracking on your part. It would have been better to have asked, “What happened yesterday?” Since a “What” question does not invite a “Yes” or “No” answer, you may get a fuller response. Ill-conceived closed questions can also lead to inefficient communica-tion that simply generates unusable responses. For example, when inner-city case workers ask clients, “Do you know your Social Security number?” a common reply is “Yes.” Consequently, staff members learn to be more precise in phrasing questions. They generally drop the “Do you” question and replace it with “What is your Social Security number?” In the development of your own abilities, you can adopt one help-ing style that you will use with cooperative middle-class adult clients and another style that you will use with children, uncooperative indi-viduals, persons highly respectful of your authority, and members of lower socioeconomic classes. But an alternative strategy is to build a solid foundation of skills that are effective in a broad range of cir-cumstances. The latter approach is the one we advocate. Consequently, our view is that closed probes and questions generally should be avoided, unless you would be perfectly satisfied with the brief response you are requesting. Where is your mark for option F in the dialog exercise? We believe, “Will you be with him tomorrow?” is an unnecessary closed question. But let’s say, for some reason, you really must know the answer. If that is the case, you will get a more informative response if you ask, “What are your plans for tomorrow?” Look for examples of closed probes and questions in your observer notes. As with option F, most of the closed questions you find proba-bly could have been deleted, with some being replaced by more pro-ductive open questions.

Questions to Avoid You should simply stay away from some forms of interrogation. We will examine three sorts of questions to avoid. Leading questions seek agreement rather than an honest response. With leading questions the reply you want is communicated by your biased phrasing. Here are several examples. • You’ve been in this situation before, haven’t you? • You talked to her, didn’t you? • You’re still unsure, aren’t you? Clients’ responses to such questions often have more to do with their opinion of your authority than with the actual answers. Although the truth may be considerably different, you generally get affirmative replies from clients who respect you and who want to please you. Conversely, leading questions may generate negative responses from clients who do not respect you or who want to displease you. Examine your mark for option G in the dialog exercise. Also look for examples of leading questions in your observer notes. In the future, remember that this is one style of interrogation to avoid. Multiple questions are another flawed form of interrogation. This type of response involves asking two or more questions before giving the person a chance to answer. When the reply does come, you may not know what it means, especially if you have asked multiple closed questions. For example, you ask, “Did you speak with her or did you decide to wait?” and the client says, “I did.” Although you have an answer, you still don’t know whether the client spoke with her or decided to wait. The replies to multiple closed questions tend to be confusing to workers. On the other hand, any multiple question can be confusing to clients. For instance, “What might you say to her? How could you approach her?” may be perceived as difficult to answer. Multiple questions can come about in a couple of ways. Sometimes while asking a question you think of additional ideas and you inad-vertently incorporate them into what you are saying. The problem here is one of pacing. Rather than trying to cover too much at once, it is better to be patient. The result will be communication that is understandable and effective.

A second way in which multiple questions can come about is when you ask a question, realize you could have phrased it better, and then immediately ask another version of it. Wanting to rephrase an awk-wardly asked question is a natural desire, but it is better to stop after one question and wait for the client’s response. Usually the person will understand what you wanted to ask and will give you the sort of reply you are seeking. When that is not the case, you eventually can clarify your intent and try again. Take a look at your mark for option H in the dialog exercise. You can also scan your observer notes for examples of multiple questions, but you probably won’t find any. That may be because the worker did not ask any multiple questions, or it may be because you could not write fast enough to get them down. Why questions are a third style of interrogating that you should avoid. Whatever your purpose in asking them “Why” questions are often perceived as accusations. And when clients feel threatened, they tend to respond defensively. In order to justify themselves, they may distort information, or they may fabricate answers. If you absolutely must know “Why,” you can start your question with a phrase such as, “What might be some of the reasons?” For instance, “Why are you waiting to make a decision?” could become, “What might be some reasons for waiting to make a decision?” We believe the latter question is less likely to be perceived as a challenge. Where is your mark for option I? Check your observer notes for sentences that begin with “Why.” In the future, remember to stay away from such questions. REFLECTION Reflection is using fresh words to summarize important thoughts and feelings expressed by another person. This definition has several implications. • Fresh words. The key terms in your comment are different from the ones used by the client. Repeating what the person said is not reflection. • Summarize. Reflection is selective. You do not try to include everything the person communicated.

• Thoughts AND feelings. Reflection can involve both ideas and emotions. Continually focusing on one, to the exclusion of the other, does not constitute good reflection. • Expressed. You are focusing on the client’s message. The com-munication you receive can involve nonverbal as well as verbal behavior, but the basis for your comment can be found in what has just transpired. Is reflection a new mode of response for you? If it is, you may feel as though you aren’t doing anything when you reflect. But we con-tend, for two reasons, that you are doing something. First, you are doing something when you reflect because there usu-ally are positive effects on the interaction. The other person typically perceives that you have been paying attention and that you are attempting to understand. Consequently, the individual is likely to continue discussing appropriate information. Second, you are doing something when you reflect because reflec-tion is hard work. You must hear the person’s words, understand them, remember essential themes, wait for an opportunity to speak, choose your own words to describe important messages, and then concisely make your comment to the person. Despite your best efforts, you will not be 100 percent accurate all the time. When you occasionally make a mistake and reflect inaccu-rately, the most common response from the client is to correct you. When such clarifications occur, it is likely that you now understand the person better than you did before. Nevertheless, you do not want to be incorrect and to miss the point. With regard to brief contacts, the results of one empirical study indi-cated such misperception to be the most common way in which work-ers hindered interactions (Elliott et al., 1985). And in an empirical investigation that focused on continuing contacts, the more misunder-stood clients felt, the less value they assigned to the session (Hill et al., 1988). Other researchers (Gallagher & Hargie, 1989) compared a group of experienced counselors who had recently completed a help-ing skills program to another group of experienced counselors who had not been through the program. In terms of their helping behav-iors, the greatest difference between the two groups was that the coun-selors who had been through the training program displayed more inaccurate reflections with real clients than did the counselors who had not participated in the program. The training-program counselors in this study seemed to emphasize the form of reflection over the sub-stance of accurately understanding their clients. The findings by Gallagher and Hargie (1989) can serve as a warn-ing. In practicing the use of reflection, you do not want to lose sight of the fact that your goal is to accurately summarize the client’s thoughts and feelings. Since understanding those thoughts and feel-ings is a prerequisite for good reflection, you should first concentrate on appreciating what the client is communicating. You must listen. Only after making the effort to understand, do you progress to the next task: putting your comprehension into words you say to the per-son. Good reflections usually incorporate only part of what clients com-municate. Consequently, you are providing direction when you reflect. By focusing on some material and leaving out other content, you increase the likelihood that the client will engage in additional dis-cussion of what you include, and you decrease the probability of the person further exploring what you exclude. The tone of your reflection may also influence the nature of the client’s response. For example, if an individual says, “I’m so sick of it. No matter what I try, he never listens to me,” the tone of your response can be positive and focused on the future, “You really would like to get through to him,” or negative and focused on the past, “So far, nothing you’ve tried has seemed to work.” A positive, future-ori-ented tone may encourage the client to focus on desirable conditions, whereas a negative tone may encourage further description of unpleasant circumstances. Although there certainly are times when reflections with a negative tone are entirely appropriate, you should remember your ultimate purpose is to encourage productive change. And, in order to do that, you must include reflections that are positive and are oriented toward the future. Results of empirical research suggest that when workers frequently use such comments, clients feel more powerful and confident with regard to solving their problems (Bohart et al., 1993). Other research (Seehausen, Kazzer, Bajbouj, & Prehn, 2012) has found that compared to times when a helper is taking notes, during accurate reflections the person being helped experiences less negativity and increased auto-nomic arousal. The increased physiological activity is probably linked to greater emotional depth stimulated by the reflection.

Problem solving often involves persons in addition to the identified client. When such individuals are available and willing to participate in sessions, and clients agree to their involvement, including those per-sons in all or part of the session can be both revealing and productive. The basic strategy of reflecting thoughts and feelings applies to those nonclient participants as well. Emotional Levels of Reflection Just as forms of interrogation (such as open and closed questions) can be defined according to the range of information being specified, a reflection may be referred to by its feeling level. In terms of emo-tional content, we can consider three broad categories of reflection. Factual reflections describe conditions without any reference to emotions. By avoiding feelings, you promote rapid movement through topics. Surface feeling reflections recognize obvious emotions being expressed. By matching or slightly exceeding the intensity communi-cated by the client, you encourage the individual to consider issues being discussed. Underlying feeling reflections suggest emotions that have not been explicitly stated or expressed by the client. When the person accepts the validity of the comment such statements can powerfully draw attention to deeper issues. On the other hand, if the client is not ready to see the truth of the remark or if the observation is inaccurate, you may create a miscommunication that will take some effort to repair. Here is an example of a client statement, followed by three differ-ent levels of reflection. Client: After examining the tumor they removed, my doctors say the cells look borderline, and the cancer experts are recommending against chemotherapy. Although I had prepared myself to accept it, I’m relieved that I won’t have to go through the chemotherapy regi-men. I still get frightened at times, but it’s not like I felt before the surgery, when I thought I might soon be dead. I will be glad when I’m strong enough to return to work and to move back to my own place. The bills are piling up and living with my parents is tough on all of us, but it’s also wonderful just to be alive.

Worker: Factual Reflection The medical report was good, and your main task now is to recover from the surgery. Surface Feeling Reflection Occasionally you feel scared, and there are frustrations associated with your rehabilitation. But you’re very thankful for the positive medical findings. Underlying Feeling Reflection Facing death has been revitalizing and has enabled you to take a fresh look at what really is important in your life. Empirical research (Sharpley et al., 2000) has demonstrated that both factual reflections and feeling reflections are associated with higher ratings of rapport. In line with such research, we believe that factual reflections can be useful and that it is difficult to go wrong with an accurate surface feeling reflection. But our opinion is that underly-ing feeling reflections are educated guesses and that you should usu-ally avoid them. When reflecting emotions, novices sometimes feel limited by their vocabulary. If that happens to be the case with you, we offer the following set of words. Although we hope the list is help-ful, there are some dangers associated with it. First, remember you want to be accurate in your reflections; so don’t use the words indis-criminately. Second, never have the list in front of you during a role play or when working with real clients; looking down at such a docu-ment is distracting to clients and will greatly diminish, if not destroy, your ability to establish positive relationships. Third, do not say words you feel ill at ease using; your vocabulary should remain natural and comfortable. calm

comfortable comforted

contented

mellow patient peaceful

pleased relaxed relieved

serene

smooth steady thankful

trusting

confident

accomplished adamant

assured

brave cheerful

courageous

determined empowered

encouraged fearless

invincible powerful proud satisfied secure

strong sure worthy

excited

amazed cheerful

curious delighted

eager ecstatic

encouraged

energetic

energized

enjoyed enthusiastic

exhilarated glad

happy hopeful

joyful liberated

love optimistic

overjoyed

pleased refreshed

relieved

thankful

thrilled upbeat

angry

aggravated annoyed

appalled bitter

cross disgusted

enraged

exasperated

fed up frustrated

furious

hate incensed

infuriated insulted

irate

irked irritated

livid

mad miffed

offended

outraged perturbed

resentful sore

hurt

abandoned abused agonizing

alienated anguish

ashamed at a loss

belittled

betrayed

cheated crushed devastated

disgraced distraught embarrassed

exploited

harassed humiliated

insecure

miserable

ostracized pained regretful

rejected

rough sickened

sorry troubled uncomfortable

violated

wounded

lonely

abandoned adrift aimless alienated

cut off disconnected

excluded ignored

insecure

left out lonesome

rejected withdrawn

perplexed

ambivalent baffled

bewildered curious

doubtful

hesitant curious

doubtful

hesitant mystified

puzzled stuck

torn

pressured

burdened coerced

desperate distressed

dominated engulfed impatient intimidated

overloaded threatened

sad/tired

apathetic bleak

blue bored

dejected despondent

disappointed

discouraged disheartened dismayed

down drained

drowsy exhausted

fatigue foggy gloomy

glum

grieving

groggy let down

lethargic lousy

low numb pessimistic

run down

sleepy sluggish

somber sorrowful

unhappy weary

wornout

scared/anxious

afraid agitated

alarmed antsy apprehensive

awkward

flustered

frantic frightened

hesitant horrified

ineffectual nervous

on edge rattled

restless terrified

threatened overwhelmed

trapped

panicky uneasy unnerving

vulnerable

cautious disturbing dreading fearful

inept insecure jittery jumpy

shaken

shaky stressed

tense

worried

worrisome

surprised

alarmed appalled

astounded

blindsided

disbelief dismayed

shocked discombobulated

stunned

taken aback

Look at where your mark is for option J. What is your opinion of reflection now as compared to before? Review your observer notes and look for examples of reflection. Notice how many contain feelings.

