HHS310: H & HS Culture: The Helping Relationship (CGD1716A) Wk4 Discussion 1

Techniques

The basic skills considered earlier are implemented through use of various techniques or methods or procedures. We will examine some of the major techniques here.

Small Talk

Frequently, at the beginning of a contact—interview, discussion, conference, or meeting— inconsequential conversation that has no part in the real business of the relationship will be used as an ice breaker or to put client and worker at ease. In a committee meeting, group, or class, this could take the form of introductions, a cup of coffee, a speaker’s introductory joke, and so forth. Small talk has a utilitarian purpose because it offers clues and affords opportunity for the preliminary judgments that are made by all participants about the nature of the persons involved. It can, however, create more anxiety than it allays, particularly if carried on too long, or if used to evade the real purpose. It is a part of the worker’s task to assess the utility of this form of communication, use it as needed, and get down to the work at hand at the propitious time. In a crisis situation when feelings run high or immediate action is essential, use of small talk is usually contraindicated. If used, it should be with sensitivity to the situation and the pressure of anxiety, fear, or anger under which the client is laboring. The immediacy of the crisis will have some bearing, as will the client’s familiarity with the worker. How the client defines the worker’s role must also be considered. A uniformed police officer appearing at the door usually creates enough anxiety to make immediate identification and explanation of the purpose of the visit desirable. However, small talk and social amenities are frequently initiated by the client’s need for such communication. When the worker is making a home visit, most clients find it more comfortable to break the ice with inconsequential talk, and in ongoing contacts, this can become an

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almost ritualistic part of interviews that the worker deals with and then puts aside for the real purpose of the relationship.

The purpose and nature of the relationship itself will determine the extent to which social amenities are a part of the worker’s role; the worker should always be aware of how they are being used and what they mean. (In alerting a new worker to the problem inherent in socialization, a rural county welfare department director told the following story: A worker visited an elderly man who lived in an isolated area. As it was lunch time, the man urged the worker to share a sandwich and coffee, which she did. On her return to the office, she found an imperative memo to see the director immediately. He had received a call from the old client berating him for sending workers “to eat him out of house and home.”) In socialization, as in all things, a happy medium, knowledgeably arrived at, is the desired goal. Certainly, from our greater freedom in use of self comes the ability to engage in a greater amount of socialization within helping relationships. But when we do this, we must be prepared to understand all the possible implications and deal with the results.

Ventilation

The term ventilation covers a variety of techniques. It involves bringing to the surface, giving expression to, and opening for consideration those feelings and attitudes that need to be broached. It generally refers to feelings that are profound enough to affect the functioning of the people involved and prevent rational consideration of the problem at hand.

Feelings cannot be ignored; they must be dealt with. Positive emotions are accepted and dealt with fairly easily, but negative ones may present more difficulty, particularly in a culture where extreme emotional expressions such as anger and hate are frowned on. Only when workers are able to create a relationship in which it is safe to express any feeling, regardless of its intensity or nature, will they be able to help clients to deal with reality.

Human service workers often find themselves wishing that they could suspend their own and their client’s emotions while they utilize their rational capacities to deal with the problems of living. Emotions seem to obscure the real issues and impede solutions. Actually, the feelings themselves often constitute the basic problems that must be dealt with. Mrs. Allen is a case in point.

A neighboring university was considering Dr. Allen, a brilliant mathematician and department chairman, for an administrative position. When the team assessing his suitability visited the Allen home, they found considerable tension between the couple and an uncertainty in Mrs. Allen about her hostess role that raised concern about her ability to fulfill the social obligations of the new job. Because of his eminent suitability of the position, they arranged for an old professor and close friend of Dr. Allen’s to raise this question with him. As a result, the couple went for help to a family counselor who, after interviewing them together, talked with Mrs. Allen alone.

Levine, Joanne. Working with People: The Helping Process (Page 170). Pearson Education. Kindle Edition.

Here her initial anger was quickly dropped, and she talked at length about feeling inadequate to handle the demands that her husband’s increasing importance made on her. After securing her bachelor’s degree, she had worked for many years as a secretary to put her husband through his graduate work. Her identification was with the “girls” in the secretarial department rather than with the professionals with whom she now socialized. Behind these feelings lay her childhood in an ambitious middle-class family in which the parents were never totally satisfied with the achievements of their children, leaving her with a feeling of basic inadequacy and inability to be comfortable with other people, whom she felt were always critical of her.

In this instance, ventilation of these feelings was far from sufficient; it was only the first step, for reversing a lifetime pattern is not done overnight. But it was an essential step in helping Mrs. Allen accept and start learning to deal with her problem.

