In the helping professions, including both client-facing roles (like therapy or case management) and other roles, the importance of being able to talk constructively with people is key.
Particularly in areas like nursing or case management where both physical/medical issues need to be taken care of, patients can feel overlooked or like they’re not taken care of, even when they’re instrumental issues (e.g. their medical problems or what brought them into the service) are being handled.
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The core to making a person feel heard is to use empathy statements. These are statements that allow you to communicate in a way that makes the other person feel heard or understood.
An empathy statement has the following structure: an opening statement (often that references what the person has said), followed by an emotion, and sometimes a statement closer.
For instance, “When you say that nobody cares about you, it sounds like you’re feeling really alone.” The person may say, “Yeah, I do really feel alone, I might talk to one person a week”, that further explores the problem.
On the other hand, they might say “No, I’m not feeling alone at all, I’m more angry than anything”; this is okay! Now you know exactly what emotion they are experiencing.
DESC Model for Assertive Communication / WIN Statements
The DESC Model is one way to communicate assertively when you need something from someone, or you need them to know what you’re feeling. They also have the name “WIN” statement as a short way to remember them.
DESC stands for Describe, Express, Specify and Consequences:
- Describe the Situation – Say what behaviour the person is doing you wish to change
- Express Your Feelings – I feel ___________.
- Specify what you want – I want/prefer/need you to ___________.
- Consequences – Indicate what you and the person will gain if they give you what you’ve asked for
WIN Statements are a shorter version of this:
- When you ___________ I feel ___________; I need you to ___________.
Active Listening Training Resources
For more indepth training on active listening, you have a number of options: most crisis lines offer basic training sessions (linked here is the ContactUSA helpline accreditation standards) that cover emotional support and active listening, I have an article on building helpline skills that covers active listening, and most counselling courses cover this as well.
There are also private seminars that go over this, such as those offered by the Helplines Partnership in the UK.
Active Listening Barriers
There are some things that you want to avoid in active listening, things that get in the way of providing emotional support.
Interrupting can sometimes be because someone is speaking slowly, they’re speaking too quietly for you to hear them, because you need to get more information from them, or because you’re not sure if the sentence has ended due to a language barrier.
Unfortunately when you interrupt, this gives the person the perception that you don’t care, and that can be very invalidating – even if you knew what they were going to say. Simply practice waiting until the person has finished talking completely or asking them to speak up if you can’t hear them.
Why questions are common in our everyday speech, but their use in emotional support conversations can be very judgemental. Instead of saying “Why do you think nobody likes you”, say something like, “Tell me more about that” or “What makes you think that nobody likes you?”
Fixing / Offering Advice
Fixing, or offering advice is a very natural gesture that takes a lot of work to undo. Giving advice promotes dependence on you, which means if you tell them to do something and things go wrong, you’ll be blamed for it, and the person will be unable to make their own decisions.
We want to promote independence and empowerment by helping people to make their own decisions. Rather than making the decision for them, you can explore options with them, by asking “Have you thought about xyz?”, “Tell me how you’ve coped with this situation in the past”, and avoiding use of the word “should.”
3 thoughts on “Building Communication Skills”
Dustin, really appreciate all the great information you have provide on your site. If I really want to grasp the tactical empathy utilized on the Suicide hot line and take a deeper dive on the great info you have outlined on empathy – where do I go?
Is there a book, or course, you reccomend that is comprehensive?
I tried to respond to your email on Friday but it bounced back so here is what i wrote in my email.
Crisis lines generally provide their own training in this area. My old crisis line, Distress Centre Durham’s training is 16 hours of classroom training with the first 8 hours focused on emotional support, active listening, and demonstrating empathy. We would allow interested community members to pay a fee of $75 to subsidize the cost of the training materials and the trainer’s time and let them complete the 2-day training without needing to make the 1-year, 200-hour commitment of our active volunteers. The best source of training accessible to you would probably be at your local crisis center, completing a similar training like this.
Some organizations are now providing e-training. For example, the Johnson County Crisis Center (JCC) in Iowa has crisis chat responders that complete an e-training and then staff their chat service.) Crisis chat work is a little different than telephone work, and I haven’t completed the JCC training but it should cover those same elements of emotional support, empathy statements, reflection, paraphrasing, etc.. Your local crisis line may offer an opportunity like this that you could take advantage.
If you are near a university or college you might have the opportunity to take a course in basic counselling techniques that would definitely cover these elements as part of active listening and attending behavior, which is the first component of building a counselling relationship. This would be expensive, but you’d likely train alongside Social Work or Counselling students who are learning this for a career, and would get the same intensive training they are.
If you’re looking for a book, I’d recommend The Skilled Helper by Gerald Egan. He did a lot of work training non-counsellors in this attending behaviour and basic emotional support so he writes at a level accessible to someone with no background. You can pick up old editions very cheap (here’s one for $4 with free shipping in the US on AbeBooks.com: https://www.abebooks.com/servlet/BookDetailsPL?bi=30104593038&searchurl=tn%3Dthe%2Bskilled%2Bhelper%26sortby%3D17%26an%3Dgerard%2Began&cm_sp=snippet-_-srp1-_-title2) and that will give you a deep dive.
Video wise, Carl Rogers was the founder of person-centered therapy. You can watch him do a 45 minute therapy session with a real client, as part of the film Three Approaches to Psychotherapy. That link is here: https://www.youtube.com/watch?reload=9&v=24d-FEptYj8.
Hope this helps, please let me know if you have any other questions.