Wednesday, April 24, 2013

The Skilled Helper


In Gerad Eagan’s seminal work The Skilled Helper, he outlines three stages of skilled helping in the counseling profession. The three stages are; The Current Picture, The Preferred Picture, and The Way Forward. In the current picture, the helper seizes the opportunity to show the client their current circumstance. Many times, a client feels overwhelmed and just having someone walk them through their current crisis can have not only a calming effect, but also enlighten them and sometimes even allow them to devise a solution for themselves. This current picture is a general “snap shot” with “neither too much or too little information.(72) Stage two is the preferred picture. In the stage two the client is shown the skills necessary to create a preferred future. This could be classified as the problem management stage of helping. Stage two then focuses on the payoff for the work and the result of the sessions. In stage three, the helper zeros in on the way forward. Stage three discussions are the strategy sessions that enable the client to create and ultimately execute a change agenda.  The way forward, then, is the apparatus for planning and implementation stage.

Each stage has a set of three tasks that are involved in creating positive change of the client. In stage one, the tasks are helping the clients tell their story, and then helping them clarify a new perspective that will enable them to be more constructive, and finally to help the client focus in on which area will create the most return on their investment of time. Task one really centers on allowing the client to talk through their problem as they see and define it. The skilled helper will listen and nudge accordingly, but not interfere with the story as it takes shape. As Egan puts it, the client is in the driver’s seat of the story’s makeup. (73) Another important aspect of stage one is trust. The relationship hinges on how stage one proceeds.
In task two, the object is to help clients fill in the meaningful and missing details, so that they can be shown a more constructive view f their dilemma. Helpers should be cautious to not direct clients toward conclusions, but instead direct the client to new self discoveries about their own personal journey. Allowing the client to discover for him or herself new perspectives, see blind spots in their own lives, and make connections that may be missing is a main part of task two sessions. (230-231)
In task three, the skilled helper narrows down the issues that are plaguing the client to actionable points that can be dealt with. Attempting to fix too much too soon is a sure fired recipe for disaster and failure. Counselors can help their client to define the most problematic issues, prioritize the strategy for fixing those problems, and, when necessary, to break down larger problems into manageable (bite sized) projects that are a sub-set of the larger problem.  Confrontation and immediacy are major portions of the skilled helper’s job in task three.

Stage two focuses on the future. Task one here challenges the client to visualize a better life. What would a life missing the problem at hand look like? Visualizing the preferred future can open up the client to possibilities they may have otherwise not envisioned. Task two puts the impetus on goal setting. Now that we know the problem and have it defined, and have begun to look and imagine a better situation, what realistic goals can be set to challenge ourselves to reach that future? Likewise, task three deals with motivation. Keeping the client motivated to reach the goals that have been set up. Creating a desire in the client and them asking them to contemplate what they are willing to sacrifice for the preferred future is a core component of stage three. By seeing the sacrifices ahead of time, the client is less likely to see those same sacrifices as insurmountable later.

Stage three focuses on the path. The client should be asking him or herself, “What pathway, what game plan, what approach best allows me to accomplish my goals?” Nevertheless, Egan cautions the helper that, “action—though essential—is valuable only to the degree that it leads to problem-managing and opportunity developing outcomes.” (355) In other words, action for action sake helps no one. It must have a controlled accomplishment scenario to be effect.
In task one; we see that goal setting is now turned into a strategy session, making a battle plan for achieving the goals. Clients can brainstorm the issue taking advantage of the helper’s presence and counsel. As Solomon wrote, “plans fail for lack of counsel, but with many advisers they succeed.” Proverbs 15:22 (NIV)
In task two the objective is an actionable plan. Taking the brainstorming points and boiling them down to an actual task that can be, with deference to the client’s personality DNA, be accomplished. Here a pro/con list can be established to see how the client’s value system best matches strategies proposed.
Lastly, task three takes the strategies and plan and executes them in a clearly defines step-by-step procedure. The procedure will hopefully keep the client from becoming overwhelmed and rushing into stages and problem resolutions that have yet to be addressed.

