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Full download Helping Skills: Facilitating Exploration, Insight, and Action (newest, 5th Edition, 2020) file pdf all chapter on 2024
Full download Helping Skills: Facilitating Exploration, Insight, and Action (newest, 5th Edition, 2020) file pdf all chapter on 2024
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Developing Helping Skills: A Step-By-Step Approach to
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II. EXPLORATION STAGE
5. Overview of the Exploration Stage
Theoretical Background: Rogersʼs Client-Centered
Theory
Goals for the Exploration Stage
Preexploration Education
Concluding Comments
What Do You Think?
Key Terms
6. Skills for Providing Support
Overview of Attending and Listening
Cultural Rules for Nonverbal Communication
Nonverbal Behaviors That Facilitate Attending
Paraverbal Behaviors That Facilitate Attending
Minimal Verbal Behaviors That Facilitate Client
Exploration
Examples of Attending and Listening
Relax and Be Natural but Professional
Concluding Comments
What Do You Think?
Key Terms
7. Skills for Exploring Nonaffective Content,
Thoughts, Narratives, and Stories
Rationale for Exploring Nonaffective Content,
Thoughts, Narratives, and Stories
Restatements and Summaries
Open Questions and Probes for Thoughts
Closed Questions for Information or Facts
Distinguishing Between Open and Closed Questions
A Comparison of Skills for Exploring Nonaffective
Content, Thoughts, Narratives, and Stories
What Do You Think?
Key Terms
8. Skills for Exploring Feelings
Rationale for Exploring Feelings
Cultural Considerations in Working With Feelings
Reflection of Feelings
Disclosure of Feelings
Open Questions and Probes About Feelings
A Comparison of Skills for Exploring Feelings
Concluding Comments
What Do You Think?
Key Terms
9. Integrating the Skills of the Exploration Stage
Case Conceptualization in the Exploration Stage
Choosing Goals and Intentions to Facilitate
Exploration
Choosing Skills to Match the Goals and Intentions
Implementing the Skills of the Exploration Stage
Conducting a Practice Session Focusing on the
Exploration Stage
Dealing With Difficult Clinical Situations in the
Exploration Stage
Difficulties Implementing the Exploration Stage
Coping Strategies for Managing Difficulties in the
Exploration Stage
Example of the Exploration Stage
Is It Time to Move to the Insight Stage?
What Do You Think?
Key Terms
III. INSIGHT STAGE
10. Overview of the Insight Stage
What Is Insight?
Why Is Insight Necessary?
Intellectual Versus Emotional Insight
Markers of Readiness for Insight
Theoretical Background: Psychoanalytic and
Existential Theories
Setting Expectations in the Insight Stage
Goals and Skills of the Insight Stage
Concluding Comments
What Do You Think?
Key Terms
11. Skills for Fostering Awareness
Rationale for Using Challenges
Theoretical Perspectives on Fostering Awareness via
Challenges
Markers of Readiness for Awareness
Types of Challenges
General Guidelines for How to Challenge
Difficulties Helpers Experience Using Challenges
Concluding Comments
What Do You Think?
Key Terms
12. Interpretive Skills
Rationale for Using Interpretive Skills
Open Questions and Probes for Insight
How to Do Open Questions and Probes for Insight
Interpretations
Disclosures of Insight
What Do You Think?
Key Terms
13. Skills for Processing the Therapeutic Relationship
Rationale for Using Immediacy
Markers of Readiness for Processing the Relationship
Client Markers Indicating Appropriateness of
Processing the Relationship
Helper Markers for Processing the Relationship
Types of Immediacy
Guidelines for Using Immediacy
Example of Immediacy
Difficulties Helpers Have in Using Immediacy
What Do You Think?
Key Terms
14. Integrating the Skills of the Insight Stage
Case Conceptualization in the Insight Stage
Implementing the Skills of the Insight Stage
Caveats About Using Insight Skills
Difficulties Helpers Might Experience in the Insight
Stage
Strategies for Overcoming Difficulties in
Implementing the Insight Stage
Example of an Extended Interaction in the Insight
Stage
What Do You Think?
