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Medicina Academica Integrativa, 2024; Vol. 1, No. 1 View point
© University of Mostar
ACTIVE LISTENING – A MODEL OF EMPATHETIC
COMMUNICATION IN THE
HELPING PROFESSIONS
Marijan Tustonja, Davorka Topić Stipić, Iko Skoko, Anđelka Čuljak & Andrea Vegar
University of Mostar, Faculty of Humanities and Social Sciences, Mostar, Bosnia and Herzegovina
SUMMARY
received: 17.05.2023; revised: 14.11.2023; accepted: 18.12.2023
Background: Among the listening skills that scholars and practitioners alike consider valuable, active listening receives
the most attention. It includes paraphrasing the message, asking questions, and maintaining non-verbal involvement in
the conversation. The International Listening Association (ILA) defines active listening as “the process of receiving,
constructing meaning, and responding to spoken and/or nonverbal messages.”
Aim: The paper aims to show the development of the concept of active listening as an empathetic model of communication
that ensures understanding, acceptance, and involvement of individuals in communication processes and interactions.
Results: Active listening plays a key role in fostering meaningful connections and promoting positive interactions. With
constant communication stimuli, digital distraction, and attention deficit, active listening stands out as a potential form
of effective interpersonal communication. Active listening implies full involvement of the speaker, understanding the
perspective, and empathic response. In interaction with young people, for example, active listening creates a safe and
stimulating environment, encouraging them to freely express their thoughts, feelings, and needs. In this way, respect and
a better understanding of experiences, perspectives, and emotions are shown, which builds trust, and self-esteem and
ensures the development of a sense of self-worth and self-confidence.
Conclusion: Active listening is a crucial component of empathic communication in the helping professions. It enhances
the quality of relationships between professionals and clients by facilitating a deeper understanding of clients’ needs,
feelings, and perspectives. Active listening is a fundamental tool for professionals in the helping professions, serving as
the foundation for empathic communication. Its practice can enhance clients’ quality of life, bolster their emotional well-
being, and aid in problem-solving.
Key words: active listening, empathy, interaction, communication, relationship
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INTRODUCTION
In today’s society, communication is a key skill in almost
every aspect, and it is especially important in the helping
professions. Helping professions include various profes-
sions, such as social work, psychology, speech therapy,
medical care, and others, which deal with providing sup-
port, help, and treatment to people facing various problems
and challenges. One of the key elements of successful com-
munication in the helping professions is active listening.
Active listening is a model of communication that includes
careful and conscious participation in the communication
process, with an emphasis on understanding and empathy
towards the interlocutor. It’s more than passively listening
to the words that the other person conveys to us - it’s how
we show that we’re interested in their situation, feelings,
and needs. This paper aims to analyze the concept of active
listening as a model of empathic communication in helping
professions. Through theoretical frameworks and an over-
view of previous research, we will explore the importance
of active listening in different helping professions and how
it can improve the quality of the relationship between pro-
fessional and client.
LISTENING
The average person spends at least 50% of their waking
time listening to others (Barker et al. 1981, Wagner 2001).
If the other person’s communication is not managed effec-
tively, about half of the time it will be miscommunicated.
Verderber, KS, Verderber, RF, and Berryman-Fink (2007)
point out that listening is an active process, which means
that people have to try to listen well. When a person lis-
tens to others, he is often not only satisfied but also more
easily achieves his goals, builds a positive relationship
with the environment, and is respected and appreciated,
which means that he becomes socially competent. Devel-
oped listening skills calm the interlocutor, make him trust
the listener, and make it easier for him to express exactly
what he thinks. The first step in listening is deciding to be
43
Marijan Tustonja, Davorka Topić Stipić, Iko Skoko, Anđelka Čuljak & Andrea Vegar: ACTIVE LISTENING – A MODEL OF EMPATHETIC
COMMUNICATION IN THE HELPING PROFESSIONS Medicina Academica Integrativa, 2024; Vol. 1, No. 1, pp 42-47
fully aware. Due to heterogeneous trends in mindfulness
research, definitions vary. However, most definitions share
two key elements: attention and acceptance (Bishop et al.
