The Helping Professions
“Since helping and problem solving are such common human experiences, training in both solving one’s own problems and helping others solve theirs should be as common as training in reading, writing and (arithmetic). But this is not the case.” (Egan 1994, p.4)
This book is aimed specifically at people whose work involves helping others, in some capacity. In recent years the term ‘helping professions’ has come to be used to describe those of us whose work involves helping people tackle some aspect of their lives that has become problematic (e.g. Barsky, 2000; Combs 1971).
Some occupations are formally recognised as part of the helping professions by virtue of the fact that their daily work involves supporting people, for example social work, counselling, psychiatry, the clergy and others. But there is a second group, much larger and covering many more professions where the primary role is not seen as caring or support in the same way, but where the daily routine will inevitably involve helping people in crisis or distress, or who are struggling with the effects of social deprivation, health-related problems, or to adapt to dramatic change in their lives.
This army of ‘informal helpers’ uses many of the same skills as the first group – essentially these are the skills of counselling – yet they will often receive little or no training to develop their helping skills because the ‘supporting’ aspects of their work are seen as secondary or incidental to their primary role (Egan, 1994).
This second group includes staff in callings as diverse as advocacy, charity and aid work, conflict resolution, human resources, the law, medicine, occupational health, probation, physiotherapy, social work, human resources, teaching, and many others one can think of. Many of these professions use counselling and therapeutic approaches in their practice, and those which do not at least use the skills of counselling such and rapport-building, the conscious use of empathy, listening, questioning, problem-solving and supporting.
Some also make use of supervision, where a more experienced professional ‘de-briefs’ the practitioner at regular intervals, to aid personal development, safeguard professional standards and support the worker (Egan, 1998; Hawkins & Shohet, 2000).
One thing that all those who work in the helping professions share, is that they talk to those they help. Counsellors and psychotherapists do talking therapy, but while everyone who supports or cares for others has the opportunity to use language creatively and therapeutically, few are exposed to training that will help them do it effectively. This book sets out to address this by offering an SFBT framework for the helping professions.
There is a third group where these skills are just as important but who receive neither recognition nor training to support them in their helping role. Almost six million carers in the UK provide unpaid care for a family member, friend or partner who is ill, frail or disabled (DOH 2009). Though not formally part of the helping professions, in supporting those they care for they need to use the same skills of communication, problem solving, listening, persuading and influencing of any of their professional counterparts. Frequently this role is even more arduous than that of the professional helper because carers provide round-the-clock support for those they care for, and many are also in full-or part-time work.
The role of helper
Whether paid or voluntary, through a combination of personal qualities, skills and the helping relationship, members of the helping professions seek to enhance the quality of peoples’ lives by producing growth conditions leading to positive outcomes that are important to the client (Bramwell and MacDonald 1999). This usually means that in addition to supporting their clients, helpers are also help them to learn or develop skills that will enable them to become partially or wholly independent of the helper. Helpers therefore have a primary goal to “Help clients manage their problems in living more effectively and develop unused or underused opportunities more fully” (Egan 1998, p.7).
Clients also have desired outcomes, or goals. Often these may not be explicit at the outset, they simply want support or relief from some problem or distress. While many helpers see supporting others as a key part of their role, so is guiding the client towards increased self-sufficiency or independence. Once the initial level of support has been established, and this usually a by-product of a healthy helping relationship, the two then work collaboratively to define some workable goals for the client, and then help them move towards them.
In recent years the helping relationship has been subtly but persistently shifting from one where the emphasis was on support, to one where client independence is becoming order of the day. Empathetic and caring support is still fundamental, but in our target-driven age of financial pressure and reduced resources, this independence is increasingly a primary role of agencies and services in the social health and welfare sectors.
For the past 20 years I have been involved, as a consultant, trainer and therapist, in helping teams and individuals to make this transition. Faced with the need to cut costs staff have been told they must ‘work smarter’. Though some people resist this trend it is inexorable. In some cases helping professionals feel that they are being pressured into working more briefly with their clients and in some quarters this leads to considerable tension, not to say foot-dragging and occasional refusal to adopt new practices. In my experience this initial and understandable resistance is easily overcome when practitioners realise that becoming more effective in their work with their clients in no way compromises the quality of the service they offer, on the contrary clients are happier, helpers are more energised and interventions are usually briefer.
