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Chapter 3—Attending Behavior and Empathy
MULTIPLE CHOICE
1. Which of the following is FALSE?
a.
Attending behavior is essential to an empathic relationship.
b.
Attending behavior is the central skill of listening.
c.
Listening is more than just hearing or seeing.
d.
Listening is key to make real contact with clients.
2. Which of the following is TRUE?
a.
Attending and listening activate many areas of the brain of both counselor and client.
b.
Attending and listening are the ways in which you communicate empathy.
c.
Attending and listening are the behavioral roots of the working alliance.
d.
All of the above.
3. Which of these is NOT true of effective attending behavior?
a.
Primarily involves eye contact, body posture, and following the client verbally
b.
Requires both verbal and nonverbal sensitivity
c.
Is illustrated by frequent use of the self focus
d.
Is useful in rapport building
4. Which of the following focuses is NOT an attending skill?
a.
Visual/eye contact
b.
Vocal quality
c.
Verbal tracking
d.
Emotional intelligence
5. Which of the following is TRUE about attention?
a.
It is only of a psychological nature.
b.
It is measurable through brain imaging techniques.
c.
It does not involve brain activity.
d.
None of the above.
6. Attention is not just a psychological concept. It also:
a.
is measurable through brain imaging.
b.
is measurable through careful observation of clients.
c.
is justified by the extensive research on microskills.
d.
has become a foundation for person-center counseling.
7. When you use skillful attending skills as an interviewer, you can predict the client will ____.
a.
think more carefully about what they are sharing
b.
pay more attention to interviewer instructions
c.
share a more complete story with fewer topic jumps
d.
express more emotional release
8. Attending behavior on the part of the helping professional ____.
a.
is making sure the client is comfortable before the session begins
b.
is attending to client needs as they arise in the session
c.
is encouraging client talk and reducing interviewer talk
d.
is noting accurate details in the report following the session
9. Cultural differences:
a.
reveal clearly that counseling across cultures is virtually impossible.
b.
reveal little in the way of personal or group differences.
c.
must be taken into account, but only with groups with whom one has experience.
d.
are an important factor that must be considered in every counseling session.
10. Attending skills:
a.
exist in all cultures, but may be expressed differently.
b.
remain the same from culture to culture.
c.
are very similar, but differ occasionally in cultures.
d.
enable an interviewer to communicate with people of other cultures at a very rapid rate.
11. Which of the following is NOT a component of attending behavior?
a.
Attentive and authentic body language
b.
Verbal mirroring technique
c.
Visual / eye contact
d.
Verbal tracking
12. Who introduced the attending behavior concepts to the helping field?
a.
Ivey et al.
b.
Freud et al.
c.
Skinner et al.
d.
Rogers et al.
13. Which of the following statements is NOT accurate?
a.
Attending behavior is primarily concerned with noting body language.
b.
The multicultural background of each client may modify his or her communicating style.
c.
Good observers increase client talk.
d.
The counselor may need to adapt his or her style to meet the needs of the client.
14. Which of the following is TRUE?
a.
Many beginning counselor to try to solve client’s difficulties too soon.
b.
Most clients develop their concerns over a brief period of time.
c.
It is critical for counselors to speed up in focusing on client’s problem and solutions.
d.
Using the three Vs and one B is a waste of time during intake session.
15. According to the authors, the most effective eye contact for attending ____.
a.
depends on the cultural and socioeconomic factors of the interviewee
b.
requires consistent visual contact with the interviewee
c.
demands avoiding eye contact with the interviewee
d.
respects multicultural preferences
16. Regarding visual / eye contact, which of the following is NOT true?
a.
Direct eye contact is considered a sign of interest with European-North American middle
classes.
b.
Direct eye contact is a sign of disrespect with Native American and Latin American young
people.
c.
Direct eye contact is generally avoided by Inuit and Aboriginal Australians.
d.
Direct eye contact differences are easily noted, but cultural differences are so varied that
findings are inconclusive and unhelpful.
17. Direct but not constant eye contact is typical for:
a.
African-American clients.
b.
Hispanic clients.
c.
White middle-class clients.
d.
all of the above.
18. Which of the following may be observed when an interview issue is of interest to a middle-class
client?
a.