2004). Given these key elements, mindfulness means paying
full attention to what is happening in the present moment,
both internal (feelings and thoughts) and external stimuli,
with an open and non-judgmental attitude. As with other
types of listening, interpersonal listening involves cogni-
tion, e.g., paying attention to, understanding, receiving,
and interpreting messages, sometimes, underlying motives
and intentions (Burleson 2011, Jones 2011) and affect, i.e.,
how one feels about listening. The interpersonal context,
perhaps more than any other, emphasizes the importance
of listener behavior - “ when people listen they not only
process information cognitively, but also act towards oth-
ers” (Bodie 2018). While in some forms of communication,
such as conversation, one person (i.e. the speaker) talks to
others who listen to the speaker during the entire commu-
nication process (with minimal response), in interperson-
al contexts the participants constantly assume the role of
speaker and listener while participating in the conversation
(Bavelas et al. 2000). There are moments in a person’s in-
teractions with others that encourage them to take on a par-
ticular listening role. These forms of listening are called
“necessary” listening because there is usually a social and
relational expectation or imperative for a person to engage
in it once they realize that someone else needs to listen.
One of the most common situations that require listening
is when another person needs social support for a problem
they have. When a person signals that they need help from
another person, especially with something emotionally dif-
ficult for them, that other person can become a source of
support. Although not everyone offers support when faced
with someone in need, people give different reasons why
they do not want such support (Ray et al. 2019). Yet people
often act knowing that others are seeking (or needing) their
help or comfort. In the end, most will act as support provid-
ers. A rarer form of needed listening occurs when someone
we know dies. The role of the listener in closing conversa-
tions is perhaps more typical of the way we often imagine
listening to work in the sense that “a quiet presence can
prove more useful than well-intentioned advice” (Vora and
Vora 2008). Halone and Pecchioni (2001) argue that lis-
tening can be considered perhaps one of, if not the most
common, everyday relational activity, a set of processes in-
volved in the development, maintenance, and decay of re-
lationships. People tend to communicate, in part, based on
the goals that the situation demands and, as such, use differ-
ent ways of listening as the situation calls for (listening is
a goal-directed behavior). According to Itzchakov, Kluger,
and Castro (2017) and Trenholm and Jensen (2004), qual-
ity listening is empathic, non-judgmental, and respectful.
More generally, Ridge (1993) describes good listening as
“attentive”. People who are perceived as good interperson-
al listeners are also perceived as more likable and attractive
(Argyle & Cook 1976) and are perceived as more credible
(Mechanic & Meyer 2000). Buber’s dialogic approach ad-
vocates a kind of presence towards other beings in which a
person is receptive and receptive to their influence (Gordon
2011). Although Buber did not explicitly speak of listening,
Gordon argued that listening is an implicit - and essential -
part of Buber’s promotion of interpersonal dialogue, where
true listening means being present to the other, i.e. respond-
ing to the other as a whole and creating space for the other
to express his words and meaning. When you open yourself
to the essence of another, you do not try to speak for him
or impose your language, concepts, and models of inter-
pretation on him. According to Buber, true listening means
encouraging others to create their meanings, which may be
very different from the meanings of others (Gordon 2011).
ACTIVE LISTENING
The term “active listening” was formally coined by Gor-
don (1975) as a description of a set of verbal and non-verbal
skills essential for effective parent-child communication,
although the roots of active listening can be found in earlier
scientific works. Active or empathic listening (Stanley et al.
2000) can be traced back to Rogers (1951) as a cornerstone
of his humanistic psychology (Orlov 1992). Active listen-
ing, as most generally defined, is an attempt to show un-
conditional acceptance and impartial consideration of the
client’s experience. Active listening requires the listener to
try to understand the speaker’s understanding of the experi-
ence without the listener’s interpretive structures intruding
on his or her understanding of the other person. Since its
introduction, active listening has become a ubiquitous part
of communication training programs in a variety of fields
within and outside therapeutic settings. In the field of com-
munication, almost all interpersonal communication text-
books include the concept of active listening (Canary et al.
2003, Devito 2007, Adler et al. 2006, Trenholm and Jensen
2004, Verderber and Verderber 2004, Wood 1998). The au-
thors list several fundamental elements of active listening.
