Empathy skills

Empathy skills

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Title: Empathy skills

COUN 630 Process and Techniques of Counseling Chapter 3 Attending and Empathy Skills Your Name: Date: Use this template to answer the questions below about attending and empathy skills. Do not let your responses to each of these questions be guided or limited by the space between each item below. The space for your answer will automatically expand to accept more narrative. I am looking for no fewer than 1,500 words (including the 237 words already on the page) for this paper assignment. One word or even one or two sentence answers will not be adequate to answer these questions. Be thorough in your responses. Awareness, Knowledge, and Skills of Attending Behavior and Empathy Skills: The authors of your text discuss in Chapter 3 the following skills related to attending and listening to clients. In your own words describe the following skills. 1. Visual: Patterns of Eye Contact 2. Vocal qualities: Tone and Speech Rate 3. Body Language: Attentive and Authentic 4. Verbals: Following the Client or Changing the Topic 5. Describe the contributions of Carl Rogers in terms of Empathy, Awareness, Knowledge, and skills. Include in this description the following: a. The work of Charles Truax, and Robert Carkhuff b. Subtractive empathy c. Basic empathy d. Additive empathy e. Level I Empathy f. Level 2 Empathy g. Level3 Empathy 6. Describe how Neuroscience has changed our thinking about empathy and made it more identifiable and measurable. Visual: Patterns of Eye Contact Not only do you want to look at clients but you’ll also want to observe breaks in eye contact, both by yourself and by the client.

Clients often tend to look away when thinking carefully or discussing topics that particularly distress them. You may find yourself avoiding eye contact while discussing certain topics. There are counselors who say their clients talk about “nothing but sex” and others who say their clients never bring it up. Through eye-contact breaks or visual fixation, vocal tone, and body shifts, counselors indicate to their clients whether the current topic is comfortable for them. Cultural differences in eye contact abound. Direct eye contact is considered a sign of interest in European North American middle-class culture. However, even here people often maintain more eye contact while listening and less while talking. Furthermore, if a client from any culture is uncomfortable talking about a topic, it likely better to avoid too much direct eye contact. Research indicates that some traditional African Americans in the United States may have reverse patterns; that is, they may look more when talking and slightly less when listening. Among some traditional Native American and Latin groups, eye contact by the young is a sign of disrespect. Imagine the problems this may cause the teacher or counselor who says to a youth, “Look at me when I am talking to you!” when this directly contradicts the individual’s basic cultural values. Some cultural groups (for instance, certain traditional Native American, Inuit, or Aboriginal Australian groups) generally avoid eye contact, especially when talking about serious subjects. This itself is a sign of respect. Persons with disabilities represent a cultural group that receives insufficient attention. Box 3.1 provides an overview of some key issues. Vocal Qualities: Tone and Speech Rate Your voice is an instrument that communicates much of the feeling you have about yourself or about the client and what the client is talking about. A comfortable “prosodic” tone tends to make clients feel more relaxed with you. Changes in pitch and volume, speech breaks and hesitations, and speech rate can convey your emotional reactions to the client.

Clearing the throat, by you or your client, may indicate that words are not coming easily. If clients are stressed, you’ll observe that in their vocal tone and body movements. And if the topic is uncomfortable for you or you pick up on a client’s stress, your vocal tone or speech rate may change as well. Aucouturier and collaborators (2016) demonstrated that digital changes made to verbal communications led speakers to change their emotions in the direction shown in the digitally modified speech. Keep in mind that different people are likely to respond to your voice differently. Think of the radio and television voices that you like and dislike. This strategy can be useful for many types of clients, ranging from the depressed to those who have impulse or have anger control issues. It can be useful for social skills training for the shy or the overly aggressive. It also becomes a way that all of us can improve emotional regulation. Verbal underlining is another useful concept. As you consider the way you tell a story, you may find yourself giving louder volume and increased vocal emphasis to certain words and short phrases. Clients do the same. The key words a person underlines via volume and emphasis are often concepts of particular importance. At the same time, expect some important things to be said softly. When talking about critical issues, especially those that are difficult to talk about, expect a lower speech volume. In these cases, it is wise for you to match your vocal tone to the client’s. Accent is a particularly good example of how people will react differently to the same voice. What are your reactions to the following accents: Australian, BBC English, Canadian, French, Pakistani, New England (U.S.), Southern (U.S.)? Obviously we need to avoid stereotyping people because their accents are different from ours. Body Language: Attentive and Authentic The anthropologist Edward Hall once examined film clips of Southwestern Native Americans and European North Americans and found more than 20 different variations in the way they walked.