Direct eye contact, forward trunk lean, pupil dilation
b.
Direct eye contact, forward trunk lean, pupil contraction
c.
Partial eye contact, forward trunk lean, pupil dilation
d.
Partial eye contact, trunk lean away, pupil contraction
19. Which cultural groups are most likely to reject direct eye contact, particularly if coming from a
traditional background?
a.
White middle-class and Latina/Latino clients
b.
Native American and Latina/Latino clients
c.
African-American women and White children
d.
None of the above
20. It is important to use respectful language in dealing with those who may have a physical disability.
Which of the following terms is NOT considered appropriate?
a.
AIDS victim
b.
A person with AIDS
c.
A person with hearing loss
d.
Deaf culture
21. If you who do not face a disability, think of yourself as a member of the:
a.
temporarily able culture.
b.
fortunate culture.
c.
undestructible culture.
d.
chosen one culture.
22. Vocal qualities mean:
a.
tracking the client's story without interruption.
b.
noting what client's discuss and what they avoid.
c.
moderating your tone and speech rate to the client and the situation.
d.
facing the client when you are speaking with them.
23. Which of the following is NOT a vocal qualities behavior?
a.
Speech hesitations
b.
Verbal changes of topic
c.
Throat clearing
d.
Screaming and whispering
24. Clients and interviewers may use _________________ to highlight the important issues in their
statements.
a.
verbal underlining, topic jumps, and softer vocal tone
b.
verbal underlining, keeping to the same topic, and higher pitch
c.
verbal underlining to key words or phrases
d.
written instructions
25. Clients and interviewers highlight important issues in their statements through:
a.
written instructions.
b.
verbal underlining, keeping to the same topic, and higher pitch.
c.
verbal underlining, topic jumps, and softer vocal tone.
d.
verbal underlining, volume and emphasis on key words or phrases.
26. Which of the following is TRUE of visuals?
a.
We always need to strive for eye contact.
b.
In some cultures, eye contact is always considered inappropriate.
c.
Men have better eye contact than women.
d.
Culturally and individually appropriate eye contact is essential.
27. Both interviewers and clients may find themselves giving louder volume and increased vocal emphasis
to certain words and short phrases. This is known as:
a.
verbal tracking.
b.
vocal tone.
c.
verbal underlining.
d.
vocal quality.
28. ________ is/are a particularly good example of how different people react differently to the same
voice.
a.
Clients changing topic
b.
Interviewer’s national or regional accent
c.
Client vocal tones
d.
Interviewer’s skillful attending skills
29. Vocal qualities and verbal tracking:
a.
are essentially the same skill.
b.
are secondary and tertiary attending skills.
c.
are NOT interviewer skills.
d.
are distinctly different and critical attending skills.
30. Which one of the following statements may help a new interviewer become aware of their own pattern
of selective attention?
a.
Relax. Build on the client’s topic and learn about your client over time.
b.
You don’t want to lose track of key issues, but you can’t attack every client issue at once.
c.
Be alert to your own pattern of selective attention.
d.
All of the above.
31. We tend to listen to some topics more than others by verbal tracking. We hear some topics better than
others. It is important that the interviewer be aware of unconscious patterns of:
a.
selective attention.
b.
pupil dilation.
c.
verbal underlining.
d.
client topic jumps.
32. Which of the following is NOT true of selective attention?
a.
Selective attention is simply interviewers noting the topics to which clients attend.
b.
Clients tend to talk about what interviewers are willing to hear.
c.
It is just as important for interviewers to observe how they selectively attend to specific
topics.
d.
Interviewers may have a limited list of topics that interest them.
33. It is important for the counselor to be aware of his/her own patterns of:
a.
verbal underlining.
b.
selective attention.
c.
pupil dilation.
d.
client topic jumps.
34. Staying with the topic is important in:
a.
verbal underlining.
b.
verbal tracking.
c.
most non-attending responses.
d.
effective vocal qualities.
35. Selection attention, a key concept introduced in the microskills framework:
a.
is less important in key theories of helping such as person-centered and brief counseling.
b.
is based on the brain that is wired to attend stimuli to cope with the environment.
c.
is brought about by the hippocampus and the energizing amygdala through selective
memory.
d.
has become the central concept of person-centered and brief counseling.