Key Terms
IV. ACTION STAGE
15. Overview of the Action Stage
Rationale for the Action Stage
Deterrents to Action
Philosophical Underpinnings
Markers for Knowing When to Move to Action
Theoretical Background: Behavioral and Cognitive
Theories
Goals of the Action Stage
Skills of the Action Stage
Concluding Comments
What Do You Think?
Key Terms
16. Steps for Working With Four Action Tasks
Rationale for Action Tasks
Relaxation
Behavior Change
Behavioral Rehearsal
Decision Making
What Do You Think?
Key Terms
17. Integrating the Skills of the Action Stage
Case Conceptualization in the Action Stage
Implementing the Action Skills
Difficulties Helpers Might Experience in the Action
Stage
Strategies for Overcoming the Difficulties
What Do You Think?
Key Terms
V. INTEGRATION
18. Putting It All Together: Working With Clients in
the Three-Stage Model
Intakes
Helperʼs Work Between Sessions
Subsequent Sessions
Termination
Dealing With Difficult Clients and Clinical Situations
Example of the Three-Stage Model
Concluding Comments
What Do You Think?
Key Terms
Glossary
References
About the Author
Feedback Form
PREFACE
I have several goals for this book. After reading it, students should be able to
articulate the principles of the integrated three-stage model of helping as well
as the theoretical and research foundations underlying this model. They
should demonstrate an understanding of the interactional sequences of
helping, including the intentions that helpers have for interventions with
clients, the helping skills that are commensurate with these intentions, the
possible reactions and behaviors demonstrated by clients, and the means
through which helpers evaluate the interventions used. In addition, readers
should gain a better understanding of themselves in relation to becoming
helpers, including their thoughts about helping as well as their strengths and
areas for continued growth. Finally, I hope to instill enthusiasm for the
process of helping others—an enterprise that can provide countless
challenges and rewards.
This book has been used extensively in both undergraduate- and graduate-
level classes. The majority of students at the undergraduate level are in
psychology or education classes, and most go on to careers in mental health
professions (e.g., social work, psychology), medical professions (e.g.,
doctors, nurses, dentists), law, business, and clergy. At the doctoral level,
most are in masterʼs or doctoral programs in counseling or clinical
psychology or social work. The book has also been used in training peer
counselors and medical residents, and it has been translated and used widely
around the world, so it can be adapted to many situations, cultures, and
careers. Many of my students have said that everyone should learn the skills
(especially the exploration skills) to have better interpersonal relationships, so
they are not just skills used in helping settings. Because we know that most
people seek help first from friends, family, and clergy, it seems important to
teach these skills widely.
When using the book for masterʼs, doctoral, or medical students, I
recommend supplementing it with other primary readings. In this way,
students can gain more in-depth knowledge about the theories and
applications. I also strongly recommend that students get involved in their
own personal therapy to learn more about themselves, which in turn can help
them better help others.
It seems necessary to clarify the focus of this book by also indicating what
this text does not provide. It is beyond the scope of this book to provide
information about counseling children, families, or clients who have serious
emotional or psychological difficulties. Although the helping skills taught in
this book are crucial and form the foundation for work with all these groups,
helpers will need much more extensive and specialized training before they
will be qualified to work in those contexts.
Furthermore, I do not address the diagnosis of psychological problems or
identify characteristics of psychopathology, which are two important topics
that require extensive additional training. I encourage helpers to pursue
additional training in assessment and psychopathology after developing a
working knowledge of basic helping skills. I believe that all helpers, even
those working with healthy populations, should be able to recognize serious
psychological disorders. This level of knowledge aids helpers in making
appropriate referrals and working only with clients whom they have been
trained to assist.
RESOURCES
As with the previous editions, this fifth edition of Helping Skills offers a web-
based “Instructor and Student Resource Guide”
(http://pubs.apa.org/books/supp/hill5), the student portion of which features
more than a dozen web forms (in downloadable PDFs) that are referred to
throughout this text to assist students in evaluating their helping skills and
helper–client sessions. The website also includes an Emotion Words
Checklist—a downloadable version of this editionʼs Exhibit 8.2 (see Chapter
8)—that students have found helpful to have handy in a printed format for
easy reference during the exploration stage of a helper–client relationship. In
addition, the student resources section of the Helping Skills website includes
downloadable versions of the labs for various chapters, as well as practice
exercises for each of the skills chapters of the book.