The last item is the action arrow, which simply put is actually executing the plan. Once accomplished, the process of stage three can be repeated for the next problem on the chain.

The Three Domains Of Integrationist Psychology

The three domains of integrationist psychology are “Symptom-focused,”  “Schema-focused,” and “Relationship-focused” areas. These are also classified as functional, structural, and relational domains. McMinn and Campbell identify these three domains as an incorporation of the Imago Dei in counseling, and I agree—especially in view of my Trinitarian understanding of the Imago Dei and the nature of man as a Tripartite creature. The domains fit nicely into a reversed view of man’s dilemma as stated in 1 Thessalonians 5:23: “Now may the God of peace Himself sanctify you completely; and may your whole spirit, soul, and body be preserved blameless at the coming of our Lord Jesus Christ.” Paul sees man here as a spiritual, soulical, and physical creature vying for the love, care, and affection desired on each level. Paul lists them in order of their eternal importance. Each domain of man is seen in his conscious (or unconscious) efforts to find peace. Our spirit is, then, our God consciousness, our soul is our self consciousness, and our body is our environmental consciousness. The psychological domains simply put them in antithesis to the biblical order, which makes sense because man tends to focus on environment ahead of the spiritual.

Domain one, then, is symptom focused because it gives attention to our environmental issues—our behaviors, thoughts, and feelings. In one example, it is possible to become so burdened by the pressures of society that we can begin to have physiological symptoms based on that stress.  In the soul-care paradigm, the wise counselor can help the client navigate life to avoid pitfalls and traps that lead to the stress filled condition.  In the medical-care paradigm, the physician can prescribe drugs, such a xanax, to treat the anxiety caused by the stress, but does little to help relieve the root cause, instead focusing on the symptoms. (Many good, Christian doctors will attempt to do both.)

The counselor practicing soul care can move to level two, focusing on the soul, or self consciousness. In the medical-care paradigm a physician will refer a client to a therapist for this area. The soul-care paradigm will focus on discovering deep seated issues within the individual’s background that creates pressures and fears that lead to high anxiety.  The term “baggage” comes to mind. Counselors talk about what “baggage” are we carrying from our past that makes us who we are today. Did our fathers ignore us? Did our older brother outshine us? Did our mother and father divorce, leaving us with a sense of un-fulfillment, or a parent die leaving us with separation anxiety? This baggage weighs us down and keeps us from achieving our full potential, which the Christian counselor would say was weak at best anyway. The writer of the Bible book of Hebrews said that because “we are surrounded by so great a cloud of witnesses, let us lay aside every weight (i.e. baggage), and the sin which so easily ensnares us, and let us run with endurance the race that is set before us, looking unto Jesus, the author and finisher of our faith, who for the joy that was set before Him endured the cross, despising the shame, and has sat down at the right hand of the throne of God.” Hebrews 12:1-3 (NKJV) Let us face the facts; everyone of us has a scarred and marred soul because somewhere, sometime, someone let us down; and the fact that we are marred from God’s perfect image because of our sinful nature and actions. Nevertheless, the Bible provides a prescription for healing the scars and allowing us to lose the weight of those bags by moving forward with Christ. The integrationist approach marries, then, the best of psychology (losing the baggage) and spirituality (laying aside every sin) into soulical care.

The third domain is the reconnectivity (as I see it) of God’s Spirit and man’s spirit. Man is born with a dead spirit thanks to the sin of Adam. (see Romans 5) The medical-care paradigm has nothing to offer here. Neither does psychology, for that matter. This is the realm of clergy and the soul-care paradigm. Relationships that are broken on the human level can be repaired, and even healed. But they cannot exhibit the type of freeing joy that they deserve until forgiveness and unity are achieved at a level only God can provide. I have personally seen over the last five years of my ministry marriages restored after divorce papers were filed (with three separate couples!) because of God’s intervention at this level. When the couples began to climb the relational triangle together with the Lord, as they drew closer to Him, they naturally drew closer to each other. Man cannot have a proper relationship with his fellow man, until he has a proper relationship with God.