Professional Documents
Culture Documents
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
psychotherapy. Counselors tend to be people who are trained and licensed at
the masterʼs level, whereas psychotherapists tend to be people trained and
licensed at the doctoral level, as clinical, counseling, or school psychologists.
Counseling and psychotherapy are also sometimes differentiated by length of
treatment, such that counseling often has fewer sessions than does
psychotherapy. Clients also sometimes differ, in that counseling is more often
used with relatively “healthy” individuals who have issues with adjustment,
whereas psychotherapy serves those who have more serious pathology or
unresolved conflicts. I should note that research has not shown differences in
outcome related to type of degree or level of training (Wampold & Imel,
2015), so these terms and distinctions are often related to turf wars rather
than demonstrated competencies.
Helping does tend to differ from everyday conversation with friends,
however. Whereas conversations with friends ideally involves both people
equally sharing their problems and listening (50–50), helping more typically
involves one person sharing problems and the other person listening and
supporting (more like 80–20). But interestingly, many of the communication
skills learned early in life with friends and family transfer to helping
relationships. So, we can build on what you have learned in early
relationships to help you refine your skills and become more aware of your
impact so that you can be more effective in helping relationships.
IS PSYCHOTHERAPY EFFECTIVE?
Two factors seem to be necessary for people to seek help (Gross &
McMullen, 1983). First, people must become aware that they are in pain or
facing a difficult situation and then must perceive their feelings or situations
as being problematic. Obviously, the perception of pain varies from person to
person, such that what is unbearable for one person is easily tolerated or
ignored by another person. Second, the pain must be greater than the
perceived barriers to seeking help. Some barriers involve practical
considerations, such as the time or money required to obtain help; whereas
others are emotional and include fears about exploring problems deeply or
concerns about being stigmatized for seeking help.
Many people hesitate to seek professional help (Gross & McMullen,
1983) because they feel embarrassed or ashamed about asking for assistance
or believe that seeking help constitutes emotional weakness or inadequacy
(Shapiro, 1984). Many Americans, for example, believe that individuals
should rely solely on themselves and that all problems should be solved
individually. Many men feel do not seek help because it does not fit gender-
norm stereotypes (Pederson & Vogel, 2007). Given these beliefs, it is not
surprising that researchers have found that people seek help first from friends
and family members and only last from professionals (Snyder, Hill, &
Derksen, 1972; Tinsley, de St. Aubin, & Brown, 1982; Webster & Fretz,
1978).
Some people are concerned about talking with others because they feel
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DANCE ON STILTS AT THE GIRLS’ UNYAGO, NIUCHI
I see increasing reason to believe that the view formed some time
back as to the origin of the Makonde bush is the correct one. I have
no doubt that it is not a natural product, but the result of human
occupation. Those parts of the high country where man—as a very
slight amount of practice enables the eye to perceive at once—has not
yet penetrated with axe and hoe, are still occupied by a splendid
timber forest quite able to sustain a comparison with our mixed
forests in Germany. But wherever man has once built his hut or tilled
his field, this horrible bush springs up. Every phase of this process
may be seen in the course of a couple of hours’ walk along the main
road. From the bush to right or left, one hears the sound of the axe—
not from one spot only, but from several directions at once. A few
steps further on, we can see what is taking place. The brush has been
cut down and piled up in heaps to the height of a yard or more,
between which the trunks of the large trees stand up like the last
pillars of a magnificent ruined building. These, too, present a
melancholy spectacle: the destructive Makonde have ringed them—
cut a broad strip of bark all round to ensure their dying off—and also
piled up pyramids of brush round them. Father and son, mother and
son-in-law, are chopping away perseveringly in the background—too
busy, almost, to look round at the white stranger, who usually excites
so much interest. If you pass by the same place a week later, the piles
of brushwood have disappeared and a thick layer of ashes has taken
the place of the green forest. The large trees stretch their
smouldering trunks and branches in dumb accusation to heaven—if
they have not already fallen and been more or less reduced to ashes,
perhaps only showing as a white stripe on the dark ground.
