COUN 687 - Module 1, Counseling Skills Review

1. Basic Counseling
Skills
Reviewed

2. Listening and Attending Responses

3. Clarification
 To ensure accuracy and understanding
 When meaning is unclear, ask the client for clarification
before making an interpretation
 Asking for clarification can make a message explicit and
confirm the accuracy of what is being said
 Use the tone of voice to frame the clarification as a question and not a statement

4. Examples of Clarification:
“Are you saying …”
“Could you clarify that for me.”
“Please explain …”

5. Paraphrasing or Restating
 The purpose of paraphrasing or restating is listening for content and affect
 Paraphrasing is a restatement of a client’s primary words and emotions; it is not
simply parroting, and it generally leads to further discussion and understanding
 It lets the client know the addiction counselor is attentive and understands what he
or she is attempting to communicate
 It encourages client elaboration
 It helps keep the client focused
 When paraphrasing, try to match the addiction counselor’s words to the client’s
words without repeating them verbatim
 When using paraphrasing, deliver the paraphrase as a statement rather than a
question and translate the key parts of the client’s message into different words

6. Examples of Paraphrasing or Restating
“I sense that …”
“Sounds like …”
“As I see it …”

7. Reflection
 The purpose of reflection is to identify the feelings
of a client and repeat them back to him or her
 Reflection is similar to paraphrasing but adds an
emotional tone or quality to a client’s message
 It can encourage clients to express and explore more of their feelings
 It helps the client feel understood
 It can help defuse a client’s negative feelings about addiction counseling
 It can help clients discriminate accurately between various feelings
 When using reflection, listen for the presence of feeling words, and attend to and
reflect on nonverbal cues
 Include a brief paraphrase to add to the context of the situation
 Assess the effectiveness of the reflection

8. Examples of Reflection
“It’s clear you are really angry right now.”
“You seem to get upset every time an urge bubbles up
inside and you can’t seem to resist it.”
“Is that pretty close to what you were feeling?”
“It seems like you were feeling …”

9. Summarization
 The purpose of summarization is to tie together multiple elements or themes in the
client’s various messages from his or her viewpoint
 To formulate a summarization consider the key content and affect of what the client
has said, being careful to note patterns and themes
 It serves as a feedback tool
 It moderated the pace of a session
 Evaluate the effectiveness of the summary

10. Example of Summarization
“At the beginning of this session you indicated that you
thought you didn’t have a problem with alcohol. Following
our discussion, I noted several times where you stated that
your drinking was often out of control. Does that sound
about right?”

11. Action Responses
• Move beyond the client’s frame of reference and include more counselor-
generated data and perceptions
• Critical element is timing
• Not to be used until after a counselor/client relationship has been
developed and some trust established

12. Probing or Questioning
 Ask only one question at a time
 Avoid blame, shame-oriented or belligerent questions
 Questions are used to help further explore the client’s emotions and experiences
 If used well, probing or questioning encourages the client to express more information
 The probe or questioning encourages the client to express more information
 Open-ended questions that begin with the words “what,” “how,” “where,” and “who” usually are
the most effective
 Do not ask a question unless there is a particular purpose and response in mind
 Avoid using probing or questioning as a primary response mode. An onslaught of questions is
likely to make the client feel as if he or she is beings interrogated
 Before asking a question, the addiction counselor or other helping professional should
determine if it is legitimate and therapeutic and how should the question be phrased to provide
the most effective result
 Evaluate the effectiveness of the probing or questioning

13. Probing or Questioning
A type of action response where the addiction
counselor asks the client a question to help further
explore his or her emotions and experiences

14. Confrontation
 When an addiction counselor points out discrepancies and mixed messages in the
client’s thoughts, feelings and actions.
 Can help explore other ways of perceiving themselves and issues in their lives. It can
also identify inconsistencies in how the client feels about or behaves in a certain
situation
 There are several different methods of confrontation that are helpful in specific
situations, including experimental, didactic, strength and weakness confrontation
 A common structure for confronting a client is using a compound statement, where
the first part is “on one hand …” and the second part is “on the other hand …”

15. Confrontation (cont.)
 The counselor must develop a rapport with the client before confrontation can
effectively be used.
 Never state the confrontation as an accusation, evaluation or demand. Instead,
deliver it as a challenge, suggestion or invitation
 Statements must be directed and descriptive concrete thoughts, feelings or
behaviors
 Make sure the confrontation is prompt and direct, as opposed to long and drawn out
 Consider the cultural and gender implications of the confrontation
 Determine if the client is stable enough to handle the aftermath of a confrontation
 The key to confrontation is timing. If the confrontation is too early in the relationship
and treatment process, it can be detrimental to the client.