36. Which of the following is FALSE concerning verbals?
a.
Selective attention occurs when we listen only to one person at a time.
b.
Most of us have certain topics that we are more interested in than others.
c.
It is important to stay with the topic introduced by the client.
d.
It can be helpful if we learn our own patterns of selective attention.
37. Nonattention is:
a.
avoided by effective interviewers.
b.
not a valid skill for the interviewer.
c.
useful in shifting clients away from negative topics.
d.
rude behavior for the interviewer.
38. Through _________, we can sometimes stop clients from talking about non-productive topics.
a.
selective attention
b.
verbal underlining
c.
inattention to the client topic
d.
threats and criticism
39. Which of the following is TRUE about nonattention?
a.
It is always inappropriate.
b.
It can help a client stop repeating a story over and over.
c.
It facilitates clients talking even more about their issues.
d.
It encourages clients to talk about positive things.
40. Silence:
a.
needs to be avoided in some cultural contexts.
b.
is central when you are working with a client whom you do not really understand as it
gives them more time to think and talk.
c.
can be frightening to the beginning helper.
d.
is difficult for clients, so the counselor needs to fill in the time.
41. Which of the following is TRUE about silence?
a.
It can cause client discomfort and must be used sparingly.
b.
It can be useful in a session when clients need to think through their responses.
c.
It is not a useful tool for the helping professional.
d.
It is useful when followed by detailed analysis of the client's issue(s).
42. Which of the following determines comfortable interpersonal distance between people?
a.
Ethnic or regional heritage
b.
Age
c.
Specific topics of conversation
d.
All of the above
43. Which of the following is TRUE about body language?
a.
A comfortable conversational distance for traditional Arab-Americans is over an arm’s
length.
b.
English-speaking people generally prefer a conversation at slightly less than half an arm’s
length.
c.
Leaning forward closely toward a Latina/Latino friend will often be received as intrusive.
d.
A comfortable conversational distance for North Americans is slightly more than arm’s
length.
44. When it comes to appropriate interviewer body language, ________ is essential to building trust.
a.
sitting straight in your chair
b.
skillfully executed technique
c.
relaxed open arms
d.
authenticity
45. According to the authors, which of the following is TRUE about empathy?
a.
Empathy can exist without counseling skills.
b.
Empathy is a way to introduce caring into the session.
c.
The use of microskills produces empathy.
d.
Microskills can be more meaningful if combined with empathic constructs.
46. Empathy is defined as experiencing:
a.
the client's worldview.
b.
the world as if you are the client.
c.
awareness that you are separate from the client.
d.
the world as if you are the client, but aware that you are separate from the client.
47. Empathy is often defined as:
a.
comforting the client through difficult emotions.
b.
experiencing the world as if you were the client.
c.
the same as sympathy.
d.
being kind to the client when he/she is troubled.
48. Empathy:
a.
requires the interviewer to respond immediately to each expression of emotion from the
client.
b.
requires the interviewer to be where the client is able to hear you.
c.
requires the interviewer to mirror each emotion the client expresses.
d.
is failure of the client to express emotion during the session.
49. Empathy is best assessed by:
a.
your level of identification with your client.
b.
the client’s reaction to your statement.
c.
the grammatical quality of your statement.
d.
the accuracy of your interpretation.
50. Who was the first person to measure levels of empathic understanding?
a.
Rogers
b.
Truax
c.
Maslow
d.
Ivey
51. You can observe interview sessions and rate the use of interviewer empathy using which of the
following scales?
a.
Level 1: Additive empathy; Level 2: Basic empathy; Level 3: Subtractive empathy
b.
Level 1: Subtractive empathy; Level 2: Basic empathy; Level 3: Additive empathy
c.
Level 1: Basic empathy; Level 2: Additive empathy; Level 3: Subtractive empathy
d.
Level 1: Additive empathy; Level 2: Subtractive empathy; Level 3: Basic empathy
52. Which of the following list, in their correct order, the three anchor points used to classify and rate the
quality of empathy shown in the interview?
a.
Level 1: Additive empathy; Level 2: Basic empathy; Level 3: Subtractive empathy
b.
