What should a therapist do if they got stuck during a session?
Not just stuck, but completely baffled, unable to continue, at a loss for words? It was suggested to reflect on these doubts and we came up with three important points we would use- Encouragers and Paraphrasing.
So, what are Encouragers? Encouragers are expressions a therapist can use to prompt the clients to continue talking during the session- either verbal, nonverbal or a combination of both. These could be “mm” or nodding of heads, positive facial gestures such as tilting the head and indicating the client to continue. Silence itself can be an encourager as it indicates that there is a safe space for the client to continue talking. Encouragers encourage clients to keep talking. These encouragers help the client use both cognitive and affective thought. Repeating certain key words can encourage and influence a client and can maintain the flow of conversation as well. “I see you are pretty strong with how you do things. This is commendable”. Therefore, Encouragers and Positive Asset strokes go hand in hand. A therapist can use encouragers to also show the client that they were listening.
Using encouragers at the correct time also help the client to feel that they have a safe space to talk to. Short phrases often lead therapist to understand the underlying thoughts, feelings, or behaviours related to that word or phrase. On the other hand, the use of too many encouragers can seem wooden and lacking expression, whereas too few encouragers may suggest to clients that you are not interested.
So what is Paraphrasing? Paraphrasing is a skill or technique that help and even encourage the client to explore their issue or problem with greater depth.
According to Ivey and Ivey, an accurate paraphrase has 4 dimensions:
1. A sentence stem which sometimes using the client’s name, thus personalizing the sentence. For example,
“Mary, I hear you saying . . .,” Stems if not used correctly may sound like parroting.
2. Therapist using key words used by the client in the same way they did (tone etc) to describe the situation or person.
3. The essence of what the client has said in a briefer and clearer form.
4. A check for accuracy. A check is a brief question at the end of the paraphrase, asking the client for feedback on whether the paraphrase was relatively correct and useful. For example, “Am I hearing you correctly?” This is also a method of making the client feel like they are in power during the session. The power play ensures that the client feels like they can control the perception of the event.
The necessary and most primary objective of paraphrasing is facilitating and helping the client to explore, clarify and even reflect on their issue/presenting problem. The tone that a therapist uses is quite important as it helps the client understand if the therapist is interested in the story or not. It also conveys that the therapist is not just attempting to listening but also actually attempting to understand what is being said, the underlying motivations and desires that they are still scared to tell.
Accurate paraphrasing gives a sense of being “heard” to the client. The client also feels understood. The skill of paraphrasing involves using certain keywords of the client’s story that the client itself used and/or retaining the main concepts and repeating it to the client.
Whenever you as a therapist get stuck, it is always beneficial to look at these two and more ways / techniques which allow you to continue with the rest of the session as smooth as possible.
References
Ivey, A. E., Ivey, M. B., & Zalaquett, C. P. (2013). Intentional Interviewing and Counseling: Facilitating Client Development in a Multicultural Society - Standalone Book (8th ed.). Cengage Learning.
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