This week we learned about some skills we use when counselling: Paraphrasing, Reflecting, Open Questions and Summarising.
We learned that Paraphrasing is a tool used in counselling. It is when the counsellor repeats back key points that the client has mentioned so far, condensing them into the essence of the problem, not necessarily with the clients own words. It makes the client feel that they have been heard and really listened to, that the counsellor is following their story and is trying to understand the emotions and feelings the client was experiencing. Adding a tentative, questioning tone to your voice when you are paraphrasing causes the client to interpret it as a question, and encourages them to expand further, adding clarification.
An example of Paraphrasing would be if during a session a client outlined the problem as “I met a girl online and we had a brief affair lasting just four weeks because the distance between us made meeting up difficult. I sent her a text recently after I’d had a drink to see how she was, I hardly expected a reply but since then we have texted every day! We flirt and talk about how amazing the sex we had was, and we are even talking of meeting up again but she says it will be purely for friendship as she has a boyfriend and they are buying a flat together soon. She has to delete my texts quickly in case he sees them. She is the only girl I have ever loved and my feelings for her are driving me crazy!”
To which, as a counsellor paraphrasing, I would reply: “It sounds like you two had a great time for a while there. You both thought it was over, but you clearly still have very strong feelings for this girl, and I get the impression that maybe she’s not so sure?”
My paraphrased reply condenses the client’s initial exposition; sums up his feelings of affection towards the girl, and shows that I noticed how conflicted the girls actions seem, which I think, is causing most of the clients agitation – he wants to be in a relationship with the girl again but while she is flirty and responsive, she said that any future meetings would be as friends only as she has a new partner. The questioning nature and upward inflection at the end of the paraphrased reply encourages further input from the client.
Reflecting is repeating a word or short sentence back to the client; usually in the clients own words, paying particular attention to the most emotion-laden word or words. Reflecting not only further encourages elaboration and a deeper exploration of the feelings and emotions reflected back at the client; it also makes the client feel that the counsellor understands, or at least is trying to understand, their feelings and emotions, and is trying to see the clients issues or problems from their point of view, which is called empathy. Reflecting gives weight and importance to a client’s emotions by drawing attention to them, and brings them into the current moment for the counsellor and the client to explore together.
If a client said something like “I couldn’t believe that my brother and sister were arguing over their inheritance at my Mother’s funeral, I was just so het up, I couldn’t stand it, I felt I had to just get out of there before I screamed, threw up, collapsed into a big heap on the floor or punched someone in the face”
A reflection would be “You felt het up?” – Very short and simple, but it invites the client to expand further upon exactly how they felt, and what “het up” means to them. Language can be tricky, and some words or phrases, especially things like slang, colloquialisms and portmanteau words can have slightly (or possibly even substantially) different meanings to different people. Drilling down into the meanings of such words and phrases, and the emotions that have combined to form them, allows the counsellor to develop a deeper understanding of what was happening inside the client. It would be presumptuous of me to expect my personal definition of “het up” to be precisely the same as someone else’s definition of “het up”.
Open Questions are questions that a counsellor uses to further explore and understand aspects of the client’s problems and circumstances by allowing them to elaborate and disclose more. They typically start with how, when, what, which and where; and they invite the client to answer deeply rather than with a simple yes or no, which would quickly stall the conversation. We did some roleplay using only Open Questions, as my tutor felt that after last year’s students had problems including all four aspects (Paraphrasing, Reflecting, Open Questions and Summarising) into their roleplay, we were to only use Open Questions.
Our tutor did outline the importance of not using questions that start with “Why”. They can feel very accusatory and could put clients on the defensive, and to be quite honest, sometimes I cannot explain exactly why I have acted in a certain way. If someone were to question me as to why I did something I may not be able to answer them to a standard they feel they require. Sometimes I just feel like doing something, it is not something I can rationally explain. Rephrasing questions that begin with why to use one of the other questioning words enables the client to explore their reasoning at a deep level, rather than making them feel like they have to come up with a justification or defence. For example: “Why did you steal the money from the till?” could be rephrased to “What made you feel you had to take the money from the till?”, or “What were the circumstances that made you feel you had to steal some money from the till?”, so that the emphasis is on exploring the client’s feelings, their emotional state and their inner motivations rather than making them feel like they are being interrogated by an aggressive authority figure.
It is important that a counsellor and client develop a trusting relationship in which the client feels she is understood, valued, and comfortable enough to express her emotions and tell her story – questions beginning with why will not help in achieving this.
Open questions could also be statements said with an upward inflection, indicating a question mark at the end of the sentence, a slight squint in one eye and a subtle sideways head movement – “It sounds as if you were confused?” or “Correct me if I’m wrong, but you felt more than just let down by your friend?”. Asking such questions in a tentative way makes the client feel as if they are the expert on themselves.
After learning about it, I feel that Summarising is one of the most useful skills a counsellor can use. Summarising is when a counsellor sums up and condenses the clients key points, main themes and important issues over a longer period of time than a Reflection or Paraphrasing, usually over the course of a session and they also tend to be longer and more in depth than Reflections or Paraphrasing. A mini-summary can be used at any point in a session, but a full summary is absolutely essential at the end of the session.
Summaries are also useful in that they help the counsellor remember key points of the conversation, and a summary used at the end of the session would still be fresh in the counsellor’s memory when it came to making notes of the session after the client had left. These notes could then be used to refresh a counsellor’s memory before the next session with that client, and also be used as the basis of a summary to begin the next session with. This can be a useful starting point to get the discussion going.
Sometimes if the session seems to have stalled, a mid-point summary can help move things along again, and adding “Did I get that right?” to the end of a summary can help, as clients are usually eager to correct a counsellor if they have got something wrong, or add in a detail that a counsellor missed that they feel is important. People like to be heard, and to know they have really been listened to and understood, and summaries are powerful tools which facilitate this. Thus, Summarising helps towards good counsellor/client relations, it builds trust within the relationship, and being listened to and feeling understood allows the client to feel confident enough to tell their story, all of which are very important.
You can also use Reflections in Summaries – using the clients own definitions and descriptions of how they felt shows that as a counsellor you are picking up on what the client feels is important enough to mention, and that you are really listening to what they are saying.
