Types of Therapeutic Communications

The therapeutic relationship facilitates positive change in the client who seeks assistance. How does this happen? Every therapist learns a variety of basic skills and when to use them effectively. In their text on helping skills, Drs. Clara Hill and Karen O'Brien describe these techniques and what part they play over the course of the therapy relationship, in terms of helping the client explore, gain insight and take action.

Attending and Listening

• Attending and listening are multi-faceted skills that provide a strong foundation for all other communications. Attending refers to the way you show the client, physically, that you are present in the moment with them. Listening refers to understanding what the client is communicating, verbally or nonverbally. Eye contact, smiling, facial expression, touching, nodding, or synchronizing movements with the other person convey a high degree of interest and attention.

Reflections

• Restatements, or reflections of meaning, involve paraphrasing the content of what a client says and "reflecting" it back to them. This helps others to feel heard and supported, and encourages further exploration. Restatements use similar words in a more concise and concrete manner.

  Reflections of feelings help clients explore feelings deeply by identifying the emotions they are experiencing. Many clients discount, deny, or ignore what they're feeling because someone has communicated a lack of acceptance, which makes this type of communication important.

Questions

• Closed questions are designed to gather specific kinds of information, and can often be answered with a "yes" or "no." Although helpful when seeking a certain response, closed questions tend to shut down the exploration process. Open questions, in contrast, encourage further examination of the client's feelings and problems. For example, the question, "What are you feeling right now?" would be open, because it nudges the client to expand his or her response beyond a few words.

Challenge and Interpretation

• Challenges highlight discrepancies or contradictions that the client may be unaware of. The intention is to promote insight by identifying maladaptive thoughts, behaviors, and feelings and dealing with resistance to change. Challenges must be carried out with respect and sensitivity to be effective.

  Interpretations present new explanations for thoughts, behaviors, or feelings to promote insight into problems. This may also give the client "permission" to experience the feelings associated with the problem, now that a reason has been identified.

Self-Disclosure and Immediacy

• Therapists sometimes self-disclose by presenting their own personal experience with a problem. Clients can then decide whether the insight or way of handling the problem would work for him or her. Self-disclosures present a model for addressing the problem successfully.

  Immediacy uses the therapist's feelings about the client to provide a present-time source of information about how he or she is perceived. Problems in the therapeutic relationship, which may mirror difficulties the client has with others out in the world, can be addressed when immediacy is used.

Information and Direct Guidance

• Therapists give clients information to help them carry out changes when they're ready to act. Facts, experiences, resources, and perceptions of the client are types of information that might be provided to facilitate taking action. Direct guidance goes a step further and involves the therapist directing the client, making suggestions or giving advice.