Lesson 8: OVERVIEW OF THE FIVE-STEP HELPING PROCESS

Objectives
To develop an understanding of the 5-step helping process
To understand attending, observation and hearing
To practice basic skills

Rationale for Using Basic Helping Skills

A relationship in which the client feels safe and respected allows the intake worker and the client to mutually discover areas of strength and areas that need improvement. It encourages the client to risk revealing problems and, therefore, opens the door to finding solutions.

For many of you, this section of the training will be a refresher; for others it will put a framework around what you do naturally; for still others it may be a brand new way of looking at relationships with clients. In the five step helping process that we will discuss in a few minutes, developing a good relationship, often called rapport, is the first step. This includes three major components:

    • Acceptance and respect
    • Understanding and empathy
    • Trust and confidentiality
    • Warmth and genuineness

a. Acceptance and Respect

The facilitators' ability to accept clients as responsible for themselves and capable of making good choices and decisions is basic to the helping process. This belief system is central to being a good helper. No matter how good our ideas are, they are worthless if they do not fit clients' wants, needs, and values.

Often the hardest thing a facilitator can do is to help clients find their own solutions--even when we do not think they are the best decisions. We indicate respect when we show interest and concern, offer support during career exploration and decision-making, and accept the fact that all are unique in their choices.

b. Understanding and empathy

Empathy is the attempt to put ourselves in our clients' shoes and see their situation as they see it. Facilitators can demonstrate empathy by listening to the thoughts and feelings of clients and verbalizing this understanding.

c. Trust and confidentiality

Trust between facilitators and clients is built by a demonstration of acceptance, understanding, empathy and respect. It involves a non-judgmental attitude and requires, within the limits of the law, keeping confidential the information the client has entrusted to us.  Trust enables clients to go beyond superficial conversation and, thus, allows our work to progress quicker and easier.

Clients need to feel secure that what they share with you goes no further.  However, it is your responsibility to inform the client that you might at times need to share concerns with a supervisor for guidance (see ethics and scope of work issues in Lesson 6).

d. Warmth and genuineness

These qualities are difficult to depict but we all know when we receive this open sincerity.  Eye contact, tone of voice, attending and truly “being with” the person are keys to warmth and genuineness.

We will spend a fair amount of face-to-face time working on these and more advanced facilitative skills, but these basic skills are the underpinnings of all helping relationships.

Techniques for Building a Helping Relationship

In his classic text, The Skilled Helper, Geralad Egan (1990) described the following five keys to the helping process:  attending, listening, reflecting, encouraging and questioning.  Skills in these areas will be invaluable to you. We will practice these skills in class, but for now here’s a brief description of each:

a. attending:  Egan uses the acronym SOLER to summarize the most important aspects of attending—face the client SQUARELY; adopt an OPEN posture; LEAN towards the client; maintain good EYE contact; and try to be RELAXED.  These guidelines work well for the North American culture but need adjusting for others.

b. listening:  paying attention to both the content and the feelings being conveyed and acknowledging both.

c. reflecting:  your most effective work will mirror the clients feelings versus analyzing, problem-solving or advising alternatives.

d. encouraging:  saying, “Tell me more about that,” or “Can I have an example of that,” are examples of encouraging that may help you better understand and encourage your client to better understand his/her feelings.

e. questioning:  open and closed questions yield different results and both have their place.  We will practice all of these techniques in class.

 

Overview of the 5-Step Helping Process

Cormier and Hackney (1993) present a particularly useful road map for facilitators to follow in assisting clients. It is based on the premise that the helping relationship is developmental in nature. Although each of their five stages is not truly discrete from the others, and clients may move back and forth among the stages, the process can be described in a linear fashion. The stages are: (a) relationship building, (b) assessment, goal-setting, (d) interventions, and (e) termination and follow-up.

a. Relationship Building

(Was discussed above under the rationale for using basic skills.)

b. Assessment

The second stage, assessment, makes use of the techniques of clarifying questions, open-ended questions, and closed questions. It uses both formal and informal methods of appraisal, including tests. Some of the information that one might want to acquire in an intake interview include: identifying data; range of problems; current life setting; family history; and personal history--medical, educational, military, vocational. (Formal and informal assessment techniques will be discussed in more detail in later sessions.)