SEQUENCES AND COMBINATIONS OF RESPONSES Now that you have encountered the basics of interrogation and reflection, it is possible to think about sequences and combinations of those responses. We will focus on three patterns: the funnel sequence, the inverted funnel sequence, and the reflection-interrogation combi-nation. Funnel sequences begin with a broad probe or question, continue with reflection and possibly some open interrogation, then end with closed interrogation to fill any gaps in information you must gather. Such sequences are appropriate when the client is comfortable talking with you and understands the nature of the information you are seek-ing. Here is an example of a funnel sequence that begins with a gener-al inquiry, then transitions to a more specific focus. (Imagine that all of the remarks are being made to the same person and that there is a client response between each one.) • How was the first day on your new job? • You realize there is a lot to learn, but you are excited about the challenge. • What sort of training will you be having?

You’re looking forward to the orientation sessions. • Once you are trained, what shift will you be working? Inverted funnel sequences begin with easily answered closed ques-tions, and then move to broader responses such as reflection and open interrogation. This technique is the best approach we know for encouraging a client to talk when the individual is reluctant to speak with you. Here is an example of an inverted funnel sequence. (It is taken from an interaction with a 16-year-old who was hospitalized fol-lowing a drug overdose suicide attempt. In response to an initial open question of, “How are things going?” the patient said nothing and turned away from the worker. But communication soon began to flow as a result of the following inverted funnel sequence.) Worker: Did Dr. Matthews see you this morning? Client: Mmhmm. Worker: Have they brought you breakfast? Client: Yeah. (Turning toward the worker with a disgusted look) Worker: You didn’t like the food. Client: It was awful. Everything was cold, and the fried eggs were all runny. It was almost as bad as that stuff they had me drink last night to make me throw up. I just want out of here. Worker: You’d really like to go home. Client: But they’re making me stay, even though I’ve told them I want to go home. This place is terrible. It’s boring and there’s nothing to do. Worker: What do you think would need to happen in order for Dr. Matthews to discharge you? Initially, this client seemed to have no intention of talking with the worker. But two easy-to-answer closed questions evoked minimal responses. Next, two reflections elicited animated descriptions of thoughts and feelings, and then an open question led the interaction toward a discussion of positive change. A reflection-interrogation combination takes place as a compound response to the client’s most recent remarks. First, you reflect the essence of what the person just communicated, and then you ask a question or state a probe. By having your question or probe follow a reflection, you are able to gather necessary information while still con-veying understanding and attention. Here are several examples of reflection-interrogation combinations. (They are taken from interactions with five different clients.) • You were surprised by his account. How did you respond to him? • A fresh start seems to you like it might be worth the risk. Tell me what a new beginning would allow you to do. • It’s hard to stay within your food budget because you use a “coun-try-cooking” style of meal preparation. Give me an example of a “country-cooked” meal. • Attempting to discipline your children has been an ordeal. What are some of the strategies you’ve tried? • Her leaving has you feeling discouraged and adrift. You’ve been imagining what it would be like if you would just disappear. Are you thinking of killing yourself? MULTIPLE-CHOICE QUESTIONS The remainder of the chapter consists of opportunities for you to use material that has been presented. We start with a set of multiple-choice questions. Items 1–7 are with one client, and items 8–20 are with another client. Here are your instructions for this exercise. • For each of the following client statements, choose the response or responses you believe would be appropriate. (Several items have more than one correct answer.) • Indicate your selections in writing. • Read the discussions of all four options. • If you are correct, go to the next item. • If you are incorrect, think about the explanations and, if neces-sary, review relevant portions of the chapter; then, once you bet-ter understand the issues, proceed to the next question. 1. My mother called last night—I’m about four hours away from home—and she told me how sad she is and how she doesn’t have anyone. This is the second time she’s called this week. We’re very close. We’ve always been close—through everything. I feel badly about being away from her and just dealing with my life here, when she is back home all alone. She needs me, and I feel very guilty and depressed. A. You don’t think she really wants you to move back home, do you? B. Living a half-day away means that most of your communica-tion is by phone rather than face-to-face. C. Have there been other weeks in which she has called you twice? D. It hurts to think of her being so sad. Discussion of Options A. You don’t think she really wants you to move back home, do you? • Your leading question suggests that you are biased and that you are expecting a certain answer. B. Living a half-day away means that most of your communica-tion is by phone rather than face to face. • With so much emotion expressed by the client, this factual reflection misses the heart of the person’s statement. C. Have there been other weeks in which she has called you twice? • You may get a simple “Yes” or “No” to your closed ques-tion. In addition, your response unnecessarily directs the interaction and changes the focus from the present to the past. D. It hurts to think of her being so sad. • By providing this surface feeling reflection, you are demon-strating interest and attention, while leaving the client free to decide where the interaction goes next. 2. I feel very ashamed. I know she’s having a lot of problems, and I could easily solve them by moving home. But I can’t do that because of my responsibilities here. A. Why do you think you could fix everything? B. You regret not doing more for your mother.

C. I’m sure your mom does not hold you responsible for her problems. D. It sounds to me like being here is very demanding, and you are looking for a reason to return home. Discussion of Options A. Why do you think you could fix everything? • Asking a “Why” questions is likely to put the client on the defensive. The response you get probably will be a justifi-cation, which may not be very productive. B. You regret not doing more for your mother. • Your surface feeling reflection conveys understanding and is likely to encourage the client to continue bringing up new thoughts and feelings. C. I’m sure your mom does not hold you responsible for her problems. • You do not know the client’s mother. Consequently, you have no basis for offering such reassurance. This response may distance you from the client, since the person proba-bly does not share your opinion. D. It sounds to me like being here is very demanding, and you are looking for a reason to return home. • Such analysis changes the focus from the individual’s opin-ions to yours. And you may get an angry response if you are incorrect or if the person is not ready to see the validity of your observation. 3. Talking to her has increased the pressure on me. With my work and with her second call of the week, I’m very frustrated. I’m depressed because she’s depressed. A. The two conversations with her really have you down, and you are thinking that something needs to change. B. You feel helpless. C. I’m sorry you have so much stressing you. D. It seems you have quite a few responsibilities that you are try-ing to fulfill. What are some of the stresses associated with your work?

Discussion of Options A. The two conversations with her really have you down, and you are thinking that something needs to change. • This reflection describes the situation and then recognizes the client’s feelings and thoughts. By stating that the person desires change, you rephrase the client’s frustration with a positive tone that may help the individual move forward, rather than talk again about being ashamed and depressed. Although you want to recognize the client’s emotions, doing nothing but reflecting depressive feelings may result in a downward spiral that leaves both you and the client feeling sad. B. You feel helpless. • Your feeling reflection probably is accurate, but it is also a very strong statement that may suggest there is nothing the client can do. The comment could be improved by choos-ing a less emphatic word and by emphasizing that it repre-sents how the person is feeling now. For example, the work-er might say, “Right now you’re very discouraged.” C. I’m sorry you have so much stressing you. • In a worker-client relationship, this expression of sympathy probably is not helpful. D. It seems you have quite a few responsibilities that you are try-ing to fulfill. What are some of the stresses associated with your work? • The client is focusing on mother-related feelings and issues, but this combination of a factual reflection and an open question may change the topic away from what is foremost on the person’s mind. 4. If I don’t actually move back home, maybe at least I should try to be there more often. I’ve been home very little this year, and we really have not had much time to spend together. I am her only child, so I know she needs me. A. One possible way of helping your mom is to make more fre-quent trips to see her. What might those entail? B. What do you do when you are together? How could you improve the time you do spend with each other?

C. What would you do if you were there? D. Have you told her how you feel? Discussion of Options A. One possible way of helping your mom is to make more fre-quent trips to see her. What might those entail? • This reflection-interrogation combination allows you to con-vey interest and understanding, while also requesting rele-vant information. B. What do you do when you are together? How could you improve the time you do spend with each other? • Asking a multiple question may confuse the client. A better strategy is to ask one question, then wait for a response. C. What would you do if you were there? • The client’s statement ends with a comment of being need-ed, and your open question encourages further discussion of that issue by requesting concrete examples of actions the person would take. D. Have you told her how you feel? • A brief reply may be the response to this closed question. Your phrasing also suggests that you have decided what the client should do. 5. I guess I just think I should spend some time with her. There are a few jobs around the place that need attention, so we might work on those together. But I imagine the most important thing is for her to have another person there to talk with. A. I think you should arrange a visit to see your mom. B. What are some tasks the two of you might tackle? C. Feeling that you can solve your mother’s problems gives you a sense of power. D. You would feel better if there were face-to-face interactions taking place.

Discussion of Options A. I think you should arrange a visit to see your mom. • Your statement cuts off the client’s discussion of thoughts and feelings. Rather than focusing on what the individual has to say, you give advice, which implies that you believe the person is not capable of making productive plans. B. What are some tasks the two of you might tackle? • The form of this open question is good, but the information you are after is of secondary importance at the moment. Consequently, you may sidetrack the interaction to a minor issue. C. Feeling that you can solve your mother’s problems gives you a sense of power. • You are taking a shot in the dark with this underlying feel-ing reflection. The result may be a sidetracking discussion regarding the accuracy of your observation. D. You would feel better if there were face-to-face interactions taking place. • The client’s opinion regarding the key activity that ought to happen is the focus of this reflection. But your comment also sets the stage for expanding available options, since you do not say that the client must be the one to provide the interaction. 6. She definitely needs someone to be with her and talk with her. I’m sorry I can’t be there all the time, but I have my own obliga-tions here. There is no way that I can be home enough to take care of all her needs. I guess she really has to become less depen-dent on me. A. You feel guilty about not being with her. B. It seems you are thinking she might need other sources of sup-port. C. You’re saying that going to see her would be a mistake, since it would reinforce her dependency. D. What comes to mind when you think of her becoming more independent?

