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Reflective Listening Helps Build Rapport

Clients with co-occurring disorders often complain that treatment professionals don't listen to them. One active-listening technique can remedy this problem.

An employment specialist needs to be a good listener. People with mental illness often complain that professionals do not listen to them. It's important to fully understand what the person is saying before offering information, suggestions, or ideas. One feature of active listening is reflecting back to the person what you think you've heard. This lets the person know that you've been listening carefully and that you are interested in their views.

This technique is called reflective listening. For example, after the person has talked for several minutes and has come to a stop, summarize what you have heard. For example, you might say, "If I understand you correctly, you have been unemployed for several years and you are worried about working too much because you are out of practice. So you want to start with just a few hours per week. Does that sound right?"  Reflection lets the clients know that you are listening and trying to understand their point of view. It also provides an opportunity for people to correct any misunderstandings and to share additional information.

Example of Reflective Listening

Jean: "I don't want to lose my benefits. I knew someone who went to work and then Social Security cut her off. I've been on Social Security for years and I'm not saying that I don't want to work, but I don't want to work if I'm going to lose my benefits."

Eli: "You definitely want to keep your benefits."

Reflective listening allows clients to hear what they have said, and it gives them an opportunity to explain more about what they mean.

Reflective listening can also help interviewers discover that they have misunderstood the person being interviewed. If the person corrects your understanding, summarize again to make sure you have it right.

Example of a Summary and Correction

Angie:  I've worked as a maid in a hotel and I really hated that job. We only had 22 minutes to clean a room and some of those rooms were a mess! In the summer it was really miserable because the air conditioning wasn't on in all of the rooms.   I also had a job where I cleaned a Laundromat at night after it closed down. The hours were terrible. I only got two hours a night so it wasn't very much money and I had to work from 11PM to 1AM. I didn't feel safe going back and forth to work.

Tyrone:  So, you wouldn't want another cleaning job. (Reflection)

Angie:  I didn't say that. I didn't like the hours at the Laundromat job, but the work was OK. I worked alone, and I could work at my own pace.

Tyrone:  Oh! And being made to work too fast at the hotel bothered you. Sounds like it is important to you to be able to work at your own pace. (Corrected reflection)

Angie:  Right.

Tyrone:  And you also want to feel safe coming and going to work.

Angie:  Definitely.

Excerpted and adapted from

Supported Employment: Applying the Individual Placement and Support (IPS) Model to Help Clients Compete in the Workplace. Dartmouth, 2008, 2011. Published by Hazelden.
Evidence-based treatment models

The Hazelden Co-occurring Disorders Program helps treatment programs implement effective, integrated services for people with non-severe mental health disorders that co-occur with substance use disorders.

Integrated Combined TherapiesIntegrating Combined Therapies utilizes a combination of motivational enhancement therapy (MET), cognitive-behavioral therapy (CBT), and Twelve Step facilitation (TSF) therapy. Each of these models of therapy has been proven successful when used in community addiction treatment programs.

Cognitive-Behavioral TherapyCognitive-Behavioral Therapy, utilizes cognitive-behavioral therapy (CBT) principles to address the most common psychiatric problems in both mental health and addiction treatment settings.

Read more about the Hazelden Co-occurring Disorders Program

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