Test of annex node

Effective communication, proper questioning techniques, active listening, unconditional positive regard, attending and observing behaviour, barriers to effective counselling.

For counselling to be effective, the case manager should cultivate empathy, congruency, genuineness and concreteness, and unconditional positive regard. These concepts and their practical application are described below:

Empathy

It is the ability “to stand in the other person’s shoes,” aiming to look at the world through the other person’s eyes. Observing the other person’s point of view, without filtering it through personal lenses, allows avoiding a judgmental attitude and enables deeper understanding.

It is important to underline that here empathy is intended as the ability to feel “something similar” to what another person is feeling. It does not mean to know exactly how or what he or she is feeling. This is an important distinction. Examples of an empathetic approach in counselling:

1. It must have been very tough to go through those events.
2. I can understand that you are feeling angry at what has happened to you.
3. I see that you have difficulties talking about your experiences.
4. Simply sitting in silence while the person expresses their feelings or weeps.

It is not enough to experience empathy; it is also important to be able to transmit empathy.

Examples of transmitted empathy in counselling:

1. I am trying to figure out how you feel. I can only imagine it...
2. Help me to understand how I can help you.
3. I see that you are considering some options.
4. I notice that you are struggling to find a solution.

➔ Empathy is different from sympathy. While empathy means “understanding” the feelings of someone, sympathy means “sharing” the feelings of someone and taking his or her side. Empathy is the correct approach to adopt when it comes to counselling. The judgement and lucidity of a case manager may be impaired if they identify too close with a returnee’s story. Sympathy can encourage the case manager to believe that they should be taking responsibility for the difficulties of returning migrant and to make false promises or create false expectations.

Examples of a sympathetic approach in counselling:

1. Poor you... Your problem is very difficult to solve!
2. I am astonished... It is horrible that this has happened to you.
3. Be sure: I am here and I feel how difficult your situation is.
4. I am so sorry for you!

• In addition, a counsellor must not be apathetic, meaning literally “without emotions”, indifferent, incapable of showing concern, participation or motivation. Adopting an apathetic approach makes the other person feel unlistened to, not understood and left alone.

Examples of an apathetic approach in counselling:

1. It’s not my problem...
2. Bah... I don’t know if it is possible to find a solution.
3. Can you speak a little more quickly? I have another person to meet.
4. Go ahead... I’m listening to you... I am just writing an email...

To recap:

Empathy involves accepting the other person’s point of view and being interested in exploring its implication on their behaviour. Sympathy involves feeling sorry for the other person. Apathy means not caring much for the other person beyond the pure mechanics of the job to be done.

Congruency and genuineness

Involves honesty and sincerity by the counsellor who does not act a role but tries to be true and authentic to themselves and to the returnee. Congruency avoids the risky approach of having the counsellor being seen as the expert, who looks down patronizingly on the returning migrant. Congruency is also crucial to obtain trust, which is the core ingredient of any helping relationship. If a counsellor behaves and feels in a congruent and genuine way, this makes the returning migrant feel at ease and allows them to be open and honest with themselves.

Examples of a congruent attitude in counselling:

1. I do not have a ready-made solution, but let’s look for it together.
2. I must admit that it is rare to listen to stories like yours.
3. I am sorry... I do not understand what you say: can you say it with other words?
4. I may seem distant, but, believe me, I am here fully listening to you.

Concreteness

Concreteness is the ability to communicate figures, facts, and information that can help the migrant to have a more complete grasp of the situation. Migrants at times do not have clear information about the real situations and rely on rumours or assumptions. Concreteness enables the counsellor to help identify the misinformation or information gaps and to help the migrant acquire a more realistic view of the situation. Concreteness helps the returnee to focus on specific topics, reduce ambiguity and channel energies into more productive paths of problem solution.