Level 1: Basic empathy; Level 2: Additive empathy; Level 3: Subtractive empathy
c.
Level 1: Subtractive empathy; Level 2: Basic empathy; Level 3: Additive empathy
d.
Level 1: Additive empathy; Level 2: Subtractive empathy; Level 3: Basic empathy
53. When the interviewer focuses on the negative or distorts client conversation, this is:
a.
empathy.
b.
subtractive empathy.
c.
basic empathy.
d.
additive empathy.
54. The counselor responds to Dominic with “I heard you saying that things are great, but now how do you
really feel about doing ‘women's work?’” How would you rate this confrontation on empathy?
a.
Level 1 subtractive
b.
Level 2 somewhat subtractive
c.
Level 3 interchangeable
d.
Level 4 somewhat additive
55. When the interviewer links to an earlier client comment, introduces a new frame of reference, or the
positive asset search, these are components of:
a.
empathy.
b.
subtractive empathy.
c.
basic empathy.
d.
additive empathy.
56. When the interviewer paraphrases and reflects feeling to communicate that he or she understands the
client, this is:
a.
empathy.
b.
subtractive empathy.
c.
basic empathy.
d.
additive empathy.
57. When interviewer responses are basically interchangeable with those of the client, this is:
a.
empathy.
b.
subtractive empathy.
c.
basic empathy.
d.
additive empathy.
58. Interchangeable empathy is best defined as:
a.
the interviewer interchanges responses with the client.
b.
the interviewer changes roles with the client.
c.
the relationship is one of equity and understanding.
d.
the interviewer says back to the client what has been said accurately.
59. The interviewer is demonstrating _______________________ when he/she is able to say back
accurately what the client has said.
a.
basic empathy
b.
additive empathy
c.
subtractive empathy
d.
none of the above
60. When demonstrating ____________________ the interviewer is able to offer a congruent idea or
frame of reference that helps the client see a new perspective.
a.
basic empathy
b.
additive empathy
c.
subtractive empathy
d.
none of the above
61. Inappropriate interviewer responses that give back less or distort what the client has said demonstrate
____________.
a.
basic empathy
b.
additive empathy
c.
subtractive empathy
d.
none of these choices
62. An empathic person who watches a cared partner being shocked in an experiment:
a.
draws on memories from the hippocampus to deal with the strain.
b.
draws on the amygdala to understand the other.
c.
actually feels his partner’s pain, even though just watching.
d.
has some parallel pain centers activated in his or her brain.
63. Mirror neurons:
a.
fire up when clients look at themselves.
b.
guide clients’ grooming behavior.
c.
fire up when clients observe actions by others.
d.
fire up when clients look into a mirror.
64. Empathy is not just a psychological concept. It also:
a.
is measurable through brain imaging.
b.
is measurable through careful observation of your actions.
c.
is assessed by the extensive research on microskills.
d.
has become a foundation for person-center counseling.
65. Which of the following disruptive behaviors can lead to a poor session?
a.
Visual contact
b.
Verbal tracking
c.
Body language
d.
All of the above
66. In every interview the quality of attending and non-attending responses ____.
a.
is always the same
b.
depends on how actively you demonstrate attending
c.
depends on the situation
d.
depends on how well versed you are in expressing non-attention
67. "You think you might have been selfish?"
a.
Attending
b.
Non-attending
68. "How old are you now?"
a.
Attending
b.
Non-attending
69. "Cohesive group?"
a.
Attending
b.
Non-attending
70. "Sounds as if you felt you had personal problems in a cohesive group. How does this tie in with your
comments about being a therapist and selfishness?"
a.
Attending
b.
Non-attending
71. "Could you tell me more about that?"
a.
attending
b.
non-attending
72. "Earlier you were talking about some feelings of selfishness as a child. Could you tell me more about
them?"
a.
Attending
b.
Non-attending
73. "I've had personal problems too. But I don't think I'm selfish."
a.
Attending
b.
Non-attending
74. In all of the examples, we can assume:
a.
the attending responses were the best.
b.
the non-attending responses were the best.
c.
quality would depend on the situation.
d.
a and c.