The first involves communicating non-verbal involvement/
immediacy. Active (or empathic) listeners must commu-
nicate to the speaker that they are involved and give the
person unconditional attention (Levitt 2001). Second, ac-
tive listening involves paraphrasing the speaker’s message
(both content and sentiment) by repeating, in the listener’s
own words, what the listener thinks the speaker is trying to
say (Trenholm and Jensen 2004). This must be done with-
out making judgments about the speaker’s message. Final-
ly, most active listening treatments suggest that the listener
asks questions to encourage the speaker to elaborate on
their beliefs or feelings (Devito 2007). Active listening as a
communication skill is an integral part of life. Watzlawick
et al. (1967) state that it is impossible not to communi-
cate. Messages are always sent in human relationships,
including through silence or deliberate absence. Further-
more, self-expression is always present in communication
(Schulz von Thun 2001), which is most clearly expressed
in oral communication. That is, apart from the content, the
speaker always sends messages to the interlocutor about his
Marijan Tustonja, Davorka Topić Stipić, Iko Skoko, Anđelka Čuljak & Andrea Vegar: ACTIVE LISTENING – A MODEL OF EMPATHETIC
COMMUNICATION IN THE HELPING PROFESSIONS Medicina Academica Integrativa, 2024; Vol. 1, No. 1, pp 42-47
44
state of consciousness, feelings, and what he thinks about
their relationship. ing - short, occasional repetition of the other person’s key
points - is used to confirm understanding. Reflecting on
Figure 1. Active listening skills (Hoppe 2007)
That is why it is so important that at the other end of the
communication channel, there is someone ready to make
a mental effort to understand the other person. In general,
listening skills are perceived on a sensory and cognitive
level (Tyner 2009). The sensory level refers to the so-called
passive listening, in which we listen to the interlocutor, but
are not cognitively engaged or show understanding (Gor-
don 1996). Instead, through active listening, we conscious-
ly choose to engage cognitively. McNaughton et al. (2007)
see active listening as a multi-step process aimed at better
understanding the speaker’s point of view. Active listening
skills are an umbrella term for six communication skills that
can be considered an effective model of empathic commu-
nication: attention, non-judgment, reflection, clarification,
summarization, and contribution to a solution. First, we
pay attention to the content expressed by the speaker, but,
as Rosenberg (2007) adds, also to the feelings and needs
associated with certain content. The primary goal of active
listening is to set a comfortable tone and allow time and op-
portunity for the other person to think and speak. By paying
attention to your behavior and the behavior of the other per-
son, the conditions for a productive dialogue are created.
Throughout this phase, one should keep in mind that the
intention is to connect with the other person and understand
them, not to interrogate them. It is necessary to act from
a position of respect, allowing yourself to empathize with
the other person. Furthermore, it is necessary to maintain
pleasant eye contact and show interest. Close observation
and effective listening require attention. It is necessary to
pay attention to the non-verbal and verbal behavior of the
other person to understand the important information he is
offering. Another skill requires an open mind. As a listener,
you must be open to new ideas, perspectives, and possibil-
ities. Judgment is especially important when tensions are
high. It is not necessary to immediately solve problems or
give advice, the main task is to listen and pay attention. This
does not necessarily mean that the person agrees with it, it
shows that they are trying to understand. Through the third
skill of reflection - like a mirror, information, and emotions
are reflected without agreeing or disagreeing. Paraphras-
another person’s information, perspective, and feelings is a
way to demonstrate that you hear and understand the other
person. It is not good to assume that it was well understood.
The ability to reflect the content and feelings of another
person creates a strong rapport and deepens relationships.
Through the fourth skill, any problem that is ambiguous or
unclear is checked again. Open and clarifying questions are
essential tools within this skill. These kinds of questions
attract people and encourage them to expand their ideas.
They enable the detection of hidden problems. They also
encourage people to think rather than justify or defend their
point of view or try to guess the “right” answer. Open ques-
tions cannot be answered with a simple yes or no. Clar-
ifying questions helps ensure understanding and clear up
confusion. They define problems, reveal information gaps,
and encourage accuracy and precision. Through the fifth
skill, key topics raised by the other person are repeated as
the conversation progresses. Summarizing helps people see
their key themes and confirms and solidifies their under-
standing of their point of view. Summarizing doesn’t nec-
essarily mean you agree or disagree, it allows the loop to be
closed. This can lead to additional questions as a transition
to problem-solving. It also helps both parties to be clear
about mutual responsibilities and next steps. Ultimately,
being an active listener does not mean being a “sponge”
- passively absorbing incoming information, but actively
participating in the conversation, with thoughts and feel-
ings. However, active listening is primarily about under-
standing the other person, and then about being understood.