Discussion of Options A. You feel guilty about not being with her. • In previous multiple-choice responses 1D and 2B above, you reflected the hurt and regret the person is feeling. Al-though the client comment in item 6 also contains a state-ment of regret, there probably is no need to cycle back into a discussion of that emotion. B. It seems you are thinking she might need other sources of sup-port. • This factual reflection of the client’s comment puts the emphasis on a positively stated objective that has the poten-tial to become a focus of discussion. C. You’re saying that going to see her would be a mistake, since it would reinforce her dependency. • You miss the mark with this reflection. The client has not said or implied that it would be wrong to visit her. D. What comes to mind when you think of her becoming more independent? • Your open question requests the client to reveal additional thoughts on the issue of independence, which seems as though it could become a productive topic. 7. I would feel a lot better if she had some friends she could count on and confide in. She gets along with people at work, but part of her problem is the stress there. So opening up to her cowork-ers isn’t the answer. She should be with friends outside of work who she can talk to and visit. A. You think she needs time with nonwork friends. B. How could she develop such relationships? C. I’m sure that some new friends would make a big difference. D. Do you know anyone she might spend time with? Discussion of Options A. You think she needs time with nonwork friends. • You recognize the client’s thoughts regarding the possible role of nonwork friends, thereby encouraging further dis-cussion focusing on that perceived need.

B. How could she develop such relationships? • Your open question puts the emphasis on how appropriate friendships might be built by the client’s mother. But the mother is not your client. Instead of discussing plans that a nonclient could make, it generally is better to concentrate on actions that might be taken by the person who has come to see you. C. I’m sure that some new friends would make a big difference. • You have no direct evidence to support your reassurance. D. Do you know anyone she might spend time with? • At this point, there is no need for a closed question. By ask-ing one, you may limit the individual’s reply. The remaining multiple-choice items involve a one-to-one interac-tion with a 15-year-old in foster care who is seeing you for the first time. In the waiting area is Mrs. Williams, the foster mother, who has brought the young person to your office from school. 8. (You begin the body of the interview by saying, “How are things going?” and the teenager responds by staring at the floor.) A. Things aren’t that bad, are they? B. Why are you staring at the floor? C. Did you go to school today? D. Would you tell me what’s on your mind? Discussion of Options A. Things aren’t that bad, are they? • The content of this leading question suggests you will find it difficult to accept the validity of any intense discomfort described by the client. Consequently, it becomes less like-ly that the young person will share such feelings with you. B. Why are you staring at the floor? • Your “Why” question may be perceived as threatening and provocative. The most probable response is continued silence. C. Did you go to school today? • Providing a “Yes” or an affirmative head nod is easy for the client to do because all that is required is an acknowledgment of information the student believes you already have. Consequently, the young person is not surrendering much by answering the question. But even a head shake is more of a response than staring at the floor. And for now, a small indication of cooperation is all you are after. D. Would you tell me what’s on your mind? • By offering this closed question, you have set yourself up to receive a negative head shake. Barring that, more silence probably is what you will get. 9. (In response to the question, “Did you go to school today?” the client gives an affirmative head nod.) A. You’ll feel better if you tell me what’s on your mind. B. You’re probably feeling isolated since you are a new student there. C. You’re having a lot of problems at school, aren’t you? D. Did Mrs. Williams pick you up at school? Discussion of Options A. You’ll feel better if you tell me what’s on your mind. • You demonstrate your lack of appreciation for the client’s perspective when you offer such reassurance. Although you may believe the statement to be true, the young person is likely to view its guarantee as being worthless. B. You’re probably feeling isolated since you are a new student there. • By providing this analysis, you put the focus on your opin-ions, thereby decreasing the probability of the client shar-ing thoughts and feelings. It also turns out, as you will see later in the interview, that you are wrong. C. You’re having a lot of problems at school, aren’t you? • You have no information on which to base your leading question. And by asking it, you give the client an opportu-nity to supply a negative response. D. Did Mrs. Williams pick you up at school? • The positive qualities of response 8C also exist in 9D. This closed question increases your chances of getting a cooper-ative reply. 10. (In response to your asking, “Did Mrs. Williams pick you up at school?” the client provides an affirmative head nod.) A. I get the feeling you are very angry. B. She really goes the extra mile for you, doesn’t she? C. I guess you would have preferred that our appointment be during school rather than after. D. Did you talk on the way over? Discussion of Options A. I get the feeling you are very angry. • You have insufficient evidence to make this underlying feel-ing reflection. Although your comment turns out to be cor-rect, making it now probably will not result in a productive response from the client. B. She really goes the extra mile for you, doesn’t she? • You are focusing on someone other than the client in this leading question. And, given the nature of the responses you’ve received to this point, you do not have enough infor-mation to justify making such a judgment. As you will later learn, your observation is not in tune with how the young person is feeling. C. I guess you would have preferred that our appointment be during school rather than after. • There is no basis for your observation. Consequently, you probably are distancing yourself from the individual. D. Did you talk on the way over? • The positive qualities of responses 8C and 9D also charac-terize this closed question. Another limited expression of cooperation is the most likely result. 11. (The client’s response to the question, “Did you talk on the way over?” is “Yes.”) A. If you can talk with her, why can’t you talk with me? B. What did you talk about? C. Well, I think you should also be talking to me. D. Would you tell me what you discussed?

Discussion of Options A. If you can talk with her, why can’t you talk with me? • You probably will increase the client’s defensiveness by ask-ing a “Why” question. B. What did you talk about? • Having asked three closed questions in a row, you encounter the client’s first verbal reply. Now is a good time to try asking an open question, since the individual may answer with another verbal response. C. Well, I think you should also be talking to me. • It is unlikely that the client will respond positively to this advice. D. Would you tell me what you discussed? • Although your idea is a good one, phrasing it in a “Would you” question gives the client an easy opportunity to reply in a negative manner. 12. (In response to, “What did you talk about?” the client says, “The same old stuff.”) A. I’m sorry it wasn’t something pleasant. B. What was this topic that you’ve discussed before? C. Was it just as bad this time? Did you really dislike it? D. It seems to me that you should develop a better attitude toward Mrs. Williams. Discussion of Options A. I’m sorry it wasn’t something pleasant. • Your sympathy is out of place here and probably will seem odd to the client. B. What was this topic that you’ve discussed before? • This open question pulls for more information. Since you got some actual words in response to your last open ques-tion, you are likely to get a few more in reply to this one. In addition, your remark recalls what the client said previ-ously about “the same old stuff,” thereby demonstrating that you have been paying attention.

C. Was it just as bad this time? Did you really dislike it? • You may confuse the client by asking these multiple closed questions. If you do get an affirmative or a negative answer, you can’t be certain which question the young person is addressing. D. It seems to me that you should develop a better attitude toward Mrs. Williams. • It is almost certain that the client’s reaction to this advice will be a defensive one. 13. (After you ask, “What was this topic that you’ve discussed be-fore?” the client says, “Rules.”) A. Entering a new living situation always involves learning to do a few things in new ways. B. I guess that wasn’t very pleasant, was it? C. So, you were talking about things to do and not to do. D. In the past, what sorts of problems have you had with rules? Discussion of Options A. Entering a new living situation always involves learning to do a few things in new ways. • Your analysis comes in the form of a general observation about life that probably applies to this client. But in offer-ing it you appear to be taking sides with the foster parents, thereby increasing the chances of alienating yourself from the young person. B. I guess that wasn’t very pleasant, was it? • You are jumping to a conclusion with this leading question. By putting words in the client’s mouth, you decrease the chances of open communication. C. So, you were talking about things to do and not to do. • You acknowledge the teenager’s answer with this factual reflection. By using it, you give your client the responsibili-ty for determining where the interaction goes from here. D. In the past, what sorts of problems have you had with rules? • Your open question shifts the focus from the present to the past, which probably is not something you want to do at this point.

14. (Following the reflection of, “So, you were talking about things to do and not to do” the client says, “Like always.”) A. There are frequent discussions of the expectations Mr. and Mrs. Williams have for you. B. Could you tell me what the reason might be for this repeti-tion? C. It sounds like they have to repeat a lot of things for you. D. Mrs. Williams probably keeps talking about the rules because she is not satisfied with how you are following them. Discussion of Options A. There are frequent discussions of the expectations Mr. and Mrs. Williams have for you. • This factual reflection has the same productive characteris-tics as response 13C. You are again giving the client a chance to determine where the interaction proceeds next. B. Could you tell me what the reason might be for this repeti-tion? • By phrasing your request as a “Could you” question you give the client an opportunity to say “No.” C. It sounds like they have to repeat a lot of things for you. • Your comment may be true. But the client is not likely to respond in a productive way, since the statement appears to take the side of the foster parents. D. Mrs. Williams probably keeps talking about the rules because she is not satisfied with how you are following them. • No doubt you are accurate in this analysis. By providing it, however, you put the focus on your opinion, which seems to favor the foster parents. 15. (In response to your reflection of, “There are frequent discussions of the expectations Mr. and Mrs. Williams have for you” the client says, “Yeah, and I’m sick of it.”) A. You’re fed up with being told what to do. B. Do you think your foster parents are tired of it? C. Why do you think it comes up so often? D. You should tell Mrs. Williams how you feel.

Discussion of Options A. You’re fed up with being told what to do. • This is an accurate surface feeling reflection. It acknowledges the client’s initial verbal description of a clear-cut emotion. By recognizing the young person’s frustration, you are encour-aging further exploration of issues associated with that exas-peration. B. Do you think your foster parents are tired of it? • You put the focus on the foster parents with your question, rather than on the client. And since it is closed, you also give the client an opportunity to reply with nothing more than a brief response. C. Why do you think it comes up so often? • This “Why” question is likely to put your client on the defensive. D. You should tell Mrs. Williams how you feel. • Your advice probably will not result in a productive re-sponse from the client. 16. They just give me too many rules about everything in the house and outside. A. Are any of the rules necessary? B. Greater freedom is something you would like to have. C. It would be nice to be making more of your own decisions. D. The feelings of confinement you are having are typical for a person who moves from a less restrictive to a more restrictive environment. Discussion of Options A. Are any of the rules necessary? • Your closed question invites two potential problems. The first is the possibility of a brief response, and the second is the likelihood of a negative reply. With this client, a nega-tive reply would mean the individual wants a home with no rules, and that is not a realistic option. B. Greater freedom is something you would like to have.

By phrasing this factual reflection in a way that puts a pos-itive twist on the client’s remarks, you invite additional dis-cussion of the freedom issue. C. It would be nice to be making more of your own decisions. • The wording of your factual reflection opens the door to a discussion of areas in which the individual would like to have increased autonomy. D. The feelings of confinement you are having are typical for a person who moves from a less restrictive to a more restrictive environment. • This analysis probably is accurate. But, despite the validity of your observation, it has little relevance to exploring the client’s thoughts and feelings. Consequently, you are not encouraging movement in a productive direction. 17. Yeah, I need more freedom. But they treat me like a baby. They tell me when and where I can go places, like they don’t know that I should be able to make some decisions on my own. I can take care of myself, so why do they think I want a nice cozy home with somebody always telling me what to do? A. I’m sure they believe they’re doing what’s best for you. B. You’re rebelling against what you really want most and have rarely had—a stable and predictable home environment. C. You really would like to be telling them what to do. D. You’re angry about the restrictions on you. Give me an exam-ple of a rule you believe is unfair. Discussion of Options A. I’m sure they believe they’re doing what’s best for you. • You are shifting the focus to the foster parents, and you appear to be siding with them. Consequently, your com-ment may lead to an argument or to a shutdown of com-munication. B. You’re rebelling against what you really want most and have rarely had—a stable and predictable home environment. • This analysis may or may not be true. Even if it is true, the client is likely to respond defensively, rather than admit to the validity of the statement.