This work of destruction is carried out by the Makonde alike on the
virgin forest and on the bush which has sprung up on sites already
cultivated and deserted. In the second case they are saved the trouble
of burning the large trees, these being entirely absent in the
secondary bush.
After burning this piece of forest ground and loosening it with the
hoe, the native sows his corn and plants his vegetables. All over the
country, he goes in for bed-culture, which requires, and, in fact,
receives, the most careful attention. Weeds are nowhere tolerated in
the south of German East Africa. The crops may fail on the plains,
where droughts are frequent, but never on the plateau with its
abundant rains and heavy dews. Its fortunate inhabitants even have
the satisfaction of seeing the proud Wayao and Wamakua working
for them as labourers, driven by hunger to serve where they were
accustomed to rule.
But the light, sandy soil is soon exhausted, and would yield no
harvest the second year if cultivated twice running. This fact has
been familiar to the native for ages; consequently he provides in
time, and, while his crop is growing, prepares the next plot with axe
and firebrand. Next year he plants this with his various crops and
lets the first piece lie fallow. For a short time it remains waste and
desolate; then nature steps in to repair the destruction wrought by
man; a thousand new growths spring out of the exhausted soil, and
even the old stumps put forth fresh shoots. Next year the new growth
is up to one’s knees, and in a few years more it is that terrible,
impenetrable bush, which maintains its position till the black
occupier of the land has made the round of all the available sites and
come back to his starting point.
The Makonde are, body and soul, so to speak, one with this bush.
According to my Yao informants, indeed, their name means nothing
else but “bush people.” Their own tradition says that they have been
settled up here for a very long time, but to my surprise they laid great
stress on an original immigration. Their old homes were in the
south-east, near Mikindani and the mouth of the Rovuma, whence
their peaceful forefathers were driven by the continual raids of the
Sakalavas from Madagascar and the warlike Shirazis[47] of the coast,
to take refuge on the almost inaccessible plateau. I have studied
African ethnology for twenty years, but the fact that changes of
population in this apparently quiet and peaceable corner of the earth
could have been occasioned by outside enterprises taking place on
the high seas, was completely new to me. It is, no doubt, however,
correct.
The charming tribal legend of the Makonde—besides informing us
of other interesting matters—explains why they have to live in the
thickest of the bush and a long way from the edge of the plateau,
instead of making their permanent homes beside the purling brooks
and springs of the low country.
“The place where the tribe originated is Mahuta, on the southern
side of the plateau towards the Rovuma, where of old time there was
nothing but thick bush. Out of this bush came a man who never
washed himself or shaved his head, and who ate and drank but little.
He went out and made a human figure from the wood of a tree
growing in the open country, which he took home to his abode in the
bush and there set it upright. In the night this image came to life and
was a woman. The man and woman went down together to the
Rovuma to wash themselves. Here the woman gave birth to a still-
born child. They left that place and passed over the high land into the
valley of the Mbemkuru, where the woman had another child, which
was also born dead. Then they returned to the high bush country of
Mahuta, where the third child was born, which lived and grew up. In
course of time, the couple had many more children, and called
themselves Wamatanda. These were the ancestral stock of the
Makonde, also called Wamakonde,[48] i.e., aborigines. Their
forefather, the man from the bush, gave his children the command to
bury their dead upright, in memory of the mother of their race who
was cut out of wood and awoke to life when standing upright. He also
warned them against settling in the valleys and near large streams,
for sickness and death dwelt there. They were to make it a rule to
have their huts at least an hour’s walk from the nearest watering-
place; then their children would thrive and escape illness.”
The explanation of the name Makonde given by my informants is
somewhat different from that contained in the above legend, which I
extract from a little book (small, but packed with information), by
Pater Adams, entitled Lindi und sein Hinterland. Otherwise, my
results agree exactly with the statements of the legend. Washing?