In addition, three DVDs are available to demonstrate the model. Helping
Skills in Practice: A Three-Stage Model was created to illustrate the three
stages of working with a client struggling with concerns related to childhood,
eating, and self-esteem. Dream Work in Practice was created to illustrate the
three stages with a client who had a troubling recurrent dream. Meaning in
Life: A Case Study was created to illustrate how to work with meaning in life
from the perspective of the three-stage model. All three DVDs are available
from the American Psychological Association
(https://www.apa.org/pubs/videos/index).
Finally, I sought to write a book that both supports studentsʼ development
as helpers and provides challenges to facilitate the development of helping
skills. Becoming an effective helper is an exciting and challenging process.
For some, this undertaking can be life-changing. Many students are
fascinated by the process of becoming helpers, and they pose thoughtful
questions as they struggle to learn the skills, develop confidence in their
ability to assist others, and learn about themselves. Because the focus of this
book is on helpers (not clients), I pose many questions that relate to the
helpersʼ development and concomitant feelings and thoughts.
ACKNOWLEDGMENTS
I am grateful to the many people who have read selected chapters or all of the
book and provided valuable feedback on at least one of the editions:
Oyindamola Adedipe, Rebecca Adams, Lydia Ahn, Margaret Barott,
Katherine Calabrese, Colleen Case, Kevin Cramer, Jennifer Dahmen,
Elizabeth Doschek, Jessica England, Lisa Flores, Norm Friedlander, Suzanne
Friedman, Judy Gerstenblith, Melissa Goates, Julie Goldberg, Jim Gormally,
Allison Grolnick, Kelly Hennessey, Beth Haverkamp, Jeff Hayes, Debby
Herbenick, Pamela Highlen, Laura Hipple, Merris Hollingworth, Gloria Huh,
Samiha Islam, Skyler Jackson, Jennifer Jeffery, Ian Kellems, Alexandra
Kindahl, Shakeena King, Kathryn Kline, Sarah Knox, Misty Kolchakian, Jim
Lichtenberg, Rayna Markin, Monique McIntyre, Katherine Morales, John
Norcross, Kathy OʼBrien, Sheetal Patel, David Petersen, Jennifer Robinson,
Missy Roffman, Katherine Ross, Nina Shen, Pat Spangler, Eric Spiegel,
Jessica Stahl, Barbara Thompson, Linda Tipton, Terry Tracey, Nicole Taylor,
Collin Vernay, Jonathan Walker, Heather Walton, Daniel Wesley, Elizabeth
Nutt Williams, Shuping Yang, and Stephanie Yee.
I also thank the numerous anonymous reviewers who have read and
reviewed the book for the American Psychological Association and provided
invaluable feedback.
I have profited considerably from the editorial feedback, guidance, and
encouragement of Joe Albrecht, David Becker, Beth Beisel, Dan
Brachtesende, Elizabeth Budd, Amy Clarke, Elise Frasier, Beth Hatch,
Phuong Huynh, Linda Malnasi McCarter, Ed Meidenbauer, Peter Pavilionis,
Susan Reynolds, and Ron Teeter—all from the American Psychological
Association Books program—on the various editions of the book.
I am most indebted to the many students in my undergraduate course in
helping skills and graduate course in theories and strategies of counseling
psychology over the past many years. They have taught me a tremendous
amount about how to teach helping skills with their willingness to challenge
my ideas, offering thoughtful perspectives on the process of becoming
helpers, and providing examples for the text. I tried out all the chapters and
the lab exercises on many classes before including them in the book. Finally,
and with much gratitude, I recognize and acknowledge my therapists,
professors, supervisors, and colleagues who served as wonderful models for
how to use helping skills and provided much encouragement throughout my
process of becoming a helper. I particularly want to acknowledge Bill
Anthony (who studied with Robert Carkhuff), from whom I first learned
helping skills many years ago in graduate school. I clearly recall the heady
times of coming to believe that I could help clients if I applied the helping
skills. I also want to particularly acknowledge my colleague Charlie Gelso,
whose collaboration and friendship was crucial in helping me develop my
ideas over the years. And finally, and most importantly, my husband, Jim
Gormally, who was in the first helping skills course with me and has listened
to and added to my ideas over all these years.
