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Seattle & King County
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Seattle, WA 98104

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Harm reduction: Interviewing skills

Open ended questions

  • Questions that cannot be answered with "yes" or "no".
  • Avoid asking "why?"

    • "What have you considered doing different?"
    • "How would you like things to be different?"
    • "What does drinking do for you?"
    • "When would you be most likely to share needles with others?"

Reflective listening

  • Keep inflection down. If it goes up, it may become a question.
  • Types of reflective listening:

    • Repeating: Repeats an element of what the speaker said.

    • Rephrasing: Listener stays close, but substitutes or rephrases.

    • Paraphrasing: Major restatement in which listener infers meaning.

    • Reflection of feeling: Emphasizes emotional aspect of communication through feeling statements.

    • Double-sided reflection: Variation on paraphrasing that reflects both sides of ambivalence.

Suggestions when using reflective listening:

  • Don't get caught up in the "type" of reflective statements (paraphrasing vs. double sided).
  • Focus on reflection--do not ask questions! This is not listening.
  • You cannot harm anyone or "make a mistake" if you use this skill. You are simply reflecting their feelings or statements.
  • Remember--reflective listening is a skill used to reduce resistance. Use it when resistance is present.

How can I provide choices?

  • Brainstorm all the possible options for your clients--not just the ones that you think are right.
  • Include a very wide range of options.
  • Ask them what ideas they have about solving their problem/dilema.
  • "What do you think would be useful or helpful at this point?
  • Ask permission to provide the options/choices.
  • "I've got some ideas that you may find helpful. Would you like to hear some of them?" or "Some people who have been in a similar situation as you have found a couple of things helpful. Would you like to hear what they are?"
  • Always let them know that they make the final choice.

How can I be a guide and not an authoritarian?

  • Listen--Don't preach
  • Don't tell them what to do.
  • Minimize the "I'm the expert" role and "I know what is best."
  • Inform them that they make the final choices and decisions in their life regardless of what others say or do.
  • Ask them "How can I be helpful?

How can I facilitate an egalitarian relationship?

  • Follow suggestions under, "How can I be a guide..."
  • Define how each of you has information and suggestions that may be useful. You are not the expert on your client, they are.
  • Emphasize a partnership: How can "we" come up with a plan?

How can I be non-judgmental?

  • Recognize that being non-judgmental is impossible. We all have judgments. It is a question of degree and how we respond to our judgments. Can we put them aside or do they interfere with your relationships?
  • Recognize that changing your client is not the goal. Giving them tools is.
  • Stay with them where they are. In other words, avoid pushing them or going to a place where they are not able or willing to go. It is about what they are ready for, not you. If you do this, you may end up getting frustrated, angry and even...judgmental.
  • "They are lazy, in denial." "They don't want to change." "He can't be trusted."