16. Confrontation Techniques
Confrontation: A type of action response
where the addiction counselor points out
discrepancies and mixed messages in the
client’s thoughts, feelings and/or actions
Experimental Confrontation: When the
addiction counselor focuses on the client’s
discrepancies
Didactic Confrontation: Attempting to clarify
misinformation or remedy a lack of
information
Strength Confrontation: Where the focus is
on the client’s resources and past successes
Weakness Confrontation: Drawing the
attention to the client’s perceived failings,
flaws and shortcomings in hopes of
encouraging the client to take action

17. Interpretation
 Used to provide the client with an opportunity to take a
fresh look at him or herself and examine an alternative
explanation for his or her thoughts, attitudes and behaviors
 Differs from listening responses in that it deals with the implicit part of the client’s
messages
 May identify casual relationships or patterns in the client’s behavior and messages
and promote insight
 Can contribute to the development of a positive therapeutic relationship
 The counselor should listen carefully for the client’s implicit meanings and formulate
and interpretation that provides the client with a slightly different point of view

18. Interpretation (cont.)
 Make sure the interpretation is based on the client’s
actual messages and sufficient data rather than the
addiction counselor’s biases
 Interpretations need to be offered in a sage and empathetic atmosphere
 Consider phrasing the interpretation in a tentative rather than
an absolute manner
 Make sure the interpretation is congruent with the client’s culture
 Look for nonverbal “recognition” and “understanding” from the client

19. Interpretation Example
A type of action response where the addiction
counselor provides a client with another explanation
for his or her thoughts, attitudes and/or behaviors

20. Nonverbal Responses

21. Eyes
 Direct eye contact indicates willingness
to continue or exchange information
 More shared contact, the better the level of
involvement with some exceptions (cultural)
 Lack of eye contact is not an indicator of deception nor discomfort
 Excessive blinking may be an indicator of anxiety
 Continued eye shifting may indicate attentiveness, interest or emotional arousal

22. Head
 An erect but relaxed head may indicate receptivity
 Nodding head up and down indicates agreement or confirmation
 Shaking the head may indicate anger or disagreement
 Rigidity in the head may indicate anxiety
 Failing to lift the head may indicate disapproval,
embarrassment or sadness

23. Eyebrows
 Anger is expressed when brows are lowered, drawn together
and with vertical lines between them
 Sadness is shown when the inner corners are drawn up and
upper eyelids are raised
 Fear is shown when brows are raised and drawn together
 Surprise is indicated when brows are curved high

24. General Facial Expressions
 Happiness and surprise many be conveyed
through the lower face (mouth and jaw) and eyes
 Anger is often expressed through the lower face
and brows
 Fear is usually expressed through the eyes

25. Mouth
 Smiles are generally associated with
happiness
 Tight lips are associated with stress,
frustration, anger or hostility
 When the mouth is open may be an indicator of surprise or difficulty talking

26. Paralinguistics
 Pauses in speech filled with “uhs” many be an indicator
of anxiety or emotional arousal.
 Pauses or silences in speech may be an indicator the
individual is making a decision about past, present or a
future response.
 Periods of silence may also indicate avoidance.

27. Hands and Arms
 Trembling, fidgety or clenched hands may be an indicator
of anxiety or anger
 Hands that perspire may be an indicator of anxiety or arousal
 Arms folded across the chest may indicate avoidance or
reluctance to disclose
 Relaxed, unfolded arms may indicate openness

28. Legs and Feet
 Legs and feet that are relaxed and comfortable may indicate an
openness to interpersonal exchange
 Anxiety or impatience may be demonstrated by shuffling or tapping
of the feet/legs
 Depression or impatience may be see when an individual repeatedly crosses or uncrosses their
feet/legs
 “Stiff” legs may indicate a controlled person, signal anxiety or a closing off of communication