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New Hope Case Discussion

Dr. Bill Gaultiere
(714) 971-4213
DrBill@CrystalCathedral.org

The most important thing we do as New Hope counselors is to listen. Effective listening is active listening that means listening with your ears and your hearts and then communicating your listening with your voice (over the phone) or hands (on the internet).

I am very excited to offer you this "New Hope Case Discussion." This is an actual New Hope Online counseling session and, therefore, a great way to demonstrate, very practically, how to apply the active listening skills that we teach. In a previous article I’ve summarized these skills using L-I-S-T-E-N as an acronym:

Loving, nonjudgmental attitude. It’s a must. It enables you to step into another's shoes and begin to understand. Be open-minded and gracious, as nothing closes a heart faster than criticism and prejudice. When appropriate caring comments like, "I’m concerned for you" or "Thanks for calling New Hope" are helpful in communicating a loving attitude.

Invite self-disclosure with open-ended questions like, "Tell me what happened?" or "How do you feel about that?" Avoid questions that can be answered with "yes" or "no."

Summarize what you're hearing to verify that you're understanding the issue by saying something like, "What I'm hearing you say is...." (Summarizing is much more helpful than solutions. Don't give advice!)

Timely reflection of feelings (inner emotions, experiences, and felt needs) is key. Focus on feelings more than facts by saying things like, "It sounds like you feel...." "It seems that you need...."

Even-tempered listening is a must. Stay calm, don't react; think before you speak. Emotional reactions (e.g., shock, surprise, anger, disgust, pain, fear) shut people down.

Nonverbal cues like "Mm hmm," a steady gaze, and a warm smile help people know that you're listening.

Now let’s look at an actual call transcript from a disappointed internet user and consider how the counselor could’ve been more helpful by focusing on expressing care through active listening. I’m using this transcript to offer a teaching tool to help all of you to focus intentionally on using your active listening skills. The point is not to second guess or to criticize this anonymous counselor. Nor is it to put perfectionistic expectations on any of you. This is a learning, growing opportunity.

Counselor: Hello this is New Hope. How can I help you?

Caller: I have chronic pain, and have recently lost the use of one hand, I also have to sit most of the time. I am having great trouble coming to terms with this.

Counselor: Sounds like you are experiencing some tough times. Can you focus in a little more on how this came about?
Comment: The "sounds like" phrase is a good way to begin an empathic reflection. The counselor identified the caller’s feelings as "tough times." A more empathic and "deeper" response would focus on the caller’s loss or her pain. Then the question the counselor asks is not helpful because it’s a "why?" question that takes the caller out of her feelings and into her head.

Caller: I have had back and neck problems for many years, now a nerve is compressed, leading to the loss of use of my hand, hypersensitivity of the nerves there, and the loss of those muscles.

Counselor: Wow! Sounds like you really need help. What have you or your doctors tried?

Comment: "Wow!" is a surprised response and is not "even-tempered listening." The question about what the doctors have tried is a good question, but it’s the wrong time to ask it. It focuses the conversation on possible action steps or solutions. We want to save that for near the end. First we want to build a caring connection. We could reflect her feelings by saying something like, "I hear that you’re in a lot of pain." Or we could make a summary statement that invites further self-disclosure by saying, "That must be very difficult for you to have lost the use of your hand." Or we could ask an open-ended question that invites her to share more from her heart, something like, "How much of the time are you in pain?"

Caller: Much pain relief has been tried, but with severe reactions, so can't use these. I have just had an MRI scan on both my back and my neck. I have osteo arthritis along my apine, many bony spurs, disk space narrowing and several bulging disks, but none in the place which would cause my symptoms. I have used a TENS machine, relaxation techniques, meditation, herbal medicines, etc.
Counselor: So, it sounds as if the doctors are a bit puzzled about what is causing this last situation.

Comment: This is a good summary statement.

Caller: I am now waiting for an EEG.

Counselor: Do you have family or friends to assist you or a church family?
Caller: Yes, I have a husband who does everything for me, but my main problem is coming to terms with the loss of activity, I am so low at the moment.

Counselor: Well, I am so pleased that you came to New Hope so that we could pray for you and encourage you. How wonderful to have a supportive husband, too.

Comment: The caller is saying that she feels "low" and is grieving over the loss of her hand. She’s having extreme nerve pain in her hand and can’t function like she used to be able to. She also must be frustrated and exasperated that the treatments she’s receiving haven’t helped. Here, the counselor is minimizing the caller’s pain with a "look on the bright side" approach. A reflecting feelings or summarizing statement would work nice here, "It sounds like you’re grieving your loss of activity." Or a loving, caring statement combined with an invitation (similar to an open-ended question): "I’m concerned to hear that you feel low. Please tell me more about that."

Caller: I have always been very practical and independent, now I have lost that.

Counselor: So many wonderful things are happening in the medical world today. Perhaps the information gained from the EEG will give the Dr.’s some insight in how to help you.

Comment: The counselor is giving more "look on the bright side" input rather than demonstrating her understanding and care.

Caller: Maybe so, but I have to know how to adjust in the meantime.
Counselor: Ahh...yes, to loose one's independence is difficult to deal with I am sure. Do you suppose that God is wanting to give you some insight into learning about trust and understanding about how this must also feel to others?

