 Hi everybody, welcome to your course on communication skills and rapport building. Hi everybody, welcome to your course on communication skills and rapport building. During this presentation, we're going to identify characteristics of effective communication. We will explore ways to improve communication, we'll define rapport, and then we'll look at the most effective ways to enhance rapport through effective communication skills. So rapport is really the relationship or lack thereof between two people. Good rapport involves honesty, understanding, openness, and a willingness to listen and discuss other points of view. And of course, effective communication when you're discussing those points of view. Poor rapport usually leads to what we call resistance. Resistance means that you're not understanding the other person's motivations or what they're trying to communicate. So when we're thinking about rapport, think about a relationship that you have with somebody you just met versus a relationship you have with someone you've known for maybe a month or a year or longer. As you get to know one another, your rapport theoretically improves because you're becoming more honest with each other, you're doing some mutual self-disclosure, you're gaining a greater understanding of one another, and theoretically you're developing an openness or a willingness to listen to that other person's point of view and you're respecting one another. When two people first meet, you don't know what to expect from them and you don't know how to really interact with them. So rapport is really navigating that relationship to develop an understanding of one another. If you feel like you aren't connecting with someone, you're probably not. When you connect with someone, you know, and you can talk, the conversations flow easily. You may have differences of opinion, but you're able to connect on some level. If you feel like it's just completely disjointed or you can't seem to get your point across or maybe they're repeating the same thing over and over again, you're not connecting. And that means there's not good rapport. Oftentimes it indicates you've taken the expert role and have become closed off to alternatives. So when you're talking to someone, especially as a coach or a counselor, and you hear a lot of yes, buts or excuses, that's the clue that you need to stop and step back and figure out, okay, what am I missing here? If somebody repeats something multiple times, it means they feel like they're not being heard. Even if they don't intentionally do it, if they repeat it multiple times, especially in different ways, then they feel like they're not being heard. And it's time for you to stop and step back and try to figure out what they're trying to communicate, not just their words, but what's the underlying meaning. Some questions that you can ask yourself if you feel like you're not communicating or connecting with someone. Do you understand what this person believes he or she wants or needs from you? So if you're continuing to hit this wall, ask yourself if you understand what this person's wants and needs are versus your own. Because too often we try to impose our own values, beliefs, wants and needs on other people, which just shuts down rapport and communication. Have you been hearing what he or she is concerned about and wants to do? Now, you may want to ensure that your client stays clean and sober and happy. The client may be more concerned about getting a job or getting his or her kids back. Now, in order to stay clean and sober and happy, they're probably going to have to get a job and try to get their kids back because those are their personal goals. But if you keep trying to force them down, let's know. We want to look at staying sober right now. We'll worry about your kids later. That's telling the person that their wants and needs and desires don't matter. So we want to hear what's important to them right now. What are they motivated to work on? Because if it's a positive goal, then it's likely going to move them in the direction of staying clean and sober and being happy. Are you focusing more on trying to persuade the person to do what you want or to find a way to achieve his or her goals in a way that aligns with what he or she wants? So again, we need to hear what this person wants, whereas it might not specifically be what we're asking them to do. It's probably going to lead them in the direction that we want them to go. And if they're motivated to work on it, we want to go back to that ethical principle of autonomy and say, okay, let me support you in achieving the goals that you want in a way that meets your needs. And we're going to talk about needs more as we work in learning style and temperament, because the way I learned something and the needs that I have may be very different than those of my client. So the keystone of good rapport is communication. When we communicate, we want to simplify our thoughts before communicating our message. A lot of times, I don't know if you've ever taken a class from a professor who wrote the textbook that you're using or who was just so brilliant and gifted in their field that they have a hard time breaking it down and simplifying it because they jump over big concepts, assuming that you know them. So what we want to do when we're communicating with clients is simplify our thoughts and say, okay, what are the three steps our client needs to take today? And communicate those instead of overwhelming them with this big picture and this huge involved plan. They may not need that right now. They may need to focus on what are we doing today or what are we doing this week? We want to analyze the intent in each and every message. So what is our intent when we're telling them that we've observed X and so behavior in them? Are we trying to increase their motivation? Are we trying to get them to do something? Are we