C. You really would like to be telling them what to do. • You probably are right, but where does this comment lead? You are not likely to negotiate a solution that involves the client supervising the foster parents. D. You’re angry about the restrictions on you. Give me an exam-ple of a rule you believe is unfair. • The correct responses in items 8-16 have combined to form an inverted funnel sequence designed to get the client talk-ing. In this instance the technique has worked. Now, for the first time, the client has responded with several sentences in a row. By using a combination response (1) to reflect a cen-tral feeling expressed by the young person, and (2) to re-quest a specific example relating to that emotion, you are encouraging a more detailed discussion of what is troubling the individual. 18. Mrs. Williams says I have to be in by 9:00 on school nights. That’s too early. I don’t have time to do anything. She’s just try-ing to stop me from being with my new friends. A. Tell me what you believe your foster parents do want. B. You’d like to be with them more. C. Having enough time with your friends is important to you. D. You’re hopeless about conditions ever changing with your fos-ter parents. Discussion of Options A. Tell me what you think your foster parents do want. • By responding with this probe, you change the focus to the foster parents. It is better to continue concentrating on the person with whom you are talking. B. You’d like to be with them more. • You encourage the interaction to move in a positive direc-tion with your factual reflection. By recognizing the indi-vidual’s desires, you are laying the groundwork for consid-eration of what the young person would be willing to do in order to have more social time. C. Having enough time with your friends is important to you.

• Your factual reflection describes the client’s complaint in terms of a positive objective. Consequently, this comment may help to set the stage for an eventual discussion of how the young person could work toward bringing about the desired arrangements. D. You’re hopeless about conditions ever changing with your fos-ter parents. • This degree of discouragement was not expressed by the client. Instead of reflecting what the young person actually said, you are reading too much into the individual’s state-ment. Your choice of the word “hopeless” may also give an unnecessarily negative direction to the interview. Rather than moving toward a consideration of adaptive possibili-ties, the client may pick up on your cue and discuss why nothing will work. 19. Yeah. Although we haven’t known each other very long, I’ve made some really close friends. But Mrs. Williams keeps saying they are a bad influence on me, and she won’t let them come over. Without ever meeting them, how does she know they are so terrible? A. What would you think about asking Mrs. Williams to come in so that the three of us could discuss issues relating to your friends? B. She has you really angry. C. Mrs. Williams believes your friends are a bad influence, and she won’t let them come over. D. You think Mrs. Williams is too unbending when it comes to your friends, but you seem pretty unbending yourself when it comes to Mrs. Williams. Discussion of Options A. What would you think about asking Mrs. Williams to come in so that the three of us could discuss issues relating to your friends? • In this situation, you have available the individual about whom the client is complaining. Bringing Mrs. Williams into the discussion might allow for a fuller exploration of relevant issues. B. She has you really angry. • You have previously acknowledged the client’s anger. At this point, there is no need to reflect that feeling again. C. Mrs. Williams believes your friends are a bad influence, and she won’t let them come over. • There are two problems with this comment. It uses the client’s words rather than your own, and it changes the focus from the young person to Mrs. Williams. D. You think Mrs. Williams is too unbending when it comes to your friends, but you seem pretty unbending yourself when it comes to Mrs. Williams. • At this stage of the interview, your confrontational state-ment is not likely to be productive. Since the client will probably respond defensively, you are risking an argument. 20. I don’t care if she comes in. All I want is an even break. I’m happy when I’m with my friends. Why can’t the Williams just let me be happy? They’re always trying to bring me down. I need to be myself. But how can I be myself if they are always telling me what to do? A. It’s frustrating to have your desires blocked at every turn. B. Adolescence is a time of transition from childhood depen-dency to the independence of adulthood. Feeling confined is a typical experience during this period of maturation. C. It sounds like ways of getting more independence might be a topic for us to discuss with Mrs. Williams. D. I think if you and Mrs. Williams really listen to each other, everything will work out. Discussion of Options A. It’s frustrating to have your desires blocked at every turn. • This feeling reflection identifies a negative emotion and focuses on the client’s perception that his foster parents re-ject all proposals. Don’t forget that you may be moving toward a three-way discussion involving Mrs. Williams. Concentrating on unpleasant feelings toward her probably will not encourage productive interaction when she enters the room. B. Adolescence is a time of transition from childhood depen-dency to the independence of adulthood. Feeling confined is a typical experience during this period of maturation. • Your general observations about life are accurate but not very helpful. There is little chance that these opinions will move the interaction in the direction of adaptive change. C. It sounds like ways of getting more independence might be a topic for us to discuss with Mrs. Williams. • Your comment phrases the client’s complaint in a positive manner that draws attention to the idea of negotiating a productive plan. D. I think if you and Mrs. Williams really listen to each other, everything will work out. • You are reaching too far with your reassurance, and the client probably knows your comment is unrealistic. Consequently, the young person may start thinking about what won’t be accomplished with Mrs. Williams. SHORT-ANSWER QUESTIONS Write your answer for each of the following questions. 1. Give a situation in which you believe it would be inappropriate to offer advice. 2. Describe an instance in which you think it would be appropriate to offer advice. 3. Give a situation in which you believe it would be inappropriate to pro vide analysis. 4. Describe an instance in which you think it would be appropriate to provide analysis. 5. Give a situation in which you believe it would be inappropriate to express sympathy. 6. Describe an instance in which you think it would be appropriate to express sympathy. 7. Give a situation in which you believe it would be inappropriate to communicate reassurance.

8. Describe an instance in which you think it would be appropriate to communicate reassurance. 9. Give an example of an open question. 10. Provide an example of a closed question. 11. Give an example of a leading question and describe difficulties it might create. 12. Cite an example of multiple questions and describe problems they could cause. 13. Give an example of a “Why” question and describe a negative reaction that might result. 14. Provide a surface feeling reflection for the following statement. “My campus job wasn’t paying the bills, so I took on a second job at a restaurant. Although it seemed like a good idea at the time, my academics have taken a nose dive. I had a decent grade-point average coming into this term, but I don’t know if I can make enough money to stay in school and still be a good student. And if I don’t have time for the class work, why should I even be here?” 15. Give an example of a funnel sequence. 16. Provide an example of an inverted funnel sequence. 17. Give a reflection-interrogation combination in response to the fol-lowing statement. “My boyfriend says our relationship is exactly what he wants, but he also says he needs his ‘space.’ I think him being independent is fine, but when I don’t hear from him for days at a time, I begin to fear that maybe there is a problem between us.” POSSIBLE ANSWERS FOR SHORT-ANSWER QUESTIONS Use the following answer-checking procedures. • For each item, compare your answer to the one we provide. • If you believe your answer is correct, you are done with that item. • With any question for which you believe your answer is incorrect, consider our answer and, if needed, review relevant portions of the chapter. Keep your original answer that you now think is incorrect, but add to it a response that you believe would be cor-rect.

1. Generally, supportive workers do not give advice before drawing on the client’s ability to generate options. For example, it would be too directive to tell a person to get out of a bad marriage rather than to have the individual name and consider available possibilities. 2. It is appropriate to give advice in order to preserve life. For instance, a productive comment to a suicidal person might be, “I don’t want you to be dead. Instead of killing yourself, I would like you to give us a chance to address the difficulties you are facing.” 3. In most instances, supportive workers do not provide analysis if the client is capable of developing a meaningful understanding of how things got to be the way they are. For example, an individ-ual is seeing you in order to discuss family problems, but the per-son changes the subject whenever the focus turns to the prob-lematic relationships. You could analyze the changes in topic and say, “You are resisting our attempts to address the reason for you being here.” But it probably would be more effective to have the client do the analysis by making a comment such as, “You are here to talk about difficulties with your family. Several times we have been ready to examine that issue, but on each of those occa-sions you have brought up other topics for us to discuss. What do you think might be the reason for those changes in topic?” 4. Analysis can be appropriate in order to provide a rationale for a recommendation you make. For instance, you might say, “Often there is a biochemical component to low energy, gloomy thoughts, and despondent feelings such as you are experiencing. I think it would be a good idea to have an evaluation regarding your appropriateness for antidepressant medication.” 5. It generally is inappropriate to express sympathy in a relation-ship if you are not in the habit of self-disclosing personal infor-mation about yourself to the other individual. With such a per-son, the following statement would not be helpful, “I’m sorry you have had so many tragedies in your life.” 6. It would be appropriate to express sympathy when you are with an individual to whom you regularly self-disclose personal infor-mation. In such a relationship, the following comment might be appreciated, “I’m sorry you’ve been in so much pain.” 7. It is inappropriate to communicate reassurance in which the guarantee is worthless. For example, you cannot support a state-ment such as, “I’m sure that everything will turn out OK.”

8. It can be appropriate to communicate reassurance in which the guarantee is backed by facts. For instance, you might be able to say, “The necessary repairs have been made in your apartment, and you have been certified as being eligible for a return of your security deposit. The check will be sent tomorrow.” 9. An example of an open question would be, “How do you feel about being accepted?” 10. An example of a closed question would be, “Are you receiving rental assistance?” 11. An example of a leading question would be, “You’ve had finan-cial difficulties before, haven’t you?” Regardless of the individ-ual’s actual financial history, a person who wants to please you may give a positive response, and a person who wants to dis-please you is likely to give a negative response. 12. Examples of multiple questions include, “Are you willing to accept the help, or do you want to try to make it on your own?” and “What will the program mean to you, and how do you feel about receiving assistance?” If you get a “Yes” or “No” to the first set of questions, you won’t know what it means, and either set of questions may be confusing to the client. 13. An example of a “Why” question would be, “Why did you wait so long before coming to us?” Such a question is threatening and may result in a response that is fabricated or distorted. 14. A possible surface feeling reflection would be, “Having gotten your finances in order, it’s now really frustrating to see your grades drop.” 15. An example of a funnel sequence would be: “How have things gone since our last meeting?” “Knowing the check came through is very satisfying.” “You’re still anxious about not having enough money to pay your bills. Have you applied for assistance?” 16. An example of an inverted funnel sequence would be: “Did you start the program?” “Is it worth the effort?” “What will you be doing next week?” “You’re feeling more hopeful about the future.” 17. An example of an appropriate reflection-interrogation combina-tion would be, “Despite your boyfriend’s assurance, when days go by without contact you begin to worry about the stability of your relationship. What do you do when you have such doubts?”