Problems are the starting point for the helping process. Problem situations arise inside ourselves, between ourselves and others, within families, groups, teams and organisations, at work and in communities. Those we help, whether they are troubled by intrapersonal problems, unwanted habits or behaviour, or something external to themselves such as relationship difficulties, unfair treatment, navigating complex administrations, finding their voice or becoming more effective in some aspect of their lives, seek improvement in some way (Egan 1998).
They are seeking to change something about themselves or in their relationships with others and they are seeking – or have been told they must seek –seek help to alleviate their difficulties and become more effective.
The role of the helper to is to fulfil two major purposes; establishing a relationship and facilitating action (Brammer and MacDonald 1999). Incumbent in this role is the responsibility to those we help to be as effective and resourceful as we can in our helping, which in turn implies a commitment to continuing professional development to enhance our skills and understanding. If we do not do the best we can by continuing to learn and improve we are failing ourselves and our clients.
Implicit too in the role of helper is the ability to help clients solve problems. Most of us are not very well schooled in doing this, and many helping professionals struggle with this aspect of their work. Most have studied models of helping, but these often prove inappropriate or ill-adapted to the complexities of our client’s worlds, their lack of motivation and even at times, their hostility. SFBT provides a structured, short-term and approach which enables client and helper to establish a collaborative relationship, plan actions and construct solutions to their problems.
Solution-talk versus problem-talk
SFBT is an approach to therapeutic communications that empowers both clients and helpers. Though it has developed – as its title suggests – as a form of brief, talking therapy, the approach brings with it a wealth of easily learned and adaptable techniques which will enhance the skills of any capable health professional whatever the setting.
Traditionally clinical approaches have focused on what is wrong with the client, communications have naturally followed suit. But imagine for a moment a world where, in discussing a problem with the client, rather than focussing on what is wrong and exploring problem, we focus on what is working; on the successes and strengths which the client (and helping professionals very often too) will have overlooked.
Steve de Shazer, generally credited with being the originator of the approach, says “Traditionally therapy focused on problem solving… when solution focused, the therapist talks about changes, differences that make a difference and solutions, rather than talking about difficulties, complaints and problems.” (1986, pp. 48-49) The changes that clients experience simply as a result of this cognitive shift in focus can be quite remarkable, and therapists and helpers find the approach feeds their enthusiasm for working with their clients, rather than depleting their energy in hours spent discussing the problem.
Over the years the thousands of helping professionals I have met through my workshops and seminars have confirmed the appeal of introducing solution focused ideas into their work. Many of these were counsellors who were seeking to refresh or update their skills, but most have been from other professions, and who felt the need develop the skills that would enable them to work more effectively with their clients. Sometimes this was because in the increasingly ‘results-driven’ culture of the public services their case load was increasing, while others were seeking to improve their work-related communication skills. Whatever the reason, all were agreed that they wanted to work more effectively in helping their clients.
Why the Helping Professions need SFBT
A few years ago a physiotherapist said to me “I never wanted to be a counsellor, but as soon as I saw my first client I realised that was part of what I have to do.” Since then I have repeatedly heard similar comments from practitioners from many different backgrounds in the social, health and welfare fields, education, the church, occupational health and increasingly lately, in business as well.
The role of the Helping Professional requires a full and effective range of communications skills. Just as a physiotherapist’s role – whether hospital based or out in the community – means working with people who may be anywhere on the spectrum from contented and cooperative to angry and antisocial, so many other professionals, from teachers to social workers, acupuncturist to medical practitioner, find their communication skills tested to the limit in demanding situations.
This does not only mean service users. Relatives, other carers and even colleagues can test our abilities (and our nerves) to the limit at times. The ability to communicate as an effective professional is part of the remit and virtually every carer, helper and support worker. Even though most of people that I have met in almost two decades spent training health care staff have shown themselves to be capable and dynamic in this area, I also meet those who admit to feeling drained, demoralised or at least defeated by a client or patient’s non-compliance, inability or unwillingness to follow instructions, or their constant negativity.
Dealing with people in such circumstances means having to handle the full range of emotional expressions and experiences which, though they might be quite incidental to the main object of the relationship, can make the difference between success or failure. And success or failure will have a critical impact on outcome and thereby on the professional self-esteem, confidence and morale of the helper. We can’t win ‘em all, as they say, but every successful and satisfying outcome breathes a little bit of new life into us and benefits our future clients.
So how would it be to feel more confident and resourceful in the face of even the most daunting response from a patient or client? The benefits for service users and practitioners could be enormous. Solution Focused Brief Therapy (SFBT) gives us a range of tools to do just that and more.