Question 1

There are many reasons why doulas should be concerned with professional ethics. Which of the following is the most critical purpose of applied professional ethics?

Accepted Answer

The most critical role of applied professional ethics is to maintain internal regulation and avoid external regulation. Self-regulation is preferred because no one knows a profession better than its members. With self-regulation, external agencies are less likely to interfere with practice. Ethical codes foster professional identity and encourage doulas to both define themselves and to communicate who they are in relation to others. Through professional ethics, consumers and care-givers are protected, creating increased confidence in the profession. Ethical codes also signal professional maturity, which stimulates further development of ethical codes and guidelines.

Question 2

Keeping an open mind is an essential part of active listening and helps clients feel:

Accepted Answer

When a doula follows the precepts of active listening, the speaker will feel validated or supported in what they are saying. They will feel truly "heard," and respected. The speaker will gain trust in the listener, and will feel comfortable continuing the conversation. Active listening opens the door to positive communication. The speaker will not feel ignored, violated or uncomfortable, and will, in fact, have positive feelings about the conversation.

Question 3

While listening to someone speak:

Accepted Answer

One of the most basic principles of active listening is attending to the speaker without letting your mind wander. Taking time to respond after the speaker finishes his or her thoughts is acceptable and even encouraged. This gives you the chance to hear all that the speaker has to say in order to avoid miscommunication. The listener should respond without value judgments, and should always focus on the speaker rather than trying to do other things while having a conversation.

Question 4

_______________ is the art of being able to not only understand, but also to feel, another's emotions in the situation being discussed. _______________ is the ability to have compassion without necessarily having experienced feeling the same emotion in a given situation.

Accepted Answer

A doula has empathy if she is able to understand and feel her client's feelings for herself. For example, if hearing a birth story makes the doula feel almost as if the story concerns her personally, she is empathetic. Sympathy, on the other hand, signifies compassion for another while not necessarily feeling the feelings expressed. For instance, if a client is sharing her experience of miscarriage, but the doula has never personally experienced that type of loss, she might have a sense of regret for her client but would not feel the client's emotions as her own. Compassion, understanding, validation, and concern are all valuable character traits for a doula to possess in addition to the ability to empathize.

Question 5

Ways to show you are interested in what your client has to say include all of the following EXCEPT:

Accepted Answer

Multitasking by trying to complete documentation while your client is speaking signals a lack of respect for the client's thoughts, which can lead to a breakdown of trust and end effectively sharing ideas. Ways to improve trust and show respect for the client's thoughts include body cues such as nodding, making eye contact, leaning toward or moving closer to the speaker, touching the client's arm or shoulder, etc. Body language often speaks louder than words, so a doula needs to be conscious of what she is doing when she is conversing with her client.

Question 6

Communication is an exchange of ideas between people. One person - the speaker - sends a message, while the others - the listeners - receive and perceive that message. How the listener understands a message may be different than what the speaker intended, and can easily be affected by all of the following except:

Accepted Answer

The way a doula dresses may say a lot about her level of professionalism, and may impact her ability to relate to her clientele, but is less likely to change how messages are perceived than the other attributes listed. The way a speaker chooses words, the visual cues she uses, and her own personal biases all contribute to the sent message. Then, the listeners own cultural beliefs, vocabulary, and body language contribute to their understanding or perception of the message. This complicated interplay leaves many openings for miscommunication, but can be navigated using active listening skills.

Question 7

Reflective listening includes saying back to the client what they just said to you to be sure you are in agreement and includes feelings as well as facts. This communication style:

Accepted Answer

Reflecting content and emotions back to a client in an open-ended fashion allows the client to clarify any difference between what she said and what the doula heard. She will know the doula was truly listening to what she said, and she will be able to add to or revise her thoughts to enhance understanding. While it may seem stilted at first, reflective listening doesn't need to follow a set prescription, and with practice, it can become secondnature.

Question 8

One way your client knows whether you are listening or not is by noticing your:

Accepted Answer

Body language, or the visual cues given by posture and expression, sends a strong message to the speaker about whether or not the listener is paying attention. While a doula's clothing and personal grooming can display a certain level of professionalism, they are not the foundation of strong communication. Tone of voice can provide positive or negative feedback, but may not be as closely related to active listening as mannerisms.

Question 9

Personal assumptions, judgments, and beliefs can __________ what we hear.

Accepted Answer

Interjecting personal bias can lead to judgmental responses to the client, rather than respectful communication. Personal biases do nothing to improve understanding. As a listener, your role is to grasp what is being said, which might require reflecting on the information given to you by the client orasking for clarification. The best way to keep bias from affecting a doula's responses is for her to recognize what her personal preconceptions are and to work at not assuming anything.

Question 10

Active listening is a model for ____________, which is why a doula's personal judgments should be left out of the conversation.