FILL-IN-THE-RESPONSE QUESTIONS This is the chapter’s final exercise. It provides you with a series of statements from a single client. For each item, write a worker response that you believe would be appropriate. 1. I’ve got a problem where I live. I have a new neighbor who is especially inconsiderate. At all hours of the night, this guy plays very loud music that keeps me awake. Often I don’t get enough sleep, and then I’m tired the next day. 2. In the morning, I need to get moving early. But after a night of his noise, my alarm goes off and I feel like I’ve hardly been asleep at all. Most mornings this week, I just couldn’t get myself going because I had been kept awake by the music coming from his place. As the day drags on, I feel tired, and I want to sleep. It’s really getting to me. I know I’m not functioning as well as I should be. 3. I can’t take it much longer. I’ve thought about going over there at 2:00 A.M., pounding on his door, and screaming, “Turn down that racket!” But to me that doesn’t seem like the right approach. I’m not sure I would get anywhere, and I might just end up mak-ing the situation worse. 4. I’m not the kind of person who actually could yell at him. I guess what I really should do is go over when I’m calm, sometime dur-ing the day, and sit down and have a talk with him. I ought to just lay out the situation and tell him that I need some peace and quiet. 5. I’ve thought about asking him not to play his music after 11:00. But I’m not sure if he is the type of person who would take into account how his actions are affecting others. He might not care what someone else wants or thinks. Who knows how he’d respond? I’ve also wondered if I’m the only one around here who feels this way. I think his noise must be bothering other people, too. 6. Maybe it’s time to do something. So far, I’ve just been keeping things to myself and boiling inside. Although I’ve thought about a few ideas, the fact is that I really haven’t done anything yet. But that needs to change. I can’t continue to put up with his noise.

POSSIBLE ANSWERS FOR FILL-IN-THE-RESPONSE QUESTIONS For each response opportunity, there are many possible correct answers. We list two, and we suggest you use them in the following manner. • Look at our two answers and think about them. • Consider relevant material covered in the chapter. • Read the client statement again, then immediately read your answer and the two options listed here. • Write another response that you believe might be an improve-ment on your first effort. (Do not use any of the feeling words that appear in the following responses. Instead come up with other fresh and accurate words that identify how the client is feeling.) • Repeat this procedure for each of the remaining items. 1. • The nighttime noise has you exhausted. • You’re really frustrated with his behavior. 2. • It’s exasperating to have your life so disrupted. • Not having enough energy to face your responsibilities is dis-heartening. 3. • You’ve been so mad that you’ve felt like confronting him in the middle of the night. • At times, when you’ve been so furious, you’ve imagined going over and yelling at him. 4. • One option would be meeting with him during the day and saying what’s on your mind. • What might you say to him in such a meeting? 5. • Confronting him by yourself would entail some risks, but you’re also thinking there could be others who are fed up with his behavior. • Speaking with him yourself is one idea you’ve had, and you’ve also considered the possibility that others might be disturbed by what he is doing. 6. • You’re ready to decide on an effort you could make. • We’ve talked about a couple of strategies: having a discussion with him, and finding out how others are feeling about the noise. At this point, what possible action would you like to dis-cuss further?

SUMMARY Most efforts intended to be supportive can be categorized accord-ing to five basic ways of responding. Telling the individual what to do is the purpose of advice, but this response runs the risks of rejection, failure, or dependency. When analyzing, you provide your explana-tion of how circumstances developed, rather than focusing on the other person’s thoughts. Being sympathetic means saying how you feel about the client’s difficulties and can be interpreted as pity or insin-cerity, while false reassurance means offering a worthless guarantee that communicates a lack of appreciation for the severity of the situa-tion. Interrogation can come in several forms. Open varieties give the client considerable latitude in responding, but closed types can be answered with one word or with a small bit of information. Questions to avoid include leading questions, multiple questions, and “Why” questions. Reflecting is using your own words to summarize essential ideas and emotions communicated by the other person. At times, you may want to employ phrasing that matches a client’s negative tone, but it is also necessary for some of your reflections to encourage dis-cussion of productive change. Depending upon the feeling content of your statement, reflections can be classified as factual, surface feeling, or underlying feeling. When working with an individual who is reluc-tant to talk, a good strategy is to combine interrogation and reflection into an inverted funnel sequence. And, if you want to gather certain information while still conveying interest and understanding, a reflec-tion-interrogation combination is an effective technique.

Chapter 5 FINE-TUNING

Now that you have encountered a fair number of concepts, this chapter discusses some common errors made in implementing those ideas. In our experience, when novice workers receive correc-tive feedback, it usually relates to one or more of the areas discussed below. Although several of these problems have already been ad-dressed, we present them again in order for this chapter to contain a comprehensive list of fine-tuning issues. Concentrating on nonproductive behavior is not pleasant, but iden-tifying such difficulties can help you weed out tendencies that may detract from your efforts. Although we are focusing on mistakes, you can avoid most of these errors by implementing four principles: (1) use the least amount of authority necessary to accomplish your objec-tives, (2) demonstrate your understanding of the client, (3) talk in ways that seem natural and unrehearsed, and (4) remember your ultimate purpose is to encourage productive change. The opposites of those principles are the pitfalls to avoid: (1) asserting too much authority, (2) speaking in ways that fail to demonstrate understanding, (3) employ-ing phrasing that seems artificial and programmed, and (4) using terms that can hinder movement toward productive change. Most of those mistakes will not apply to you, and you need not worry about them. Instead, focus on the few recurring errors that you do find yourself making, and keep the relevant caveats in mind as you hone your skills. USING TOO MUCH AUTHORITY One common difficulty is being too directive. This can occur in a number of ways, including the following: using an opening phrase that implies you are going to solve the client’s problem, making opinion-ated statements, offering general observations about life, giving ad-vice, being too quick to suggest options, concentrating on persons other than the client, inappropriately changing the topic, interrupting, not recognizing alternatives discussed by the client, making judgmental exclamations, and offering to take an action that would be better for the client to initiate. All of those mistakes will be discussed, but we will start with a group of errors that share the theme of inappropriate inter-rogation, as demonstrated by the following: asking unnecessary closed questions, several questions in a row, “Why” questions, and multiple questions, as well as routinely making reflections into questions. Asking Unnecessary Closed Questions One of the most common mistakes by novice workers, and by trained professionals who have forgotten their roots, is asking unnecessary closed questions. Remember that it is best not to ask a closed question unless you would be satisfied with a brief reply. Asking Three or More Questions in a Row without Reflecting Any of the Client’s Responses When you get replies to questions you ask, don’t keep asking more questions. Instead, reflect the answers you are getting. (An exception to this may occur when you are purposefully using an inverted funnel sequence.) Asking “Why” Questions Asking “Why” questions can put your client on the defensive. The responses you get will often contain rationalizations as the client be-comes increasingly uncomfortable. If those are not results you want, abandon “Why” questions. Asking Multiple Questions Confusing responses, a confused client, or both can result from mul-tiple questions. Such interrogation tends to occur when you try to cover too much at once or when you rephrase a question you’ve just asked. If you are having trouble with these issues, you can get on track again by following two principles: (1) Maintain a moderate pace. (2) Wait for the client’s response before concluding that a question needs to be rephrased. Routinely Making Reflections into Questions Occasionally, you may be so unsure of a reflection that you make it into a question with your tone of voice. Doing that when you are uncertain is acceptable. But when you routinely use your tone of voice to change reflections into questions, you are doing a lot of unneces-sary interrogating. Starting the Interaction by Taking Responsibility for Solving the Client’s Problems Some workers immediately assume responsibility for resolving the client’s difficulties by beginning the interaction with a question such as, “How can I help you?” Rather than putting the focus on yourself, it is better to remember that a supportive worker’s task is to assist clients in developing their own problem-solving abilities. With this in mind, a more productive way to open might be, “How are things going?” or “Tell me your reason for contacting us.” Making Judgmental Comments Another common error, displayed by both new and veteran work-ers, is making judgmental statements. Often these are positive opin-ions expressed when clients are discussing options or plans. For exam-ple, a client says, “I will just tell her what she has been doing, how I feel about it, and what I think should happen” and the worker responds with, “I think that would be a good idea.” But whether con-veying agreement or disagreement, such responses place some deci-sion-making responsibility on the worker, thereby decreasing the cli-ent’s independence. Consequently, a more productive acknowledg-ment of a client’s decision may be to offer a statement that merely rec-ognizes the person’s opinion of the option, such as, “You’re ready to be assertive with her.” Offering General Observations about Life When sharing truisms you think are applicable, you focus on your own ideas rather than on what clients believe. Consequently, it is almost always better to reflect. For example, a client says the follow-ing. “I’m on my own for the first time, and I’m really feeling shaky. When I come home at night there’s no one here but me. That’s not what I’m used to.” You could respond with a general observation about life, such as, “It takes time to get used to a new living situation.” Rather than providing your analysis of the circumstances and offering a general observation about life, it would be better to focus on the client by reflecting thoughts and feelings. For example, one possibili-ty might be, “Living alone is new for you, and you’re feeling uneasy about it.” Giving Advice When you are in a supportive helping mode, telling clients what to do is not your role. So for the most part, stay away from advice. Suggesting Options Too Soon Remember that you do all you can to pull for client-generated options. Only after making that effort is it appropriate for you to offer additional ideas for consideration. Focusing on Someone Other Than the Client Clients often discuss problems that involve other people. But rather than concentrating on the thoughts and feelings of those other indi-viduals, you can bring such persons into the discussion by focusing on your client’s ideas and emotions as they relate to those persons. For ex-ample, “He really got angry” changes the focus to the other person, whereas, “You were surprised by his anger” keeps the focus on the client. Inappropriately Changing the Topic For reasons that briefly may make sense to them, workers some-times change topics rather than encourage clients to continue pro-ductive discussions. But appropriate input from clients is what you want. So, when you are getting relevant discussion, you should sup-port those efforts rather than attempting to divert them.

Interrupting Occasionally, clients engage in monologues and must be interrupt-ed. In less drastic situations, however, interruptions generally are un-necessary. When you find that you have interrupted inappropriately, it may be best simply to stop talking and to let the client continue. When eventually there is an opportunity for you to speak, be sure not to start with the same phrasing you used when you interrupted. Otherwise it will appear as though you haven’t been listening to the client since you last spoke. When the need to interrupt a client outweighs the risk of hurting the person’s feelings, remember to be honest, tactful, and respectful with your interruption. In the following example, the worker inter-rupts a client who for the last 35 minutes has been venting nonstop about the intricate legal proceedings of a car accident she had last year. “Excuse me, Mrs. Jones, I can tell it’s important to you that I understand the specific details of your accident and its legal entangle-ments. But before our session is over today, I want to make sure that you leave with some concrete plans for dealing with your frustrations over these exasperating experiences. If moving in that direction is OK with you, I would like you to tell me about some of the things you’ve been doing that have helped you cope with the great amount of stress you’ve been under.” Those remarks use polite language, address her in a respectful manner, reflect the overall topic and feelings she has discussed, explain why you want to learn about another aspect of what has been happening, and give her a new direction for the discussion. Hopefully those efforts have minimized the trauma of cutting her off and will move the interaction into a more productive mode. Failing to Recognize Options Generated by the Client Sometimes the problem is not with what you say but with what you don’t say. When a client puts energy into exploring an option, don’t ignore those efforts. Instead, recognize the client’s contribution. Making Opinionated Exclamations If you want to come across as being unskilled, this is a good way to do it. By blurting out a statement such as, “Oh, my God!” you strip away any semblance of professional demeanor. So, if you want to pro-vide supportive help, avoid editorial expletives.