trying to point out a weakness that we want them to address? A lot of times our intent in the message still needs to be articulated. Consider the overall physical setting whenever you communicate. If you're talking to someone when you're standing on the platform getting ready to get on the train, that's going to be a much different type of communication than if you are sitting down having coffee or in an office situation where both of you can focus on one another, take notes, do whatever you need to do. If you're communicating sort of on the fly, then it's important that you keep things very, very simple. Write them down and don't present too much information. You may have a bunch of really awesome information to communicate, but don't overwhelm someone in the physical setting where they're at. Likewise, even if you are doing a home visit, for example, and they have their kids are there and there's four children running around, they can't focus 100% on you. So when you're communicating, you need to make sure that you keep that in mind. Collaborate with others wherever appropriate in planning communication. So if you're talking to someone and you're having a difficult time connecting or you're not sure how to explain something, try it out on somebody else and say, here's what I'm trying to communicate. And maybe it's a complex concept. What would you do or how would you communicate it in order to get the idea across? They'll give you their idea. You have your ideas. You can take what you need and leave the rest, but it's always great to talk to other people to find out if they have analogies or ways of presenting information that you don't know yet, because that improves your communication henceforth and forevermore. Pay attention to the overtone as well as the basic content of your message. The content are the words. What are you saying? But what's the underlying message or the overtone? Are you happy? Are you supportive? Or are you being critical and condescending? And obviously those are two very different ends of the spectrum. But you do want to pay attention to how it's coming across to your client. If you are text messaging, this is super important. Super important to pay attention to overtone, use emoticons, make sure you're keeping it with the tone that you want so it doesn't come off as snarky or short tempered. Suggest something of value or help. So you want to make it meaningful to the receiver. If you're providing information, it may be great information, but if they can't connect it to something meaningful for them, it's probably not going to get filed away in their long term memory. So if you present a tool or if you present a concept, relate it to them, have them relate it to something that they know. So you can relate it to them, but then also have them relate it to something that they know because then they're going to have to go digging in their mental archives. This will help solidify the memory. When you're presenting information, you want to periodically summarize what's going on. So people can say, okay, yes, I've got it. And in summary, you can use visual aids, texts or worksheets or discussion to deepen the understanding. So like with PowerPoint, it gives you basic bullet points about what we're talking about. So there's a summary that you can look at. It's a visual aid. If I were asking you to think about how you would apply these communication guidelines to a situation that you were in in the past week, then that would be helping the person or helping you apply the information and sort of discuss it. You may just be discussing it with yourself, but you're discussing it. So we want to simplify our communication. We want to simplify our message. Make sure we pay attention to the physical setting and how much attention the person can give us. And we want to pay attention to our overtone as well as the basic content of our message when we're trying to communicate things. Timing and choice of medium are appropriate to the purpose, audience and material. When you first meet someone and you're doing an assessment, you're probably not going to be sharing your personal story and dumping a bunch of information about what you're going to do over the next six months. The first meeting when you're meeting with a client, you're getting to know one another a little bit, but more than that, you're getting to know them. So timing is going to be really important until they feel like you know them. They're not going to hear a lot of your, quote, advice and suggestions. So it's important to get to know them, establish that rapport before you start trying to make suggestions. Otherwise, they're going to go, you don't know me from Adam's house cat. So what do you know? And your choice of medium. There are some things that you can communicate in a text. You can send a check in message and just go thinking about how you're doing, hoping things are going well today. Contact me if you need me. That's fine for a text message. If it's something more involved or something more in depth, a text message may not be appropriate. Maybe a phone call or maybe you need a face-to-face meeting. Tone is appropriate to the purpose, audience and material. If it's serious, keep a serious tone. If you're trying to help them learn how to have fun and explore happiness, it doesn't need to be so serious. You know, get a little bit silly. Material is made relevant to the person using the person's interests and concerns. So if we're talking about what a person needs to do in order to improve their sleep, we're going to identify what's affecting their sleep and we're going to make it relevant to them. Looking at Sally, who has two children at home, is working full-time and is in early recovery. What does getting better sleep mean to her? How could it improve her life? And what are her concerns and how could sleep help her better address those concerns? Maybe having