Accepted Answer

Active listening helps the doula to gain the client's respect and trust, and keeps lines of communication open. It facilitates conversation so that misunderstanding can be avoided. The doula should not feel awkward using this mode of listening. The doula is gaining information and perspective. She will gain nothing by attacking the speaker or putting her down.

Question 11

Rehearsing, or thinking about what you are going to say next, can cause you to:

Accepted Answer

In order to accurately hear what the speaker is saying, the doula needs to remain attentive and not allow her mind to rehearse how she would like to respond. While the doula may think of a valuable response, she loses the speaker's trust with her inattention to the conversation. By not rehearsing, the doula remains in the flow of the conversation, and achieves strong interpersonal communication with the client.

Question 12

Types of body language that signal to a client you are listening include all of the following EXCEPT:

Accepted Answer

Crossing arms while another is speaking signals to the speaker that the listener does not agree with them, or is making judgments about what they are saying. This negative body language shuts down strong communication. Making eye contact, moving physically closer to the speaker, and nodding her head as the client talks are positive signals that the doula is following the speaker's thoughts.

Question 13

Paraphrasing is a component of active listening that helps to clarify communication. When paraphrasing, be cautious not to _______________________, but rather to _________________________.

Accepted Answer

Verbatim regurgitation of what the speaker has said may show that the listener heard the words, but will not help the speaker feel truly understood. Summarizing the speaker's thoughts while adding clarifying questions shows a deeper understanding, and leads to stronger communication. Paraphrasing may show the doula's bias or her flexibility, but should always be a conversation aid rather than detraction. Body language continues to be an important component of active listening and should make the speaker feel valued.

Question 14

When a client's tone of voice and body language say one thing, but her words say another, the best way a doula can achieve understanding is to:

Accepted Answer

By asking an open-ended question that tries to identify the speaker's feelings, the conversation can be clarified and understanding more fully achieved. For instance, using the format "You seem ______ that _______. What would happen if...," the client will not feel judged, but rather truly heard, and she will either agree with your assessment or she will add more information so you can more fully appreciate her emotions. While commiserating does inject empathy or sympathy into the conversation, it is not as effective as active listening. Ignoring the client's emotions closes the conversation and limits understanding.

Question 15

Asking open-ended questions when conversing with a client does all of the following EXCEPT:

Accepted Answer

Asking questions shows the speaker you were truly listening to what he or she said, and that you are invested in learning more through continued conversation. Closed-ended questions that can be answered "yes" or "no" do not illuminate the conversation. Open-ended questions, on the other hand, elicit more information from the speaker, allowing for continued exploration. This give-and-take permits self-discovery and improved communication. As a doula, open-ended questions used as part of active listening empower the client to search for solutions that work for her and her family.

Question 16

Ways to convey empathy non-verbally include all of the following EXCEPT:

Accepted Answer

Looking away signals to the speaker that the listener is no longer interested in what is being said, and creates a barrier to good communication. Empathy can be conveyed not only through the words used, but also through body language. Facial expressions, touch, and conversational pauses all signal that thoughtful communication is being achieved.

Question 17

When responding to a client using reflective listening, you can choose an additive, interchangeable, or subtractive response. The one that enhances communication the most is:

Accepted Answer

Additive responses deal with the present, are empathetic rather than accusatory, and help the speaker find a deeper understanding of his or her feelings. Subtractive responses, on the other hand, lead away from exploring the speaker's feelings, and leave him or her feeling "unheard." Interchangeable responses assign the obvious feeling, and show you were listening, but do not broaden understanding. It is important to appreciate the speaker's tone in order to pinpoint the correct feeling, butasking an open-ended question with your additive response allows for clarification.

Question 18

Researchers say that people remember on average 10%-25% of what they hear. More important than "hearing" is __________, which aids in information retention.

Accepted Answer

Finding a strategy to not only hear the words that are used, but also to truly listen to the implications of those words opens the door for strong communication. Seeing is another way of learning information, and may be important when it comes to body language. Talking out of turn - especially if interrupting a speaker during a conversation - can lead to miscommunication. Multitasking signals to the speaker that the listener is no longer interested in the conversation, and leads to a breakdown in communication.

Question 19

For most people, good communication skills:

Accepted Answer

Learning to communicate effectively takes practice, and is well worth the time spent. These skills are important in building a trusting doula/client relationship, and may not be easy or natural for some people. With practice, active or reflective listening becomes more regular, and will no longer seem like an affectation.

Question 20

Your client says, "I am so tired all the time and my partner does nothing around the house. We both work full-time, and I'm pregnant. But I still do all the cooking, cleaning, laundry. How will we ever add a baby to this marriage?" Your BEST response is:

Accepted Answer

By identifying the frustration the client is feeling, as well as proposing a solution, the doula facilitates the process of communication. The client then has the opportunity to agree, or to clarify her emotions, and to find a solution that works best for her. Empathy and understanding are important, but communication is improved when the speaker is not given platitudes from the listener. Judgmental words like "worse" and "jerk" should be left out of the doula's reply.

Quiz 2: Communication