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…both 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…and that if the client you are listening to balks, you know you have jumped too far too fast…and if it feels like you’re 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:
Simple:
• Repeating or rephrasing: Substitutes synonyms or phrases; stays close to original statement
Complex:
• Paraphrasing: Makes a major restatement inferring the speaker’s meaning
• Reflection of feeling: Emphasizes emotional aspects through feeling statements
• Double-sided reflection: Presents two sides of an issue: “On the one hand…and on the other hand…”
• Summarizing: Reflects multiple points, tying them together
Example:
Client: My doctor referred me here but I am not sure if this is what I need
• Repeating: “Your doctor referred you here today but you are not sure if this will be helpful”
• Paraphrasing: “You believe it’s important to listen to your doctor but you may not always agree with his/her recommendations”
• Feeling reflection: “You’re feeling somewhat confused and frustrated about being referred here”
• Double-sided reflection: “On the one hand, you don’t always agree with your doctor, but on the other hand, you’re also a little concerned”
When using reflections, by simply saying “you” and then the statement-it keeps you from asking a question and keeps the conversation going…so statements may sound like “you are really frustrated that you have to come to see me”…or ”you’re wondering if I am going to keep this conversation confidential.”
And you may have to be careful using starter phrases such as, “it sounds like” and “what I hear you say is that” too much because many of these starter phrases can make the client feel like they are hearing “counselor speak.” 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.
For more information about Motivational Interviewing resources, contact Eunice Akinyi Okumu, by phone (919) 843-2532, or by email, eunice_okumu@med.unc.edu