Mr. Ziegler, on the other hand, had to deal with a transitory emotion that, once expressed, left him free to proceed with the practical details of straightening out his tangled financial situation. He was obviously laboring under great emotional strain when he came into the credit counselor’s office, and it required only the seemingly casual comment, “You really are shook up today,” to release an explosion of anger toward the loan company and the small print, not understood, in the time-payment contract that had been his Waterloo.

It is not difficult to get people to express feeling; the problem lies in knowing how much feeling to encourage and how to deal with what is expressed. he worker must be aware of the fact that mere expression of feeling, continued for too long, tends to feed on itself and assume unreasonable proportions. To leave the client wallowing in anger, selfpity, remembered pain, and fear is to do a disservice. In a sense, expressing feeling is clearing out the underbrush that prevents forward movement; the worker must be prepared to help the client move into the here-and-now situation, deal with the problems that occasion or are occasioned by these feelings, and concentrate energies on working toward change.

Human service workers are still predominantly white, middle-class people who frequently enjoy a fairly high degree of affluence, social prestige, and security. And—in the better paid and more powerful positions—they are usually men. We need to recognize and, if necessary, deal with the anger this may cause in clients and in other workers who lack these rewards. These feelings can be exacerbated when insensitive or inadequate workers disregard the reality of what it means to be poor, a member of a minority, jobless, handicapped or old, or a woman subjected to sex discrimination. Workers recognizing and undertaking to deal with these angers and depressions must know and face honestly their own feelings before they attempt to cope with those of others.

Support

Support is another term that encompasses many different techniques. In general, it means to encourage, to uphold, and to sustain. Workers must first know what they are supporting—an internal strength, a way of reacting, a decision, a way of behaving, a

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relationship. Once they have decided this, they must select a technique that will meet the need and express it in a way the client can understand and use. Techniques can range all the way from listening to the client talk, to sharing responsibility, to action. Most of what workers do should be supportive; even confrontation and questioning are done with acceptance and concern for the client’s need. In giving support, workers must not make the client’s success or failure in the area of being supported a matter of the worker’s “personal” feeling. If a worker does so, clients will have difficulty in sharing and dealing with the failures that are an inevitable part of life because they will feel that they have failed the worker.

The scene was a Gestalt therapy session, and the young man in the “hot seat” had just finished describing a dream. The other members had attacked his explanation of its meaning vigorously and had related this to what they saw as the destructive, unpleasant aspects of his behavior in the group. When he sat, crushed and weeping, they crowded around him, placing their hands upon him, raising him up, and physically supporting him with their bodies.

Mary Williams, 16 and long the scapegoat for her family’s problems, was supported by the worker in a family counseling session when he turned to her and asked rather pointedly, “What do you think is the problem in your family?” Here the worker was supporting the girl’s right to evaluate and contribute to the discussion and to see things from her own perspective.

A social worker, a teacher, an employer, or a doctor, faced with the necessity of helping a client, a student, an employee, or a patient accept and deal with some failure, will often consciously preface statements about inadequacy by pinpointing and giving credit for some success. Thus the obstetrician who must take issue with his pregnant patient about her weight gain will first indicate the successful results of other tests. Sustained by this success and support, the patient is better able to accept and work upon the failure.

To be useful, a helping relationship must be supportive, but the element being supported must be realistic. Support on a false basis is more destructive than no support at all, and support alone is not enough. “She always found something good to say,” said the mother of a large family with many, many problems, in trying to describe what her worker did that was helpful to her; she finished wistfully, “and sometimes she had to look pretty hard because things aren’t very good around here.”

A helping relationship by its very nature is supportive through the fact that workers are concerned people in and of themselves.

Ms. Millis, retired after an active and satisfying career, underwent annual examinations because of previous surgery for cancer. Each time she went to get the results of these tests, she called the agency to ask for a worker to accompany her. She wanted an objective person who could support her in her fear and with whose own emotional reaction she would not have to deal if the results indicated a return of the disease.

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Reassurance Although it can be considered a way of being supportive, reassurance is important in its own context. It involves assuring clients that the situations with which they are struggling have an attainable solution. Reassurance is a valid tool in that there is no life situation to which some adaptation cannot be made, even though the fact itself—for example, terminal illness or the destruction of a family home by urban renewal—cannot be changed. It is important that the worker reassure (1) realistically, not using superficial overall comforting that ignores reality; (2) at the proper time, giving the client a chance to adequately express concern and grief; and (3) knowingly, with awareness that both general and specific adaptations are possible in all situations. Wisely used, reassurance can be comforting and enabling. Poorly used, it can create even greater anxiety, as the client will feel that the worker does not fully understand the seriousness of the problem.

