Communication skills Lecture (4) Verbal communication Skills

Learning objectives
By the end of this lecture students will be able to: Identify the types of verbal skills Explain the purpose of each verbal skills Differentiate between the types of questions Explain what normalizing skill is about explain how to normalize emotional state, changing behaviour, role and relationship

Verbal skills
By using one or three words By using many words

Examples of verbal encouragements (1 3 words)

I see I understand I get it Thats clear Uh-huh I hear you ok Continue Carry on Well yes

Verbal skills (using many words)

Paraphrasing /reflection of content Reflection of feelings Checking understanding Asking questions Normalizing

Paraphrasing
Paraphrasing is: restating what the client/patient said in different words in order to demonstrate attention and encourage him/her to continue

continue
Paraphrasing means to state in your own words what the client said without changing the meaning

What is the importance of paraphrasing?

It makes a person deeply appreciate being heard Stops miscommunication Makes you remember what was said

2. Reflection of feelings
Refection of feelings is one of the most important micro-skills. it is at the same time similar to and different from paraphrasing. 1. It is similar because it reflecting back to the client information provided by the client/patient

Cont
2. It is different because it deals with
emotional feelings, whereas, paraphrasing deals with the information and thoughts that make up the content of what the client/patient is saying

Feeling s are quite different from thoughts Thoughts: Thoughts mill around in our brains. They are at a head level Feelings: Feeling are to do with emotions. Feelings are at a gut level not a head level and tie into our physiological sensations

Cont
For example: a person who is feeling tense emotionally may experience his tension in his muscles, often in the neck or shoulder An anxious person may have sweaty palms, an increase heart rate

Clients/patients Feelings
Clients/patients usually avoid exploring their feelings, because they want to avoid the feeling associated with strong emotion such as :
Sadness Despair Anger and anxiety

Cont.
It is better to encourage the client to express his feeling, rather than to talk about his problem in general and to experience the emotional effect of the problem. If the client/patient keep telling his problem without express his feeling, then he will not feel better or reach resolution

Cont

If the client get in touch with his feelings then he will be able to move forward, feel emotionally better, and then will be able to make sensible decision for himself Do not encourage the client/patient to run away from his feelings, by saying to him : Dont cry, it will be alright, because he will never be so if he didnt release his emotional pain

Cont.

As a Nut./counsellor encourage the patient/client to experience his/her emotions:

To be sad To cry To be angry To shout To be frightened

 By doing so you will help the patient / client to gain from emotional release and to move forward

How to reflect feelings

Some times client need permission from the counsellor to cry, so the counsellor can reflect feeling as follow: You are angry You are happy I can see the tears in your eyes You look sad today Its OK to cry: Then the tears will start to flow

Cont
Do not comfort the patient /client in any way or hand him tissues until the emotion cool down naturally If you do so then the client will withdrew his feelings, and will not experience them fully, and the healing effects of emotional release will be diminished

Asking questions
Purpose: Further exploration of facts. Help patient/ client to think more about the situation and perhaps find a way of coping with them. Help client/patient explain what s/he already knows about his/her disease/complain.

 To show our attempt to understand the person and the problem s/he is trying to explain. Help communication process move on Help patient / client identify problems.

Asking questions
Open-ended questions are: questions that cannot be answered by a yes or no. Closed questions: are those that can be answered by : yes or no

Open ended questions

Permits a person to choose how to respond and helps him to examine the situation more carefully. Invite a person to talk more Allows a person to give opinions, ideas etc.

Points to remember when asking questions

Use simple open ended questions and simple language when structuring questions. Ask questions that are clear and easy to understand. Ask one question at a time. Use one question at a time. Use ones key words in from a persons answers to frame the next question.

Answering questions
Sum total of ways in which a doctor/counsellor responds to clients inquiries in a way that is helpful to both the client and counselor.

Points to remember when answering questions

Behind every question there is a story, it is helpful to find out why someone has asked a particular question before answering it. You do not have to be intorrogative. Before answering, check that you have understood the question by asking open ended questions. Use simple, clear language.

Cont.
Only give accurate information. Avoid jargon. For some questions there are no answers. It is ok to say I dont know. Always explain why.

Checking understanding
Keeps you from being destructed Check-out the accuracy of your understanding Conveys to the client/patient that you are with him

Normalization
Normalization is particularly useful and powerful one if used correctly Normalizing means to give the client/patient a better understanding of his situation/condition so that can deal more effectively with it, and thereafter to be able to move forward.

Cont.
Normalizing do the following: It reduces the emotional state of the patient / client Reduces the anxiety of the patient /client Tells the patient /client that his/ her feelings are normal and appropriate for some one who has such experiences/suffers from such diseases Helps the patient / client to accept his/ her feelings and to move forward

Common errors in communication

Controlling Judging Moralizing Labeling Non-acceptance of patient /clients feelings Advising

Cont.
Interrogation Encouraging dependence Cajoling i.e. persuading the client/client to accept the new behavior by deceit or flattery