Comment: The caller is again trying to talk about her difficulty adjusting to her pain and her loss and now the counselor is spiritualizing the issue. The counselor would be better to stick with the first part of her response and focus just on the caller’s feelings by saying, "It’s scary for you to lose your independence. This is a very hard adjustment."

Caller: I'm sure it is bad for others, right now I need to be able to deal with this, so that I am not so difficult to live with.

Counselor: Probably your best help is to read the scriptures and listen to good music. Are these available to you?
Caller: Never mind.
Counselor: I will say prayers for you and ask others at New Hope to do the same. I am truly sorry that you are experiencing so much pain. Please know that God is our refuge and strength and a very present help in trouble.
Caller: Your help is not making much impression on my feelings. I have these feelings, and reading the scriptures and listening to music, does not help me feel less useless.
Counselor: Oh, ok. I am sorry. It must have been devastating for all of this to happen. Has it been rather gradual?

Comment: The caller doesn’t’ want spiritual input! And has gotten the counselor’s attention such that in this last part of this sequence the counselor has connected with the caller by using a good feeling word — "devastating" - to describe her pain. Although, the follow up question at the very end re-directs the caller back into factual descriptions instead of her inner pain.

Caller: It started when I was in my twenties, I could deal with it until I lost the use of my hand, and had to sit all day.
Counselor: I understand now, what you are saying. When I made those recommendations I was thinking more of your physical feelings.
Caller: I can deal with those. I can't read anyway, I can't hold a book or turn the pages.
Counselor: I see. Then it seems like you just are feeling useless and unable to do anything for yourself.
Caller: Exactly.

Comment: Here the counselor really connects with reflecting feelings and summarizing the core of the caller’s struggle.

Caller: But it's not a case of "just."
Counselor: Can you explain that a little more?
Caller: You said that it was "just" a case of my feeling useless and unable to do things for myself, as if it was a small matter.
Counselor: No, I did not mean that. I must be VERY devastating to have this happen.

Caller: Yes it is, and not easy to adjust to.
Comment: At this point the counselor is dialed in to the caller’s feelings and is being supportive and the caller has misinterpreted the counselor’s "just" comment to be a minimization when actually it was meant as an amplification, as if to say, "You’re so devastated, it’s all that you feel." Perhaps the caller is still angry about how the conversation started or the caller is revealing a negative, spoiling tendency.

Counselor: Do you have a minister, therapist, or friend you could talk to or that you have talked to about your feelings?
Caller: That's what I thought you were there for.
Counselor: I am. However, sometimes if one can talk face to face with someone it seems to help more. That was what I meant by asking that.
Caller: I have trouble getting out, and counselors have long waiting lists.
Comment: The counselor is trying to encourage the caller to follow up by seeking face to face help. This is a good idea, but the caller doesn’t like it and makes excuses. The referral may have come across better if the conversation had started out better with a better and longer caring connection with the caller’s feelings of loss and pain and struggle to adjust.

Counselor: I'm concerned for you. It seems that you are really hurting. Please give me a moment to think about what you've said.

Comment: Here is a caring response. The pause is also helpful (On the internet a pause needs to be spelled out!), as the counselor is trying to figure out how to deal with the caller’s spoiling.

Counselor: The serenity prayer is what comes to me. Are you familiar with it?
Caller: I am familiar with it, but can find no help from it.
Counselor: I would encourage you to pray it and to pray it out loud. When things, especially positive things, are spoken aloud, they are more powerful. If you cannot read, perhaps you could listen to some encouraging tapes and also go to the Crystal Cathedral web page and read some of the articles and sermons to help you. Particularly one by Dr. Schuller: "How to Manage Your Moods." I am not saying this is "just a mood" you are in... this is a really powerful article.
Caller: I would have thought by now that you'd have noticed that I wasn't a Christian, I thought you dealt with everyone, and not just Christians.
Counselor: We do. Perhaps that could be a consideration for you. To investigate that possibility of accepting Christ.
Caller: I have investigated, but it is not for me.
Counselor: I hope that you will reconsider that decision. I am glad you came to New Hope and we will all say prayers for you. I need to go. My husband is waiting, as my shift has gone overtime. You can come back online and someone else will be online to help. God loves you and so do I.

Comment: Understandably, the Counselor had trouble dealing with this caller’s negativity that surfaced at the end. She also struggled to wrap up the conversation at the end. The resources were a good idea, but didn’t fit this caller and shouldn’t have been pushed once the caller declined. One possible response to the caller’s negativity would be, "You seem frustrated. What is it that you want from this call that you’re not getting?" A good way to wind down a conversation like this is to say something like, "I need to be going in a few minutes, what can I do to help you before we finish?" Or, "I have to sign off in five minutes. Is there something else you need to say or hear before I leave?"

Closing Comment: Even though this counselor missed some important opportunities for connecting through active listening and got off track in some places there were was also some good help offered: being there to chat, trying too help, validating and caring for her feelings and struggles in the middle part, and offering to pray. This caller was negative, critical, spoiling, and difficult to help and that is part of the reason why this call was disappointing to the caller.