Reading C

All worthwhile helping frameworks, models or processes ultimately help clients ask and answer for themselves four fundamental questions:

• What’s going on? “What are the problems, issues, concerns, or undeveloped opportunities I should be working on?” This is the client’s current picture.
• What do I need or want? “What do I want my life to look like? What changes would make me happier?” This is the client’s preferred picture.
• How do I get there? “What do I need to do to make the preferred picture a reality? What plan will get me where I want to go?” This plan outlines the actions clients need to take to create a better future.
• How do I make it all happen? “How do I turn planning and goal setting into the kind of action that leads to solutions, results, outcomes, or accomplishments that have the impact I’m looking for? How do I get going and persevere until I manage my problems and develop my unused opportunities?”

Stage I: The Current Picture – Helping Clients Clarify the Key Issues Calling for Change

In Stage I, the current picture, counselors help clients spell out the issues, concerns, difficulties, or problems they are facing. What are the problems, issues, concerns, and undeveloped opportunities with which Mara needs to grapple? As we shall see here and in the chapters that follow, each stage is divided into three interrelated tasks. Like the stages themselves, the tasks are not steps in a mechanistic, “now do this” sense. Rather they are stage-specific activities designed to help clients achieve the goals of each stage. In Stage I the tasks are activities that help clients spell out their concerns as clearly as possible with neither too much nor too little detail. These three tasks help clients develop answers to three questions:

1. “What’s going on in my life or what are my main concerns?”
2. “As I look more closely, what’s really going on in my life or what new perspectives will help me deal with my concerns?”
3. “What should I be working on or which issues, if handled well, will make a real difference in my life?” Now let’s take a closer look at each of these tasks.

Task 1: Help Clients Tell Their Stories

Carlos knows that if he can help Mara get a reasonably clear picture of herself, her problems, and her unused opportunities, she will have a better chance of doing something about them. Using the communication skills outlined in Chapters 5, 6, and 7, he helps Mara tell her story and review her concerns.

When Carlos begins the session by saying, “Well, Mara, what’s going on? How can I help?” Mara responds by saying that she’s not there to rehash the accident and its immediate consequences, though she admits that she is still working it through. As she talks, however, she realizes that this is not going to be as easy as she thought. Talking about the accident would be relatively easy, but talking about the fact that she has come to realize that she is broadly dissatisfied with the direction of her life seems much more daunting. This is unchartered territory. Furthermore, she is not used to sharing her concerns with anyone, not even her parents. She also wonders whether she should have chosen the woman as her counselor. Up to this point she has been able to keep all her problems under control but begins to wonder whether talking about them to a stranger will “cause the dam to burst.” In the midst of her ruminations Carlos suggests, “A bit of background about you and your family might help.” This sounds good to Mara. It’s relatively safe. So through the give and take of the conversation the details of the background outlined above emerge.

Then in the rest of this session and the next one a week later she moves on to her more immediate concerns. She is worried about her father, who has never gotten over the death of his son, the loss of his career, or his self-imposed exile from his country. He lives in America but has never felt American. His business is faltering because the economy is sputtering and cars are not selling. He has become more and more dependent on his daughter, though he can’t seem to admit this either to himself or to her. And because he does not take care of himself, he has health problems. He does not get checkups. He became disoriented one day, was taken to the hospital, and then released. The doctor said that he might have had a mini-stroke.

Besides worrying about her father, Mara has her own set of issues. Although in many ways fully American, she feels she has allowed herself to remain a captive of “old country” cultural norms. During her trip to Iran she had conversations with young people who seemed to be much more “culturally free” than she was. In her eyes they seemed to suffer from some political and financial constraints but seemed to know what they wanted. In the United States she certainly does not feel like an outsider, but she knows that she is not leading the “American life.” She’s not even sure that she wants to. She expresses some hostility toward her two cousins, at one time saying, “These guys,” while shaking her head. From her point of view they have brought American materialism hook, line, and sinker, and it has not really made them happy.

The young people she met in Iran seemed to have a rich social life. Not a wild one, but a rich one. She feels that she is missing out on something. These feelings have recently become more intense because she met a man she likes through work and has met him a few times for coffee. She has not told her parents anything about this, but she knows that they would not approve. She feels guilty about this. She has been suffering from insomnia and headaches for the past few months but has always put on such a good face that no one suspects. She talks about all of these things in a very matter-of-fact way.

These are some of the issues Mara brings up. As she becomes more comfortable with Carlos and with herself as client, she talks more freely. But there are still some hesitancies; Carlos realizes that clients’ stories don’t come tumbling out all at once in a neat package. Stories sometimes emerge or even “dribble out” over the entire course of the helping relationship. He also wonders whether at some point it would be wise to revisit the accident and the story of her recovery. But she is in the driver’s seat.