Offering to Take Action That the Client is Fully Capable of Doing Being supportive sometimes means acting on behalf of clients. But you do not want to be too hasty with offers of assistance. Before say-ing you will do something for the client, be sure it really is necessary for you to accomplish the task. SPEAKING IN WAYS THAT FAIL TO DEMONSTRATE UNDERSTANDING Demonstrating understanding requires focused effort on your part. When this task eludes workers, it tends to do so in one or more of the following ways: relying on vague terms for referring to content; ignor-ing feelings; using feeling terms that are too broad; saying, “Tell me more” before reflecting what you already know; posing questions the client has already answered; saying “I see” or “I understand;” inap-propriately diminishing the intensity of your comments by using qual-ifiers; unintentionally reducing an event’s importance by saying “just;” and repeating the phrase “you know.” Using Terms Such as “Situation,” “Stuff,” or “This” to Refer to Circumstances You Have Not Specifically Reflected It is possible to conduct an entire interaction without ever identify-ing the circumstances being discussed. Instead, they may be referred to in a nebulous way with terms like “problem,” “concern,” “situa-tion,” “stuff,” or “this.” Such phrasing is acceptable only after you have reflected the nature of the conditions being described. Remember, in order to demonstrate understanding you must reflect both feelings and the particular conditions under discussion. Failing to Reflect Feelings We have seen some workers avoid reflection of specific content, and we have observed others do entire interactions without reflecting any feelings. If you ignore the emotional component of a client’s message, you are not engaging in supportive helping. So, remember to include feeling reflections.

Using Vague Feeling Terms All clients with distressing emotions are “concerned,” “upset,” and “bothered.” Since such vague terms apply to almost any client, they do not demonstrate that you understand the particular person you are interviewing. In order to do that, you should use more specific terms to identify the emotions you perceive. Making a Statement Such as “Tell Me More” without First Reflecting What the Client Already Has Told You Appearing wooden and stiff often is the net result of using pat phras-es like “Tell me more.” Such directives certainly do not demonstrate understanding, and they may even suggest uneasiness or lack of atten-tion. In order to show that you comprehend what the client is com-municating, you need to reflect rather than try to rely on trite responses. Asking Questions the Client Has Already Answered Asking a question the client has already answered lets the person know, in a very demonstrable way, that you have not been listening. Since attention is what you should be communicating, supportive help-ing requires that you listen and that you demonstrate your under-standing of the client’s message. If you want to ask a question while still demonstrating understanding, one good technique is a combina-tion response in which you offer a reflection and follow it with a ques-tion that has come to mind. Saying “I See,” “I Understand,” or “I Know How You Feel” Such responses do not demonstrate that you see, understand, or know. If showing what you’ve learned is what you hope to do, you are better off reflecting. Using Qualifiers That Diminish the Intensity of Your Comments When That Is Not Your Intent If you wish to lessen the intensity of your statement, you can do so by using qualifiers such as “kind of,” “a little,” and “sort of.” But you should omit such phrases if you want your comment to carry its full impact.

Inappropriately Decreasing the Importance of an Event by Saying “Just” When you make a response such as, “You’re just having trouble with your youngest child,” one connotation is that the difficulty is real-ly not very significant. Since belittling the client’s issues is not some-thing you want to do, a better comment would be, “Trying to get your youngest child to obey has become a taxing experience.” Saying “You Know” Frequent use of this phrase only serves to blur the focus of what you are trying to communicate. So, if you wish to speak clearly and con-cisely, avoid peppering your remarks with “you know.” TALKING IN WAYS THAT SEEM ARTIFICIAL AND PROGRAMMED Supportive helping involves a variety of techniques. But, as you recall, the eventual goal is to incorporate these methods into a per-sonal style that is both natural and effective. Unfortunately, rather than demonstrating that you are responding as an authentic individual, it is possible to come across as artificial and programmed. This robotic style is often associated with two behaviors: employing repetitive phras-ing, and parroting what a client has said. Using Repetitive Phrases If you want it to appear as though your intent is to parody support-ive helping, then begin all of your reflections with “So,” “Well,” “It sounds like,” “You feel,” “You’re feeling,” or “I hear you saying.” That last phrase is so hackneyed that Hollywood scripts now use those words when the character speaking them is intended to be an unflat-tering caricature of an individual attempting to facilitate therapeutic change. Since you want to be perceived as a competent professional, don’t begin reflections with, “I hear you saying.” On the other hand, it can be appropriate to use “So,” “Well,” “It sounds like,” “You feel,” and “You’re feeling,” as long as you mix them with other openings.

Frequently Restating Exact Words Used by the Client Rote repeating of phrases is not reflection and adds nothing to the interaction. Avoid frequent parroting of client comments, unless you want to come across as being an automaton. USING TERMS AND PHRASES THAT CAN HINDER MOVEMENT TOWARD PRODUCTIVE CHANGE The ultimate purpose of supportive helping is to encourage pro-ductive change. But that objective can become more difficult to attain when workers create roadblocks or detours by using certain respons-es. Problematic comments include statements that suggest clients “must” react in certain ways, as well as words or phrases that are un-necessarily strong. Saying That Something “Makes” the Client Act or Feel Certain Ways In supportive helping, there are two fundamental realms for pro-ductive change. One is the client’s environment, and the other is how the client responds to that environment. As we mentioned in Chapter 4, although some situations cannot be altered, how the client acts in response to those situations often can be modified. But you may imply that changing one’s reactions is impossible when you use phrases such as “makes you,” “made you,” “must be,” or “must have.” Automatic responses are implied if you offer the following sorts of remarks: “Their rudeness makes you feel unimportant” or “You must feel awful when they speak so harshly to you.” It is best to avoid such phrasing if you want to leave open the possibility of clients changing how they react. Using Strong Words and Phrases without Considering Their Impact The term depressed can carry a lot of labeling implications. Unless you are ready to discuss the diagnostic definitions and therapeutic options for depression, you may want to rely on less clinical words, such as “sad” or “down.”

Often occurring in conjunction with depression are two other pow-erful terms: hopelessness and helplessness. Although you might be accu-rately reflecting a client’s feelings, saying, “It’s hopeless” or “You’re helpless” may suggest nothing can be done, and that rarely is what you want to communicate. On the other hand, you leave open the door for change when you make reflections such as, “It’s been dis-couraging” or “You’re tired of trying and not succeeding.” There also are other phrases that tend to cut off discussion of options. For example, after reflecting, “There’s nothing you can do” or “You’re at a dead end,” where do you go from there? Additional terms that can create unwanted effects are nonclinical emotional labels having negative connotations. These include adjec-tives such as “jealous,” “spiteful,” and “vindictive.” Rather than using those sorts of words, you may want to employ alternative phrasing. MULTIPLE-CHOICE QUESTIONS The first 6 items are with one client; items 7–13 are with a second person; and items 14–20 involve a third individual. Your instructions are the same as in the previous chapters. • For each of the following client statements, choose the response or responses you believe would be appropriate. (Several items have more than one correct answer.) • Indicate your selections in writing. • Read the discussions of all four options. • If you are correct, go to the next item. • If you are incorrect, think about the explanations and, if neces-sary, review relevant portions of the chapter; then, once you bet-ter understand the issues, proceed to the next question. 1. The teachers in our school district are on strike, and the school board is refusing to negotiate with them. I think the board and the teachers should be talking to each other. So at the last school board meeting I was able to get on the agenda in order to express my opinions. When it was my turn, I got up to speak. But I froze, and I couldn’t say anything. I was so embarrassed that I just left the room. I felt like such a fool.

A. Good grief! B. So, you were sort of overwhelmed. C. You were ashamed of your performance. D. You felt badly about how you handled the situation. Discussion of Options A. Good grief! • Your opinionated exclamation is inappropriate. B. So, you were sort of overwhelmed. • It does not make sense to precede the word “overwhelmed” with a qualifier such as “sort of.” How can someone be kind of completely overpowered? C. You were ashamed of your performance. • This reflection is on target. D. You felt badly about how you handled the situation. • Before using the term “situation,” it is better to define the circumstances. 2. I had lots of things I wanted to say. But when I got up and the spotlight was on me, and all of those people were looking at me, I just lost it. I froze. A. As you rose to speak, you were thinking about the message you wanted to deliver, but then you began to focus on your own nervousness? B. At first, you were thinking about the opinions you wanted to present, but then you became extremely uncomfortable. C. You really overreacted to the pressures that night, and you seem to be overreacting now as you continue to ruminate about what happened. D. Being the center of attention was frightening, and your pre-pared thoughts left you. Discussion of Options A. As you rose to speak, you were thinking about the message you wanted to deliver, but then you began to focus on your own nervousness? • There is no need to make this reflection into a question.

B. B. At first, you were thinking about the opinions you wanted to present, but then you became extremely uncomfortable. • You have accurately reflected the client’s comment. C. You really overreacted to the pressures that night, and you seem to be overreacting now as you continue to ruminate about what happened. • This is a judgmental statement that criticizes the client. D. Being the center of attention was frightening, and your pre-pared thoughts left you. • Your reflection demonstrates that you understand the client. 3. I was really charged up. I wanted to tell the board that they had a responsibility to our children and that they were letting our kids down by refusing to negotiate. But I’m the one who ended up let-ting the kids down by not being able to deliver my comments. I thought that what I had to say was important. Instead of making my point, though, all I did was end up looking like a bumbling fool. A. When you found yourself unable to deliver your remarks, how did the board react? B. It sounds like you have children who are missing school. Tell me what you’ve been doing to help them cope with the strike. C. Why were you so intimidated? D. Failing to deliver your message was disappointing. Discussion of Options A. When you found yourself unable to deliver your remarks, how did the board react? • You have shifted the focus away from the client. B. It sounds like you have children who are missing school. Tell me what you’ve been doing to help them cope with the strike. • As with option A, this comment changes the topic away from what the client has been discussing. C. Why were you so intimidated? • This “Why” question may threaten your client. D. Failing to deliver your message was disappointing. • You provide an accurate surface feeling reflection of what the client has said.

C. 4. I finally took a stand on something. And I really never had done that before. But when I got up there and lost it, I also lost all of my confidence. I still would like to get my point across, but I feel so humiliated. A. You regret having failed in your initial effort, but you contin-ue to believe that you have something important to commu-nicate. B. Before going to the meeting, did you spend some time prac-ticing what you were going to say? C. You wish you had done better, but you still have ideas you want to express to the school board. D. You are concerned about your performance, but you still have a need to convey your thoughts to the board. Discussion of Options A. You regret having failed in your initial effort, but you contin-ue to believe that you have something important to commu-nicate. • This is an accurate reflection of your client’s thoughts and feelings. B. Before going to the meeting, did you spend some time prac-ticing what you were going to say? • It is not necessary to ask this closed question. C. You wish you had done better, but you still have ideas you want to express to the school board. • This reflection is accurate, but it does not recognize the client’s feelings. D. You are concerned about your performance, but you still have a need to convey your thoughts to the board. • The feeling term “concerned” is vague. You can do a better job of identifying specific emotions. 5. I was there for the kids, and I let them down. I know I lost my courage that night, but I really don’t want that to stop me. I need to get it together so I can effectively get my point across to the board.

D. A. As you think back to that evening, how did you feel? B. So, you would sort of like to try again in some way. C. You don’t want to be stopped by what happened at that meet-ing. Instead, you want to effectively get your point across to the board. D. You’re determined to persevere. Discussion of Options A. As you think back to that evening, how did you feel? • You already have the answer to this question. B. So, you would sort of like to try again in some way. • By using the phrase “sort of,” you diminish the intensity of your comment, and that probably is not your intent. C. You don’t want to be stopped by what happened at that meet-ing. Instead, you want to effectively get your point across to the board. • Your response repeats exact words and phrases used by the client. D. You’re determined to persevere. • This is an accurate reflection of the client’s comments. 6. I hope I never make a fool of myself like that again. But I just can’t let this issue drop. Either I need to request to speak to the board again, or I need to let them know my thoughts in some other way. A. Failing, like you did that night, is not something you want to do. B. I see. C. One option is speaking again, but there might also be other possibilities. D. You don’t really plan on trying to speak to them again, do you? Discussion of Options A. Failing, like you did that night, is not something you want to do. • This comment does not recognize the options brought up by the client.

