1. Listening Skills Workshop Joseph N. Rawlings, M.D. M.B.A. Regional Medical Officer/Psychiatrist United States Department of State

2. Peer Support Crisis intervention services Provided by person who are not mental health professionals Directed toward individuals with similar key characteristics

3. When Does It Work? Group possesses a unique culture Group potentially misunderstood Limited ability to trust or share concerns with outsiders Good training of peer counselors

4. Results of Peer Counseling Decreased illness, sick-leave Fewer serious problems, including suicide Improved functioning and performance

5. Objectives Improve listening skills! Role play exercises Brief overview of the basics of listening

6. Overview Hearing vs. listening What are listening skills? Body language Referral, confidentiality Practice

7. Hearing vs. Listening Hearing: –the act or process of receiving sounds Listening: –Making a conscious effort to hear; attending closely Webster’s New World Dictionary, 3 rd College Edition.1988

8. Tips ParaphrasingParaphrasing ClarificationClarification FeedbackFeedback Body languageBody language SilenceSilence LocationLocation ReferralReferral Say Do

9. Paraphrasing Shows your partner that you have heard Leads to improved understanding Allows the partner to hear what is being heard by others Gives time to organize your thoughts Allows clarification

10. Clarification Ask questions about anything you don’t understand Clears away some common “filters” used in conversation –“you know how it is…” –“…like we all do.”

11. Feedback Sharing with your partner your reaction to what has been said Effective feedback: –Immediate –Honest –Supportive

12. Body Language Eye contact Nodding Posture Monitor body language of your partner!

13. Silence Allows time for reflection Not all communication is verbal Encourages the other person to respond

14. Location and Time Comfort? –For both Distraction? –Noise, dogs, phones Privacy? –Confidentiality Safety?

15. Listening Skills Active, not passive Meaning is not transmitted by the speaker: –Stimulated in the receiver Drifting away? Change position Body position defines situation: –Listener or Deflector

16. CARE: Active Listening C C oncentrate: - focus on the speaker A A cknowledge - use body language R R espond - ask questions for clarification and interest E E mpathize - share emotions and feelings.

18. Role Playing Topics 1.Possible alcohol problem 2.Anger management 3.Symptoms of depression 4.Relationship dispute 5.Unwanted sexual advances 6.Cultural incompatibility

20. Five Minute Sessions: Scoring Review 1.Stay on one subject until both understand 2.Avoid assumptions. Denies the benefit of understanding 3.Minimize use: gives the impression that previous statement not important. Consider using: 1.Yes and No, without qualifiers 2.And instead of But

21. 4.Avoid bringing up past issues creates conflict - Stay in the present 5.Interruptions should be limited to need - Open with apology, end with invitation to continue 6.Avoid - Can be misinterpreted 7.Avoid 1.Learned defensive reaction. Rarely productive 2.“Help me understand…” Five Minute Sessions: Scoring Review

22. 8.Avoid 1.Rarely helpful 2.Reevaluate relationship 9.Avoid 1.Suggests the other is not worthy of understanding 2.“I respect your position. My view is…” 10.Consider what the other says - Do not need to agree Five Minute Sessions: Scoring Review

23. Role Playing Topics 1.Possible alcohol problem 2.Anger management 3.Symptoms of depression 4.Relationship dispute 5.Unwanted sexual advances 6.Cultural incompatibility

25. Suicide Risk Factors Mood disorders (depression or bipolar disorder), psychosis, panic disorder Prior suicide attempts Family history of suicide Alcoholism and substance abuse or dependence Chronic medical illness (including chronic pain) Living alone, male, older Recent stressor/loss Intent? Plan? Access to weapons/means?