The skill of listening is perhaps the most important tool in any therapist's armoury. It forms a crucial part of the two-way communication that takes place between the client and the therapist.

If this communication is lacking then the client does not feel heard, and will therefore feel unable to bring their feelings to the surface to discuss them.  They are more likely to keep something back from the therapist, making analysis difficult.  Without full disclosure, the right treatment may be delayed, or in some cases, not given at all.  In fact, resentment may occur in the client, preventing the healing process from gaining a hold.  The client will ultimately reject any suggestion the therapist has to offer, and not play that crucial role in his or her own healing.

By providing a comfortable and non-judgmental environment, the therapist can analyse the client's predicament much easier.  If the client feels that the therapist is listening they will be more likely to talk about the problems they are facing.  In this way the therapist can tease out ever-deeper answers to the client's circumstances, and make better value judgements as to what type of healing is required.  And of course, whether they are the right person for the client, or have to suggest another therapist with more appropriate skills.

It is important to know where to draw the line between listening and counselling.  The therapist should never attempt to counsel unless they are qualified to do so.  They will not be covered by their insurance or Code of Conduct, and could find themselves in very deep trouble as a result.  If it is apparent that the client needs more expert help than the therapist is able to give, then they should refer them on to someone who is more appropriately qualified. 

The therapist should not sit directly facing the client, as this may be seen by some as a little confrontational.  Looking directly into someone else's eyes can be quite daunting.   Eye contact is a vital ingredient in the communication process, but too much can be threatening and disconcerting.  If the therapist is unhappy or uncomfortable about looking in the client's eyes, then they can always look at the client's nose instead.  Most people are unable to tell the difference. 

Eye contact reinforces the messages that we send to people that we are communicating with.  However, it should be remembered that in some cultures it is considered discourteous to look someone in the eyes who is older or considered to be wiser than you are.

The therapist should sit facing the client at a slight angle, allowing some space for the client to look into while they consider their answers.  The therapist should use positive body language that confirms a listening stance, and interest in what the client has to say.  For example, leaning forwards signifies concentration and active participation, whereas leaning backwards indicates a lack of concentration and boredom.  The therapist should avoid crossing their arms and fidgeting.  They should always give the client their full and undivided attention.

Use of receptive language, such as 'I see', 'oh really' etc. will encourage the client to keep talking.  Smiling, where appropriate, and nodding the head also encourages this.

Smiling affects the voice, making it sound more positive and encouraging.  This gives the client confidence to keep talking and expressing themselves.  It also reinforces the fact that the therapist is listening.  If the client is talking about particularly difficult or emotional problems, then it is obviously not appropriate to smile, as this will give the impression that they are not being taken seriously, and the therapist is trivialising their problems.  The therapist's body language must always be appropriate for the situation.

As less than 75% of communication is non-verbal, the more open and relaxed the therapist is, the more relaxed the client will be, thus enabling the process to progress without stumbling.  Both verbal and non-verbal communication should reflect and reinforce each other.

The therapist should ask open rather than closed questions, which encourages the client to respond and continue talking.  They should avoid using jargon or long words; but explain things in a way that may be more easily understood.  If misunderstanding ensues then the therapist should indicate this, and ask the client to clarify.  Never make assumptions, as to assume anything makes an ASS out of YOU and ME.  It is also important to maintain confidentiality at all times.

The therapist should always maintain a neutral and detached disposition, and avoid being critical or judgmental, as this will encourage the client to be more forthcoming.  A reassuring touch on the arm or shoulder can work wonders, but care should be taken not to invade the client's personal space.  It is equally important that the therapist maintains their own boundaries, and that these are not encroached upon by the client.  If these boundaries are broken it could lead to unhealthy client attachment to the therapist, which may result in the client maintaining their illness so that they can continue to visit you.  For this reason, it is a good idea to review their progress after every 3 treatments.  Male therapists should be particularly wary of touching male clients, as some may not appreciate this and could easily misinterpret the intention. 

Projection of one's own experiences on to the client should be avoided, as this can lead to misinterpretation of the client's situation.  No two people are the same, and will always experience and perceive things in different ways.  Although you may have had similar experiences, they are your experiences, and not the client's.  Make sure it stays that way.

Many people, particularly older men have difficulties in opening up and expressing themselves due to the strong belief that it is weak to cry, engendered by the so-called British stiff upper lip.  In reality this is highly dangerous, as it is extremely unhealthy to bottle up feelings and emotions.  Like a glass of water that is left under a running tap, the body can only handle so much.  Eventually these deep emotions will find their own way out, initially by whispers, which if left unheard may turn into chronic pain shouting to be dealt with.  If left to fester these repressed feelings and emotions may eventually give rise to physical complaints, such as arthritis, or even cancer.

Research in the United States has now shown that up to 85 percent of illness is due to our own attitude and lifestyle.  The logical extension of this is that we are to blame for being ill, and have brought it on ourselves, but this is to over simplify things.

Every thought that we have determines our future, whether good or bad.  This idea can be very helpful, as it enables us to be aware of where we are causing unnecessary difficulties for ourselves.  It can also help us to stop blaming others for our problems, and instead look to our own behaviour, and take responsibility for our actions in order to effect positive change.  We may not be able to change other people, but we can change our own attitudes, beliefs and perceptions.  
 
The therapist can suggest positive ways to help the client deal with their problems and stresses.  The simplest things are often the most helpful.  For example, pillow fights, or digging the garden can be used to help express anger in a safe and therapeutic way.  Writing our thoughts on paper and burning them as a way of releasing can also be helpful.  The therapist can also suggest practical ways that can help the client to relax.  Good examples are gentle exercise, such as Yoga and Tai Chi, meditation, and creative pursuits, such as drawing and painting.  Writing a diary can also be very therapeutic, or simply taking a break from your usual routine.

The therapist should never tell the client what to do; their job is simply to listen and make suggestions.   The client must maintain responsibility for his or her own health and well-being at all times, and should not in any way place the therapist on a pedestal, as this leads to more unhealthy attachments.

The communication that takes place between client and therapist is very important.  Ultimately, it is not the therapist who has to fully understand the client's situation, but the client who has to understand it for themselves. Through the process of listening and asking suitable questions the therapist can tease out information that can help the client piece together the puzzle of their life, and hopefully create a picture that gives the answers they are looking for.  It is the client's own words that will eventually provide the key to the puzzle.