The Listening Process:
- Hearing and remembering verbal and non-verbal messages
- Selecting and sorting information, ideas and feelings
- Understanding meaning and emotions
- Responding
Signs of poor listening:
Fidgeting: body language indicates lack of interest
Aggressive listening: remarks and intense staring can be intimidating
Intellectual listening: listen to words but deaf to emotions (quick with solutions)
Overly passive listening: overly nodding and agreeing, lack of sincerity
Prejudiced listening: inability to separate what we hear from preconceptions and own emotional concerns and interests.
12 roadblocks to listening
Directing: telling someone what to do.
Warning: pointing out risks
Advising: making suggestions
Persuading: trying to convince with logic.
Moralizing: preaching
Judging: Implies something is wrong
Agreeing: taking sides with the person
Shaming: can include ridiculing
Analyzing: seeking out the real problem or hidden meaning.
Probing: asks questions to gather facts
Reassuring: sympathizing or consoling
Distracting: trying to draw people away from what they are experiencing by humoring or changing the subject.
Roadblocks tend to divert people from their natural flow of experience and take away from the purpose of active listening which is to understand the person’s perspective and experience.
A Good Listener will:
Show engagement with variations of facial expression.
Posture themselves appropriately (leaning forward, etc)
Small vocal sounds, “I hear you”.
No interruptions, not looking around, maintaining eye contact
Not asking too many questions (can divert conversation towards topics of particular interest rather than just listening).
Simple guide: no more than 3 questions in a row.
Counseling
Goals
The Counseling Process:
time-limited relationship in which counselors help clients increase their ability to deal with the demands of life.
Goals:
Immediate: provide assistance so that clients can gain control over their problems
Long-term: restore/develop client’s ability to cope with changing demands of their lives (empowerment)
The Counseling Process:
Establishing relationship
Assessment
Setting goals
Interventions
Termination & follow-up
Trans-professional Practice =
acquiring some skills of another profession to improve efficacy of intervention outcomes
Use of CBT in dietetics
CBT Main Areas of Action:
Identify and change unhealthy/unhelpful thought and behavior patterns → identify the train of thought that precedes unwanted behavior
CBT Main Areas of Action:
Distinguish between thoughts vs feelings, analyze thought validity and interrupt harmful thoughts
Change patterns of thinking by replacing them with productive self-talk (ex. Write down negative thought and change it to a positive one)
- or cognitive restructuring to change beliefs
Stress management by calm one’s mind/body while new behaviors are learned
6 Principles of Working with Adult Clients
1) adults bring knowledge and experience
2) Relevancy oriented
Adults need to know what, why and how the need exists in advance of learning
- Must be convinced it is worth the time and effort
3) Autonomous and self-directed (allow for self-assessment/evaluation)
4) Practical
Need to believe outcome will involve development of useful skills to be motivated
5) Task centered and problem oriented, life centered
6) Intrinsically motivated
Motivated by internal desires/pressures
Adult Learning Considerations:
Include the spouse
Advantages: good comprehension check, distribution of food prep tasks, allows for viewing couple interactions around food and coaching
Disadvantages: spousal takeover, criticism during sessions, bringing spotlight to spouse, time wasted pulling client back into conversation
Investigate physical environment
Social supports
Teach positive coping talk
Ask client to verbalize and write down goals to solidify their reality
Goal Setting Involves:
Give direction: structure, purpose, relevance, lead to action and help client prioritize
- Explore options and build upon previous success/failure experiences
Define roles for client and counselor
Motivate by ensuring achievable goals which confirm personal capacity (therapeutic)
- Define a precise, measurable goal the client hopes to achieve through counselling and partnership with client
- Divide behavior changes into smaller achievable steps to increase perception of self-efficacy
Measure progress to benchmark and identify end of counseling
Adherence definition
Reasons for poor adherence
Adherence is new term vs compliance - more focused on collaborative approach
Reasons for:
Lack of education
Faulty healthcare beliefs - not convinced of value of change
Lack of skills or self-efficacy
Lack of support
Negative reinforcement (ex. From family environment) or depression
Forgetfulness → use notes/cues, records and plans
Tuckman’s 6 Stages of Group Development
Forming: anxiety/uncertainty, familiarizing, create positive environment and structure
Storming: highest conflict/competition, dominant members emerge, maintain boundaries to ensure all voices are heard
Norming: cohesiveness, creativity, reinforce positive feel and continue to promote interaction between members
Performing: interdependence, supportiveness and productivity, leadership can observe more (not reached by all groups)
Cohesiveness = degree of attraction members of a group feel towards one another (“We” vs “I”)
Adjourning: validate anger or sadness, group closure activity and honor accomplishments and participation of members
Advantages/Disadvantages of Group Counselling
Advantages:
Emotional support
Group problem solving and modeling effect
More people helped in less time
Data shows more effective than 1:1 counselling
Can support hope for change when seeing others make changes
Disadvantages:
Variation in individual responsiveness
Difficult personalities or leader personalities that take over or others that are shy to share
Poor role models or negative energy from a participant
Difficult to organize group with shared issues or meet the needs of a diverse group
More prep time needed
Group Facilitation Tips:
Give feeling-focused open-ended questions for discussion
Active listening and be respectful
Clarify by paraphrasing
Correct misinformation when it crops up
Summarize group decisions/discussions