more energy to be more focused on her kids in the evening. Well, if she gets better sleep, then that's probably going to happen. When you draw conclusions, there are two ways to present them. If the person is sympathetic, if you've got a good rapport going and they're hearing what you're saying and they seem to be agreeing, then you can present the conclusions directly. So what I'm hearing is X, Y and Z and you think that you want to do A, B and C to address it. That's direct communication. Indirectly, you want to present evidence first and conclusions last. So for example, if you're talking about the stage of change someone's in, you might say, you know, over the past week, you have missed some appointments. I've seen you start burning the candle at both ends. You're not going to meetings anymore. And I'm really concerned about where you're going as far as meeting your goals because it seems like you've slid back into a contemplation or pre-contemplation stage of change. So you're providing the evidence. You're showing the person, this is what I'm dealing with. And this is the conclusion that I've drawn. And then the person can either say, yes, you're right or no, you're not. Now, be prepared if you're providing constructive feedback, regardless of how right you are, you may still be met with, no, that's not it, the denial, minimization and rationalization. Let the person chew on it overnight is not something that you have to confront right away and go, yeah, I think I am right and get into a power struggle. You've provided them the information, let them mull it over and come to their own conclusions. If by the next day, they haven't come to the same conclusion, then you may need to address or reassess your approach. And again, that goes back to consulting with others. You may consult with another coach or consult with the person's clinician and go, you know, I'm really concerned about Jim Bob for these reasons, I'm wondering what I'm missing. Material needs to be arranged in a logical and coherent sequence. You don't want to be all over the place talking about going to meetings, then talking about eating well, and then talking about, oh, by the way, how are your kids? Have a logical coherent sequence to what you're going through. The purpose or central idea is sufficiently limited and stated clearly for meaningful discussion. What does that mean? That means we're not going to present meta concepts, and we're going to handle one thing at a time. If you've ever been in an argument with someone, which I think all of us have, and they just unleash a whole litany of done me wrongs, you're sitting there getting basically assaulted by a barrage of things, and you don't even have time to adjust or process what's going on. A better way to address it or deal with it, maybe you have that list, but you're going to deal with one at a time. When that one's finished, you move on to the next one instead of just verbally assaulting someone, which we don't want to do. You want to have an organizational statement usually at the end of the opening. It's like, hi, Jim. How are you doing today? Glad you came in. Today, what I think we're going to talk about is, so give Jim an idea about what's going to happen in the meeting. When I do staff meetings, I always have an agenda that I give people when they walk in so they can see generally what the flow is going to be. Subordinate ideas are effectively identified and related clearly to the main purpose or central idea. So if we're talking about relapse prevention and all of a sudden I go off on this tangent about exercise, that's a subordinate idea. That's a sub concept that I need to tie back into relapse prevention. How does exercise relate to relapse prevention? When you provide text, it's coherent with new information linked to previously discussed information. So something old and something new. You want to talk about, you know, remember when we discussed the stages of change? Well, now we're going to look at what's going on with you and you're going to identify what stage of change you are in. The text needs to be appropriately highlighted. I try to avoid, when possible, a whole bunch of pros. I like bullet points. That's partly my style though. So if somebody likes a whole lot of pros and discussion, I generally try to accommodate that. But it's important to understand that we don't want to put too much stuff in there. If you remember back when you were in grade school and you were learning how to do word problems and they would put all the distractors in there, all the superfluous information that you really didn't need to solve the problem, I hated that. I would go through and I would just cross out all the superfluous information. So it was sort of a wasted effort for the teacher to put it in there, except for the fact that he or she was trying to figure out if I could identify what was useful or not. This isn't a word problem. We want to present what is useful to our clients and then if they want more information, if they want more in-depth information, provide them resources. A persuasive strategy appeals to your credibility. Are you credible? Do you know what you're talking about? Do you have something to back it up? A persuasive strategy is also logical. It takes information, research, past history, experiences and combines it with what's going on and makes logical sense. A persuasive strategy also uses feelings. We want to increase people's feelings of self-empowerment, self-efficacy, self-esteem and a persuasive strategy also is ethical. If you're asking someone to do something, if you're asking someone to consider changing their opinion, then we want to make sure it's an ethical stance. If it's not ethical, they're going to see that and go, well, that's not ethical, so go away. If you're not appealing to their feelings, if it's not something that's rewarding in some way, they're not going to be