FS02. Effective Communication
Welcome to the Family Support Group Program.
Here you can download the session PDF below by clicking on the button or continue scrolling to the online version. The videos password is craft.
Session Online Version
CHECK IN SECTION – Maximum time 20 minutes
Mindful Minute -- take a break from what you have been doing, breathe deeply, relax and recharge.
Step 1: Find a comfortable seated position with both feet grounded on the floor. Put a hand on your stomach. Close your eyes.
Step 2: Take a deep breath in through your nose and out through your mouth. Notice your thoughts and feelings and any tensions in your body.
Step 3: As you inhale and exhale, breathe deeply so your belly fills and empties with air. The hand on your stomach helps you practice belly – not chest breathing.
Step 4: For the next minute make breathing in and out your only focus. Let your thoughts come and go without trying to control them. If you find an area of tension in your body, relax it and let the tension go.
Step 5: At the end the minute slowly open your eyes. Gently bring your presence back to your surroundings.
Our Purpose
Family Support Groups are for parents, partners, families and other Concerned Significant Others (CSOs) who have a loved one that is struggling with a substance use or mental health disorder. We know from first-hand experience that loving someone with these challenges can be a difficult, lonely journey. To create a safe place for honest sharing of our lived experience we use appropriate language and behavior. We are empathetic, nonjudgmental, genuine, respectful, steer clear of confrontation and imposing our own solutions. We encourage hope and compassion for all. CRAFT Connect reframes and energizes connections between you, your loved one and behavioral health professionals into a “therapeutic alliance” that leads to progress and healing. There is a lot we can learn from one another.
What experience did you have practicing CRAFT Connect principles and skills? ____________________________________________________________________________________________________________________________________________________________________________________________________________
What did you do to purposefully take care of yourself and show self-compassion?
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LEARN SECTION – Maximum time 30 minutes
1. Communication problems are routinely found in family relationships. For many of us, communication can be negative and filled with strong emotions. Chances are we have experienced years of nagging, pleading, and threatening trying to change unwanted behaviors. And, chances are it hasn’t helped. Oftentimes the way we interact brings about the very behavior we are trying to stop. We need to feel free to communicate our needs and concerns and encourage others to openly express their needs and concerns in ways that are not controlled by another. Instead of doing the same things and hoping for a different result, we need to change the way we communicate. We are going to learn two effective patterns for communication that have proven to help build positive relationships.
2. The first communication skill is called PIUS. (Meyers and Wolfe, 2004). There are seven principles to positive communications:
Be brief. Resist the urge to bring up too much. Keep it simple.
Be specific and clear. Focus on one thing.
Be positive while communicating what you want. Avoid blaming, name calling and over generalization
Label your feelings. Describe the emotional impact on you in a calm, nonjudgmental, non-accusatory way.
Offer an understanding statement. Try seeing it from the other person’s point of view.
Accept partial responsibility. Share a small piece of the problem.
Offer to help.
Discuss: What do you notice about the principles of positive communication that might be different from how you have been communicating with others?
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3. When someone is doing an unwanted behavior; we often react with phrases that start with “You” and feel accusatory. This doesn’t help encourage change. We need to rephrase those negative statements into PIUS statements. By removing the “You,” and forming positive “I” statements, others are far more likely to hear and receive what we are saying. It is important to understand that PIUS statements aren’t sugar coating the truth. They are all about truth but phrased differently (Meyers and Wolfe, 2004).
4. As we read through these examples of negative “You” and PIUS statements think about the different messages they deliver.
Negative “You”: You always get drunk and embarrass me.
PIUS: I enjoy being with you when you don’t drink. I know it’s not always easy for you, so that makes it really special.
Negative “You”: You never listen to me when I’m talking to you.
PIUS: I understand that some of our conversations are upsetting, I’d love it if you could help me work them out.
Watch: “2 Minute Therapy- Positive Communication with I Statements” video.
5. As part of the PIUS communication pattern we also want to offer an “I Understand why…” statement. This lets others know that we understand them and care about their feelings. It makes it much easier for them to hear what we are saying without becoming defensive. An understanding statement can help turn the negative “Don’t ever let me catch you yelling at the kids like that again, you bully.” into a PIUS “I know the kids can be frustrating, please help me set a good example by talking to them calmly.” statement.