75. Teaching attending behavior to clients is recommended by the authors because:
a.
it will make clients into beginning interviewers and counselors.
b.
it provides something to do when the interview begins to slow down.
c.
research and counseling practice has revealed that it can be highly beneficial to many
clients.
d.
all of the above.
76. The microskills can best be taught to:
a.
many client and volunteer populations.
b.
hospitalized in-patients during the early stages of treatment.
c.
high school peer counselors.
d.
volunteers in the community.
77. Social skills training may refer to ____.
a.
dating behavior
b.
drug-refusal skills
c.
assertiveness training
d.
all of the above
78. Which of the following is FALSE about teaching the microskills to challenging clients in different
settings?
a.
Depressed hospitalized patients do not respond well to social skills treatment.
b.
Teaching troubled clients the attending skills is usually effective.
c.
Attending skills improve preparation of high school peer mediators.
d.
Communication with troubled children can be regained by using the attending skills.
79. Being aware of what one is doing can interfere with coordination and smoothness. This is known in
microskills training as ____.
a.
the difficulty of practice
b.
the Samurai effect
c.
the need for fewer skills and a simplified model of training for some beginners
d.
the nonverbal effect
80. Practice in meditation:
a.
has recently become important in person-centered counseling as a key strategy.
b.
can help samurais forget the individual skills in order to master them.
c.
facilitates emotional growth through taming the amygdala.
d.
is a strategy that should only be used with a very few clients.
81. Learning attending and the other microskills involves breaking each skill to its smallest component
and is similar to ____.
a.
how Samurai learn swordplay
b.
learning to drive a car for the first time
c.
becoming proficient with demanding activities ⎯ sports, dance, music
d.
all of the above
82. As the interviewer, when you don't know what to do next, which of the following should you do?
a.
Continue attending to the client.
b.
Ask the client to start over.
c.
Consult your notes regarding the client's issues.
d.
End the session.
83. Which of the following represents one of Shenk’s findings regarding excellence?
a.
Practice changes your mind but not your body.
b.
Skills are non-specific.
c.
The brain drives the brawn.
d.
All of the above.
84. Which of the following is NOT one of the suggested guidelines for effective feedback?
a.
Feedback is most helpful when it includes strengths.
b.
Feedback is most helpful when it is comprehensive and generalized.
c.
Feedback is most helpful when it is relatively nonjudgmental.
d.
Feedback is most helpful when it is lean and concrete.
TRUE/FALSE
1. According to the authors, attending behavior and listening are essential for human communication but
need to be tailored according to individual and multicultural differences.
2. Without attention, nothing will happen.
3. Smiling, listening, and a respectful and understanding vocal tone are behaviors that “fit” virtually all
cultures and individuals.
4. Empathy is identifiable by means of functional magnetic resonance imaging (fMRI).
ESSAY
1. Present a concrete example of a time when it may be appropriate NOT to provide attention (attending
behavior to client talk).
2. What are the four main concepts of attending behavior? Evaluate yourself on each of these.
3. Describe cultural differences that may exist in the four main concepts of attending behavior.
4. Define and provide an example of the following terms:
verbal underlining
selective attention
5. Provide examples of effective attending and effective non-attending counselor responses to this client:
Client: "It was a long, hard hearing. The lawyer kept questioning me about the so-called 'assault' for
two hours. I'm not guilty and I didn't do it. I can't see why they are after me all the time."
6. Explain the acronym “3 Vs + B” and provide examples of each aspect.
7. Explain what “topic jumps” means. Describe what interviewers can do to prevent or cope with it.
Provide examples.
8. Describe the concept and discuss the pros and cons of using silence in the interview.
9. How might you go about teaching the skill of attending? Illustrate your discussion with an example
client problem such as shyness, lack of friendship, depression, or other specific issue.
10. Describe the Samurai Effect and its relevance for the mastery of the microskills.
11. Discuss the concepts of basic empathy, subtractive empathy, and additive empathy and give an
example of each.
12. Explain what mirror neurons are and and how they support empathy.
13. What are the guidelines for effective feedback and how have you found them useful in your own
session practice?
14. Provide a specific example in your own work of classification, basic competence, intentional
competence, and, if you have experience, teaching competence. Show in your own way that you have a
sense of your own level of competence of these concepts.