Task 2: Help Clients Develop New Perspectives That Help Them Reframe Their Stories More Constructively

The purpose of Task 2 is to help clients uncover hidden concerns, clarify vague issues, add important detail, explore their hesitancies, see their problems from a more constructive perspective, add important information they are leaving out, find unused strengths and resources, and spot and explore opportunities buried in or masked by problem situations. Counselors add great value when they can help their clients identify blind spots related to their problems and unused opportunities. In order to do this Carlos uses communication skills discussed in Chapters 8 and 9. Here are some of the things they uncovered as they worked together.

The first thing that Carlos notes is that Mara herself has developed a very useful new perspective. While she could have blamed the discontent she was feeling about her life on the auto accident, she realizes that the accident was a wake up call. Over the course of the helping encounter Carlos helps Mara develop a range of useful perspectives so that both of them will have a clearer picture of what’s going on in Mara’s life and what is bothering her the most. For instance, because she never talks about her mother, Carlos at one point says, “I’m curious why you never talk about your mother, except indirectly when you say ‘my parents.’ She’s sort of a missing person.” This helps Mara realize that she does not see her mother as an “agent” in her story. Her mother is “just there,” as it were. She hasn’t seen this as an issue, but maybe it is.

Carlos also helps Mara see that while, externally, she gives people the impression that she is assertive, a doer – that’s the way she comes across – she seems to endure personal problems rather than wrestle with them. Or in some ways she’s a doer and in other ways not.

Also because she feels culturally adrift – she describes herself as living between two cultures without becoming her own person in either of them – he wonders aloud how this might be affecting her. For instance, in her view her cousins having bought into the worst of American culture, are very narcissistic. She knows that her father disapproves, but he says nothing. She wonders what he’s saying to himself inside.

Carlos believes that some of the symptoms Mara is describing constitute a mild form of depression, though at this point he does not see any value in using the word itself. In one session he asks her whether she sees her insomnia and headaches as symptoms of health problems or reactions to the concerns she is discussing. Mara thinks that it is the latter but observes, “Well, this might be the kind of incentive I need to get a physical checkup. I haven’t had one in years. I don’t want to end up like my father.”

Carlos helps her get in touch with the fact that she describes herself as very duty driven. For instance, even though she does a great deal for her father both at work and at home, she intimates that she should be taking better care of him. She feels some guilt because she is not doing as good a job as she thinks she should do. Mara begins to realize that she resents the fact that she thinks like this.

Carlos does not just tell Mara all these things or interpret what she is saying. He does not use Task 2 skills and activities to “psych her out.” Rather he acts as a catalyst to help her make problem-making discoveries for herself.

Task 3: Getting Value - Help Clients Work on Issues That Make a Difference

Many clients have a range of issues. Mara certainly does. In such a case, help them choose issues that will make a significant difference in their lives. If a client wants to work only on trivial things or does not want to work at all, then it might be better to defer counseling.

At one point Carlos says to Mara, “So there are a number of things you would like to do to reset your life. What’s most important for you? If you could work on only one or two things, what would that be?” As they talk, three areas of concern emerge. First, Mara tends to take things as they are. She is reactive rather than proactive. Except for getting a business degree, she has done nothing about developing a career. She feels she has talents she is not using. In one session she notes, “Everyone sees me as a good worker. I do all my assigned tasks well and on time. I’m a good example for others there. But I don’t really add to the business. There’s a lot of things we could do to make the business more viable, but I’ve left all that to my father. But he’s not going to do it. Given what’s happening in the automotive industry, we could go out of business.” Furthermore, she is on automatic pilot in her dealings with her parents, doing what she is “supposed” to do. She gets on with the everyday tasks of life quite well. Her parents have never faulted her for not being a contributor.

Second, she has not come to grips with being an Iranian-American. She has no social life outside the family and work and has a vague sense of taboo when it comes to developing an intimate relationship with a man. She does not known what kind of social being she is or wants to be. She realizes that she has come to hate what she calls her “cultural neutrality.”

Third, she realizes she lacks “enthusiasm,” perhaps her way of saying that she feels depressed much of the time. Carlos is quite hesitant to suggest that she work on her “depression” directly. She seems to be depressed because she feels that she is going nowhere rather than being unable to go anywhere because she is depressed. His best bet is that it will diminish or disappear once she begins to make headway in the substantive areas of her life.

Mara does not come up with all of this in the order which it is presented here. In the actual sessions, the three tasks are interrelated. Carlos uses the three-task helping framework to organize and help Mara organize the facets of her story. At the beginning of each session Carlos gets feedback from Mara as to the impact of how the relationship is going, what she has learned during the session, and how she intends to make use of what she has learned as she goes about her life between sessions. As a result Mara feels like she is getting somewhere.