Just as cultural differences in eye contact exist, body language patterns also differ. A comfortable conversational distance for many North Americans is slightly more than arm’s length, and the English prefer even greater distances. Many Latinas/os prefer half that distance, and some people from the Middle East may talk practically eyeball to eyeball. As a result, the slightly forward lean we recommend for attending is not appropriate all the time. What determines a comfortable interpersonal distance is influenced by multiple factors. Hargie, Dickson, and Tourish (2004, p. 45) point out the following: Gender: Women tend to feel more comfortable with closer distances than men. Personality: Introverts need more distance than extraverts. Age: Children and the young tend to adopt closer distances. Topic of conversation: Difficult topics such as sexual worries or personal misbehavior may lead a person to more distance. Personal relationships: Harmonious friends or couples tend to be closer. When disagreements occur, observe how harmony disappears. (This is also a clue when you find a client suddenly crossing the arms, looking away, or fidgeting.) Ability: Each person is unique. We cannot place people with physical disability in any one group. Consider the differences among the following: a person who uses a wheelchair, an individual with cerebral palsy, one who has Parkinson’s disease, one who has lost a limb, or a client who is physically disfigured by a serious burn. Their body language and speaking style will vary. Attend to each client as a unique and complete person.

Ensure that your working space makes necessary physical accommodations. A person may move forward when interested and away when bored or frightened. As you talk, notice people’s movements in relation to you. How do you affect them? Note your own behavior patterns in the session. When do you markedly change body posture? A natural, authentic, relaxed body style is likely to be most effective, but be prepared to adapt and be flexible according to the individual client. Your authentic personhood is a vital presence in the helping relationship. Whether you use visuals, vocal qualities, verbal tracking, or attentive body language, be a real person in a real relationship. Practice the skills, be aware, and be respectful of individual and cultural differences. Box 3.2 demonstrates the impact of our attending behavior on people from different cultures, Verbals: Following the Client or Changing the Topic Verbal tracking is staying with your client’s topic to encourage full elaboration of the narrative. Just as people make sudden shifts in nonverbal communication, they change topics when they aren’t comfortable. In middle-class U.S. communication, direct tracking is appropriate, but in some Asian cultures such direct verbal followup may be considered rude and intrusive. Verbal tracking is especially helpful to both the beginning interviewer and the experienced counselor who is lost or puzzled about what to say next in response to a client. Relax; you don’t need to introduce a new topic. Ask a question or make a brief comment regarding whatever the client has said in the immediate or near past. Build on the client’s topics, and you will come to know the client very well over time.

The Central Role of Selective Attention. The normal human brain is wired to attend to stimuli and focus on what may be essential to accomplish the tasks at hand, while other potentially useful information falls into the background. Selective attention is central to interviewing, counseling, and psychotherapy. The thalamus is seen as the “switching station” that sends and exchanges specific messages with various brain regions, the brain stem, and spinal cord, enhancing body response to stimuli (see Appendix IV). Clients tend to talk about what counselors are willing to hear. In any session, your client will present multiple possibilities for discussion. Even though the topic is career choice, a sidetrack into family issues and personal relationships may be necessary before returning to the purpose of the counseling session. But some counselors may not be as interested in career work, and most of their career clients end up talking about themselves and their personal history and end up in long-term therapy. How you selectively attend may determine the length of the session and whether or not the client returns. A famous training film (Shostrum, 1966) shows three eminent counselors (Albert Ellis, Fritz Perls, and Carl Rogers) all counseling the same client, Gloria. Gloria changes the way she talks and responds very differently as she works with each counselor.

