Mental illnesses and emotional problems are no laughing matter, let alone those who are thinking of ending their lives. As a family member, partner or friend, it is no doubt distressing when someone we know, and love is going through hard times. The question here then is: How can we talk to them so that they will feel better? Easier said than done, talking to someone who is going through great pain is never easy, but it does not mean there is no way.

        That was the exact problem faced by Dr. Xavier Amador when his brother was diagnosed with schizophrenia. The increasing tension caused by the miscommunication between the brothers, prompted Dr. Amador to come out with a communication approach abbreviated as LEAP: L (listen), E (empathize), A (agree), P (partner). Incorporated with elements from Medication Adherence and Insight Therapy (MAIT) and Person-Centered Therapy, LEAP is a communication tool that aims to improve alliance between the therapist and client so that the bond developed can better persuade the client for better opinions and solutions. Despite being a method that professionals use, Dr. Amador assured that LEAP can be learned and practiced by anyone.

L – Listening

        Listening is the most essential factor in communication, for there is no such thing as a one-sided communication. It sounds easy enough, but often we do not listen to what we are supposed to. The type of listening encouraged by LEAP is called reflective listening. Reflective listening is when we listen carefully to the other person’s problems and subsequently reflecting back to them without passing any comments, disagreements or arguments. It is claimed that the most crucial thing to do is to abandon our agendas and goals. Instead of wanting to give solution, our main aim is to listen whole heartedly. This also means that we should listen without any judgment no matter how wrong or contradicting the person’s words are to us. Some may say that we are listening to learn, not to pass comment. Such form of listening is important because, according to LEAP, it helps the person to feel validated, respected and understood. Once those feelings are established, it would be easier for them to trust and subsequently agree with the necessary solutions or opinions. Should we ever feel the need to give our opinions, we can always opt for what Dr. Amador called ‘The Three A-Tools’. It involves (A)pologizing for the differences in view, (A)cknowledging that we could be wrong and (A)greeing to disagree.

E – Empathy

        Most people are familiar with the term ‘empathy’, which is synonymous with the phrase ‘being in someone’s shoes’. Although such a feeling is common, the feeling of empathy is a greatly valued virtue when communicating with someone in distressed. In LEAP, empathy is crucial because it enhances the person’s feelings of being heard, understood and validated. Empathizing is not easy in the LEAP approach because it means to empathize with the person no matter how outrageous or delusional their view may be. It is posited that some of the person’s feelings that we should empathize with when communicating are their frustrations, fears, discomfort and desires. Some of the techniques that can help us with empathizing is to communicate in a manner that allows the person to ‘save face’. Recognizing and acknowledging the person’s view is also important. Using admiring and approving statements may also help.

A – Agree

        After listening and empathizing with the person, we usually will reach to a point where both us and the other person is able to come to a common ground. It may not be much nor significant, but we should take every possible opportunity available and work with it. In LEAP, to agree is to work on the observations and views together, while remaining a neutral stance, and to discover the motivating factors the person has to change. Some might say that agreeing can happen when the person’s defenses are down and gates started to open. An important element here is to ‘agree to disagree’. This is especially important when the person feels threatened by us and we can always point out that disagreements are not always threatening and can be constructive. Normalizing the person’s views and experiences are also important by stating that the experiences happen to others as well. Discussion on the person’s perceived problems as well as the advantages and disadvantages of suggested solutions are also encouraged.

P – Partner

        The partnering stage of LEAP is reached when we and the other person have agreed to work together on how the solution can be executed on the person’s term. Howbeit, it is always advisable to agree and partner on goals that are reachable. We can always take baby-steps and progress according to the person’s readiness. Although small step, it is progress no doubt. LEAP concept might take time but patience would definitely be rewarded. Some posited that the ‘scientist approach’ should be practiced where we should always keep an open mind and continue to explore and discover.

Written by: Ryan Wong Kar Wai (Aizen) (MPS Psychological Services Intern)

Supervisor: Mr. Liang Yaw Wen

References:

1. Amador, X. (2015). Lessons learned about denial in persons with serious mental illness. Paradigm, 19(2). https://www.sccgov.org/sites/bhd-p/Training/Documents/2019/June%202019/Motivational%20Interviewing%20Intensive%204-day%20Training%20and%20Certification/Day4/2.%20Anosognosia_SMI%20Insight.pdf
2. Ihm, M. A. (2012). A Pilot Fidelity Study of Listen-Empathize-Agree-Partner (LEAP) with Assertive Community Treatment (ACT) Mental Health Clinicians [Doctoral dissertation, Columbia University]. Columbia University Libraries. https://doi.org/10.7916/D8J390MH
3. E.A.P. http://growastrongfamily.org/wp-content/uploads/2017/10/leap.pdf
4. The L.E.A.P. Method – An Overview. https://www.spotlightonmentalhealth.com/wp-content/uploads/2017/03/The-LEAP-overview.pdf