B. I see. • Making such a response does not demonstrate understand-ing. C. One option is speaking again, but there might also be other possibilities. • You have provided an accurate reflection that facilitates the problem-solving process. D. You don’t really plan on trying to speak to them again, do you? • Your judgmental leading question conveys the idea that you believe she should not attempt to speak again. The next seven items are with a different client. 7. My mother broke her hip about three months ago, and since she got out of the hospital, she’s been living with me. I’ve had to take care of her, and she’s not the easiest person to take care of. I’m really tired and at the end of my rope. A. Providing for her needs has become an exhausting experi-ence. B. So your difficulties just relate to her staying with you. C. Tell me more. D. The demands of your mother’s convalescence have you really depressed. Discussion of Options A. Providing for her needs has become an exhausting experi-ence. • You make an accurate surface feeling reflection. B. So your difficulties just relate to her staying with you. • Although you may not intend it, using the word “just” can suggest that you believe the client’s problems are not very significant. C. Tell me more. • You are more likely to demonstrate interest and under-standing if you reflect your impressions. D. The demands of your mother’s convalescence have you really depressed.

When used by a human services professional, the term “depressed” can be seen as being very strong. Unless you are prepared to deal with the labeling implications of “depressed,” avoid this term. 8. Yeah, that’s pretty much it. My mother has always been the dom-inating type. Even before her accident she thought it was her duty to constantly tell me what to do. I could cope with her in short stints, but now she’s living in my house. I have my own way of cleaning, my own way of disciplining my children, and here she is, repeatedly trying to tell me what I should be doing. A. You’ve come to dread her critiques of your behavior. B. The daily routine at your house has become a frustrating experience, as you receive one type of criticism after another. C. It seems to me that you haven’t been assertive enough with your mother. D. You are upset about your mother’s interference in your life. Discussion of Options A. You’ve come to dread her critiques of your behavior. • Your reflection is on target. B. The daily routine at your house has become a frustrating experience, as you receive one type of criticism after another. • You provide an accurate surface feeling reflection of the client’s comment. C. It seems to me that you haven’t been assertive enough with your mother. • This is a judgmental statement that is inappropriate for a supportive worker. D. You are upset about your mother’s interference in your life. • Most clients are “upset.” Try to be more specific in identi-fying feelings to reflect. 9. We have been apart for years. But, because of her injury, I have to be her caregiver, plus look after all of my usual responsibilities. Between her and my kids, I have absolutely no life of my own.

A. It’s draining to have so many people depending on you. B. You should have a meeting with your mother and your kids so that you can tell all of them exactly how you are feeling. C. What do your kids think about the changes brought about by your mother’s presence? D. So, it has been quite some time since you and your mother lived together. Discussion of Options A. It’s draining to have so many people depending on you. • This is an accurate surface feeling reflection. B. You should have a meeting with your mother and your kids so that you can tell all of them exactly how you are feeling. • Your advice implies the client is incapable of generating alternatives. C. What do your kids think about the changes brought about by your mother’s presence? • At this point in the interaction, it is better to keep the focus on your client, rather than changing it to others involved in the situation. D. So, it has been quite some time since you and your mother lived together. • Your reflection is accurate, but it does not contain a feeling component. You can do better. 10. Although I feel like I can’t take it much longer, I don’t know what else to do. I have two younger sisters, but they have their own lives. Since I’m the oldest, I’ve felt that I should be the one to look after my mother. I know she is going to need care for at least a few more months. But I’m tired, and I want my own life back. A. As you look ahead to the future, you feel hopeless because of your commitment to provide the assistance that your mother continues to need. B. You have taken a lot of responsibility on yourself, but at this point the frustrations of caring for your mother make you want to give up. C. My gosh! You mean you have taken this burden on yourself, and you haven’t even asked your sisters for help?

E. So you decided to care for your mother on your own, but, at this point, you really need a change in those arrangements. Discussion of Options A. As you look ahead to the future, you feel hopeless because of your commitment to provide the assistance that your mother continues to need. • This might be an accurate reflection, but the term “hope-less” is very strong. Rather than opening doors to available possibilities, it implies that there are few, if any, opportuni-ties for change. B. You have taken a lot of responsibility on yourself, but at this point the frustrations of caring for your mother make you want to give up. • Although there are probably alternatives regarding care for the client’s mother, it is possible that the client will contin-ue to provide the needed support. If the latter is true, the only option for change will be in how the person views the task of supplying that assistance. But by using the phrase “make you,” you have implied that providing care will always result in feelings of discouragement. Thus, you have closed the door on a potential area for progress. C. My gosh! You mean you have taken this burden on yourself, and you haven’t even asked your sisters for help? • Your opinionated exclamation is followed by a judgmental statement that suggests advice. Consequently, on at least three different counts, this is not an appropriate response for a supportive worker. D. So you decided to care for your mother on your own, but, at this point, you really need a change in those arrangements. • By highlighting the client’s role in the decision-making process and by recognizing the desire for change, you are giving the person an opportunity to begin thinking about alternatives. 11. I did take charge and decide what should be done. But my one sister and her husband don’t have a home situation that is con-ducive to my mother living with them. They’re just starting out, and they only have a one-bedroom apartment. And my other sister has three children, with the oldest being five, so she can’t take her. Plus, both of my sisters live several hours away. By staying with me, though, my mother has been able to remain in her home community. That’s been important, especially with regard to friends from the church who regularly come by to visit her. A. One possibility you haven’t mentioned is a nursing home. I’m wondering what you might think about using such a facility. B. Although you’ve provided most of the care yourself, another important source of support has been the church. C. Your mother living with you seemed to be the best option. And one positive outcome of your decision has been her abil-ity to see church friends. D. You still don’t think your sisters are going to be much help? Discussion of Options A. One possibility you haven’t mentioned is a nursing home. I’m wondering what you might think about using such a facility. • You have inappropriately changed the subject. For now, stay with the topics the client is discussing. B. Although you’ve provided most of the care yourself, another important source of support has been the church. • By recognizing contributions of the church members, you focus the interaction on a resource that may have addition-al potential for the client. C. Your mother living with you seemed to be the best option. And one positive outcome of your decision has been her abil-ity to see church friends. • This reflection is accurate and notes a source of support that may deserve further discussion. D. You still don’t think your sisters are going to be much help? • Your response does not need to be a question. But even if you make it into a reflection, it would not do much to move the interaction in the direction of productive change. 12. Yeah. She looks forward to their visits. And when they’re here, I actually feel like I can take a breather for a few minutes. During their stay, she doesn’t criticize me, and she has them take care of little needs that might come up, like getting her some water or adjusting her position in the bed. A. With regard to your sisters, it has been you, not them, who has made the decision that you would be supporting your moth-er. B. Your mother really likes to have her church friends visit. C. So, having the church members over does provide some relief for you. D. What would you think of having her church friends over more often? Discussion of Options A. With regard to your sisters, it has been you, not them, who have made the decision that you would be supporting your mother. • Your response inappropriately changes the subject, and it fails to recognize the option being discussed by the client. B. Your mother really likes to have her church friends visit. • You are focusing on the mother, rather than on your client. C. So, having the church members over does provide some relief for you. • This comment keeps the interaction centered on a continu-ing source of support. D. What would you think of having her church friends over more often? • At this point in the interaction, there is no need to make such a suggestion. 13. I guess they have been the one bright spot in all of this. Maybe getting them more involved is what I need to do. Their visits have been pretty short. I guess one possibility would be seeing if some of them might be willing to stay a little longer, so I could get a bit more of a break. A. I could get in touch with the church and see if they would be willing to organize some regular times to provide relief for you.

B. One possibility would be seeing if some of them would be willing to stay a little longer, so you could get more of a break. C. Involving her church friends seems like a good idea to me. I really believe that is an option you should seriously consider. D. You think talking to them about longer visits might be worth a try. Discussion of Options A. I could get in touch with the church and see if they would be willing to organize some regular times to provide relief for you. • You are offering to take a step that the client probably is fully capable of doing. B. One possibility would be seeing if some of them would be willing to stay a little longer so you could get more of a break. • Your response repeats exact words used by the client. C. Involving her church friends seems like a good idea to me. I really believe that is an option you should seriously consider. • Although positive, your comment is much too judgmental to be used by a supportive worker. D. You think talking to them about longer visits might be worth a try. • This accurate reflection continues the positive momentum with regard to the church member resource. The remaining multiple-choice items are with a different client. 14. My brother is very intelligent and talented. Although I don’t have bad abilities myself, I’m really not in the same ballpark as him. So while I’m all but ignored, it seems that he is always getting tons of praise. Just to be around him drives me nuts sometimes. Even though I love him, I can’t seem to kick these feelings of jeal-ousy. A. Do you want your brother to do worse? Or do you want to do better? B. You’re bothered about the issue of recognition, and you’d like to have more of what you see your brother getting.

C. Although you have different talents from your brother, you long for your own positive attention. D. This situation has you really discouraged. Discussion of Options A. Do you want your brother to do worse? Or do you want to do better? • Your multiple closed questions might confuse the client, and the answer, especially if it is a simple “Yes” or “No,” might confuse you. Also, you have conceptualized the issue in an overly simplistic way. B. You’re bothered about the issue of recognition, and you’d like to have more of what you see your brother getting. • It is better to use a more specific feeling word than “both-ered.” C. Although you have different talents from your brother, you long for your own positive attention. • You respond with an appropriate surface feeling reflection. D. This situation has you really discouraged. • Rather than using a term such as “situation,” it is better to reflect the nature of the circumstances, so that both you and the client have a clear understanding of what you are dis-cussing. 15. I feel like I do my best, but it never seems good enough to get me the kind of attention he gets. I wish it could be me who was the sunshine in the room for once. Our family makes a big com-motion about his successes, but mine don’t seem to matter to them. A. You’d kind of like them to focus on you a little more. B. When you do well, you crave for your relatives to take notice. C. You feel helpless to change the response of your family mem-bers. D. Tell me more.

Discussion of Options A. You’d kind of like them to focus on you a little more. • By using the qualifiers “kind of” and “a little,” you diminish the intensity of your comment, which in this case you prob-ably do not want to do. B. When you do well, you crave for your relatives to take notice. • You have provided an accurate surface feeling reflection. C. You feel helpless to change the response of your family mem-bers. • Although it might be accurate, your use of the strong term “helpless” has the potential to shut off consideration of problem-solving opportunities. D. Tell me more. • You have enough information to make a reflection. Consequently, if you are going to offer a response, you are better off demonstrating your understanding than making a statement that fails to show your comprehension of the client’s message. 16. Although I think they see me as a failure, I’m a person with feel-ings, and it hurts to be viewed as second class. I get so angry at them for not trying to understand me and for not seeming to care about what is happening in my life. A. It’s exasperating to miss out on the support you know they are capable of giving. B. Why are their opinions so important to you? C. So it’s just your family’s reaction that has you so unhappy. D. You’re angry at them for not trying to understand what is hap-pening in your life. Discussion of Options A. It’s exasperating to miss out on the support you know they are capable of giving. • Your surface feeling reflection effectively demonstrates understanding.

