LWL03. Reflective Listening

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CHECK-IN section – Maximum time 20 minutes.

Mindfulness: Take a break from what you have been doing, breathe deeply, relax and recharge.

Step 1: Find a comfortable seated position with both feet grounded on the floor. Put a hand on your stomach. Close your eyes.

Step 2: Take a deep breath in through your nose and out through your mouth. Notice your thoughts and feelings and any tensions in your body.

Step 3: As you inhale and exhale, breathe deeply so your belly fills and empties with air. The hand on your stomach helps you practice belly – not chest breathing.

Step 4: For the next two minutes make breathing in and out your only focus. Let your thoughts come and go without trying to control them. If you find an area of tension in your body, relax it and let the tension go.

Step 5: At the end of the two minutes slowly open your eyes. Gently bring your presence back to your surroundings.

Gratitude: Taking time every day to be grateful can help our health, relationships, emotions and happiness. What is something you are grateful for this week? (Everyone in group shares.)

Review “How Are We Doing?” worksheet. (Led by loved one with behavioral health disorder.)

·      Past week’s recovery activities.

·      Goals for next week.

Discuss: How did you benefit from working on last week’s commitments? (Everyone in group shares.)

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SKILL FOR A LIFE WORTH LIVING section – Maximum time 20 minutes

Think: Am I really listening to and connecting with others?

A communication skill that helps us become better listeners and connect with others is called Reflective Listening. This skill is based on the fact that what we believe or assume someone means may not necessarily be what they really mean. Our focus is on ‘decoding’ or translating what someone is saying, rather than asserting our understanding of it. This requires that we listen very carefully, observe others body language and behavior and reflect using our own words.

“If I were to summarize in one sentence the single most important principle I have learned in the field of interpersonal relations, it would be this: Seek first to understand, then to be understood." Steven R. Covey. Listening, guided by love, is one of the greatest gifts we can offer to others. [1] People in healthy relationships talk with each other, not at each other. People should feel safe telling one another their thoughts, feelings, and concerns. Communication occurs when someone understands you, not just when you speak. Although sometimes it may not ‘taste’ good, constructive feedback feeds healthy relationships. It may help you to tap into your blind spots and get a different perspective.

OBSERVATION ACTIVITY

Step 1: Decide on a member of the group to be the “Speaker” and someone to be the “Listener”.

Step 2: Based on what the Listener has observed about the Speaker during the last few minutes in group have them write down a reflective statement. If you need help getting started here are some ideas. “I noticed you just...", “What are you thinking?”, and “You’re feeling...because....”). Your reflective statement:__________________________________________________________ ______________________________________________________________________________________________________

Step 3: The Speaker shares his response to the Listener’s reflective statement with the group.

Every time you offer someone a reflection you get immediate feedback as to how accurate it was. There is no penalty for missing because when you guess wrong the person simply tells you more about what they actually meant. Good reflective listening tends to keep others talking, exploring and considering. It also offers an opportunity for others to hear their own words, feelings and behaviors reflected back to them. You can get pretty good at guessing what others mean from their words, voice tone, context and non-verbal cues. This feedback or validation process is what distinguishes reflective listening and makes it so effective.

Discuss: Why is it important to keep the conversation going?______________________________________________________________________________________________________

SIMPLE REFLECTION ACTIVITY

Step 1: Decide on a member of the group to be the “Speaker” and someone to be the “Listener”.

Step 2: Have the Speaker complete this statement, “One thing I like about myself is that...”

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Step 2: The Listener guesses what the speaker really means by creating a simple reflection. For example, “You like that you...”

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Step 3: Rotate on to the next group member, who becomes the Speaker completing the “One think I like about myself is that…” statement.

Step 4: Another group member becomes the new Listener and guesses what the new Speaker really means by creating a simple reflection. For example, “You like that you...”

Step 5: Complete this activity until everyone has had an opportunity to be the Speaker.

Another way to form a reflection is to think or guess about what someone really means. For example, a friend Mary tells you “I’m getting really discouraged about controlling my anxiety”. Here’s what might flash through your mind. What’s discouraging Mary? -- think your question first, “Do you mean that you have been trying hard and your anxiety levels are still high? Now make your question into a reflecting statement by removing the “Do you mean that” at the front and inflecting your voice downward at the end. The reflection you now say aloud to your friend Mary is, “You’ve been trying hard and your anxiety levels are still high.” (Types and examples of other reflections are included in the "Reflective Listening Handout".)

One final note on communication. It isn’t enough to know what or how to say it, we also need to know when to say it. There may be better or more ideal times to communicate with others. Make sure your communication is a safe physical and emotional conversation. Sometimes we have so many overwhelming feelings, we ‘bottle up’ our emotions. When our “emotional dam” bursts we blurt out things which can cause a breakdown in communication and loss of connection with others. When we use Reflective Listening, we focus on what someone else is feeling without being hostile, critical or overly emotional. ______________________________________________________________________________________________________

COMMIT & CELEBRATE

This week I will commit to:

·      Using Reflective Listening at least once a day.