I
OVERVIEW
1
Introduction to Helping
Nothing in life is achieved without effort, daring to take risks, and often some
suffering.
—ERICH FROMM
Angeli was a stellar student and athlete. She was president of her high school class and had been
accepted into an elite eastern university. By any standard, she was an exceptional and talented
individual with much promise. However, after arriving at college, Angeli began to feel sad.
Much to the dismay of her family, teachers, and friends, she lost interest in interacting with
others, studying for her classes, and attending track practice. Angeliʼs track coach encouraged
her to meet with a helper, who helped Angeli explore her feelings and gain understanding of the
issues underlying her sadness and inactivity. Angeli felt supported and cared for by her helper.
The helping relationship enabled her to express, understand, struggle with, and overcome the
feelings of inadequacy, loneliness, and loss that emerged when she left home for college.
As you read about Angeli and think about what it would be like to be her
helper, you may have contradictory thoughts and feelings. You may feel
confident that you could help someone like Angeli because you have listened
to and advised friends and family members about similar problems. But you
may also feel anxiety about knowing specifically how to help her explore her
feelings, gain understanding, and work to get back her confidence.
If you are interested in learning more about the skills that could help you
work with someone like Angeli, you have come to the right place. The first
purpose of this book is to provide you with a theoretical framework that you
can use to approach the helping process. The second purpose is to teach you
specific skills to use in sessions with clients to help them explore, gain
insight, and make changes in their lives. The third purpose is to get you
started in the process of coming to think of yourself as a helper. The fourth
purpose is to help you become more aware of your thoughts, feelings, and
behaviors and how you might affect clients.
In this chapter, I first define helping and then talk about the effectiveness
of helping, along with the facilitative and problematic aspects of helping. I
then describe what makes people seek out professional helpers, and that leads
naturally to a discussion about of the healthy and unhealthy motivations for
helping other people. Then, turning to learning helping skills, I talk about the
importance of practicing the skills to become a better helper. A section on
ethics is included next to stress the importance of acting ethically and
professionally. Finally, I describe the organization of the book and discuss
how it can best be used.
Welcome aboard! I hope you enjoy learning and using helping skills as
much as I have.
WHAT IS HELPING?
Helping is a broad and generic term that includes the assistance provided by
a variety of individuals, such as friends, family, counselors, psychotherapists,
and human service providers. Although there are many kinds of assistance
that can be provided (e.g., instrumental help, such as driving someone to the
airport), in this book, the skills we focus on are primarily the verbal help
related to listening and encouraging exploration of personal and emotional
concerns.
I use the broad term helping because such verbal help can be provided by
many people (friends, partners, associates, counselors, psychotherapists).
Within the broad construct of helping are the narrower fields of counseling
and psychotherapy, which are reserved for people who engage in further
education and credentialing to become mental health professionals. Similarly,
Wampold and Imel (2015) defined psychotherapy as a
primarily interpersonal treatment that is a) based on psychological
principles; b) involves a trained therapist and a client who is seeking
help for a mental disorder, problem, or complaint; c) is intended by the
therapist to be remedial for the client disorder, problem, or complaint;
and d) is adapted or individualized for the particular client and his or
her disorder, problem, or complaint. (p. 37)
Throughout this book, then, the term helper refers to the individual
providing assistance, and the term client refers to the person receiving
support. Helping can be defined as one person assisting another in exploring
feelings, gaining insight, and making changes in his or her life. Helpers and
clients work together to achieve these outcomes, with helpers guiding the
process and clients deciding what, when, and how they want to change. Note
that this process is not the same as a sick person going to a medical doctor
and hoping to be fixed by the expert, but rather is the collaboration between
one person (the client—clients are the experts on themselves and have the
agency to choose to change) consulting with another (the helper, a humanly
flawed person who chooses to listen and serve as a sounding board) about a
problem in living.
When I talk in this book about trainees who are learning helping skills by
practicing with each other or with volunteer clients, I refer to the process as
helping. In contrast, when I talk about clients seeking help from trained and
licensed professionals, I use the terms counseling (or counselor) and
psychotherapy (or therapist or psychotherapist).
Students often also ask about the differences between counseling and
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