Stage II: The Preferred Picture – Help Clients Identify, Choose, and Shape Problem-Managing Goals

In Stage II the counselor helps clients explore and choose possibilities for a better future – a future in which key problem situations are managed and key opportunities developed. “What do you want this future to look like?” asks the helper. The client’s answer constitutes his or her “change agenda.” Stage II focuses on outcomes.

Unfortunately, some approaches to problem management skip Stage II. They move from the “What’s wrong?” stage (Stage I) to a “What do I do about it?” stage (Stage III). As we shall see, however, helping clients discover what they want has a profound impact on the entire helping process. It opens the door to a more profound kind of change. Stage II also has three tasks – that is, three ways of helping clients answer as creatively as possible the question “What do I need or want?”

Task 1: Help Clients Use Their Imaginations to Spell Out Possibilities for a Better Future

This often helps clients move beyond the problem-and-misery mindset they bring with them and develop a sense of hope. Brainstorming possibilities for a better future can also help clients understand their problem situations better – “Now that I am beginning to know what I want, I can see my problems and unused opportunities more clearly.”

One theme Mara explores is “Mara the doer.” “Doer” is her code for substantial change. She wants to change from being a passive person who manages the everyday problems of life “well enough” to a person who reaches out to life. She describes the direction as “from observer to participant to player to contributor and, who knows, maybe even leader.” Carlos says, “Tell me what the new Mara would look like. Draw me some pictures.” Mara does precisely that. She says that she would like to draw on her business education and be more assertive at work. “For instance, the dealership has no business strategy. I would pull one together. I know the numbers better than anyone. And then we could debate it.” She even talks about the possibility of getting an MBA part time and moving out of her father’s business. A wilder thought is getting a job with either Honda or Toyota. They’re both growing. What better for someone who has misgivings about American car companies?

Another area of “doing” is family and social life. She is dissatisfied with home life. “I want to move from dutiful daughter to partner. I’m an adult.” The new Mara wants to be one of the decision makers at home. While she doesn’t like the fact that her parents lead such a quiet life – they see it as quiet, while she is beginning to see it as dull – she realizes that it’s not her job to change them. She also dislikes time spent with her two married cousins. She is turned off by what she sees as their narcissism. She is not sure that she wants to be married, but she wants to find out whether she wants to or not. She certainly does not want a marriage like the marriages of her cousins. Jim (her coffee partner) probably plays a role in that.

Mara does not need much nudging from Carlos. All in all she shows much enthusiasm for exploring possibilities that Carlos has some concerns that she might be biting off more than she can chew. She might try to do too much too soon. He does not want to sell Mara short and thinks that breakthroughs are possible, but most people need to transform themselves bit by bit. The last thing she needs is to move too fast, fail in what she is trying to accomplish, and risk becoming depressed or perhaps more depressed than she is already.

Too many clients are locked in to the present. Even when they try to use their imaginations, they think incrementally. The future they envision is not much better than the present they dislike. Helpers do a service for their client when they encourage them to engage in some kind of “break away” thinking.

Task 2: Help Clients Choose Realistic and Challenging Goals That Are Real Solutions To The Key Problems And Unused Opportunities Identified In Stage 1

Because helping is about solutions, outcomes, and impacts, possibilities need to be turned into goals. A client’s goals constitute his or her agenda for change. If goals are to be pursued and accomplished, there are certain criteria for viable goals: Ideally, they need to be clear, related to the problems and unused opportunities the client has chosen to work on, substantive, realistic, prudent, sustainable, flexible, consistent with the client’s values, and set in a reasonable time frame. Effective counselors help clients shape their agendas to meet these requirements.

Carlos does not burden Mara with goal criteria. Rather he keeps them in mind as he tries to help her choose from among the possibilities she has come up with and shape them into an agenda for change. Mara runs into some difficulty here because she has, and rightly so, spelled out possibilities without necessarily thinking of obstacles. For instance, even though she thinks she has the ability to add value to her father’s business, she is not so sure that he sees her in that role. In fact, she suspects that he doesn’t. Also, there are a couple of other managers who might resent this “girl” invading their territory. So some tailoring of Mara’s goals is in order. Carlos has some fears that Mara might bite off more than she can chew.

Mara comes up with a more modest intermediate goal. It is time for her to have a conversation with her father about her future in order to establish what both of them see as possibilities. She needs to clear the way, but she realizes that this is something they will have to do together. Her fear is that the conversation cannot be limited to her role in the workplace. It will almost inevitably spill over into a conversation about career, her role in the family, and her desire for a different kind of social life. Carlos understands this, but will her father? Her father, without thinking about it or talking about it, probably sees his family as traditionally patriarchal. Everybody talks but he makes the decisions. These rules are not written down anywhere, they’re just there.

