A central tenet of client centered work is that the client’s understanding of themselves and their lives is privileged over what the counselling professional may think or believe they ‘know’ about the client. The client is considered the expert in their lives.

This core idea can guide all aspects of our communications with our client. This includes the skill of affirming. When we focus on our client’s ideas and knowledge of their strengths and positive qualities we are potentially opening up a powerful new aspect to this very helpful micro-skill. We are inviting co-creation and autonomy in affirming.

You may be able to hear the invitation for autonomy and co-creation in affirming in this quote from Motivational Interviewing 3rd ed :

‘The spirit of MI starts from a [….] strengths-focused premise, that people already have within them much of what is needed, and your task is to evoke it, to call it forth. The implicit message is ‘You have what you need, and together we will find it’ p21
Miller and Rollnick

So, in this issue we are exploring merging these two principal MI ideas:
Calling forth the client’s knowledge and emphasising their autonomy (this reduces resistance and enhances empowerment in the change process)
Affirming our client’s strengths (this increases hope and confidence to change)

Read on to discover more about this powerful skill mash up!

Read Issue 20

#affirming #autonomy

For those of you who are seasoned practitioners, you will be familiar with the very bumpy road that is characteristic of our clients’ behaviour change process. If you are new to facilitating change in others I am sure that a minute of self reflection will confirm that even (or particularly!) for ourselves, ‘being’ different and ‘doing’ different is hard work requiring energy, focus and commitment.

It is not uncommon for our clients to share ‘problem saturated stories’ of repeated experiences of failure, lack of hope or even reluctance to be visiting our office to meet with us. It can be a genuine challenge to our skill of affirming to seek out our clients’ strengths to reflect back to them when there’s seemingly nothing ‘going right’. The paradox is of course, that this can be a powerful time to do it. Demonstrating our willingness to notice capacity and capability in our client when they cannot see it for themselves can be a strong alliance builder.

So where to start?

Read Issue 19

#about affirming clients #affirming

I recently had a series of very humbling experiences…..listening to recordings of myself at work with clients. I was required to record several client sessions to analyse my skills for a training application that was due this month. In this process of listening and self analysis (and with mentoring from my Skills Coaches), I discovered that my affirming needed some work.

One thing I was surprised to learn is that when I engage in affirming I can sometimes inadvertently ask a question by ending the affirmation with an upward voice inflection. Easily done (especially if you are an Aussie). Not necessarily harmful but also not particularly helpful.

These recent experiences of mine got me thinking about this next issue. Now that I have lead the way, I thought we might explore ways that we accidentally stuff our affirmations up.

Quick Menu of Affirmation ‘Stuff Ups’

Here’s a wee check list of three easy ways we might go off track when trying to practise the skill of affirming:

Make it about us
Engage ‘Cheer Leading Mode’ (also known as positivity overload)
Inadvertently ask a question (see my ‘Exhibit A’ above!
Download this issue to read some examples of what these ‘stuff ups’ may sound like and some strategies for correcting them…

Read Issue 18

#about affirming clients #affirming

In Issue 16: Working With Our Clients’ Strengths, I finished up with the following suggestion for reflection:

If you are new to affirming you may like to practice by:

reflecting on the strengths of each of your current clients
writing two or three strengths in each of your clients files
experiment with affirming your client in their next session….just once
Following on from a group discussion in the last training workshop, I thought it may be valuable to list some examples of strengths and attributes we may encounter in our clients.

Below is a list you may like to consider and reflect on. It is largely inspired by ‘The Library of Strengths’ in Stephanie Dowrick’s book Choosing Happiness (Penguin 2007). Download to contemplate more…..

Read Issue 17

#about affirming clients #affirming #non-diet approach

For most people struggling with change, being really heard is a very encouraging and positive experience. Past issues of Practice Pavestones have featured lots of discussion about the power of reflective listening in assisting our clients this way. Affirming takes the skill of reflective listening one step further to amplify the positive effects of being heard and understood.

In the course of a session, clients can say an awful lot to us. What we select from our clients’ statements to reflect back to them can have a real influence on our client and the direction of the conversation in session. As we become more skilled at active listening we can become more deliberate in what we highlight to our client in our reflective responding.

Affirming is the intentional act of reflecting back to our client something about:

their strengths
what they want (motivations for change)
what matters to them
the effort they are putting into their change process
Here’s a great definition from David Rosengren:

‘Affirmations are statements of appreciation for the client and his or her strengths. ….The statements are strategically designed to anchor clients to their strengths and resources as they address their problem behaviour’ p 62

When we affirm, we sift through our clients dialogue and actions and creatively highlight aspects of forward movement. To read more on what this may sound like and the practitioner attributes involved go for the download!

Read Issue 16

#about affirming clients #affirming #reflecting #unconditional positive regard

In this issue we are going to be exploring a little about clients who talk more than others and the challenges this may place on our practice of reflective listening.

We are all familiar with the scenario. We invite our client to speak and within a short period of time we are getting that uneasy feeling………’whoa…where is this going?’ . We may start to panic, there is time to keep, the next client will be here in 15 minutes, we need to ‘get to the point’ but we know the value of reflecting and attending. It can all get us a bit overwhelmed…..