Research on verbal behavior in the film revealed that Gloria tended to match the language of the three different counselors (Meara, Pepinsky, Shannon, & Murray, 1981; Meara, Shannon, & Pepinsky, 1979). Each expert indicated, by his nonverbal and verbal behavior, what he wanted Gloria to talk about! Should clients match your language and chosen topic for discussion, or should you, the counselor, learn to match your language and style to that of the client? Most likely, both approaches are relevant, but in the beginning, you want to draw out client stories from their own language perspective, not yours. What do you consider most significant in the session? Are there topics with which you are less comfortable? Some counselors are excellent at helping clients talk about vocational issues but shy away from interpersonal conflict and sexuality. Others may find their clients constantly talking about interpersonal issues, excluding critical practical issues such as getting a job. Observe the selective attention patterns of both you and your clients. What do your clients focus on? What topics do they seem to avoid? Now ask yourself the same questions. Are you particularly interested in certain thoughts and behaviors while perhaps missing other critical issues? The Value of Redirecting Attention. There are times when it is inappropriate to attend to the here and now of client statements. For example, a client may talk insistently about the same topic over and over again. In such cases, what seems to work best is paraphrasing and/or summarizing the client’s story so far, using his or her own words as much as possible (see Chapter 6).

This can be followed by questions as you search for relevant details or a deliberate topic jump to more positive experiences and memories. But remember that clients who have been traumatized (such as by hospitalization, breakup of a long-term relationship, accident, or burglary) may need to tell their story several times. A depressed client may want to give the most complete description of how and why the world is wrong and continue on with more negatives in their lives. We need to hear that client’s story, but we also need to selectively attend and not pay attention only to the negative. Clients grow from strengths. Redirect the conversation to focus on positive assets when you observe a strength, a wellness habit (running, spirituality, music), or a resource outside the individual who might be helpful. The most skilled counselors and psychotherapists use attending skills to open and close client talk, thus making the most effective use of limited time in the interview. The Usefulness of Silence. Sometimes the most useful thing you can do as a helper is to support your client silently. As a counselor, particularly as a beginner, you may find it hard to sit and wait for clients to think through what they want to say. Your client may be in tears, and you may want to give immediate support. However, sometimes the best support may be simply being with the person and not saying a word.

Consider offering a tissue, as even this small gesture shows you care. In general, it’s always good to have a box or two of tissues for clients to take even without asking or being offered. Of course, don’t follow the silence too long, search for a natural break, and attend appropriately. There is much more happening in the brain than just silence. It turns out that the auditory cortex remains active when you are attending or listening to silence. Your brain remains highly sensitive, as revealed by functional magnetic resonance imaging (fMRI) and an increasing array of technologies, including computed tomography (CT), positron emission tomography (PET), electroencephalography (EEG), and diffusion-weighted magnetic resonance imaging (DW-MRI). Brain imaging has become a central area of research, with profound implications for counseling and therapy practice. For a beginning counselor, silence can be frightening. After all, doesn’t counseling mean talking about issues and solving problems verbally? When you feel uncomfortable with silence, look at your client with a supportive facial expression. If the client appears comfortable, draw from her or his body language and join in the silence. If the client seems disquieted by the silence, rely on your attending skills. Ask a question or make a comment about something relevant mentioned earlier in the session. Talk Time.