Many clients are excited by the futures they want to create. However, even when the futures they want to create are both exciting and reasonable, both the path to a better future and the consequences of creating it can be difficult and painful.

Task 3: Help Clients Find the Incentives That Will Help Them Commit Themselves to Their Change Agendas

The question clients must ask themselves is: “What am I willing to pay for what I need and want?” Without strong commitment, change agendas end up as no more than some nice ideas. This does not mean that clients are not sincere in setting goals. Rather, once they leave the counseling session, they run into the demands of everyday life. The goals they set for themselves, however useful, face a great deal of competition. Counselors provide an important service when they help clients test their commitment to the better future embedded in the goals they choose.

Mara has certainly demonstrated that she has the skills, drive, and spunk to do what she sets out to do. She showed this in spades during her rehabilitation program after the auto accident. But she is untested when it comes to the kind of transitions she’s thinking of making. Some of the changes, such as resetting her relationship with her father and role within the family generally, are going to be emotionally difficult. Her overriding incentives are the satisfaction that will come with a more fulfilling work life and a different kind of social life.

Carlos talks with her about the rewards of a new life and the costs. He points out that Mara has a great deal of resolve but he notes that in most cases that resolve gets tested. He is not being negative. It’s rather a case of “forewarned is forearmed.”

Commitment is not something that is handled all at once toward the beginning of the change process. It needs to be revisited throughout the process. Carlos knows that it will come up as Mara runs into obstacles. The last thing she needs is to run into a wall and become depressed.

Stage III: The Way Forward – Help Clients Develop Strategies and Plans for Accomplishing Goals

Stage III defines the actions that clients need to take in order to translate goals into problem-managing accomplishments. Stage III answers the question: “How do I get there?” It is about identifying and choosing action strategies and plans. Stage III also has three tasks that, in practice intermingle with one another and with the tasks of the other stages.

Task 1: Help Clients Review Possible Strategies to Achieve Goals

Stimulating clients to think of different ways of achieving their goals is usually an excellent investment of time. That said, clients should not leap into action. Hasty and disorganized action is often self-defeating. Complaints such as “I tried this and it didn’t work. Then I tried that and it didn’t work either!” are often signs of poor planning rather than of the impossibility of the task.

As to the business, Mara’s longer-term goal is to become the general manager, while her father remains owner and president. But she needs to find out whether she is fit to do so and whether she really wants to do so. Carlos helps Mara explore what she needs to do to make that happen. She has always worked behind the scenes in finance and accounting and she handles almost all the correspondence. Now it is time to see what the other roles in the business are like. She would like to try her hand at sales. She thinks that she should work in the parts department and also find a role in the service department – not as a mechanic, obviously, but as a service clerk or something like that. She would also like to get in on the conversations that her father has with the automotive company’s representatives. There is also the possibility of some industry training programs.

There are plenty of good ideas that could be put together into a program, but one major hurdle remains – getting her father’s blessing for some of the changes she wants to make, or figuring out what to do if her father says no or remains ambiguous. So, Carlos suggests, first she has to plan the conversation with her father, giving some serious thought as to what it should look like. Something in her says, “He’s my father. I just go and have a conversation, tell him what’s on my mind. That’s more natural.” That’s probably more natural for her, but not completely realistic. On the other hand, a father engaging in conversation with a daughter who wants to challenge and change the prevailing family culture – that’s probably not natural for him. Her plan, Carlos suggests, needs to take into account how he might react – from totally embracing what she wants to do to feeling offended and angry at her “betrayal.” They go on to map out how she might prepare for the conversation. She thinks it might serve her well to jot down some of the things she would like to say and think further about how she would like to say them. She has some homework to do.

She also begins to explore ways of explaining her social life. Should she develop her relationship with her coffee-break friend? What opportunities are there locally to meet new people? What kind of social life would she want? It hits her. Though she is on friendly terms with almost everyone in the workplace, she really has no friends. All of a sudden this strikes her as odd. Once more she thinks of the young people she met in Iran, especially in Tehran, and how lively they were.

Task 2: Help Clients Choose the Strategies That Best Fit Their Resources

Whereas Task 1 provides clients with a pool of possible strategies, Task 2 helps clients choose the action strategies that best fit their talents, resources, style, temperament, environment, and timetable.