6. By communicating in a way that demonstrates a willingness to share responsibility, others are also more likely to hear what we are saying. “Even though you are not the cause of the problem, you are intimately involved with it and do have an effect on it” (Meyers and Wolfe, 2004, p. 137). Thus, it may make sense, whenever possible, to share a small piece of the problem for things that can go wrong in any loving relationship. We simply need to let others know that we see ourselves as part of the ‘big’ picture. Finally, making a “How can I help?” offer is seen as a non-blaming, supportive act that others are more inclined to respond positively to (Meyers and Wolfe, 2004; 2008).
7. Look for the seven principles of positive communication as you review this sample PIUS statement.
I… (HOW DO YOU FEEL?)…was embarrassed
when you…(DESCRIBE THE BEHAVIOR OR CONDITION)…spoke to me that way in front of my friends.
because… (WHY DO YOU FEEL THIS WAY?)…it made me feel like a child.
I would like… (WHAT DO YOU WANT TO HAPPEN?)…to discuss this in private next time.
I know… (YOU UNDERSTAND THE OTHER’S POSITION)…talking about these kinds of things can be hard.
Let’s try to… (YOUR WILLINGNESS TO SHARE RESPONSIBILITY.)… set aside a time to talk when we are both feeling better.
(HOW CAN I HELP?)
CHANGING “YOU” TO “I” ACTIVITY
Step 1: Individually think about some of the negative things you say in typical interactions. Write out two of those things under Negative “You” Statements
Negative “You” Statements.
One:________________________________________________________________________________________________________________________________________________________________________________________________________
Two:________________________________________________________________________________________________________________________________________________________________________________________________________
Step 2: Now using the seven principles of positive community try to rewrite those negative “You” statements into PIUS statements like the examples above.
Positive “I” Statements.
One:________________________________________________________________________________________________________________________________________________________________________________________________________
Two:________________________________________________________________________________________________________________________________________________________________________________________________________
Step 3. Share a “You” statement and rephrased PIUS statement with the group.
Discuss: Why do you think using PIUS statements might be more effective than negative “You” statements?
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8. The second communication skill that helps us better connect with others is called Reflective Listening. This skill is based on the fact that what we believe or assume someone means may not necessarily be what they really mean. Our focus is on ‘decoding’ or translating what someone is saying, rather than asserting our understanding of it. This requires that we listen very carefully, observe others body language and behavior and reflect using our own words. Types and examples of other reflections are included in the "Reflective Listening Handout".
OBSERVATION ACTIVITY
Step 1: Decide on a member of the group to be the “speaker”. The rest of the group will be listeners.
Step 2: Based on you have observed about the speaker during the last few minutes write down a reflective statement. Here are some examples to help get you started. “I noticed you just...", “What are you thinking?”, “What are you feeling right now?” and “You’re feeling...because....” Your reflective statement:___________________________________________________________________________ ______________________________________________________________________________________________________
Step 3: Share what you wrote with the speaker.
SIMPLE REFLECTION ACTIVITY
Step 1: Decide on a member of the group to be the “speaker”. The rest of the group will be listeners. The speaker completes this statement, “One thing I like about myself is that...”
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Step 2: Group members serve as listeners and write their guess about what the speaker really means by creating a simple reflection. For example, “You like that you...” ____________________________________________________________________________________________________________________________________________________________________________________________________________
Step 3: Rotate on to the next person, who becomes the second speaker with a topic of their own choosing, while the other group members work Step 2 to generate reflection statements on that topic.
9. Another way to form a reflection is to think or guess about what someone really means. For example, a friend Mary tells you “I’m getting really discouraged about controlling my anxiety”. Here’s what might flash through your mind. What’s discouraging Mary? -- think your question first, “Do you mean that you have been trying hard and your anxiety levels are still high? Now make your question into a reflecting statement by removing the “Do you mean that” at the front and inflecting your voice downward at the end. The reflection you now say aloud to your friend Mary is, “You’ve been trying hard and your anxiety levels are still high.” (Miller & Rollnick, 2013, page 53, 57).
