Therapeutic Communication Interactive Reasoning

Communication in General

Tools of the Trade Body Language Listening Questions Leads & Responses

Body Language Relax! Smile Arms open Mirror the client Good eye contact Sit STILL!!

Affect Allow your affect to reflect your response, but avoid judging, disgust, shock!

Listening Goals Self-perception Perception of others Perception of how others view them Main concerns Perception of therapy Goals Defenses and coping Values

Questions? Implies authority to ask questions and that you will have a solution! Will this inhibit the flow?

Open ended Questions You felt great after the game, didn’t you? You don’t seem yourself today. Anything wrong? Do you want to learn transfers? Do you like school? Your little sister is adorable, isn’t she? Don’t you think this is a great idea?

Indirect Questions How do you like your new job? vs. I wonder what you think of your new job. How does the new splint feel? What are you feeling right now? How did that make you feel?

One at a time please Do you want to come tomorrow or the next day? How are those exercise working for you? Have you had any pain? How will you handle to ride to work and the steps up to your office?

When to ask questions Confused, need clarification So you are saying that if is hard to move in the morning, is that right? Need specific information What makes the pain worse? Guide the conversation What gets in the way of getting what you want done in the morning?

Verbal Tools Reflecting & paraphrasing Clarifying Minimal encouragers What do I say next?! What do I say next?! Think, Think, Aggh, I can’t think of anything! Reflecting & paraphrasing Clarifying Minimal encouragers Summarizing Linking Self- disclosure

Simple Responses Silence! Mmmm (minimal encourager) Restatement Clarification

Higher level responses Reflection- provide a mirror to attitudes and feelings “Because I’m a no good drunk, I wasn’t there for my kids.” “I don’t belong here, everyone here is crazy.” “I can’t work, I just don’t get along with people. They always pick on me.”

Leads Interpretation Proceed with caution! State as tentative Only when the client is about to realize it themselves “You find it hard to think of yourself as disabled in some way”

Ok but not too much Encouragement- can be patronizing Better: provide structured tasks that naturally reward Reassurance- only tell the truth, sometimes a hug is better Suggestions- only as options, never tell them what to do. Avoid the yes, but syndrome

Never use Advice Urging Moralizing Criticism Direct disagreement Denial or disbelief Demand or blackmail

What is the single most important tool that students forget to use? SILENCE!

Interrogation vs. Interview Open ended questions Allow for silence Avoid interrupting client Client talks more than you Avoid jargon Don’t write everything down!