1. SWK 511 CLASS FIVE Copyright (c) 2012 Brooks/Cole, a division of Thomson Learning, Inc.

2. Verbal Following Skills Furthering Paraphrasing Reflection Closed-ended responses Open-ended responses Seeking concreteness Providing and maintaining focus Summarizing EPAS 2.1.10b

3. Furthering Minimal prompts ◦ Non-verbal (head nodding, facial expressions) ◦ Verbal (“And?”, “Tell me more”, “I see”) Accent responses ◦ Client: “I’ve really had it with the way my supervisor at work is treating me.” ◦ Social worker: “Had it?”

4. Paraphrasing Restating client’s message in your own words Focus on the cognitive aspects of the message  Elder client: “I don’t want to get into a living situation in which I will not be able to make choices on my own.”  Social worker: “So independence is a very important issue for you.”

5. Reflection Simple reflection ◦ Identify emotions expressed by the client Complex reflection ◦ Adds meaning or emphasis to convey a more complex picture Reframe ◦ Puts the context in a different light

6. Closed and Open-ended Responses Close-ended questions ◦ Define a topic ◦ Restrict client’s response Open-ended questions ◦ Invite expanded response ◦ Allow client to express what s/he feels is most relevant

7. Seeking Concreteness Types of responses that facilitate specificity of expression by clients ◦ Checking out perceptions ◦ Clarifying the meaning of vague or unfamiliar terms ◦ Exploring the basis of conclusions drawn by clients ◦ Assisting clients to personalize their statements ◦ Eliciting specific feelings ◦ Focusing on the here-and-now, rather than on the distant past ◦ Eliciting details related to clients’ experiences ◦ Eliciting details related to interactional behavior Specificity of expression by social workers

8. Focusing Selecting topics for exploration Exploring topics in depth ◦ Open-ended responses ◦ Seeking concreteness ◦ Empathic responding Blending open-ended, empathic and concrete responses Managing obstacles to focusing ◦ Intervening to help clients focus or refocus

9. Summarizing Highlighting key aspects of problems Summarizing lengthy messages Reviewing focal points of a session Providing focus and continuity

10. Analyzing Verbal Following Skills CLIENT MESSAGE OPEN-ENDED RESPONSES CLOSED- ENDED RESPONSES EMPATHIC RESPONSES LEVEL OF EMPATHY CONCRETE RESPONSES SUMMARIZING RESPONSES OTHER TYPES OF RESPONSES 1. 2. 3. 4. 5. 6. 7.

11. Additive Empathy and Interpretation Discrepant viewpoint Semantic vs propositional interpretation Expand client’s awareness of: ◦ Deeper feelings ◦ Underlying meanings of feelings, thoughts, and behaviors ◦ Wants and goals ◦ Hidden purposes of behavior ◦ Unrealized strengths and potentialities EPAS 2.1.10b

12. Additive Empathy and Interpretation (continued) Guidelines for employing interpretation and additive empathy ◦ Use sparingly until a sound helping relationship has evolved ◦ Employ these responses only when the client has or is ready to engage in self-exploration ◦ Pitch these responses to the edge of the client’s awareness and attempt to foster remote awareness ◦ Avoid making several of these responses in succession ◦ Phrase interpretive responses in tentative terms ◦ Carefully note the client’s reactions after the interpretation ◦ If the client responds negatively, acknowledge your probable error, respond empathically, and continue discussion

13. Confrontation Stages of change Guidelines for employing confrontation ◦ When a violation or imminent danger to self or others is involved, a confrontation must occur no matter how early in the working relationship ◦ Whenever possible, avoid confrontation until an effective working relationship has evolved ◦ Use confrontation sparingly ◦ Deliver confrontations in an atmosphere of warmth, caring, and concern ◦ Whenever possible, encourage self-confrontations

14. Confrontation (continued) ▫ Avoid using confrontation when clients are experiencing extreme emotional strain ▫ Follow confrontations with empathic responsiveness ▫ Expect that clients will respond to confrontations with a certain degree of anxiety ▫ Do not expect immediate change after confrontations Indications for assertive confrontation ▫ Cognitive/ perceptual discrepancies ▫ Affective discrepancies ▫ Behavioral discrepancies

15. Stages of Change STAGECHARACTERISTIC BEHAVIORSOCIAL WORKER TASK PrecontemplationClient does not believe that he or she ahs a problem; considered unmotivated by others Raise awareness of concerns held by others; stimulate dissonance with risk-reward analysis ContemplationAware of existence of problem but not moved to action; appears ambivalent; shows awareness, then discounts it Attempt to tip decisional balance by exploring reasons to change; strengthen confidence in change as a possibility PreparationRecognizes problem; asks what can be done to change; appears motivated Help client plan appropriate course of action ActionImplements plan of actionDevelop plan to implement action; plan details to make it possible (e.g. transportation, child care) MaintenanceSustains change through consistent application of strategies Identify strategies to prevent lapses and relapses RelapseSlips into problematic behaviors and may return to precomtemplation stage Attempt to return to contemplation without becoming stuck or demoralized; reinforce achievement; treat with respect Adapted from Kear-Colwell & Pollack (1997) and Prochaska, DeiClemente, & Norcross (1992)