It can be very hard to know what to attend to and what to reflect when the client has done the metaphoric, story-telling equivalent of turning their handbag upside down and letting gravity work its magic. Or man-bag. It would be dangerous to assume that it is only our female clients who can be the talkative ones.

A Strategy to Consider

There are many reasons why some clients talk a lot. One is anxiety. Meeting with a Dietitian or talking about stressful behaviours can be extremely anxiety provoking. Long and complex stories are often a symptom of a hyper-aroused state and can be (unconsciously) functional in providing a great distraction.

Anxiety in our client is important to acknowledge as it points to some ways we can be helpful in this situation. Here’s a handy acronym to get a handle on things:

Read on to find out more

Read Issue 15

#reflecting clients #reflections

Responding reflectively to our clients can be a challenging skill to develop when we are trained in advisory and solution focused models. In the counselling skills training group this week we brainstormed together all of the possible road blocks to reflecting with our clients.

Here is a summary of what was collated:

Trying to make ‘it’ OK for our client
Meeting requirements of our workplace assessment form
Focusing on an outcome
The Almighty Urge to ASK QUESTIONS
Lack of practice
Worry about getting the reflection ‘wrong’
To bring these road blocks to life, let’s consider how these challenges may appear in response to the following client statement:

‘My last diet resulted in me gaining 5 kg more than I started with. It was a disaster.’

Read on to learn more………

Read Issue 14

#reflecting clients #reflections

So far we have explored Active Listening through the skills of attending (Issues 7 – 11). Whilst attending is always our first step in engaging in Active Listening, the process would be rather futile if sitting in silence was all we did, no matter how perceptive we were.

Active Listening is as much about how we respond to our clients’ communications as it is about how we attend to our clients’ communications… this may be in part why this form of listening is called Active not Passive Listening.

Helpful Responses in the Active Listening Process

We can engage in both helpful and unhelpful responses when we listen to our clients. Our responses to our clients’ disclosures have the capacity to keep the talk about the client and their experiences or start to make it about us (what we know, what we what them to do and all that jazz). Our responses have the capacity to close the exploratory conversation down or open the exploring up. Our responses can enhance safety and acceptance or invite a subtle tone of expectation or even judgement.

No prizes for guessing which of those options is more helpful!

For this issue I’d like to briefly explore helpful responses in three rough categories. Read on to understand more and what these responding categories may sound like in session with a client..

Read Issue 13

#responding

On December 8, 2013 Issue 1 of Practice Pavestones was sent out to 54 brave subscribers (they signed up without knowing what they were going to get!). Since then we have had 12 monthly editions, a fabulous two day training intensive and the subscription base is now sitting at over 820! Your enthusiastic feedback has been a huge motivator for content and ongoing improvement and development. THANK YOU!

This issue is offering you the opportunity to consolidate and reflect on your learning so far. You can revisit a favourite issue or, for new subscribers, get a chance to catch up on previous issues you may have missed.

IN THIS SPECIAL BUMPER EDITION you’ll find:

A synopsis of issues so far (1-11) with a brief summary of content, link to full issue (click on the issue no.) and a sample reflective question.
A CPD questionnaire so that you can turn your dedicated reading into self-assessed CPD hours for your APD renewal (just around the corner). Scroll down to the purple Pavestone Box to access links to the on-line quiz. As a thank you to all of my subscribers it will be FREE for the next 7 days ONLY so hop on now and assess your professional development hours.
A super competition give away worth up to $360.00 in training….read on in the training announcement below
Special Birthday Messages and ‘Thanks’ to Pavestone VIPs – read on after my sign off in the classifieds section

Read Issue 12

As health professionals, we are trained to use our minds in the listening process to listen evaluatively. Listening evaluatively enables us to perform two very important functions within the medical model of patient care:

1. Assess our client’s nutritional health

2. Formulate an appropriate intervention, education or prescription.

Our skill as evaluative listeners is a hand in glove match for performing the role of helper in the medical model. However, when we start to segue into the client centered model, evaluative listening can often prove to be something of a hindrance. Let’s explore why.

Through our training, we are often oriented towards spending valuable listening energy formulating responses and advice whilst our client is talking. Our busy and eager ‘helping mind’ can really get in the way of effectively attending to our clients’ messages. This can cost us valuable engagement and can also set us up to work much harder than our client.

Let’s consider too that when our clients are struggling it can be so tempting to step out of listening and engage in some quick ‘installation therapy’ i.e. telling the client what we know to make them ‘better’. And we often know a lot of really useful stuff! But as many of us have learned the hard way, installation therapy rarely works……….

…….our client may simply not be ready to hear what we know
……what we know may be irrelevant (ouch)
………..or our client may have a much better idea of what they need to do!

So when we need to be listening, what are we to do with our expert knowledge and urge to help? Neither are wrong, it’s just how we harness them that keeps them useful. As a place to start, it can be helpful to remember the power of keeping our client front and center and our ideas second place. Read on for some tips on this challenging process…

Read Issue 11

#active listening #giving advice