motivated to stick with it. If it's not logical, if it's confusing, then they're going to have a hard time making sense of it and committing it to memory. If you're not credible, then they're not going to have a whole lot of motivation to listen to you anyway. Credibility, logic, feelings and ethics are important when you're trying to persuade anyone to do anything or to think anyway. That includes if you're trying to persuade them to focus on the positives about themselves. A lot of our clients haven't looked at their own positives for so long. They focused on the negatives. We're persuading them. We're trying to help them change the way they look at things that involves persuasion. How credible are you? If you remember when you were little and your mom said, oh, you are gorgeous and you're like, well, you got to say that. You're my mom. Mom doesn't have a lot of credibility because mom is mom. Somebody else may have more credibility. Same sort of thing is going here. If they think that you're saying it just because you have to or because you're trying to earn something, salesmen have a bad reputation a lot of times as far as credibility goes because you figure anything they're telling you is only the good stuff and they're not telling you the bad stuff. When you're trying to persuade something, make sure your examples are relevant, specific, detailed, sufficient, and persuasive and use quotations to support the argument. If you're trying to persuade someone that improving their nutrition is going to help their recovery, well, that's all well and good, but how do you know that? Maybe using some very short quotations from journal articles or from a registered dietitian will help in persuading them. For example, when I talk about nutrition, one of my good friends who was a registered dietitian and she would come into my class and lecture when I taught at UF used to say, what you want to do is use a salad plate and have three colors on the plate. If you have three colors on the plate at every meal, you're probably going to do pretty good at getting the range of vitamins and minerals you need. That didn't come from me. That came from her and she had the credibility of being a state licensed registered dietitian and use a presentation that demonstrates knowledge and insight. So you're not just parroting something. You're not just reading from a script and you're not just winging it. If you go up there and you're like, I'll figure out what I'm going to say, then you lose a lot of credibility. In addition to all of these, we want to make sure our word choice is economical, clear, specific, accurate, unassuming, free of cliches and misused jargon. Speak clearly, speak simply. This is not the time to try to make yourself sound important. This is the time to try to make yourself sound clear. So when you're presenting that overarching concept of what we're going to talk about, when you're stopping to periodically summarize, when you're trying to make it apply to the person, you're not going to be using all these fancy flowery words. Use action verbs. What we are doing today, instead of, you know, what I'd really like to do today, that's not action. That's a feeling. We are going to is a lot more direct and a lot more bringing people right into the moment. Meaningful examples are given or elicited to highlight the main points. So you might talk about other, not using their names, obviously we want to protect their confidentiality, but you might want to talk about other people's experiences that you know when they faced a similar challenge. Figurative language like metaphors and similes enrich and deepen the argument when they are used effectively. If you use something that is way off base or a super philosophical and the person's doesn't have a whole lot of background in that, it's going to miss the point. When I talk and I talk about being young, I use the phrase knee high to a grasshopper. People get the idea that I'm talking about being little. And when I say that, they tend to laugh because you wouldn't expect sort of a country phrase like that coming out of me necessarily. So, figurative language will help deepen and enrich the experience. And then finally, even though you've been summarizing along the way, trying to keep it clear, presenting it in a logical sequence, at the conclusion, you want to restate your argument or thesis. And I don't like the word argument because it sounds aggressive, but you want to restate your premise and identify the actions to be taken. So you're going to make a global summary of what's going on. So what we've talked about today is the fact that it seems like your motivation is waning. And we've figured out that you want to take the next three steps in the next week in order to get your motivation back on track. That would be a conclusion statement. You've already gone through the argument, you've already persuaded, you've come to a conclusion or an ending point. And then you're just summarizing what it is, what the premise was, and what the solution is going to be. Attributes needed for good communication, open-mindedness. Your way is not always the right way. Tolerance of different perspectives and accepting of changes in authority and status, and even a desire for challenge. One of the groups of people that I love working with are people who are involuntary clients, people who are there because the court says they have to be. People whose motivation is not in the action stage of change. I love working with them because it's a challenge to understand where they're coming from, to try to take their point of view and see how they can look at their behaviors and what's going on in their life and not see a problem with it. And then an open mindedness to help them achieve their goals. One of the analogies I would use when I would work with this particular group is that of the Borg. And if you haven't watched Star