Discuss: How would an English teacher describe this kind of reflective statement?
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10. Every time you offer someone a reflection you get immediate feedback as to how accurate it was. There is no penalty for missing because when you guess wrong the person simply tells you more about what they actually meant. Good reflective listening tends to keep others talking, exploring and considering. It also offers an opportunity for others to hear their own words, feelings and behaviors reflected back to them. You can get pretty good at guessing what others mean from their words, voice tone, context and non-verbal cues (Miller & Rollnick, 2013). This feedback or validation process is what distinguishes reflective listening and makes it so effective.
Discuss: Why is it important to keep the conversation going?
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11. One final note on communication. It isn’t enough to know what or how to say it, we also need to know when to say it. There may be better or more ideal times to communicate with others. Don’t try to have a conversation when they have been doing unwanted behaviors. Make sure your communication is a safe physical and emotional conversation. Sometimes we have so many overwhelming feelings, we ‘bottle up’ our emotions. When our “emotional dam” bursts we blurt out things which can cause a breakdown in communication and loss of connection with our loved one. When we use PIUS communication, we express what we are feeling, in Reflective Listening we focus on what someone else is feeling – all without being hostile, critical or overly emotional.
GROUP SHARING SECTION – Maximum time 30 minutes
12. We will now begin the sharing portion of the meeting. You are invited to share from 3 to 5 minutes about your experience as it relates to your loved one’s recovery, this week’s session or what you are currently working on. Please focus your sharing on potential solutions rather than the problems. We will conclude the sharing five minutes before the end of the meeting. Who would like to begin?
MY COMMITMENTS SECTION – Maximum time 10 minutes
13. Please remember that what has been shared here is confidential and that the opinions expressed are of the individuals who shared them. These are our group commitments, we will start the next CRAFT Connect session by reporting on them. This week I will:
A. Do the in-between session assignments.
● Use the “PIUS Communication Worksheet” to write sample statements and try to use one every day.
● Use Reflective Listening at least once a day.
B. Share what I am learning with my family, friends and community.
C. Show kindness to myself by having self-compassion and taking care of myself. As you listen to this “Song about Connection”, take a few minutes to quietly think about what you learned in this session. Write your thoughts and personal commitments below.
Song about Connection: Watch: “Cat Stevens - Can't Keep It In [Lyrics Video]” video.
What are the most important things I learned in this session? ____________________________________________________________________________________________________________________________________________________________________________________________________________
What will I do differently because of what I learned? ____________________________________________________________________________________________________________________________________________________________________________________________________________
PIUS Communication Worksheet
There are seven principles to positive or PIUS communication:
1. Be brief. Resist the urge to bring up too much. Keep it simple.
2. Be specific and clear. Focus on one thing.
3. Be positive while communicating what you want. Avoid blaming, name calling and over generalization
4. Label your feelings. Describe the emotional impact on you in a calm, nonjudgmental, non-accusatory way.
5. Offer an understanding statement. Try seeing it from the other person’s point of view.
6. Accept partial responsibility. Share a small piece of the problem.
7. Offer to help.
Write down a verbal/text or email interaction between you and a loved one.
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Using the seven principles write what you might communicate with a loved one the next time the same situation occurs, in a way that limits defensiveness and does not lead to an argument. Be sure to refine and practice your PIUS statement before using it.
I… (HOW DO YOU FEEL?)
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when you…(DESCRIBE THE BEHAVIOR OR CONDITION) ____________________________________________________________________________________________________________________________________________________________________________________________________________
because… (WHY DO YOU FEEL THIS WAY?)
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I would like… (WHAT DO YOU WANT TO HAPPEN?)