Examples of concreteness in counselling from the side of the counsellor:

1. You said you want to run a bakery because you like that job. But you said you have never worked in that business, right? What actions do you think you need to take to be prepared for the challenges?
2. You say you want financial support from the organization... I understand it... Do you have a plan about how to spend the money?
3. The project that you describe is not clear enough to be funded: can we work it out in more detail?

Effective communication

Communication is the process of sharing information, thoughts and feelings between people through different means: speaking, writing or using body language. Communication is effective when the transmitted content – questions, statements, answers – is received and understood by someone in the way it was intended.

Therefore, the goals of effective communication include creating a common perception and understanding.

Example, from the side of the counsellor:

1. Do you think I now have all the information that I need to help you?
2. Is there anything else that you want to add?
3. Is there any other question that you think I should ask you?

Effective communication is not only a matter of words, but entails:

• WHY those words are said – the intention behind what is said;
• HOW those words are said – the tone of voice, the way the body is used while saying those words;
• WHEN those words are said – in which context and in which moment.

The elements that make communication effective in a counselling situation are:

Proper questioning

In order to acquire information, make a good start and keep the conversation going, attention has to be brought to questioning. Asking open questions – such as “tell me about...” – helps the returnee to express themselves and guides the dialogue, which otherwise might be vague and directionless.

It is of course essential to verify at all times that the key information is correctly understood: this can be done by, for example, repeating the core messages using the words of the returning migrant:

Examples:

• M. I live with my family of seven people... two brothers and two sisters...
• C. You said two brothers, right?
• M. Yes... two brothers... one is 15 years old and the other 17...
• C. Ah... one is 15 and the other 17...
• M. I suffered terrible headaches and I had nightmares when I was in Europe... 
• C. Headaches... How long have you suffered from them?
• M. If I go back to my country I will be persecuted.
• C. When you say persecuted, what do you mean?
• M. I left my little brother behind.
• C. Your little brother... how old is he?

Active listening

It is the ability of being open to the person who is speaking, attentive and focused on his or her messages. Listening actively means that it is not sufficient just to hear and listen, but it is important to show the returnee that what they say is understood. The counsellor plays an active role in the listening process and this can be shown:

• Using gestures and body language such as nodding your head and smiling;
• Using verbal affirmation such as saying “yes”, “OK”, “I see”;
• Asking questions pertinent to what the returnee has told you, to clarify your understanding;
• Paraphrasing what the migrant has said to you;
• Summarizing key points of the discussion.

Clarifying

It means to ask questions to better understand what has been heard. The purpose is to reduce misunderstanding and to ensure that the understanding of what is being said is correct. Another purpose is to reassure the speaker that the listener is genuinely interested and is attempting to understand what is being said.

Examples of clarifying:

• M. Where do I get that stuff to cook my baby’s food?
• C. What is the stuff you are talking about?
• M. I want to work… I want to attend a course…
• C. When you say “I want to attend a course” do you mean that you want to attend a course to learn job skills?

Clarification can be introduced by sentences like these:

“I’m not quite sure I understand what you are saying.”
“I don’t think that I have understood the main issue here.” “When you said [...] what did you mean?”
“Could you repeat ...?”

Paraphrasing

It means to repeat what has been heard with one’s own words and in a reduced form.

Examples of paraphrasing:

M. I lost my documents at the train station and when I went to your office your colleague helped me to get new ones
C. Ah, good! So, my colleague helped you replace your lost documents…

M. I don’t know if it is better to stay here or to go to another village...
C. You have doubts about staying or moving away… right?

Paraphrasing can be introduced by sentences like:

...you are saying that...
Do you mean that...?
Am I right if I say that you...
So, in other words...
Oh, I see... you want to say that...
I get it: you mean that...
Let me see if I understand you correctly... What I think you are saying is...
If I am hearing you correctly...

Summarizing

It is quite similar to paraphrasing except that it implies a longer time and more information. It includes: to tell the key message of the story and to reformulate a longer statement into a shorter and direct form.