This is difficult for everyone to learn and apply. It can be
especially difficult for people in leadership positions, who
are led to believe that they need to be understood first so
that others can follow them (Hoppe 2007). This model of
empathic communication can in many ways be a useful and
effective tool for professionals in the helping professions.
Developing active listening skills is essential in many pro-
fessions, including medicine (Bryant 2009), law (Tyner
2009), policing (McMains 2009), social work (San-
zharovets & Shatylo 2020, Seden 2005), helping profes-
sions (Bryan 2015), etc. Although this skill has become a
Marijan Tustonja, Davorka Topić Stipić, Iko Skoko, Anđelka Čuljak & Andrea Vegar: ACTIVE LISTENING – A MODEL OF EMPATHETIC
COMMUNICATION IN THE HELPING PROFESSIONS Medicina Academica Integrativa, 2024; Vol. 1, No. 1, pp 42-47
45
ubiquitous element in different contexts such as marriage
counseling (Cole & Cole 1999), counseling in crises (Mis-
hara & Daigle 1997), caregiver practice (Edwards et al.
2006), care for patients with Alzheimer’s illness (Sifton
2002), education (Jalongo 1995), psychotherapy (Lester
2002) and sales skills ( Comer & Drollinger 1999), has not
received the attention it deserves in the social science lit-
erature.
RESEARCH OVERVIEW
So far, two large empirical research groups are dealing
with active listening. One of the contexts for the education
of active listening refers to the education of counselors.
Overall, research suggests that active listening is a skill that
can be practiced and that practicing active listening skills
increases overall listening skills. Thus, Paukert, Stagner,
and Hope (2004) were able to improve the active listening
skills of helpline volunteers and found that active listening
training was still effective at least nine months after it was
implemented. Levitt (2001) finds that active listening train-
ing improves the listening skills of counseling students.
Miller, Hedrick, and Orlofsky (1991) also found that teach-
ing crisis intervention counselors active listening improved
their empathic listening. Professionals in related fields also
seem to benefit from active listening training. Graybill
(1986) found that an active listening training program for
parents improved active listening skills. In addition, Cole
and Rice (1996) report successfully training married cou-
ples in the use of a range of communication skills based on
Guerney’s (1977) speaker-listener model (based on active
listening) and that the couples retained these skills after one
year. Garland (1981) also reports successful active listen-
ing training in married couples. The literature suggests that
active listening is a skill that can be practiced by everyone.
Another part of the empirical research deals with the effec-
tiveness of active listening in creating positive outcomes
for the listener, the speaker, and/or the relationship. Some
research shows that active listening benefits the active
listener. Undergraduate counseling students who have re-
ceived specialized training in the micro-skills of active
listening are considered more effective counselors and
outperform their supervisors in various counseling skills
(Levitt 2001). Preparatory students were also perceived as
better listeners after active listening training (McNaughton
et al. 2007). In addition, parents trained in active listening
felt less anxious and had more confidence in their ability to
solve problems with their children (Graybill 1986). Inves-
tigating coping strategies for crying children in a Scandi-
navian kindergarten, Lisper and Nilsson (1982) found that
parental responses to active listening resulted in shorter
crying times than the other two strategies tested. Further-
more, Davidson and Versluys (1999) found that brief train-
ing in active listening increased the use of active listening
during conflict interactions, among many other skills, and
that active listening during conflict increased the likelihood
of agreement between the parties. A Japanese study found
that managers of employees with lower levels of job-re-
lated psychological stress reported using active listening
more often (Mineyama et al. 2007). For example, research
suggests that while a patient’s initial level of anxiety is as-
sociated with active physician listening, active physician
listening does not predict subsequent patient anxiety (Fas-
saert et al. 2007). Carl Rogers long ago argued that non-
judgmental listening provides a safe space for the speaker
by reducing the threat of evaluation. This threat reduction
relaxes speakers and allows for non-defensive introspec-
tion (Rogers 1951, 1980). Recent work has provided sup-
port for Rogers’ arguments. Specifically, Itzchakov et al.