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I know… (YOU UNDERSTAND THE OTHER’S POSITION)
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Let’s try… (YOUR WILLINGNESS TO SHARE RESPONSIBILITY)
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(HOW CAN I HELP?) ____________________________________________________________________________________________________________________________________________________________________________________________________________
Reflective Listening Handout
Adapted from Chapter 3—Motivational Interviewing as a Counseling Style Enhancing Motivation for Change in Substance Abuse Treatment, https://www.ncbi.nlm.nih.gov/books/NBK64964
Motivational Interviewing (MI) is a technique in which you become a helper in the change process and express acceptance of your loved one. Your role is directive, with a goal of eliciting self-motivational statements and behavioral change from your loved. In addition, you can gently create discrepancies between your loved one’s values and their behavior that enhance motivation for positive change. Essentially, MI activates the capability for beneficial change that everyone possesses. Although some people can continue change on their own, others require more formal treatment and support over the long journey of recovery (Miller and Rollnick, 1991; Rollnick and Miller, 1995).
NOTE: ALTHOUGH THE FOLLOWING REFLECTIVE LISTENING EXAMPLES USE SUBSTANCE USE, WELL SUPPORTED SCIENTIFIC EVIDENCE SHOWS THEY WORK FOR OTHER BEHAVIORAL HEALTH DISORDERS AS WELL.
Simple Reflection
The simplest approach to responding to resistance is with nonresistance, by repeating the loved one's statement in a neutral form. This acknowledges and validates what the loved one has said and can elicit an opposite response.
Loved One: I don't plan to quit drinking anytime soon.
Family Member: You don't think that abstinence would work for you right now.
Amplified Reflection
Another strategy is to reflect the loved one's statement in an exaggerated form--to state it in a more extreme way but without sarcasm. This can move the loved one toward positive change rather than resistance.
Loved One: I don't know why you are worried about this. I don't drink any more than any of my friends.
Family Member: So, I am worrying needlessly.
Double-sided Reflection
A third strategy entails acknowledging what the loved one has said but then also stating contrary things she has said in the past. This requires the use of information that the loved one has offered previously.
Loved One: I know you want me to give up drinking completely, but I'm not going to do that!
Family Member: You can see that there are some real problems here, but you're not willing to think about quitting altogether.
Shifting Focus
You can defuse resistance by helping the loved one shift focus away from obstacles and barriers. This method offers an opportunity to affirm your loved one's personal choice regarding the conduct of his own life.
Loved One: I can't stop smoking reefer when all my friends are doing it.
Family Member: You're way ahead of me. We're still exploring your concerns about whether you can get into college. We're not ready yet to decide how marijuana fits into your goals.
Agreement With A Twist
A subtle strategy is to agree with the loved one, but with a slight twist or change of direction that propels the discussion forward.
Loved One: Why are you so stuck on my drinking? What about all of my wife’s problems? You'd drink, too, if your wife were nagging you all the time.
Family Member: You've got a good point there, and that's important. There is a bigger picture here, and maybe I haven't been paying enough attention to that. It's not as simple as one person's drinking. I agree with you that we shouldn't be trying to place blame here. Drinking problems like these do involve the whole family.
Reframing
A good strategy to use when a loved one denies personal problems is reframing--offering a new and positive interpretation of negative information provided by the loved one. Reframing "acknowledges the validity of the client’s raw observations, but offers a new meaning...for them" (Miller and Rollnick, 1991, p. 107)
Loved One: You’re always nagging me about my drinking--always calling me an alcoholic. It really bugs me.
Family Member: I really care and am concerned about you. It sounds like I am expressing it in a way that makes you angry. Maybe you can help me learn how to tell you that I love you and am worried about you in a more positive and acceptable way.
Rolling With Resistance
Accept your loved one’s perception, understanding they can be shifted over time. In this strategy new perspectives are invited but not imposed. This is not "reverse psychology”, it is stating what the loved one has already said while arguing against change, perhaps as an amplified reflection. If a loved one is ambivalent, taking the negative side of the argument evokes a "Yes, but..." from them, who then expresses the other (positive) side. Be cautious in using this with strategy with a loved one who is in early treatment or may be depressed.
Loved One: Well, I know you think I drink too much, and I may be damaging my liver, but I still don't believe I'm an alcoholic or in need of treatment.
Family Member: We've spent considerable time now going over your positive feelings and concerns about your drinking, but you still don't think you are ready or want to change your drinking patterns. Maybe changing would be too difficult for you, especially if you really want to stay the same. Anyway, I'm not sure you believe you could change even if you wanted to.