Hapana—there is no such thing. Why should they do so? As it is, the
supply of water scarcely suffices for cooking and drinking; other
people do not wash, so why should the Makonde distinguish himself
by such needless eccentricity? As for shaving the head, the short,
woolly crop scarcely needs it,[49] so the second ancestral precept is
likewise easy enough to follow. Beyond this, however, there is
nothing ridiculous in the ancestor’s advice. I have obtained from
various local artists a fairly large number of figures carved in wood,
ranging from fifteen to twenty-three inches in height, and
representing women belonging to the great group of the Mavia,
Makonde, and Matambwe tribes. The carving is remarkably well
done and renders the female type with great accuracy, especially the
keloid ornamentation, to be described later on. As to the object and
meaning of their works the sculptors either could or (more probably)
would tell me nothing, and I was forced to content myself with the
scanty information vouchsafed by one man, who said that the figures
were merely intended to represent the nembo—the artificial
deformations of pelele, ear-discs, and keloids. The legend recorded
by Pater Adams places these figures in a new light. They must surely
be more than mere dolls; and we may even venture to assume that
they are—though the majority of present-day Makonde are probably
unaware of the fact—representations of the tribal ancestress.
The references in the legend to the descent from Mahuta to the
Rovuma, and to a journey across the highlands into the Mbekuru
valley, undoubtedly indicate the previous history of the tribe, the
travels of the ancestral pair typifying the migrations of their
descendants. The descent to the neighbouring Rovuma valley, with
its extraordinary fertility and great abundance of game, is intelligible
at a glance—but the crossing of the Lukuledi depression, the ascent
to the Rondo Plateau and the descent to the Mbemkuru, also lie
within the bounds of probability, for all these districts have exactly
the same character as the extreme south. Now, however, comes a
point of especial interest for our bacteriological age. The primitive
Makonde did not enjoy their lives in the marshy river-valleys.
Disease raged among them, and many died. It was only after they
had returned to their original home near Mahuta, that the health
conditions of these people improved. We are very apt to think of the
African as a stupid person whose ignorance of nature is only equalled
by his fear of it, and who looks on all mishaps as caused by evil
spirits and malignant natural powers. It is much more correct to
assume in this case that the people very early learnt to distinguish
districts infested with malaria from those where it is absent.
This knowledge is crystallized in the
ancestral warning against settling in the
valleys and near the great waters, the
dwelling-places of disease and death. At the
same time, for security against the hostile
Mavia south of the Rovuma, it was enacted
that every settlement must be not less than a
certain distance from the southern edge of the
plateau. Such in fact is their mode of life at the
present day. It is not such a bad one, and
certainly they are both safer and more
comfortable than the Makua, the recent
intruders from the south, who have made USUAL METHOD OF
good their footing on the western edge of the CLOSING HUT-DOOR
plateau, extending over a fairly wide belt of
country. Neither Makua nor Makonde show in their dwellings
anything of the size and comeliness of the Yao houses in the plain,
especially at Masasi, Chingulungulu and Zuza’s. Jumbe Chauro, a
Makonde hamlet not far from Newala, on the road to Mahuta, is the
most important settlement of the tribe I have yet seen, and has fairly
spacious huts. But how slovenly is their construction compared with
the palatial residences of the elephant-hunters living in the plain.
The roofs are still more untidy than in the general run of huts during
the dry season, the walls show here and there the scanty beginnings
or the lamentable remains of the mud plastering, and the interior is a
veritable dog-kennel; dirt, dust and disorder everywhere. A few huts
only show any attempt at division into rooms, and this consists
merely of very roughly-made bamboo partitions. In one point alone
have I noticed any indication of progress—in the method of fastening
the door. Houses all over the south are secured in a simple but
ingenious manner. The door consists of a set of stout pieces of wood
or bamboo, tied with bark-string to two cross-pieces, and moving in
two grooves round one of the door-posts, so as to open inwards. If
the owner wishes to leave home, he takes two logs as thick as a man’s
upper arm and about a yard long. One of these is placed obliquely
against the middle of the door from the inside, so as to form an angle
of from 60° to 75° with the ground. He then places the second piece
horizontally across the first, pressing it downward with all his might.
It is kept in place by two strong posts planted in the ground a few
inches inside the door. This fastening is absolutely safe, but of course
cannot be applied to both doors at once, otherwise how could the
owner leave or enter his house? I have not yet succeeded in finding
out how the back door is fastened.