With Carlos’ guidance, Mara does two things. The first deals with a possible career in the automobile dealership industry. She begins exploring some possible training programs and conferences for dealers. She studies the literature and makes a few phone calls. From all the offerings, she puts together a list of learning events that appeal to her. She puts on events that talk about the future of the automotive industry in the United States and on new ways of marketing cars locally. She also begins to pinpoint the jobs within her father’s dealership that would best help her learn the ropes and prepare her to become a general manager. She also begins to explore the job market in other dealerships. Which automotive companies are hiring? For what dealership jobs?

Second, after creating a list of things she thinks she should discuss with her father, she lists what she thinks his reaction might be to each topic. How would he react to an expanded role for her in the business? She reviews her list with Carlos. He has a suggestion: Why don’t they (she and Carlos) do a few dry runs. Carlos will play her father and respond as he thinks her father might respond. He will play in turn the open-minded father, the skeptical father, the shocked father, the hurt father, and so forth. They do a few of these and then debrief. Mara now wonders why she ever thought of going into such a serious conversation cold.

Task 3: Help Clients Pull Chosen Strategies Together into A Viable Plan

Help clients organize the actions they need to take to accomplish their goals. Plans are simply maps clients use to go where they want to go. A plan can be quite simple. Indeed, overly sophisticated plans are often self-defeating.

After a couple of dry runs of the conversation she wants to have with her father, Mara believes that she is ready to move forward. Although she does not want Carlos to take on the role of resistant or angry parent, she now thinks that she should not throw too much at her father at once. So she decides to limit the conversation to her work life. The social dimensions of her life can wait till later. Even though she now believes that the workplace status quo is no longer acceptable, she wants to take a more upbeat approach, talking mainly how she thinks she can add value to the dealership because he talks to her only about lower-level operational issues. She doesn’t know whether he thinks about strategy at all. He has an engineer’s rather than a manager’s mind.

She sees the possibility of three broad kinds of responses from her father – accepting, cautionary, or negative, but she spends little time on the negative. The rest of her plan depends on what kind of response she gets. If her father’s response is accepting, she will within a week present him an outline of her plan to come up to speed in the business. She will ask for his feedback and suggestions because she needs his buy-in to the plan. If the response is cautionary, she will as soon as possible present him with a much more modest version of her plan and try to get him to construct on with her, again to get his buy-in. If the response is negative, she will have to go back to square one and discuss her next steps with Carlos.

The Action Arrow: Help Clients Implement Their Plans

All three stages of the helping model sit on the “action arrow,” indicating that clients need to act in their own behalf right from the beginning of the helping process. The action arrow is a strong reminder that all three stages of the helping process are about outcomes and impact. The bias toward action outlined in Chapter 2 must permeate every stage and every task of the helping process. While it is true that Stage I drives Stage II, it is also true that Stage II and III define Stage I. Stage I is about a past and present that call for change. Stage II and III are about planning for change, not constructive change itself. Planning is not action. Talking about problems and opportunities, discussing goals, and figuring out strategies for accomplishing goals is just so much talk without goal-accomplishing action. There is nothing magic about change; it is hard work. But, as we shall see in subsequent chapters, each stage and task of the process can promote problem-managing and opportunity-developing action right from the beginning.

Mara has the conversation with her father and it proves to be disastrous. His response to his daughter was a bit accepting, at times cautionary, but mostly negative. An example of an accepting response: “You know, Mara, you’re one of the best workers I’ve got. You’re certainly the only one I trust completely.” One cautionary response sounded something like this: “This is a rough business, Mara. It’s a man’s rather than a woman’s business. It’s not enough to be smart. You have to be tough. Are you sure you’re one of the tough ones?” But Mara found his negative comment devastating. One was: “Mohsen’s [her brother who died in the auto accident] death was the most bitter moment in my life. In many ways I’ve treated you the way I would have treated him. You know, I’ve let you do a lot of things. Some would call me indulgent.” He ended the conversation by saying, “I don’t know where all of this is coming from. I don’t know who has been talking to you. I do know that this is the wrong time to talk about all this.” Mara came away confused and disoriented. At their next meeting Carlos meets a very agitated and depressed Mara. He knows that they have to retrace their steps.

Of course, all is not lost. Up to this point Mara has accomplished a lot: she has developed a working relationship with Carlos, she has learned a lot about herself by telling her story, she has identified and clarified key problem situations and some key opportunities, she has outlined for herself a different future, she has some new perspectives on both her problems and her strengths, she has identified some tentative goals, she has drawn up some tentative plans to achieve these goals, and in talking with her father she has taken one large first step despite the outcome. In the chapters that follow we will return to Mara and her struggle to create a brighter future for herself. She will continue to see Carlos, but she will also do a lot of work on her own.