·      Doing a group recreational activity to celebrate recovery. (See “Celebrate Recovery”
 handout for ideas.) __________________________________________________________________

Watch: Lyric video. (Video that reinforces this week’s topic.)

 

REFLECTIVE LISTENING HANDOUT

Motivational Interviewing (MI) is a technique in which you become a helper in the change process and express acceptance of “Speakers”. Your role as a reflective listener is directive, with a goal of eliciting self-motivational statements and behavioral change those you are listening to. In addition, you can gently create discrepancies between the Speaker’s values and their behavior that enhance motivation for positive change. Essentially, MI activates the capability for beneficial change that everyone possesses. Although some people can continue change on their own, others require more formal treatment and support over the long journey of recovery. (Adapted from Chapter 3—Motivational Interviewing as a Counseling Style Enhancing Motivation for Change in Substance Abuse Treatment, https://www.ncbi.nlm.nih.gov/books/NBK64964/)

NOTE: ALTHOUGH THE FOLLOWING REFLECTIVE LISTENING EXAMPLES USE SUBSTANCE USE, WELL SUPPORTED SCIENTIFIC EVIDENCE SHOWS THEY WORK FOR OTHER BEHAVIORAL HEALTH DISORDERS AS WELL.

Simple reflection. The simplest approach to responding to resistance is with nonresistance, by repeating the Speaker's statement in a neutral form. This acknowledges and validates what the Speaker has said and can elicit an opposite response.

Speaker: I don't plan to quit drinking anytime soon. Listener: You don't think that abstinence would work for you right now.

Amplified reflection. Another strategy is to reflect the Speaker's statement in an exaggerated form--to state it in a more extreme way but without sarcasm. This can move the Speaker toward positive change rather than resistance.

Speaker: I don't know why you are worried about this. I don't drink any more than any of my friends. Listener: So, I am worrying needlessly.

 Double-sided reflection. A third strategy entails acknowledging what the Speaker has said but then also stating contrary things she has said in the past. This requires the use of information that the Speaker has offered previously.

Speaker: I know you want me to give up drinking completely, but I'm not going to do that! Listener: You can see that there are some real problems here, but you're not willing to think about quitting altogether. 

Shifting focus. You can defuse resistance by helping the Speaker shift focus away from obstacles and barriers. This method offers an opportunity to affirm the Speaker's personal choice regarding the conduct of his own life.

Speaker: I can't stop smoking reefer when all my friends are doing it. Listener: You're way ahead of me. We're still exploring your concerns about whether you can get into college. We're not ready yet to decide how marijuana fits into your goals.

Agreement with a twist. A subtle strategy is to agree with the Speaker, but with a slight twist or change of direction that propels the discussion forward. 

Speaker: Why are you so stuck on my drinking? What about all of my wife’s problems? You'd drink, too, if your wife were nagging you all the time. Listener: You've got a good point there, and that's important. There is a bigger picture here, and maybe I haven't been paying enough attention to that. It's not as simple as one person's drinking. I agree with you that we shouldn't be trying to place blame here. Drinking problems like these do involve the whole family.

Reframing. A good strategy to use when the Speaker denies personal problems is reframing--offering a new and positive interpretation of negative information provided by the Speaker. Reframing "acknowledges the validity of the client’s raw observations, but offers a new meaning...for them" (Miller and Rollnick, 1991, p. 107) 

Speaker: You’re always nagging me about my drinking--always calling me an alcoholic. It really bugs me. Listener: I really care and am concerned about you. It sounds like I am expressing it in a way that makes you angry. Maybe you can help me learn how to tell you that I love you and am worried about you in a more positive and acceptable way.

 

Rolling with Resistance. Accept the Speaker’s perception, understanding they can be shifted over time. In this strategy new perspectives are invited but not imposed. This is not "reverse psychology”, it is stating what the Speaker has already said while arguing against change, perhaps as an amplified reflection. If the Speaker is ambivalent, taking the negative side of the argument evokes a "Yes, but..." from them, who then expresses the other (positive) side. Be cautious in using this with strategy with a Speaker who is in early treatment or may be depressed.

Speaker: Well, I know you think I drink too much, and I may be damaging my liver, but I still don't believe I'm an alcoholic or in need of treatment. Listener: We've spent considerable time now going over your positive feelings and concerns about your drinking, but you still don't think you are ready or want to change your drinking patterns. Maybe changing would be too difficult for you, especially if you really want to stay the same. Anyway, I'm not sure you believe you could change even if you wanted to.

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LWL02. Communication, Changing “You” to “I”

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LWL04. Validation