It can be introduced by:

“So far, we have talked about...”; “Let me summarize... you have told me that...”

Examples of summarizing:

“Let me put together all the information you have shared with me... You have said that you have one daughter and that lately you have had difficulties getting along with her... that your husband is not helpful and takes her side... that you live together with your mother-in-law in a small house... Is that right? Have I understood correctly?”

By consistently relying on “active listening”, the counsellor shows understanding and empathy for the returnee’s story and related feelings, but at the same time allows the returnee to retain the responsibility for their personal situation and reintegration.

Listening effectively to what is being said implies having an unconditional positive regard to the returnee and to what they say and an attending to and observing behaviour. What do these attitudes mean?

Unconditional positive regard

It means avoiding any attitude of judgement towards the returning migrant, not having pre-conditions for accepting them and their necessarily subjective view of the world. It means showing a sincere and neutral interest for the returnee. This means that even if the counsellor’s view radically differs from the returning migrant’s view, the counsellor respects and accepts it.

Attending and observing behaviour

It means being attentive, interested and concerned to what the migrant is sharing and to watch over what is going on during the interaction, with the aim of creating and maintaining a safe environment (not referring only to the physical one).

To help understand attending and observing in the context of counselling, it can be helpful to refer to the mnemonic SOLER:

S = Sit squarely

This means facing the returnee squarely, that is to adopt a posture that shows involvement. Sitting in an equal position: the counsellor can ask the returning migrant where he or she prefer to sit and then sit accordingly, giving the choice of sitting on a chair or on the floor. This makes the migrant feel respected and an equal of the counsellor.

O = Open posture

It is important to ask oneself which posture is culturally appropriate and shows openness and availability. In some cultures, crossing arms and legs can be signs of disrespect while an open posture can show availability and openness to what the migrant is going to say.

L = Leaning

A slight inclination of the trunk towards the migrant demonstrates interest in what is being said. Nevertheless, leaning too forward or assuming that posture too soon might be intimidating. Leaning back, on the contrary, could indicate a lack of interest, boredom.

E = Eye contact

It is important to look at the migrant while he or she is talking. This does not mean staring at the migrant but to make frequent and gentle eye contact. Nevertheless, it is highly important to be aware of cultural differences: in some cultures, eye contact is inappropriate. At the beginning of the interview, it is better not to make frequent eye contact so as to let the person get used to it. As the counselling interview goes on it is possible to increase eye contact to demonstrate full interest.

R = Relax

While interviewing the migrant, it is important to stay naturally relaxed. This helps the interviewee to get relaxed and become more focused on the topics under discussion.

Barriers to effective communication

Effective communication is also facilitated by knowing what NOT to do. These are some barriers to communication:

1. Order, command, pretend:

• You have to do what I say!
• Stop talking!
• Tell me everything about...

2. Warn or threaten

• If you do not do this, you will face bad consequences...
• You had better engage yourself...

3. Judging or criticizing

• You should have not done this...
• You had better do this...
• If you had been more careful, you would not have made this mistake...

4.  Providing unsolicited advice (even if the intention is helpful and positive)

• If I were you, I would do it this way.
• This is better: choose it!

5.  Disputing or challenging or putting into doubt the returnee’s choices:

• Did you really do that?
• Why did you decide to leave?

and:

• Overcomplicated, unfamiliar and technical terms.
• Emotional barriers and taboos: some migrants may find it difficult to express their emotions and may consider some topics completely “off-limits” or taboo, such as politics, religion, disabilities (mental and physical), and any opinion that may be seen as unpopular. 
• Lack of attention, interest, distractions.
• Differences in perception and viewpoint.
• Physical disabilities such as hearing problems or speech difficulties.
• Physical barriers to non-verbal communication. Not being able to see the gestures, posture and general body language can make communication less effective.
• Language differences and the difficulty in understanding unfamiliar accents.
• Expectations and prejudices, which may lead to false assumptions or stereotyping. People often hear what they expect to hear rather than what is actually said and jump to incorrect conclusions.
• Cultural differences. The norms of social interaction vary greatly in different cultures, as do the way in which emotions are expressed. For example, the concept of personal space varies between cultures and between different social settings.