Clients come to helpers because they need help in managing their lives more effectively. As we have seen in Chapter 3, Stage I illustrates three ways in which counsellors can help clients understand themselves, their problem situations, and their unused opportunities with a view of managing them more effectively. Counselors help clients (1) tell their stories, (2) reframe their stories in order to develop new, more useful perspectives, and (3) stay focused on issues that will make a difference in their lives. Even though these tasks are described separately, in actual helping sessions they are intermingled. It is not a question of moving from the first to the second to the third task in any rigid way. Furthermore, these tasks are not restricted to Stage I for the following reasons: First, clients don’t tell all of their stories at the beginning of the helping process. Often the full story “leaks out” over time. Second, new perspectives are needed at every stage of the helping process—telling stories, choosing problem-managing goals, developing plans, and implementing programs. Helpful new perspectives are always welcome. Third, the entire helping process is a search for value.

Stage I of the helping process can be seen as the assessment stage (Hood & Johnson, 2007)—finding out what’s wrong, what opportunities remain undeveloped, what resources are not being used. Client-centered assessment means helping clients understand themselves, find out what is going on with their lives, see what they have been ignoring, and make sense from the messiness of their lives. Assessment in this sense is not something helpers do to clients. Rather, it is a kind of practical learning in which both client and helper collaborate. Other forms of assessment such as psychological testing and applying psychiatric diagnostic categories may or may not be useful, but they are beyond the scope of this book.

Here, then, are some of the goals for Stage I. But, in view of the fact that the stages and tasks of the helping model interact with one another and don’t follow in strict sequence, these goals are clearly not limited to Stage I.

Engagement

The sooner clients are engaged and committed to the helping process the better. Engagement is not some kind of abstraction. It takes on different forms for different cases. Consider a person who has been severely burned and whose initial reaction is to withdraw from people. In the light of the patient’s despair, engagement, as Auerbach, Salick, and Fine (2006) note, means choosing to go on, finding some kind of inner strength, being willing to reach out to people who care and who can help, and being open to finding a way of dealing with the trauma no matter what its dimensions might be. If you were sitting at the bedside of such a patient, what would be going through your mind and what might you do to help the patient open up to be helped and become active in the helping process?

Initial Stress Reduction

Helping clients “get things out on the table.” This can and often does have a cathartic effect that leads to stress reduction. Some clients carry their secrets around for years. Helping them unburden themselves is part of the social-emotional reeducation process alluded to earlier. Mara, the Iranian-American woman seeking help to refocus her life, felt a great deal of relief after her second session with Carlos. She did not know how much stress she was under and how desperately she was trying to stay in control until the stress began to ebb away.

Establishing Rapport and Relationship Building

Help clients tell their stories in such a way that the helping relationship develops and strengthens. The communication skills outlined in the chapters that follow and driven by the values reviewed in Chapter 2 are basic tools for both clarity and relationship building. Effective helpers know that helping is diversity-, culture-, and relationship-oriented. Carlos is not just an interested and objective outsider. He is becoming a participant in a drama in which his objectivity can be an important resource. Because helping is a two-way street, Mara has to do her part in relationship building. She may need encouragement and support to do so, but the responsibility is hers.

Clarity

Help clients spell out their problem situations and unexploited opportunities with the kind of concrete detail—specific experiences, thoughts, behaviors, and emotions—that enables them to do something about them. Clarity opens the door to more creative options in living. Vague stories lead to vague options and actions. For instance, Carlos does not know what kind of player Mara’s mother is in Mara’s narrative. What is the relationship between the two of them like? If she a resource or an obstacle to Mara’s desire to reinvent her life? Is she both? Carlos thinks that some clarity here would help.

Client Action

Right from the beginning, help clients act on what they are learning. Clients do not need grand plans before they can act on their own behalf. In the case of the severely burned patient mentioned earlier, the burn center chaplain brings one of the burn center’s previous patients with him. The chaplain has seen it all and the recovered patient has experienced it all. The burn patient talks about all the desperate thoughts racing through her mind. The recovered patient says, “I spent a lot of time chasing those demons away.” The burn patient reaches out and touches her. Telling part of her story to a stranger and reaching out are actions—perhaps small actions, but actions nevertheless and hopefully the beginning of a flow.

The importance of helping clients tell their stories well should not be underestimated. As Pennebaker (1995b) has noted, “An important…feature of therapy is that it allows individuals to translate their experiences into words. The disclosure process itself, then, may be as important as any feedback the client receives from the therapist” (p. 3). Farber, Berano, and Capobianco (2004) outline the bright side of client self-disclosure.