Trek, this is going to fall flat. One of those analogies that you have to have some knowledge of. But the Borg was an alien race that would take over people and they would assimilate them because they all operated off of a single brain. And when I would work with clients who were involuntary and they're like, I don't plan on giving up marijuana. I don't plan on stopping drinking. I don't plan on doing this. I said, okay. That is your choice. However, while you are on papers, while you are on probation, you have to be assimilated. Let's think about it like the Borg. And once you are off of probation, you can do whatever you want. That is completely your choice. But you want to get off probation and I want to get you off probation. So what can we do in order to make sure that that happens and that you're able to meet the criteria set forth by the courts? That fell on people a lot easier. And that was assimilated a lot easier than me going, okay, I'm going to stand up here for 12 weeks and lecture you about why drugs are bad. My willingness to be open-minded and tolerating their perspective, they didn't think they needed to be there. Combined with my premise or my assertion that, okay, I understand you don't want to be here. However, we're operating within certain confines, helped me establish rapport with a lot of my clients. You want to ensure that important pieces of information are constantly being conveyed and understood by all team members. And your client is part of your team. But if you're working with their clinician, if you're working with their psychiatrist, if you're working with their caseworker, then we want to make sure, obviously, with releases of information that everybody on the team is on the same page. Be honest about wishes, needs, and concerns among all parties. Clients will pick up if you're not being genuine. So if you are concerned about them, or if you disagree or have strong reservations about something, it's okay to say that. Now, you don't need to go into a diatribe to convince them why you're right. You can just state what your wishes or your concerns are and then ask them how they plan on navigating that. I had a client that was leaving residential and he had decided to room with another client who was also leaving residential at the same time. Now, when two people leave residential substance abuse treatment, they're at high risk of relapse, well, when anybody does. And when the two of them plan to move in together, that's a huge warning sign for me because I've never actually seen it work. Usually, one person will end up relaxing and pulling the other person down with them. So when he came to me and he said, I think Jim Bob and I are going to move in together when we get out of here. I identified the fact that they created a really good friendship and both of them were doing really well in their recovery. But I had concerns about them moving in together because prior experience will indicate it's probably a relapse trap. But then I followed up with saying, what I'm hearing is you're determined to move in together and you don't see this as a problem. So I'm wondering, what is your backup plan if Jim Bob relapses? You know, I'm not trying to convince him not to move in with Jim Bob because he's made that decision and I will support his autonomy once my concerns are out there. But I do want to make sure that he's thought it through all the way to the end and he has a backup plan in case his roommate relapses, which brings us to a desire to explore and understand all angles. So if you're working with a team, ask them what their opinion or what their perception is of a situation. Again, that includes starting with your client. But if you're working with a case manager and a clinician and something's going on with your client or even if something's not, if you're having a monthly team meeting, you present what you perceive is going on or how you perceive your client is doing and why. And they will present the same. And then you can compare notes and see if you're all seeing the same version of the client when they're in your office. We need to take responsibility for being heard and understood. Just saying something doesn't mean it was heard or understood. If you've got teenagers, you know this. I can say something and it sounds like crickets are chirping. It's so quiet in my house and I'm like, I need feedback. Did you hear what I said? And they will either say, yeah, I heard you, which means they may have heard the words, but I'm not sure it registered. Or if they're on their game, they'll be like, yeah, I heard you. I've got Taekwondo tonight at four o'clock and I need to start getting ready at 3.30. Great. You heard me and you understood me. So you can make a plan from there. The best way to make sure that you're heard and understood is to have the other person paraphrase back to you what they heard you say. So after you've gone through a session, you may ask a client, so what are the things that you're getting out of this session? Or what do you think were the most salient points that we discussed today? It's condescending to go now, tell me what I just said. So please don't ever do that unless you're talking to like a three-year-old. But when you're talking to your clients, have them identify the salient points in the discussion. Or if you're talking about a certain point, ask them, so are you, is what I'm saying hitting the marker or am I missing, am I missing something? And then they may say something like, well, when you said X, Y, and Z, it really ranked true with me, but I'm not sure that your ideas for what to do about it are on point. Well, score. Okay. So we can talk from there. You want to work to clear up misunderstandings quickly and accurately. Misunderstandings when left unchecked can become the source of great conflict among team members. And again, this is between all kinds of team members. And