Finally, remember the obvious: Clients can’t talk while you do. Review your sessions for talk time. Who talks more, you or your client? With most adult clients, the percentage of client talk time should generally be more than that of the counselor. With less verbal clients or young children, the counselor may need to talk slightly more or tell stories to encourage conversation. A 7-year-old child dealing with parental divorce may not say a word about the divorce initially. But when you read a children’s book on feelings about divorce, he or she may start to ask questions and talk more freely. Play therapy may also help children tell their story and feelings about the divorce. Empathy: Awareness, Knowledge, and Skills Carl Rogers (1957, 1961) brought the importance of empathy to our attention. He made it clear that it is vital to listen carefully, enter the world of the client, and communicate that we under- stand the client’s world as the client sees and experiences it. Putting yourself “in another person’s shoes” or viewing the world “through someone else’s eyes and ears” is another way to describe empathy. The following quotation has been used by Rogers himself to define empathy. This is not laying trips on people….. You only listen and say back the other person’s thing, step by step, just as that person seems to have it at that moment. You never mix into it any of your own things or ideas, never lay on the other person anything that the person did not express….. To show that you understand exactly, make a sentence or two which gets exactly at the personal meaning the person wanted to put across. This might be in your own words, usually, but use that person’s own words for the touchy main things. (Gendlin & Hendricks, n.d.) Again, please recall the importance of empathy to the relationship, the “working alliance”; it is central to the 30% of common factors that make for successful interviewing, counseling, and psychotherapy (Miller, Duncan, & Hubble, 2005). When you provide an empathic response, you can anticipate how clients are likely to respond. Note below another description of empathy and the predictions that you can make. Carl Rogers’s thinking resulted in extensive work by Charles Truax (1961), who is recognized as the first person to measure levels of empathic understanding. He developed a 9-point scale for rating empathic understanding (Truax, 1961). Robert Carkhuff (1969), who originally partnered with Truax, developed a 5-point scale. These scales have been widely used in research and have practical applications for the session.

Many others have followed and elaborated on Rogers’s influential definition of empathy (see Carkhuff, 2000; Egan, 2010; Ivey, D’Andrea, & Ivey, 2012). A common current practice is to describe three types of empathic understanding. This is the convention that we will use in this book. Chapter interview transcripts will be evaluated on the following scale. Subtractive empathy: Counselor responses give back to the client less than what the client stated, and perhaps even distort what has been said. In this case, the listening or influencing skills are used inappropriately. Basic empathy: Counselor responses are roughly interchangeable with those of the client. The counselor is able to say back accurately what the client has said. Skilled intentional competence with the basic listening sequence (see Chapter 8) demonstrates basic empathy. You will find this the most common counselor comment level in interviews. Rogers pointed out that listening in itself is necessary and sufficient to produce client change. Additive empathy: Counselor responses that add something beyond what the client has said often are additive. This may be adding a link to something the client has said earlier, or it may be a congruent idea or frame of reference that helps the client see a new perspective. Effective use of the influencing skills of the second half of this book is typically additive. Feedback and your own self-disclosure, used thoughtfully, can be additive. The three anchor points above are often expanded to classify and rate the quality of empathy shown in the session. You can use empathy rating in your practice with microskills. And later in your professional work, it is wise to check whether you have maintained interest in your clients and are fully empathic. Client: I don’t know what to do. I’ve gone over this problem again and again. My husband just doesn’t seem to understand that I don’t really care any longer.

He just keeps trying in the same boring way—but it doesn’t seem worth bothering with him anymore. Level 1 Empathy: (subtractive) That’s not a very good way to talk. I think you ought to consider his feelings, too. (slightly subtractive) Seems like you’ve just about given up on him. You don’t want to try any more. (interpreting the negative) Level 2 Empathy: (basic empathy or interchangeable response) You’re discouraged and confused. You’ve worked over the issues with your husband, but he just doesn’t seem to understand. At the moment, you feel he’s not worth bothering with. You don’t really care. (Hearing the client accurately is the place to start all empathic understanding. Level 2 is always central.) Level 3 Empathy: (slightly additive) You’ve gone over the problem with him again and again to the point that you don’t really care right now. You’ve tried hard. What does this mean to you? (The question adds the possibility of the client’s thinking in new ways, but the client still is in charge of the conversation.) (additive and perhaps transformational) I sense your hurt and confusion and that right now you really don’t care any more. Given what you’ve told me, your thoughts and feelings make a lot of sense to me. At the same time, you’ve had a reason for trying so hard.