[M]ost clients feel that therapy is a safe place to disclose, made especially so by the goodness of the therapeutic relationship; that the disclosure process initially generates shame and anticipatory anxiety but ultimately engenders feelings of safety, pride, and authenticity; that keeping secrets inhibits the work of therapy, whereas disclosures in therapy facilitate subsequent disclosures to one’s therapist as well as to family members and friends; and that therapists should actively pursue material that is difficult to disclose. (p. 340)

Of course, other research has shown that fear of self-disclosure is a leading factor in not seeking therapy (Vogel & Wester, 2003), so it is important for you to discern whether the client you are helping rejoices in or fears the process. Farber and his associates note that many clients may not only need a helper’s encouragement to speak about difficult issues but also welcome and appreciate helpers; efforts to do so. One possibility for clients who fear face-to-face disclosure is writing (Sloan & Marx, 2004a, 2004b; Sloan, Marx, & Epstein, 2005). For many people, writing about their problems provides both physical and emotional relief. Researchers in counseling have not given this possibility the attention it deserves. At any rate, self-disclosure provides the grist for the mill of problem solving and opportunity for development. See Farber’s (2006) book Self-Disclosure in Psychotherapy for a comprehensive overview of both client and helper self-disclosure.

Finally, for whatever reason, clients frequently lie to their helpers or at least distort reality as they tell their stories (see de Angelis, 2008, for a brief summary). For many, lying is just another way of trying to protect themselves and cope with life’s difficulties. Wise therapists understand this and work with it, often enough by reviewing their own experience with lying. Finally, if you discover that your clients lie to you, first look at your own behavior, and think “Why would someone feel that it was necessary to lie to me? What am I doing or failing to do?”

Clients differ radically in their ability to talk about themselves and their problem situations. Reluctance to disclose oneself within counseling sessions is often a window into the client’s inability to share himself or herself with others and to be reasonably assertive in the social settings of everyday life. If this is the case, then one of the goals of the entire counseling process is to help clients develop the skills, confidence, and courage they need to share themselves appropriately.

There are a number of principles that can guide you as you help clients tell their stories. Hanna (2002) has developed a list of “precursors,” which “taken together form a comprehensive picture of how people change and why they do not” (p. 6). They include, on the part of the client, a sense of necessity (“I’ve got to do something about this”), a willingness/readiness to experience anxiety or difficulty, awareness, confronting of the problem, will/effort directed toward change, hope, and social support. Hanna calls these conditions “regulators of change” in the sense that “the more they are present in a person, the more quickly change will occur, and in some cases, the deeper the change will be in the psyche of the person” (p. 6). As clients tell their stories, you can listen and probe for these regulators and even help clients challenge themselves to develop them. Here, then, are a set of guidelines.

Learn to Work with all Styles of Storytelling

There are both individual and cultural differences in clients’ willingness to talk about themselves. Both affect storytelling. Some clients are highly verbal and quite willing to reveal almost everything about themselves at the first sitting. Take the case of Martina:

Martina, 27, asks a counselor in private practice for an appointment to discuss “a number of issues.” Martina is both verbal and willing to talk, and her story comes tumbling out in rich detail. Although the helper uses the skills of attending, listening, sharing highlights, and probing, she does so sparingly. Martina is too eager to tell her story.

Although trained as a nurse, Martina is currently working in her uncle’s business because of an offer she “could not turn down.” She is doing very well financially, but she feels guilty because service to others has always been a value for her. Although she likes her current job, she also feels hemmed in by it. A year of study in Europe during college whetted her appetite for adventure. She feels that she is nowhere near fulfilling the great expectations she has for herself.

She also talks about her problems with her family. Her father is dead. She has never gotten along well with her mother, and now that she has moved out of the house, she feels that she has abandoned her younger brother, who is 12 years younger than she is and whom she loves very much. She is afraid that her mother will “smother” her brother with too much maternal care.

Martina is also concerned about her relationship with a man who is 2 years younger than she. They have been involved with each other for about 3 years. He wants to get married, but she feels that she is not ready. She still has “too many things to do” and would like to keep the arrangement they have.

This whole complex story—or at least a synopsis of it—comes tumbling out in a torrent of words. Martina feels free to skip from one topic to another. The way Martina tells her story is part of her enthusiastic style. At one point she stops, smiles, and says, “My, that’s quite a bit, isn’t it!”

As the helper listens to Martina, he learns a number of things about her. She is young, bright, and verbal and has many resources; she is eager and impatient; some of her problems are probably of her own making; she has some blind spots that could stand in the way of her grappling more creatively with her problems; she has many unexplored options, many unexploited opportunities. That said, the counselor surmises that Martina would probably make her way in life, however erratically, with no counseling at all.

Contrast that example with the following one of a man who comes to a local health center because he feels he can no longer handle his 9-year-old boy.