The adjective psychosocial defines the interrelation between “mind” and “society”. In the migration field, this covers three underlying and interconnected dimensions: the biopsychological, the socioeconomic or sociorelational and the cultural-anthropological ones.

Figure A.2: Paradigm of psychosocial approach⁸³

The three factors are equally important, interdependent and mutually influencing.

The sociorelational or socioeconomic factor consists of two complementary aspects: the sociorelational brings up the quality of relations – family, friends, colleagues, peers, foreigners, enemies and others. The socioeconomic aspect has to do with the availability of and the access to resources, such as, for example, the health-care system and information technology. This factor focuses on the interactions and the interdependences between the individual and the group.

The biopsychological factor encompasses all biological and psychological factors characterizing the human being: behaviour, health, thoughts, emotions, feelings. It refers as well to the interconnectedness between the body and the mind and to the mutual influence of biology on psychological functioning and mental processes. Emotions, feelings, physical and mental health, physical and psychological vulnerabilities, stress and stress-reactions, coping mechanisms, resilience, and so on: all pertain to this factor.

The cultural-anthropological factor encompasses culture and anthropology. “Culture” is defined as “a system of shared beliefs, values, customs, behaviours, and artifacts that the members of a society use to cope with their world and with one another, and that are transmitted from generation to generation through learning”.⁸⁴ Anthropology, as complementary to culture, deals with the origins, the development and the history of human beings. It studies similarities and differences within and between societies, beliefs and behaviours of groups, including rituals and traditions correlated to specific cultures. Both these are interiorized to varying degrees by individuals. In brief, the cultural-anthropological factor considers the cultural differences among individuals, how cultures are formed and how human experiences and interactions shape the world.

The three factors influence each other, and, from a psychosocial perspective, it is possible to correctly analyse and understand every aspect of the migration phenomenon when considering their mutual implications. It is possible to scrutinize any human event from within each factor: it is important to be aware that the other two factors influence any taken perspective.

How return influences the interrelation of psychosocial factors

The paradigm presented above is used to frame the psychosocial complexity of a return migration, factor by factor and in the interrelation among factors, in particular when the migration project has not led to the desired outcome. At the individual level, referring to the psychosocial model, the main reactions are:

Biophysical level

• Fatigue, exhaustion, physical trauma
  Migrants can be exposed to violence, torture, detention, exploitative work conditions that can bring different traumas and to a general state of exhaustion, exacerbated by the stress reactions.

• Infectious and non-communicable diseases
  Migrants who return may have been subject to sexual and gender-based violence, exposed to contagion of different disorders and may have had a limited access to health services.

• Disabilities
  As a result of violence, tortures and abuse, migrants can suffer from physical and cognitive impairment, dramatically affecting their daily functioning.

• Addiction
  As a coping mechanism to the hardships of migration, some migrants can become addicted to alcohol or drugs.

Psychological level

• Shame
  Mostly determined by the perceived failure of the migration project. The returnee is persuaded that they have come back ‘empty-handed’ and have lost face. In other cases, shame might be due to traumatic events within the migration process, like violence, abuse, torture, detention.

• Guilt
  The returnee might feel guilty because he or she has not been able to make good use of the economic, psychological and social investment that family, friends and community had made to allow him or her to leave. This can be aggravated by the loss of friends and relatives back home or the time spent abroad.

• Anxiety
  The return migration itself is a source of anxiety with the high level of unpredictability about the future.

• Frustration
  It is the consequence of the perception of having been rejected, but also of having difficulties in finding a job, creating a livelihood, being accepted by the community.

• Sadness
  Sadness comes from the failure of the migration project, the rejection in the host country and the possible rejection in the community of origin, the loss of life partners and of identity.