reinforce and recognize team member efforts. Don't undermine other team members if you're the coach. And the person is working with a case manager and a clinician. And they say, you know, when I went to my therapist appointment today, he or she said that I should do X, Y, and Z. Don't turn around and go, well, that was dumb. Why did she say that? Assume that he or she had a very valid justification for making that suggestion and maybe probe a little bit. And when the another team member, including your client, does something good or achieve something, reinforce and recognize, focus on the positives all the time. When our clients come in to our meetings, they're going to bring their concerns, their challenges. That's what they expect us to help them work with. I also want them to focus on their successes and achievements while they're in there so they don't walk out without giving themselves credit where credit is due. In order to seek to be understood and to understand, you want to ask clarification questions. This helps people examine their beliefs by requesting more information. So one of the big questions or concepts in recovery is abstinence. And if somebody says they think they can do control drinking or they don't need to abstain, ask clarification questions. Okay. You don't think you need to abstain from whatever this behavior is and you can engage in controlled use. So what's going to be different now than when it was a problem? How are you going to prevent it from becoming a problem again? Clarification. I'm not telling you that you're wrong. I just want to know how you're going to deal with it because some things you can't abstain from. So if they draw the parallel and they say, well, I don't know why I should have to abstain from alcohol when people don't have to abstain from sex. Okay. Well, let's talk about that. Probing assumptions, challenges, unquestioned beliefs that underlie their stuck points. When you ask probing questions, if they're saying, I fail at everything all the time, we want to say, okay, so there's no examples of when you've succeeded. Let's think. I'm sure there are. Let's see if you can come up with three examples of something you've done well. Probing reasons and evidence helps people examine the actual evidence supporting their beliefs. So again, the probing is encouraging them to go into their memory banks and pull out supporting evidence. And then questioning viewpoints and perspectives. And this isn't saying, I want you to think about why you're wrong. You may ask the client to take the devil's advocate position or you may ask the client to give me three additional reasons why this might have happened. So maybe their significant other comes home an hour late without calling. And they just jump to conclusions that their significant other is relapsed and they go down this whole path of everything's crumbling. Once I hear them out, I'm going to say, okay, well, tell me two other reasons or three other reasons that your significant other may have been an hour late and not have called. Maybe they were stuck on the interstate and their phone was dead. Maybe you can go through a whole bunch of different reasons, but encourage them to look at different perspectives or if they get into a fight with someone, an argument, and they say, I just, she's always wrong. I don't understand why she can't take my perspective on this. It's a time to say, all right, well, why don't we try taking her perspective and see why she can't encourage the client to question what's going on to question themselves and to come up with support for it. We're not saying, again, we're not saying that they're necessarily wrong. We just want them to really evaluate the entire situation in its entirety. We want to analyze implications to help people examine the unpleasant outcomes that logically flow from holding maladaptive beliefs. If Jim Bob says, I can go to the bar and I can have one drink, and that'll be fine. We want to have them play the story all the way through. So you go to the bar, you have one drink, and then what happens? You stay there, friends show up, you get up and leave. What happens and what are the implications of having that one drink? And asking questions about questions, place the focus back on a patient, especially when a potentially inappropriate question gets asked. A lot of times of coaches, someone will say, well, have you ever been addicted to fill in the blank? Turning that back around and asking them, you know, I'm wondering why it's important to you that I've been addicted to whatever that substance is. What does it mean if I have been or what does it mean if I haven't been? Instead of coming back right away with something flip like, would you want your brain surgeon to have gone through brain surgery? Which is what I hear a lot of therapists respond. So when someone asks a question, you may turn around and ask a question right back at them that gets at their underlying meaning. I'm wondering why you want this information, or I'm wondering how this information could help you in your recovery process. The first step in any relationship is developing rapport. Rapport indicates a connection and understanding of the other person. It's important in communication to convey your message clearly. Use examples and encourage personal application. Make it meaningful to the recipient. Elicit questions, concerns, and feedback along the way, both positive and negative. You know, if they have positive feedback, if they're going, yeah, that sounds great. I want to know that. If they're having concerns, I want to know that too. Use a combination of data and emotion to persuade and enhance. And use socratic questioning to help the person arrive at their own answers and conclusions, because ultimately that will keep them moving forward toward their destination and learning how to set their own goals and question their own motivations.