(2017) found that speakers who experienced high-quality
listening were less socially anxious and defensive when
disclosing their attitudes than speakers who experienced
poorer listening quality. High-quality listening also in-
creased speakers’ openness to change to a greater extent
when they shared prejudices with high-quality listeners
compared to speakers who shared their prejudiced views
with moderate-quality listeners (Itzchakov et al. 2020).
Gearhart and Bodie (2011) found that higher scores on the
Active Empathic Listening Scale were positively related
to Riggio’s (2005) measures of social sensitivity, social
expressiveness, emotional sensitivity, and social control,
all of which were associated with a variety of positive in-
teraction and relationship outcomes. In addition, ratings
of target others on the active empathic listening scale are
positively related to target groups’ communication skills
and discriminate between people who are considered to
be “good” and “bad” listeners (Bodie 2011). Furthermore,
Drollinger et al. (2006) reported that salespeople’s engage-
ment in active listening responses was positively related to
customer ratings of sales professionals’ listening skills. An
organizational study in Japan shows that employees with
lower levels of psychological stress at work have supervi-
sors who self-report that they regularly use active listen-
ing in discussions with employees (Mineyama et al. 2007).
Reznik, Roloff, and Miller’s (2012) research on romantic
couple arguments reported that active listening was posi-
tively related to problem-solving, relationship stability, and
perceived problem solvability, and negatively related to
intrusive thoughts during arguments. Active listening train-
ing increases students’ confidence in their listening skills
(McNaughton et al. 2007). Federal law enforcement crisis
negotiators scored higher on communication skills during
mock hostage negotiation exercises after receiving active
listening training than before training (Van Hasselt et al.
2006). Similarly, supervisors rated student helpline volun-
teers as more skilled six weeks after active listening train-
ing (Paukert et al. 2004). Likewise, mental health counsel-
ing students scored higher in counseling effectiveness after
learning active listening (Levitt 2001). Miller, Hendrick,
and Orlofsky (1991) also successfully improved the em-
pathic listening skills of crisis intervention counselors by
training them to provide active listening responses. Finally,
Marijan Tustonja, Davorka Topić Stipić, Iko Skoko, Anđelka Čuljak & Andrea Vegar: ACTIVE LISTENING – A MODEL OF EMPATHETIC
COMMUNICATION IN THE HELPING PROFESSIONS Medicina Academica Integrativa, 2024; Vol. 1, No. 1, pp 42-47
46
D’Augelli and Levy (1978) reported that crisis volunteers
who responded with advice and problem-solving generated
shorter, less effective conversations than when they used
empathic (active listening) responses. Overall, these stud-
ies suggest that active listening training improves trainees’
perceptions of their listening skills.
CONCLUSION
Active listening represents an essential model of em-
pathic communication in the helping professions, with the
potential to improve the quality of relationships between
professionals and clients. Through careful and conscious
participation in the communication process, active listen-
ing enables professionals to better understand their client’s
needs, feelings, and perspectives, which can provide the
basis for effective support and assistance. Active listening,
furthermore, is a key tool available to professionals in the
helping professions and forms the basis of empathic com-
munication. Its application can improve the quality of life
of clients, contributing to their emotional well-being and
problem-solving. It is therefore crucial that professionals
in the helping professions consciously develop and nur-
ture their active listening skills to provide the best possible
support and assistance to those who need it most. As we
saw in a brief overview of research related to the analysis
of the effects of active listening in different contexts: from
crisis interventions to marital and parental communication
to counselors. Active listening is the basis of the empathic
model of communication, and in person-oriented commu-
nication, it is a skill that, as we could see in the aforemen-
tioned research, proved to be crucial. The elements of ac-
tive listening are practical patterns by which we improve
our communication competence and enable the develop-
ment of a model of empathic communication.
Acknowledgements:
This paper was financed by the Federal Ministry of Educa-
tion and Science through the project no. 1000065 Percep-
tion of communication between social workers and adoles-
cents in homes for children without adequate parental care
in BiH.
Conflict of interest: None to declare.
Contribution of individual authors:
All authors reviewed and discussed the manuscript draft
and contributed to the final manuscript and all authors give
final approval of the version to be submitted.
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Correspondence: MA Marijan Tustonja, University of Mostar, Faculty of Humanities and Social Sciences
Matice hrvatske 1, Mostar, Bosnia and Herzegovina, E-mail: marijan.tustonja@ff.sum.ba