You’ve talked about some deep feelings of caring for him in the past. How do you put that together right now with what you are feeling? (A summary with a mild selfdisclosure. The question helps the client develop her own integration and meanings of the issue at the moment.) In the first half of this book, we recommend that you aim for interchangeable responses. What is essential for empathic understanding is careful listening and hearing the client accurately. This by itself often helps the client to clarify and resolve many issues. At the same time, be aware that slightly subtractive empathy may be an opening to better understanding. You may see your helping lead as interchangeable, but the client may hear it differently. Use unpredicted and surprising client responses as an opportunity to understand the client more fully. It’s not the errors you make; it is your ability to repair them and move on that counts! Many other dimensions of empathic understanding will be explored throughout this book. For the moment, recall the following points as central. 1. Aim to understand clients’ experience and worldview as they present their story, thoughts, and emotions to you in a nonjudgmental supportive fashion. 2. Seek to communicate that understanding to the client, but avoid mixing “your own thing” in with what you say. 3. The above is the surest route to reaching that critical Level 3 of interchangeable empathic responding.

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Empathy skills Grading Rubric

Performance Category	100% or highest level of performance 100% 16 points	Very good or high level of performance 88% 14 points	Acceptable level of performance 81% 13 points	Inadequate demonstration of expectations 68% 11 points	Deficient level of performance 56% 9 points	Failing level of performance 55% or less 0 points
Total Points Possible= 50	16 Points	14 Points	13 Points	11 Points	9 Points	0 Points
Scholarliness Demonstrates achievement of scholarly inquiry for professional and academic topics.	Presentation of information was exceptional and included all of the following elements: Provides evidence of scholarly inquiry relevant to required TD topic(s). Presents specific information from scholarly sources to develop a comprehensive presentation of facts. Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.* Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.	Presentation of information was good, but was superficial in places and included all of the following elements: Provides evidence of scholarly inquiry relevant to required TD topic(s). Presents specific information from scholarly sources to develop a comprehensive presentation of facts. Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.* Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.	Presentation of information was minimally demonstrated in all of the following elements: Provides evidence of scholarly inquiry relevant to required TD topic(s). Presents specific information from scholarly sources to develop a comprehensive presentation of facts. Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.* Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.	Presentation of information is unsatisfactory in one of the following elements: Provides evidence of scholarly inquiry relevant to required TD topic(s). Presents specific information from scholarly sources to develop a comprehensive presentation of facts. Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.* Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.	Presentation of information is unsatisfactory in two of the following elements: Provides evidence of scholarly inquiry relevant to required TD topic(s). Presents specific information from scholarly sources to develop a comprehensive presentation of facts. Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.* Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.	Presentation of information is unsatisfactory in three or more of the following elements Provides evidence of scholarly inquiry relevant to required TD topic(s). Presents specific information from scholarly sources to develop a comprehensive presentation of facts. Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.* Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information
	16 Points	14 Points	13 Points	11 Points	9 Points	0 Points
Application of Course Knowledge Demonstrate the ability to analyze and apply principles, knowledge and information learned in the outside readings and relate them to real-life professional situations	Presentation of information was exceptional and included all of the following elements: Applies principles, knowledge and information from scholarly resources to the required topic. Applies facts, principles or concepts learned from scholarly resources to a professional experience. Application of information is comprehensive and specific to the required topic.	Presentation of information was good, but was superficial in places and included all of the following elements: Applies principles, knowledge and information from scholarly resources to the required topic. Applies facts, principles or concepts learned from scholarly resources to a professional experience. Application of information is comprehensive and specific to the required topic.	