Week 05 - Communication Skills

A presentation at Heritage University in September 2019 by Jacob Campbell and is tagged with BASW Program, Heritage University, SOWK 486w

Location: CBC Campus - SWL 206 Time: Wednesday from 5:30-8:15 Week 05: 09/16/19 — 09/22/19 Reading Assignment: Hepworth et al. (2016) Chapters 5 & 6 Topic and Content Area: Communication Skills Assignments Due: Reading Quiz Other Important Information: N/A

The Facilitative conditions Empathy Authenticity Discrete verbal following skills

As we have talked about, relationship and client belief in the process is key to having positive outcomes. Nearly half of the outcome relies on fundamental skills and abilities that social workers need to learn, apart from the type of treatment offered (As cited by Hepworth — Adams et al., 2008; Miller et al., 2013) Factor | Percentage —- | —- Client or extra-therapeutic factors | 40% Relationship factors | 30% Placebo, hope, and expectancy factors | 15% Model / technique factors | 15%

“Clients often have an unclear idea about what to expect from contact with a social worker, and those ideas may differ from the social worker’s expectations as well (Kadushin & Kadushin, 1997). This is most evident when the client has been referred or mandated for service. Clarifying expectations becomes a key intervention in work with clients who have not chosen to see a social worker (Rooney et al., 2009; Trotter, 2006).” Determine your client expectations: Ask questions to determine what their expectations. Help them to manage unrealistic or unreasonable expectations. Emphasize client responsibility: What are the expectations that you or others have on them. Emphasize difficulties inherent in the process: Making change is hard. Extinction burst. Clarify your own role: What will you be doing and expectations they can have on you [Small Group Activity] Have students break up into their partner group for an assignment from another class. Have them go though and help clarify roles for the assignment. B. F. Skinner (1933) “Resistance to Extinction” in the Process of Conditioning, The Journal of General Psychology, 9:2, 420-429, DOI: 10.1080/00221309.1933.9920945

Importance of How to do

Carl Rodgers and person Center Counseling probably give the best and most focus on basic helping attitudes. The facilitative conditions (or core conditions) in helping relationships were originally denoted by Carl Rogers (1957) as… Empathy Unconditional positive regard Congruence Much of the current research describes these as: Warmth Authenticity Empathy Facilitative conditions are often thought to be the foundation-level skills that undergird many treatment models and help create a positive client–social worker relationship. Research has especially supported the correlation of empathy with positive social work outcomes. The facilitative skills are particularly useful in treatment situations with voluntary clients. [Discussion] What words would you choose as antonyms for each of these? [Activity] Have everybody pair up with a partner. Each group will receive one of the three words listed above or it’s antonym. You will have a couple of minutes to think about a scenario and act it out in front of the class. The class will guess what helping (or not helping attitude is being portrayed).

The RSA. (2013, December 10). Brené Brown on Empathy. Brené Brown on Empathy. Retrieved from https://www.youtube.com/watch?v=1Evwgu369Jw The following is a short video clip from a presentation that Brené Brown did called the “The Power of Vulnerability.” [Activity] Watch the video clip. [Discussion] What did you think of Theresa Wiseman (2007) concept of four parts to empathy. “Toward a holistic conceptualization of empathy for nursing practice.” Perspective taking and recognizing their perspective as truth Staying out of judgment Recognizing emotion in other people Communicating emotion with people [Discussion] What do you think about this video?

To review, that is… Perspective taking and recognizing their perspective as truth Staying out of judgment Recognizing emotion in other people Communicating emotion with people Wiseman, T. (2007). Toward a holistic conceptualization of empathy for nursing practice. Advances in Nursing Science, 30(3), E61–E72. https://doi.org/10.1097/01.ANS.0000286630.00011.e3

With empathy being such an important skill, we need to discuss how we can develop perceptiveness to feelings. As well we know that feelings or emotions exert a powerful influence on behavior and often play a central role in the problems of clients. To respond to the broad spectrum of emotions and feeling states presented by clients, the social worker must be fully aware of the diversity of human emotions. Position of not knowing… They also need to take a “not knowing” position of learning what emotional expression means for the particular client in front of them. It is important to realize that high-level empathic responding takes place in two phases: A thinking process A responding process Applicants or voluntary clients often enter into the helping relationship with openness, hoping to explore both their concerns and their related feelings.

You feel __ about __ because __ You feel __, yet you also feel __ [Partner Group Activity] With partner, take turns sharing respectively for about five minutes, about an experience that they experienced a emotional response (any emotion, happiness, sadness, excitement, nervousness, etc. - does not need to be an overly personal story.) The person not telling the story job is to draw out the details of the event and find opportunities to respond empathetically.

There are a number of ways in which social workers can employ reciprocal empathic responding: Establishing relationships with clients in initial sessions Staying in touch with clients Accurately assessing client problems Responding to clients’ nonverbal messages —> Continues on next slide

Making confrontations more palatable Handling obstacles presented by clients Managing anger and patterns of violence Utilizing empathic responses to facilitate group discussions

[Whole Class Activity] What is authenticity and why is it important? Authenticity is defined as the sharing of self by relating in a natural, sincere, spontaneous, open, and genuine manner.