Since assessment can have positive and negative effects on clients, it is important to use care and sensitivity during the assessment portion of the helping interview. If well done, clients feel understood, relieved, hopeful, and motivated. If not well done, clients feel anxious, interrogated, vulnerable, and evaluated.

Facilitators can avoid some of these negative reactions by taking care to intersperse relationship-building techniques such as reflecting thoughts and feelings, and being sensitive to the clients reactions during the assessment phase.

c. Goal Setting

The third stage, goal setting, responds to facilitators' and clients' needs to know where they are heading. Goals have motivational, educational, and evaluative functions. In setting goals, facilitators may use the techniques of confrontation, imagery and visualization. Completing sentences ("I want . . .", "I do not want") may also be useful at this stage.

d. Interventions

The fourth stage is interventions--clearly the "meat and potatoes" of the helping meal. Selecting appropriate interventions reflects the facilitator's theoretical orientation. Let us express a hope here that you will be flexible in choosing interventions, basing your choice on your client's needs as well as your own preferences; that you will consider your client's learning style and the characteristics of the problem as well as your own experience and comfort level. Most facilitators will use one predominant type of intervention with comfort:

    1. Affective interventions are designed to help clients focus on feelings. Affectively oriented helpers listen for and reflect feelings.
    2. Cognitive interventions are designed to help clients change their belief system (their thinking). Strategies include: (a) Ellis' (e.g., 1984) A B C process for challenging irrational beliefs, (b) cognitive restructuring--shifting from self-defeating to coping thoughts.
    3. Behavioral interventions are designed to help individuals to replace a maladaptive behavior with a more desirable one. Some strategies include: role play and rehearsal, systematic desensitization, and self management techniques, such as self monitoring, self rewards, or self contracting (Brown, 1994).
    4. System interventions are designed to change the system in which individuals find themselves. They are based on the beliefs that: (a) all elements in a system (i.e. a family) are interrelated, (b) change in any part of a system (i.e. an individual) will lead to alteration of the entire system, and (c) systems have inertia and therefore resist change. This leads to the conclusion that it is difficult for individuals to change without a concomitant change in the system in which they are involved, usually their family.  Systems interventions, or family therapy, are beyond the scope of this training; when it is clear that they are needed, you should consider a referral to a mental health agency or family counselor.

e. Termination and Follow-up

Stage five, termination and follow-up, is a process that begins when either the facilitator or the client determine that the helping relationship will end soon. Follow-up should be planned and should include referral if necessary. Finally, the relationship should end.

Check these links:

http://www.cmhc.com/Features/Clinical/IntegratedServicesNotes.html

http://www.metroactive.com/papers/cupertino.courier/01.24.96/helping.skills.html

http://www.msue.msu.edu/msue/cyf/youth/nathelp.html

http://www.educationalmedia.com/books.html

http://www.utm.edu/~educ/frame/mscouns.htm#c

Assignment:

    • We will practice Egan’s techniques in class, as I mentioned above, but for now I want you to identify an issue or pressing concern you have been thinking about recently. Do not worry, you will not be asked to share this issue with anyone or me. Next I want you to imagine that you have chosen to speak confidentially to someone about the issue. I want you to become aware of your thoughts and feelings as you imagine asking that confidant for help. Finally, I want you to close your eyes and mentally sort through the people you know, and imagine choosing someone with whom you would feel comfortable discussing your concern or problem.

So, once you have completed this activity, email me describing:

    1. Some of the worries that came into your mind as you imagined asking for help; the major characteristics of the person you selected;
    2. What this tells you about how you need to be when you work serving others?
    3. Consider, this might make good notes for your journal.
    • Post something you learned by doing this activity in the Class Discussion. React to three others’ postings.  (Total points available for the email and Discussion Group posting = 30).

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Please e-mail Susan Roudebush if you have any comments.
Updated January 3, 2002
Copyright 2002 Susan Roudebush