B. Why are their opinions so important to you? • This “Why” question may elicit a defensive reaction from the client. C. So it’s just your family’s reaction that has you so unhappy. • Using the word “just” could give the client the impression that you are downplaying the importance of the topic under discussion. D. You’re angry at them for not trying to understand what is hap-pening in your life. • Your response employs too many of the words used by the client. 17. I question myself as to why I can’t let go of the jealousy. I try to be rational about it, but that doesn’t seem to work. I guess I should count this problem as another one of my failures that I haven’t been able to overcome. A. Wow! You’re really down on yourself. B. You feel hopeless regarding your ability to make any changes on this matter. C. But if you could get your family’s approval it would make you happy. D. So if you were able to dispel these feelings of envy, you would see such a change as a positive achievement. Discussion of Options A. Wow! You’re really down on yourself. • Your opinionated exclamation is out of character for a sup-portive worker. B. You feel hopeless regarding your ability to make any changes on this matter. • Your use of the term “hopeless” may be accurate, but it does nothing to encourage problem solving on the part of the client. C. But if you could get your family’s approval it would make you happy. • This is exactly the kind of interaction in which you want to avoid any implication that others’ actions can make the client react in a certain way.

D. So if you were able to dispel these feelings of envy, you would see such a change as a positive achievement. • You have identified a relevant emotion, and you have phrased your response in a way that has the potential to facilitate movement toward goal setting and problem solv-ing. In this case, it is possible that plans may focus on how the client responds to the unequal distribution of praise and attention, since those undesirable circumstances may con-tinue whatever the person does. 18. Yes. I would like to feel more secure in myself. So far, I think I have seen myself as a failure. And that’s not a very pleasant way to be living my life. A. What could you and your brother do to get along better? B. You believe it might be important for you to alter the way you view yourself. C. If you’re right about that, you know, changing the way you see yourself might be something to consider. D. Having confidence in yourself is an experience you would welcome. Discussion of Options A. What could you and your brother do to get along better? • Your question is an inappropriate attempt to change the topic. B. You believe it might be important for you to alter the way you view yourself. • Your comment encourages movement toward productive change. C. If you’re right about that, you know, changing the way you see yourself might be something to consider. • The phrase “you know” is unnecessary. D. Having confidence in yourself is an experience you would welcome. • This reflective response is likely to foster continued prob-lem-solving progress.

19. Yeah. I guess I really need to take a look at my own attitudes about myself. A. What are some attitudes you would like to change? B. What do you think should be different? Which attitude should you address first? C. You’re sort of ready for a change in some of your attitudes. D. In terms of attitude change, you might want to concentrate more on yourself and not worry so much about how others react to your brother. Discussion of Options A. What are some attitudes you would like to change? • This open question focuses the interaction on a potential area for new coping efforts. Preceding your inquiry with a reflection was not necessary in this case, since the client’s comments were brief, expressed no new feelings, and were entirely related to your question. B. What do you think should be different? Which attitude should you address first? • Your intent will be clearer if you ask one question at a time, rather than attempting multiple questions. C. You’re sort of ready for a change in some of your attitudes. • By using the phrase “sort of,” you decrease the intensity of the need for change when you should be backing that desire. D. In terms of attitude change, you might want to concentrate more on yourself and not worry so much about how others react to your brother. • It’s too soon to make such a suggestion. Instead of being so directive, supportive workers first encourage clients to gen-erate options themselves. 20. I guess I would like to be more self-confident. I would like to be able to do my best at something and then feel good about the effort. If possible, I would like those positive feelings to come from inside, so that however my family might react, I would know in my own mind that I could take pride in what I did.

A. You think you should be your own judge, rather than depend-ing so much on your family’s evaluations? B. Do you believe it’s really possible for you to make your own decisions and feel comfortable about them regardless of how your family might respond? C. You’d like to have your own inner point of reference that would give you a realistic way of determining the value of your accomplishments. D. I see. Discussion of Options A. You think you should be your own judge, rather than depend-ing so much on your family’s evaluations? • This response is not bad, but there really is no need for it to be a question. Consequently, we believe there is a better option among the other three possibilities. B. Do you believe it’s really possible for you to make your own decisions and feel comfortable about them regardless of how your family might respond? • At this point in the interaction, a closed question is not nec-essary. C. You’d like to have your own inner point of reference that would give you a realistic way of determining the value of your accomplishments. • This is an accurate reflection of what the client has com-municated to you. D. I see. • Your response does not demonstrate understanding. SHORT-ANSWER QUESTIONS Write your answer for each of the following questions. 1. When should you ask closed questions? 2. What are the problems with starting an interaction by saying, “How may I help you?” 3. If you come to believe that it is necessary to make a suggestion, at what point in the problem-solving process should you offer it?

4. If a client brings up a viable option, what should you do? 5. When first discussing a topic, what is wrong with referring to the circumstances with a word such as “situation,” “stuff,” or “this”? 6. What is the disadvantage of relying on feeling terms such as “upset,” “concerned,” or “bothered”? 7. What do you communicate when you ask a question the client has already answered? 8. When should you use qualifiers such as “kind of,” “a little,” or “sort of”? 9. What is the image you convey when you rely on repetitive phras-es? 10. What are you implying when you say that something “makes you feel” or “must have been?” 11. In terms of problem solving, what are the implications of using feeling terms such as “hopeless” and “helpless”? POSSIBLE ANSWERS FOR SHORT-ANSWER QUESTIONS The answer-checking procedures remain the same as before. • For each item, compare your answer to the one we provide. • If you believe your answer is correct, you are done with that item. • With any question for which you believe your answer is incorrect, consider our answer and, if needed, review relevant portions of the chapter. Keep your original answer that you now think is incorrect, but add to it a response that you believe would be cor-rect. 1. You should ask closed questions when you would be satisfied with a brief reply, such as a simple “Yes” or “No.” 2. An opening like, “How may I help you?” puts the focus on you and implies your role is to solve problems for clients rather than to encourage problem-solving efforts on their part. 3. If you believe a suggestion is necessary, make it at the end of the alternatives phase after first having pulled for options from the client. 4. When a client brings up a viable option you should acknowledge it.

5. You and the client ought to have a shared understanding of the conditions and events you are discussing. In order to achieve such an understanding, you must specifically describe the circum-stances, rather than referring to them in vague ways. 6. Almost all clients are “upset,” “concerned,” and “bothered.” Consequently, those terms don’t say anything unique about the person you are interviewing. 7. When you ask a question the client has already answered, you communicate the impression that you have not been paying attention to the person. 8. You should use qualifiers such as “kind of,” “a little,” or “sort of” when you want to decrease the impact of your comment. 9. Using repetitive phrases conveys the impression of being on auto-matic pilot, rather than encouraging the client to see you as an interested and caring human being. 10. Phrases such as “makes you feel” or “must have been” imply that it is impossible to change the way the client responds to the cir-cumstances. 11. “Hopeless” and “helpless” emphasize the futility of trying to cope with distressing circumstances. Consequently, reflections that use such words may discourage problem solving rather than encour-age it. FILL-IN-THE-RESPONSE QUESTIONS Listed below are a series of client statements. For each one, write a worker response that you believe would be appropriate. 1. I’m really fed up at work. I’ve been in the same position for five years, and I’ve done my job well. In fact, on our last two annual evaluations, I got the highest ratings of anyone on my team. But the promotions were announced this week, and I’ve been passed over again. 2. This is the third year that I’ve been eligible to move up. But for two of the people who got promoted, this is the first year of their eligibility, and I know I’m doing better work than either one of them. I’m sure my annual evaluations are higher than theirs. It’s not fair.

3. With the injustice of it all, I feel like forgetting about even trying to do a good job. The supervisors obviously don’t have a genuine appreciation for the work I do. They give me excellent evalua-tions, but they don’t seem to pay any attention to my ratings when it’s time to actually promote someone. 4. I feel they are just using my skills and are taking me for granted. I guess they think that they can promote people for purely polit-ical reasons and that I’ll just keep on pumping out the work. But I’d like to give them a big surprise. 5. It would be great to quit. That’s exactly what they deserve. Let them try to run the operation with the kind of people they’re pro-moting. Eventually their incompetence will do them in, and, when that happens, I’d like to be on the outside just laughing at them. 6. I’m so furious I could leave tomorrow. Although I know that, at least in the short-run, I would be in worse shape than them. Rather than realize what they were losing, they probably would-n’t even care. So I would give up my job and be out of work, while it probably would be months before they noticed that any-thing was different. POSSIBLE ANSWERS FOR FILL-IN-THE-RESPONSE QUESTIONS For each response opportunity, there are many possible correct answers. We list two, and, as in previous chapters, we suggest you use them in the following manner. • Look at our two answers and think about them. • Consider relevant material covered in the chapter. • Read the client statement again, then immediately read your answer and the two options listed here. • Write another response that you believe might be an improve-ment on your first effort. (Do not use any of the feeling words that appear in the following responses. Instead come up with other fresh and accurate words that identify how the client is feeling.) • Repeat this procedure for each of the remaining items. 1. • It’s disappointing not to get the promotion you believe you deserve.

Not being promoted has you really discouraged. 2. • The apparent favoritism is frustrating. • You’re angry that less qualified persons are advancing while you’re standing still. 3. • You feel betrayed by your superiors. • It’s hard to keep plugging away when you think your efforts will go unrewarded. 4. • The promotion process has you feeling so abused that you’re considering some drastic action. • What steps are you considering? 5. • You would enjoy seeing them fail. • It would be gratifying for them to realize the extent of your contributions. 6. • Although you feel mad enough to leave, you think you would be the one hurt the most by such a move. • You’re thoroughly disgusted with your supervisors, but you’ve concluded that quitting now probably would be unwise. SUMMARY You can avoid the difficulties discussed in this chapter by keeping four thoughts in mind: use the least amount of authority necessary to accomplish your objectives, demonstrate your understanding of the client, talk in ways that seem natural and unrehearsed, and remember your ultimate purpose is to encourage productive change. The nega-tive sides of those guidelines are the themes around which the chap-ter’s material is organized. Ways of using too much authority include the following: asking unnecessary closed questions, asking three or more questions in a row without reflecting any of the client’s responses, asking “Why” ques-tions, asking multiple questions, repeatedly making reflections into questions, starting the interaction by taking responsibility for solving the client’s problems, making judgmental comments, offering general observations about life, giving advice, suggesting options too soon, focusing on someone other than the client, inappropriately changing the topic, interrupting, failing to recognize options generated by the client, making opinionated exclamations, and offering to take actions that the client is fully capable of doing.

Behaviors that fail to demonstrate understanding include the fol-lowing: using vague words to refer to circumstances you have not specifically reflected; failing to recognize feelings; using amorphous feeling terms; making a statement such as, “Tell me more” without first reflecting what the client has already told you; asking questions the client previously has answered; saying “I see” or “I understand;” using qualifiers that diminish the intensity of your comments when that is not your intent; inappropriately decreasing the importance of an event by using the word “just;” and frequently saying “you know.” Talking in ways that seem artificial and programmed may involve using repetitive phrases or parroting exact words used by the client. Terms and phrases that can hinder movement toward productive change include saying that something “makes” the client act or feel certain ways and using strong words or phrases without considering their impact.