MI TIP # 2 - EMPATHY AND COMPLEX REFLECTIONS

(Issued 5/9/11)

We need to listen to do a reflection and show our clients we are listening. We need to really listen to do a complex reflection and be accurate. Accurate empathy can predict up to 2/3 of the variance in client outcomes.* Think of the empathy scale as a ruler marked at one end by poor listening (the counselor misses the client’s meaning) to deep listening at the other end. Deep reflections are those that make a guess as to what the client means beyond what they have not yet stated. A simple reflection is restating or paraphrasing what the client has said, and a complex reflection is a ‘good listening’ guess as what more they mean beyond what’s stated. Wild guessing does not count.


Client: I’m feeling very stressed today
Counselor: You’re robbing a bank today.


Complex reflection - yes
Accurate empathy - doubtful

Client: I’m feeling a little uneasy today.
Counselor: You have 2 job interviews this week.


Complex refection - yes
Accurate empathy - yes

*Truax/Carkhuff rating scale for accurate empathy as used by Miller, one of MI founding fathers. The above was based on comments by Bill Miller.

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