“Viewed from a therapeutic perspective, self-disclosure encourages clients to reciprocate with trust and openness. Lee (2014) has identified two types of self-disclosure: self-involving statements and personal self-disclosure” (Hepworth, et al., 2017) Self-involving statements include messages that express the social worker’s personal reaction to the client during the course of a session. Personal self-disclosure messages, by contrast, center on struggles or problems the social worker is currently experiencing or has experienced that are similar to the client’s problems

As social workers practice authentic responding and teach clients to respond authentically in their encounters with others, they should keep in mind the following guidelines related to the four elements of an authentic message: Personalize messages with the pronoun “I.” Share feelings that lie at varying depths. Describe the situation or targeted behavior in neutral or descriptive terms. Identify the specific impact of the problem situation or behavior of others.

Ragan, T. (2014 Jan 30) Carol Dweck - A study on praise and mindsets [Video File]. Retrieved from https://youtu.be/NWv1VdDeoRY. [Whole Class Activity] Watch the video. [Whole Class Activity] Discuss: How does this impact us as social workers How do we give specific praise

As social workers, we sometimes have to authentically respond when there are requests made by the client or when we believe it is for the best interest of the client. Client Initiated Requests from Clients for Personal Information Questions That Solicit the Social Worker’s Perceptions Worker Initiated Disclosing Past Experiences Sharing Perceptions, Ideas, Reactions, and Formulations Openly (and Tactfully) Sharing Reactions When Put on the Spot Experiencing Discomfort in Sessions Sharing Feelings When Clients’ Behavior Is Unreasonable or Distressing Sharing Feelings When Clients Give Positive Feedback

“Another aspect of relating authentically entails relating assertively to clients when a situation warrants such behavior.” Making Requests and Giving Directives: Work on problem solving during session and skill building. Maintaining Focus and Managing Interruptions: Keeping focus Interrupting Problematic Processes: When things aren’t going well. “Leaning Into” Clients’ Anger: Managing angry responses Saying No and Setting Limits: Saying no.

“Verbal following involves the use and sometimes blending of discrete skills that enable social workers to maintain psychological contact with clients on a moment-by-moment basis and to convey accurate understanding of their messages. Moreover, verbal following behavior takes into account two performance variables that are essential to satisfaction and continuance on the part of the client:” Stimulus-response congruence: The extent to which social workers’ responses provide feedback to clients that their messages are accurately received. Content relevance: The extent to which the content of social workers’ responses is perceived by clients as relevant to their substantive concerns.

Minimal prompts signal the social worker’s attentiveness and encourage the client to continue verbalizing. Nonverbal minimal prompts consist of nodding the head, using facial expressions, or employing gestures that convey receptivity, interest, and commitment to understanding. They implicitly convey the message, “I am with you; please continue.” Verbal minimal prompts consist of brief messages that convey interest and encourage or request expanded verbalizations along the lines of the client’s previous expressions. Accent responses (Hackney & Cormier, 2005) involve repeating, in a questioning tone of voice or with emphasis, a word or a short phrase. Suppose a client says, “I’ve really had it with the way my supervisor at work is treating me.” The social worker might reply, “Had it?”

There are two basic types of of reflection: Reflection of Content: emphasize the cognitive aspects of client messages, such as situations, ideas, objects, or persons (Hackney & Cormier, 2005). Reflection of Affect: focus attention on the affective part of the communication (Cormier, Nurius, & Osborn, 2009). In reflections of affect, social workers relate with responses that accurately capture clients’ affect and help them reflect on and sort through their feelings Reflection can take the form of the following forms: Simple reflections, which identify the emotions expressed by the client, are a heritage from nondirective, client-centered counseling Complex reflections go beyond what the client has directly stated or implied, adding substantial meaning or emphasis to convey a more complex picture Reframing: is another form of adding content. Here, the social worker puts the client’s response in a different light beyond what the client had considered (Moyers et al., 2003) Double-sided reflection: Sometimes clients express indecision and conflict between several alternatives. that captures both sides of the dilemma that is fostering ambivalence about acting (Miller & Rollnick, 2002) Reflections with a twist are reflections in which the social worker agrees in essence with the dilemma expressed by the client but changes the emphasis, perhaps to indicate that the dilemma is not unsolvable but rather that the client has not at this time solved it (Miller & Rollnick, 2013)

Closed-ended questions define a topic and restrict the client’s response to a few words or a simple yes or no answer.

Open-ended questions and statements invite expanded expression and leave the client free to express what seems most relevant and important.

Seeking concreteness is an important aspect of drawing out information from a client. We can use it to obtain concreteness in a number of areas: Checking out Perceptions: Understanding how they view the world Clarifying the Meaning of Vague or Unfamiliar Terms: Clients often times use vague terms. What does this actually mean? Exploring the Basis of Conclusions Drawn by Clients: Why do they think things are this way Assisting Clients in Personalizing Their Statements: Helping understand what it means for them… Focus on self Focus on others Focus on group or relationships Focus on content

Eliciting Specific Feelings: How do they feel more specifically. Focusing on the Here and Now: moving out of the past. Eliciting Details Related to Clients’ Experiences: What they’ve done Eliciting Details Related to Interactional Behavior: How their interactions has been

The functions of focusing skills include Selecting topics for exploration Exploring topics in depth Managing obstacles to focusing

Four Distinct facets of summarizing: Highlighting key aspects of discussions of specific problems, strengths, and resources before changing the focus of the discussion Making connections between relevant aspects of lengthy client messages Reviewing major focal points of a session and tasks that clients plan to work on before the next session Recapitulating the highlights of a previous session and reviewing clients’ progress on tasks during the week for the purpose of providing focus and continuity between sessions

Portrait style photo of Jacob Campbell

Dr. Jacob Campbell

28 slides

Description

Week five focuses on communication skills that we use as clinicians. The agenda is as follows:

The Facilitative conditions
Empathy
Authenticity
Discrete verbal following skills