Takeaway

Practicing active listening fosters compassionate client relationships and equips you to more accurately respond to client needs. 

A wise teacher of mine once said, “When a client is speaking to you, listen as if what they are saying is the most important thing you will hear all day.” Making sure your client feels heard seems like it should be an automatic offering. However, time and again clients report leaving a previous therapist to find a new one because they didn’t feel their needs were heard or met. 

Clearly, there is a gap. Even if you believe you already demonstrate excellent listening skills, it’s worth examining your communication practices to ensure you are offering active listening at every stage of the client/therapist interaction (scheduling, pre-session, on the table, post-session, between sessions, and at subsequent sessions) and at every level of being (physical, mental, and emotional). It’s a game changer when it comes to building connection and loyal relationships.

What Is Active Listening?

Active listening is a practice of being deeply present with another person when they are speaking. It involves doing more than just hearing their words; it means being engaged in the experience of communication while seeking to understand their wants and needs. It includes using all your senses as you hear them, watching their body language, empathizing with what they are feeling as they speak, and meeting them where they are with reflective responses.

When you are listening, it is worth asking yourself: What message are they trying to convey and what does it mean to them? For example, if a client says they are experiencing neck pain, their facial expressions and body positioning can guide you to recognize how much that pain is affecting them. If you are on the phone with them and can’t see their expressions, you can listen for emotion in their tone and volume. These observations are what guide you to accurately reflect the experience they are sharing. 

How to Actively Listen and Respond

There are many communication models for active listening. Below is a basic sequence of components I use to listen and respond with the goal of building strong relationships and offering the client what they want and need. 

Reflect > Remember > Deliver

Reflect:

Reflection is what makes listening “active.” It shows the speaker you truly hear them and seek to genuinely understand what they are saying. Reflecting happens physically, mentally, and emotionally, and uses all the senses. 

When you reflect what a person is saying, briefly summarize what you heard them say and ask if you are on the right track. Listen for the physical concerns as well as how their concerns cause them to think and feel. Keep your reflection statements succinct and ask if you’re on the right track. Allow them a chance to add detail or correct anything you might have misheard.

“So, it sounds like you are concerned about your neck pain because it has lasted for several months and nothing is helping. You’re afraid you might be stuck with it, which worries you because it’s causing you to feel tired and irritable. You’re also concerned the treatment we do will be painful, so you want me to take it easy on you and not go too deep. Do I have that right?”

In addition to reflecting with words, you can reflect their demeanor by mirroring their facial expressions, body language, and tone. Don’t mimic them (that would be creepy!). But you can subtly match them to create resonance. Imagine how that client might feel when they express their concerns. This fosters empathy and compassion, which are at the root of connection.

The more you embody the experience of active listening, the easier you will remember and act upon what they tell you.

Remember:

Every detail you recall about a client interaction will add to the sense of connection they feel with you. Make notes on what you learn about your client and incorporate those notes into future interactions. Always circle back so they know you were paying attention, whether it be about their neck pain or their upcoming job interview.

Deliver: Attend to the needs that have been communicated and the session plan that is set forth. It’s recommended that you start with the areas of concern; that way the client doesn’t wonder if you’ll get to what they asked for or if you’ll spend enough time there, allowing them to fully relax into the session without mind chatter or resentment.

I recommend doing more research into active-listening models to deeply embody these elements of communication that are game changers, especially when used in every client interaction.

Tips for Each Stage of the Client/Therapist Interaction

Scheduling

It might sound simple, but when a client is scheduling with you, it’s worthwhile to note any details about their schedule that could be useful for future appointment scheduling. For example, if a client tells you their best days of the week are Mondays and Fridays, say, “Since Mondays and Fridays are best for you, here are the openings I have on those days . . .” 

This shows that you heard them and won’t waste their time trying to find something they have already told you won’t work. Then, when scheduling subsequent sessions, you might say, “I recall that Mondays and Fridays are best for you. Is that still the case?” 

You’ll be amazed at how demonstrating that you not only heard but remembered their schedule will make the client feel important.

Pre-Session

Whether the client is new or returning, the intake process is ripe with opportunity for showing your client you hear their needs. 

When doing a client intake for a first-time client, spend 5–10 minutes going through each aspect of the intake form. Don’t just summarize what you think you read. Have the form in hand (or on a digital device) and go through each section, asking for additional details as needed.

When it’s a returning client, spend a few minutes checking in about the last session and asking for any updates. Bodies change. So it is highly likely your client’s needs may have changed and they need an opportunity to tell you what they want from the session on that day.

On the Table

An entire article can be written on client communication on the table. For our purposes, we’ll keep it simple by focusing on a few statements you can use to ensure your client knows you heard them during the intake process.

First, be sure you thoroughly work the area(s) they requested. This is by far the most common complaint clients have expressed not receiving during previous massage experiences. 

Second, confirm that you addressed the area to the degree they were hoping for. Using the example of the client with neck pain, after working the neck region you can ask: 

• “Did I spend enough time here or would you like for me to work a bit longer?”

• “Is there a specific part of, or point on, your neck that you want more attention or depth to?”

• “I’m going to move on, but I will return to this area briefly before the end of the session to be sure we gave it enough attention.”

Third, if spending extra time in their area of concern means you have to skim over something else, ask, “I know you asked for work on all areas of your body, so if I spend more time on your neck, are you OK with me spending only a minute or two on each leg?”

Not only will this ensure your client feels heard and their needs addressed, but it puts them in the driver’s seat of their experience rather than at the whim of the therapist.

Post-Session

After the session is over and the client is dressed, ask if their neck feels different, if they feel less pain, if the tissues are softer, if they feel a change in range of motion, etc.

Then, note it in your session documentation. At the start of the next session, you can say, “I recall this technique produced positive results last time. Would you like to try it again and see if we get another positive outcome?”

This is especially important when a client comments during or after the session on techniques they loved. If a client says, “That feels/felt so good,” don’t forget to do it again. The same goes for areas of the client’s body they don’t want worked on or techniques they don’t like. 

Between Sessions

Based on the areas of client concern, send educational pieces that will support them between sessions. Send them an article, blog post, or video link that provides more information and supportive measures to take to manage and heal their focal points. Also, prepare yourself for the next session by researching root causes and alternate approaches to their concerns. Again, it will show you listened, you care, you recall, and you want to support them.

Subsequent Sessions

Always ask the client about their progress since the last session and if they want the same/similar focus. I can’t count how many times I’ve had to remind the therapist of what we worked on previously. Session documentation isn’t just about covering yourself in the event of a liability claim or sharing your findings and actions when working with a team of health-care professionals. It’s also about really knowing your client and showing them you’ve taken the time to remember their needs so they don’t have to repeat themselves over and over.

Hear the Whole Person

If you are truly listening, you will hear that your client is reporting more than just a physical ailment. When a client reports tension and/or pain, it’s likely their life is affected by it, possibly causing frustration, anxiety, sadness, and/or thoughts of limitation, doubt, dread, or hopelessness. This isn’t always the case, of course. But the more you observe and reflect, the more accurately you will read their overall state of being and respond to them in ways that make them feel significant. Sometimes, this engagement is more powerful than your hands-on techniques. Healing requires connection, and you are in a unique position to offer it by making your client feel like what they have to say is the most important part of your day.