Effective Communication and Empathy

In this article we overview two extremely important skills within the counselling environment: effective communication and empathy. Whether you're a counsellor or mental health practitioner, or not, the principles discussed below can be useful to improve all kinds of relationships - in all walks of life.  

Effective Communication

Effective communication can assist in resolving problems before they get out of control. For example, when someone is angry or frustrated they often believe that no one is listening. When you become the one person who is really listening to them the result will usually be a positive one. In any communication, listening is the most important factor.

Defining Communication Skills

Attending - is the way you physically and psychologically orient yourself to the client. Effective attending does two things - it tells the client you are with them and puts you in a position to listen. Clients read cues that indicate the quality of your presence.

Attentive presence can invite or encourage trust. Half-hearted attention can promote distrust.

• Face the client squarely, adopt a posture that indicates involvement
• Adopt an open posture
• Maintain good eye contact
• Be aware of your non-verbal communication (i.e. body language)

Empathy - involves listening to the client, understanding their concerns and sharing that understanding with them. Listening is part of this process. Empathy is taking this a step further, trying to put yourself in the client's place and understanding their perspective.

• Understanding the other person's world
• Trying to understand how a person sees themselves that is their self perception

(Nongard, 2005)

Basic communication skills include:

Open Questions - usually begin with What, How, Why and Could. They are useful to bring out major data and facilitate conversation. For example, a client may storm into the office demanding to see you or the manager. Your response may be: What can I assist you with?

Closed questions - usually begin with do, I and are, which can be answered with a few words (quite often yes or no responses). These are used to quickly explain specific data and close off lengthy answers. They also assist in clarifying the message for example: "Would it help if you were listened to?"

Encouraging - involves repeating back to a client a few of the client's main words. This encourages detailed elaboration of the specific words and their meanings to the client.

• Shane: I am fed up with this, you are the third counsellor I've seen and you're all useless.
• Counsellor: Useless?
• Shane: Yes, the others I went to didn't listen to me; all they did was ignore me.

Paraphrasing - is repeating back the essence of the client's words and thoughts using the client's own words, for example: "The other counsellor was not helpful, and you think we can't help you either".

Reflection of feeling - is selective attention to the emotional content of the discussion. This results in the clarification of emotion underlying key facts by promoting discussion of feelings, for example: "You feel frustrated about your experience with the other counsellors you've seen".

Summarisation - involves repeating the client's facts and feelings (and reasons) in an organised form. It is useful to ensure that the client's message has been understood and validated, for example: "So, it appears to me that you feel you haven't been listened to". "You are frustrated with the lack of assistance that you have received from the other counsellors, and feel it was a waste of time to attend counselling. Is this correct?"

(Norton et al, 1998)

Obstacles to Listening/Understanding

Some examples of what could get in the way of listening to and understanding a client's perspective:

• Inadequate listening - Being distracted and not giving full attention to the speaker.

• Evaluative listening - Listening with judgement.

• Filtered listening - letting your own bias and prejudice affect the message.

• Fact-centred rather than person centred listening- not being conscious of the emotional content of what is said.

• Rehearsing- rehearsing what to respond rather than listening.

• Sympathetic listening - While tempting (particularly if a client is having problems with another service or agency), it is not helpful to take sides or buy into the situation. Realise that you are only hearing one side of the story, and could inflame the situation if you comment.

• Interrupting- In some cases you may need to clarify what the client is communicating and interruption may be appropriate. Interrupting becomes a problem when you talk over the top of someone and they don't feel you are listening. (Wessler, 2001)

Empathy

A requirement for being an effective counsellor is being able to practice and impart the skill of empathy in the client-counsellor interaction. Being empathetic ensures you are listening and dealing with the client's concerns as they present them.  You are not judging them. Some issues for you to remember when considering the issue of empathy when dealing with challenging clients.

• Intensity - responding to the feelings expressed at the appropriate level of intensity e.g. if you are working with a client. They are very agitated, about to be evicted and their mother is sick. Your response is "You are a bit upset". The client becomes distant - you have not reflected his/her level of emotion accurately.

• Context - take all aspects into account, not just word and non-verbal behaviour. A lot of people we come into contact with have multiple problems in their lives. They may behave in ways we find inappropriate but taken in context of their experience are understandable.

• Selective responding - sometimes it may be appropriate to respond only to feelings or behaviour. Some clients do not respond well to discussing their feelings, and in these cases it is useful to focus on more concrete elements, such as experience and behaviour. 

When your empathic responses have been successful, it is evident from the client's response, a nod of the head, or a positive verbal response. If your empathic responses have not been accurate, the client will indicate this non-verbally by stopping, fumbling or becoming frustrated.

Being aware of these signs will assist you in relating to a client. You may need to adjust your approach if the client is not responding to you.

By using empathy in our interactions with clients will:

• Build the relationship
• Stimulate self-exploration
• Check understanding
• Provide support
• Assist communication
• Focus attention on the client

(Hanna, 2001)

Below is a summary of what a counsellor should and shouldn't do when using empathy with clients.

A counsellor should:

• Give themself time to think, take time to listen and understand the client's perspective
• Use short responses
• Gear your response to the client - but be yourself. e.g.: using appropriate language such as "I'm down with the homies" with a young homeless client will make you look silly
• Always respond

A counsellor should refrain from:

• Asking inappropriate questions
• Using clichés
• Making interpretations or judgements
• Giving advice
• Pretending to understand - clarify the facts rather than misinterpret
• Parroting or using the client's exact words
• Using sympathy and agreement

Reference List

Hanna, F.J. (2005). Therapy with challenging clients using the precursors model to awaken change. Washington: APA.

Kotter, J. (1992). Compassionate therapy: Working with challenging clients. Los Vegas: Jossey-Bass.

Norton, K., & McGaulry, G. (1998). Professional skills for counsellor: Counselling challenging clients. London: Sage Publications.

Roes, N. (2002). Solutions for the treatment resistant client: Therapeutic techniques for engaging challenging clients. New York: Howarth Press Inc.

© Australian Institute of Professional Counsellors. The Institute is Australia’s largest counsellor training provider, offering the internationally renowned Diploma of Professional Counselling. For more information, visit the following links:

Learn to Be a Counsellor

Subscribe to our FREE eZine

Counselling Connection Blog