Therapeutic Use of Silence and Pauses – Flashcards

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Silence
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There are cultural preferences for more or less silence. Silence can be very effective. The essence of being "present" is a prime feature of silence Silence can produce anxiety Silence can be overused.
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Describing Silence
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Absence of speech, but not absence of communication Each silence carries an emotional message
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Notice what is said following silence; it may reveal a
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top concern or how a person deals with stress
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Silence is the period in the therapeutic interaction during which the provider
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waits, without interruption for the patient to begin speaking.
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A pause is...
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a natural rest in the melody of speech, whereas silence is longer.
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A pause is less than
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than 3 to 4 seconds - beyond that we would call it silence.
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Silence allows
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Interpersonal space between two people.
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Two Aspects of Silence
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-Client stops speaking and there is an absence of speech before the provider starts speaking, or the other way around. -Absence of speech that occurs when either patient or provider stops speaking and the same person resumes speaking
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Inter-response Time
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Number of seconds or minutes between instances of speaking.
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Does Inter-response time varies among geographic and cultural groups?
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YES!
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Inter-response time may depend on
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the client's condition
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A very short inter-response time has a ________ or________ feel to a person used to longer pauses or silent periods.
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-crowded -rushed
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In fast paced conversation, a________ inter-response time may be enough.
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2-second
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In a therapeutic interaction,inter-response time periods up to_______may be appropriate
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10 seconds
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Adding one or two seconds to inter-response time can
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increase client satisfaction
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Interruptions are
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-Disruptions of another person's speech or thinking that cut short the expression of ideas. -Interruptions can take the form of cutting off or reducing inter response time.
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Interruptions Can occur in ___________or during __________
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-the middle of a statement -a lull in which the person is thinking/feeling.
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Interruption Impact on conversation=
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pressure, frustration
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Over-talk
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Type of interruption in which both parties begin to speak simultaneously or one steps on the other's words.
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Over-talk may occur
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when either or both parties feel threatened.
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Overtalk can be
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-a defense against distress -can reflect need to dominate
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Over-talk characteristics
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-Over-talk and interruptions "crowd" a conversation. -Some people habitually interrupt and talk over others.
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Corrective response
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response is to consciously use silence to change the pattern (slow the pace and listen).
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Therapeutic Purposes of Silence
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1.Encouraging Clients To Speak 2. Communicating Empathy 3. Assessing Client's Condition 4. Thoughtful Self-Reflection
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Encouraging Clients To Speak=
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Expectation that client has something to say Provider must show interest and expectation Interpersonal space allows collecting thoughts
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Communicating Empathy=
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Silence has the capacity to touch one's emotions Silence can convey active listening, interest and empathy. Silence can communicate caring when words are not enough or you can't find the right words.
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Assessing Client's Condition=
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can observe client's verbal and non-verbal behaviors.
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Thoughtful Self-Reflection=
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The provider and the client can collect and reassemble own thoughts. The provider can reflect on feelings and assess how the interview is going.
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Reasons why Clients may refuse to talk:
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1.Defensiveness against perceived threats; withhold = not getting hurt 2.Provocation - to get the provider to seek them out; get special treatment 3.Underlying hostility and resistance - this feels icy, rejecting
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Intervening with Defensive Silences
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Initially the provider should demonstrate acceptance of the client's silence (attend and reflect feeling). EX: "It seems this subject makes you sad." "You seem angry about the interview."
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Intervening with Defensive Silences Provider Should
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-note the context of the silence and if there is a trend. EX:"When we touch on the subject of your progress, you become quiet." -consider silences as symptomatic of something else (try a gentle lead). EX: "I wonder what you're thinking." Please help me understand what this is like for you."
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Negative Effects Of Using Silence
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Silence is not always helpful and can be counterproductive. -Mixed provider messages. -Client more comfortable than provider. -Provider more comfortable than client.
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An interested, expectant silence helps
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clients to verbalize
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Much may be communicated during
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silence.
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The giving of silence will eventually result in
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the giving of silence in return.
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Short inter-response time may lead to
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clients feeling not understood
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The essence of being "present" is
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a prime feature of silence
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