• Disorientation
  The returnee has changed during the time spent abroad and the country of origin has changed as well. This makes them feel disoriented upon return, affecting their adjustment.

• Sense of inferiority
  The returnee may feel inferior to those left behind who did not migrate.

• Self-perception of being a failure
  The returnee has failed their migration projects and can blame themselves for this failure.

• Emotional instability
  It is in the form of ups-and-downs: even a little success can make the returnee feel well but a small setback can make them feel not understood and lonely.

• Sense of loss
  This is connected with identity crisis. Upon return, the migrant feels that the personal, social identity they had developed while abroad may not be acknowledged in the country of origin, while the old self may be lost to a certain extent.

• Feelings of hopelessness and helplessness
  These feelings are connected with a loss of confidence in one’s capacity to manage events and with the belief that no event will be positive. As a result, returning migrants might not be able to mobilize energy and be proactive.

• Fear
  Returning migrants can permanently feel in danger, whether the threat is real or not. This can be the result of past traumatic events, such as violence, torture or detention.

• Anger
  Angry feelings can be directed towards oneself, the country of migration, the return actors and agents and relatives and friends, as a reaction to stress and due to the feeling of having been rejected or being the victim of injustice.

• Loneliness
  It is a common feeling mostly connected to the perception of not being understood by family, friends and the community upon return. Loneliness has probably also accompanied the returnee during the time spent abroad.

• Low self-esteem and self-confidence
  The returnee may have a negative opinion of themselves because many of their expectations have not been fulfilled and the fear of not succeeding again when it comes to reintegration in the country of origin makes them feel unvalued. The returnee may feel that they cannot succeed in any new life project.

• Focus on the past or the future rather than on the present
  The present represents a challenge and sometimes a threat for the returnee. They may be more focused on the past, both because negative past experiences and events keep them stuck or because the past is in a way more manageable in comparison with the ongoing dynamic present. The returnee may focus on the future as a sort of escape from a challenging present.

Sociorelational level

• Risk of social stigmatization
  The decision to return can be stigmatized by the family and the community in the country of origin. However, this might not be the case when the migrant comes back voluntarily to invest what he or she acquired and earned abroad.

• Being perceived as a failure
  The returnee is perceived or can feel they are being perceived as a failure in that they have not fulfilled the expectations of family, friends, community members who have invested money, hope, admiration and other tangible and intangible resources in their time abroad.

• Being perceived as a problem or a burden
  The returnee can be seen as a mouth to feed, especially upon immediate return because of an initial lack of livelihood. In particular, if the returnee has a health condition the cost of care and the carers themselves represent an additional burden.

• Difficulty to reintegrate in the family
  The family may have invested tangible and intangible resources in the migration project of their relative and upon their return may have difficulty in welcoming them back.

• Isolation from others and feelings of not being understood
  Social withdrawal is a common reaction for the returnee who thinks that their present situation (and maybe even the initial decision to leave) is not or will not be understood. This is even more true for migrants who have been forced to return. Additionally, it is important to note that some returnees do not want to get in touch with or even inform their communities of origin of their return. Isolation is a leading factor for depression and can trigger a vicious cycle where the returnee does not receive any support because they remain distant from help of any kind.

• Lack of trust
  The fear of not being accepted and understood may determine the lack of trust towards family, friends and community. The returnee may think that nobody is willing to support their reintegration and is most likely relying on rumours and assumptions.

Socioeconomic level

• Poverty and financial issues
  The returnee often comes back “empty-handed” from a financial point of view. They can have debts to repay and a family to support.

• Difficulty in finding a job
  The economic situation of the country of origin may reduce the possibility of finding a job or of creating an income-generating activity, which may have been the reason for leaving in the first place.

• Debts
  The returnee may come back with a burden of debts that they are unable to repay. They may have debts with relatives, friends or other members of the community.