Reflective listening is another effective communication technique, and is often considered the most important, because the counselor uses statements and not questions to make sure the client knows and feels that you understand them鈥oth how they are feeling and/or what they are saying. This technique also keeps the conversation going and allows more information to be gathered from the client.
Bill Miller and Stephen Rollnick (founders of MI) talk about reflective listening as statements that make a guess as to what the person means鈥nd that if the client you are listening to balks, you know you have jumped too far too fast鈥nd if it feels like you鈥檙e going around in circles, the reflections are probably too simple.
We could continue to simply ask open ended questions, but instead, by reflecting back to the client, we attempt to make sure they know we understand them and their experience.
And there are different levels of reflection, mostly divided into two categories, as either a simple reflection or a complex reflection:
厂颈尘辫濒别:听
鈥� Repeating or rephrasing:聽Substitutes synonyms or phrases; stays close to original statement
Complex:
鈥� Paraphrasing:聽Makes a major restatement inferring the speaker鈥檚 meaning
鈥� Reflection of feeling:聽Emphasizes emotional aspects through feeling statements
鈥� Double-sided reflection:聽Presents two sides of an issue: 鈥淥n the one hand鈥nd on the otherhand鈥︹��
鈥� Summarizing:聽Reflects multiple points, tying them together
Example:
Client: My doctor referred me here but I am not sure if this is what I need
鈥� Repeating: 鈥淵our doctor referred you here today but you are not sure if this will be helpful鈥�
鈥� Paraphrasing: 鈥淵ou believe it鈥檚 important to listen to your doctor but you may not always agree with his/her recommendations鈥�
鈥� Feeling reflection: 鈥淵ou鈥檙e feeling somewhat confused and frustrated about being referred here鈥�
鈥� Double-sided reflection: 鈥淥n the one hand, you don鈥檛 always agree with your doctor, but on the other hand, you鈥檙e also a little concerned鈥�
When using reflections, by simply saying 鈥測ou鈥� and then the statement-it keeps you from asking a question and keeps the conversation going鈥o statements may sound like 鈥測ou are really frustrated that you have to come to see me鈥濃�r 鈥漼ou鈥檙e wondering if I am going to keep this conversation confidential.鈥�
And you may have to be careful using starter phrases such as, 鈥渋t sounds like鈥� and 鈥渨hat I hear you say is that鈥� too much because many of these starter phrases can make the client feel like they are hearing 鈥渃ounselor speak.鈥� It is great to normalize participation in counseling but we need to be aware of using them too much, to make sure we do not turn them off or where they tune us out.
Again, the importance of these reflective statements is to make sure the client knows that we understand how they are feeling and what they are saying, and again, these statements keep the conversation going and allows the client to tell you more about them and their experiences.
Additional Resources:聽
To see reflective listening in action, watch this clever 5 minute video clip from the Paul Burke Training Group. A client talks to a therapist about the need to communicate more effectively with his boss. And in the video, simple and complex reflections are hi-lighted so you can clearly see and hear this MI skill being demonstrated by the counselor.
For additional resources related to MI, a collection of books have been published to address several areas of practice including anxiety, wellness, social work, classroom management, groups, adolescents, medical trainees, etc. Click for a list of these books as well as chapters from books and a bibliography.
For more information about motivational interviewing or related services, contact Eunice Akinyi Okumu, by phone (919) 843-2532, or by email, eunice_okumu@med.unc.edu