Presentation of information was minimally demonstrated in the all of the following elements: Applies principles, knowledge and information from scholarly resources to the required topic. Applies facts, principles or concepts learned from scholarly resources to a professional experience. Application of information is comprehensive and specific to the required topic.	Presentation of information is unsatisfactory in one of the following elements: Applies principles, knowledge and information from scholarly resources to the required topic. Applies facts, principles or concepts learned from and scholarly resources to a professional experience. Application of information is comprehensive and specific to the required topic.	Presentation of information is unsatisfactory in two of the following elements: Applies principles, knowledge and information from scholarly resources to the required topic. Applies facts, principles or concepts learned from scholarly resources to a professional experience. Application of information is comprehensive and specific to the required topic.	Presentation of information is unsatisfactory in three of the following elements Applies principles, knowledge and information and scholarly resources to the required topic. Applies facts, principles or concepts learned scholarly resources to a professional experience. Application of information is comprehensive and specific to the required topic.
	10 Points	9 Points			6 Points	0 Points
Interactive Dialogue Initial post should be a minimum of 300 words (references do not count toward word count) The peer and instructor responses must be a minimum of 150 words each (references do not count toward word count) Responses are substantive and relate to the topic.	Demonstrated all of the following: Initial post must be a minimum of 300 words. The peer and instructor responses must be a minimum of 150 words each. Responses are substantive Responses are related to the topic of discussion.	Demonstrated 3 of the following: Initial post must be a minimum of 300 words. The peer and instructor responses must be a minimum of 150 words each. Responses are substantive Responses are related to the topic of discussion.			Demonstrated 2 of the following: Initial post must be a minimum of 300 words. The peer and instructor responses must be a minimum of 150 words each. Responses are substantive Responses are related to the topic of discussion.	Demonstrated 1 or less of the following: Initial post must be a minimum of 300 words. The peer and instructor responses must be a minimum of 150 words each. Responses are substantive Responses are related to the topic of discussion.
	8 Points	7 Points	6 Points	5 Points	4 Points	0 Points
Grammar, Syntax, APA Points deducted for improper grammar, syntax and APA style of writing. The source of information is the APA Manual 6th Edition Error is defined to be a unique APA error. Same type of error is only counted as one error.	The following was present: 0-3 errors in APA format AND Responses have 0-3 grammatical, spelling or punctuation errors AND Writing style is generally clear, focused on topic,and facilitates communication.	The following was present: 4-6 errors in APA format. AND/OR Responses have 4-5 grammatical, spelling or punctuation errors AND/OR Writing style is somewhat focused on topic.	The following was present: 7-9 errors in APA format. AND/OR Responses have 6-7 grammatical, spelling or punctuation errors AND/OR Writing style is slightly focused on topic making discussion difficult to understand.	The following was present: 10- 12 errors in APA format AND/OR Responses have 8-9 grammatical, spelling and punctuation errors AND/OR Writing style is not focused on topic, making discussion difficult to understand.	The following was present: 13 – 15 errors in APA format AND/OR Responses have 8-10 grammatical, spelling or punctuation errors AND/OR Writing style is not focused on topic, making discussion difficult to understand. AND/OR The student continues to make repeated mistakes in any of the above areas after written correction by the instructor.	The following was present: 16 to greater errors in APA format. AND/OR Responses have more than 10 grammatical, spelling or punctuation errors. AND/OR Writing style does not facilitate communication
	0 Points Deducted					5 Points Lost
Participation Requirements	Demonstrated the following: Initial, peer, and faculty postings were made on 3 separate days					Failed to demonstrate the following: Initial, peer, and faculty postings were made on 3 separate days
	0 Points Lost					5 Points Lost
Due Date Requirements	Demonstrated all of the following: The initial posting to the graded threaded discussion topic is posted within the course no later than Wednesday, 11:59 pm MT. A minimum of one peer and one instructor responses are to be posted within the course no later than Sunday, 11:59 pm MT.					Demonstrates one or less of the following. The initial posting to the graded threaded discussion topic is posted within the course no later than Wednesday, 11:59 pm MT. A minimum of one peer and one instructor responses are to be posted within the course no later than Sunday, 11:59 pm MT.