Reassurance can also be used with respect to the client’s capacities, feelings, and achievements. Clients are often reluctant to express negative feelings, particularly in a situation in which the worker has considerable power to give or withhold the help that is needed. Yet the feelings exist and influence the client’s ability to use the service. We see patients who meekly agree with doctors although they question the treatment recommended, students who continue with teachers although they feel they are not getting adequate instruction, and poor people who do not raise questions or express negative feelings because they are in terror of losing the basic essentials of life. It is the worker’s responsibility to reassure clients that they may air their questions and concerns without fear. We can only reassure in this fashion when the relationship is basically honest.

Clients often need reassurance of the significance of their own achievements and their own capabilities to deal with the problems they face. his form of reassurance in particular must be based on a realistic assessment of clients’ capabilities. It is no help to clients to set them up for failure. Often the factor that enables them to use what they have is the faith of a significant other person or people, such as a teacher or a peer group, in their capacity to change and grow. his faith reassures and supports clients in their efforts to do so.

Johnny Webster brought the employment application from the supermarket to his worker and pointed out the question, “Have you ever been arrested?” Two years earlier, he had been picked up with several other 16-year-olds at a pot party and—fortunately—had drawn a suspended sentence. Now he was trying to find a job. “I’ll never get one. If I answer ‘yes’ they won’t hire me; if I answer ‘no’ and I’m found out, then I’m ruined in this community.” The worker reassured him that while this would probably make it more difficult in some instances, it certainly was not the insurmountable obstacle that he pictured. “It’s a reality we have to deal with so let’s talk about ways in which we can handle it.”

Advocacy and Social Action

Human service workers have a long history of advocating for civil rights, better housing and health care, and educational opportunities for oppressed people—women, people of color, and gays and lesbians. Social workers are mandated by their code of ethics

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to advocate for all clients to have access to resources, services, and opportunities and for changes in policy and legislation to promote social justice (National Association of Social Workers, 2008). When we talk about advocacy, we mean representing, championing, or otherwise defending the rights of others. Social action, which includes techniques such as demonstrations or boycotts, may be used along with advocacy efforts but is typically more confrontational (Kirst-Ashman & Hull, 2001).

The process of advocacy involves working with and/or on behalf of clients (1) to obtain services or resources for clients that would not otherwise be provided; (2) to modify extant policies, procedures, or practices that adversely affect clients; or (3) to promote new legislation or policies that will result in the provision of needed resources or services. Workers advocate for individuals and families, called case advocacy, and for groups of people who have similar problems, called cause advocacy. The focus of both case and cause advocacy can be individuals, agencies, public officials, courts, legislation, and divisions of government (Hepworth et al., 2010).

Workers need to take several factors into account before initiating advocacy efforts. They need to consider whether advocacy is the best way to bring about change or whether another method is going to be more effective (also see Chapter 11). When workers are employed by an agency or other institution, they must clarify the organization’s level of commitment to the proposed advocacy efforts. Workers also must make sure that their clients agree with the workers’ advocating their causes. Clients have the right to decide whether to advocate and how far these efforts should go. Their decisions may strongly depend upon the workers’ giving them an honest assessment of both the risks and benefits. Advocacy can result in great changes, and those involved will experience varying degrees of tension and stress (also see the following sections on confrontation and conflict). Workers also cannot assume that advocacy efforts will always bring about the degree or type of change that is needed or wanted. Clarity is needed about what an acceptable amount of change will be, at what point the advocacy efforts will stop, and who will decide these matters. Clients must seriously consider the pros and cons, risks and benefits of advocacy to ensure their interests and needs are best met. here are many ways to advocate—what technique to use depends upon who or what is the focus of change, what method clients are comfortable with, the skills and abilities of the advocate, and the nature of the problem. Advocacy tactics are conferring with other agencies, appeals to review boards, initiating legal action, forming interagency committees, providing expert testimony, gathering information through studies and surveys, educating relevant segments of the community, contacting public officials and legislators, forming agency coalitions, organizing client groups, developing petitions, and making persistent demands to officials through continual letters and telephone calls (Hepworth et al., 2010; Kirst-Ashman & Hull, 2001). The worker can use tactics ranging from established procedures for appeal (e.g., review boards) to those that can border on harassment (e.g., making persistent demands through continual phone calls and letters). Prior to engaging in advocacy, workers must address the concerns and questions discussed earlier.

Perhaps the most recent advocacy tactics available to workers are available on the Internet. Electronic advocacy techniques include using web pages to post information about social injustices, provide “links” to targets of change (e.g., governmental agencies), and accept online

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