Nick is referred to the center by a doctor in a local clinic because of the trouble he is having with his son. He has been divorced for about 2 years and is living in a housing project on public assistance. After introductions and preliminary formalities have been taken care of, he just sits there and says nothing; he does not even look up. Because Nick offers almost nothing spontaneously, the counselor uses a relatively large number of probes to help him tell his story. Even when the counselor responds with empathy, Nick volunteers very little. Every once in a while, tears well up in his eyes. When asked about the divorce, he says he does not want to talk about it. “Good riddance” is all he can say about his former wife. Gradually, almost torturously, the story gets pieced together. Nick talks mostly about the “trouble” his son is getting into, how uncontrollable he seems to be getting, and how helpless he [Nick] feels.

Martina’s story is full of possibilities, whereas Nick’s is mainly about limitations. In both content and communication style, they are at opposite ends of the scale.

Each client is different and will approach the telling of their story in a different way. Some clients will come voluntarily; others will be sent. Some of the stories you will help clients tell will be long and detailed, others short and stark. Some will be filled with emotions; others will be told coldly, even though they are stories of terror. Some stories will be, at least at first blush, single-issue stories—“I want to get rid of these headaches”—whereas others, like Martina’s, will be multiple-issue stories. Some stories will deal with the inner world of the client almost exclusively—“I hate myself,” “I’m depressed,” “I feel lonely”—whereas others will deal with the outer world—for instance, problems with finances, work, or relationships. Still others will deal with a combination of inner and outer concerns.

Some clients will tell the core story immediately, whereas others will tell a secondary story first to test your reactions. Some clients will make it clear that they trust you just because you are a helper, but you will read mistrust in the eyes of others, sometimes just because you are a helper. In all these cases, your job is to establish a working relationship with your clients and help them tell their stories as a prelude to helping them manage the problems and take advantage of the opportunities buried in those stories. A story that is brought out into the open is the starting point for possible constructive change. Often the very airing of the story is a solid first step toward a better life.

When clients like Martina pour out their stories, you may let them go on or you may insist on some kind of dialogue. If the client tells the “whole” story in a more or less nonstop fashion, it will be impossible for you to share highlights relating to every core issue the client has brought up. But you can then help the client review the most salient points in some orderly way. For example, you might want to help the client review the core parts of the story by saying something like, “You’ve said quite a bit. Let’s see if I’ve understood some of the main points you’ve made. First of all….” At this point the highlights you share will let the client know that you have been listening intently and that you are concerned about him or her. With clients like Nick, however, it’s a different story. Those who lack the skills needed to tell their stories well or who are reluctant to do so constitute a different kind of challenge. Engaging in dialogue with them can be tough work. Box 4.1 provides sample questions you can help clients ask themselves to identify problem situations.

Start Where the Client Starts

Clients launch into their stories at different starting points. They can start with any stage of the helping process. Join them there. Therefore, “story” is used in its widest sense. It does not mean, narrowly, “This is what happened to me, here’s how I reacted, and now this is how I feel.” Your job is to stay with your clients no matter where they are, not forcing them to be where you would like them to be. Use the model in Chapter 3 as a map. Know where the client is and where you think they need to go. Consider the following:

• Martha starts by saying, “I thought I knew how to handle my son when he reached his teenage years. I knew he might want to try all sorts of crazy things, so I might have to keep the reins pretty tight. And that’s what I did. But now things are awful. It’s not working. He’s out of control.” Martha’s starting point is a failed solution, which has spawned a new problem. Her version of problem management went wrong somewhere.
• Thad says, “I don’t know whether I want to be a doctor or a politician—or at least a political scientist. I love both, but I can’t do both. I mean I have to make my mind up this coming year and choose my college courses. I hate being stuck with a decision.” Thad’s starting point is choosing a goal. He has an approach-approach conflict. He wants both goals.
• Kimberley, a human resources executive for a large company, says, “I’ve found out that our chief executive has been involved in some unethical and, I think, immoral behavior. He’s due to retire within the next 6 months. I don’t know whether it’s best to bring all this to light or just monitor him til he goes. If I move on him, this could blow up into something big and hurt the reputation of the company itself. If I just monitor him til he goes, he gets away with it. I want to do what’s best for the company.” Her starting point is a dilemma about which action strategy to use.
• Owen is having problems sticking to his resolve to restrain himself when one of his neighbors on his block “does something stupid.” He says, “I know when I speak up [his euphemism for flying off the handle] things tend to get worse. I know I should leave it to others who are more tactful than I am. But they don’t move quickly enough—or forcefully enough.” His starting point is difficulty in implementing a course of action to which he has committed himself.

Help Clients Paint an Objective Picture

Clients who tell stories that are general, partial, and ambiguous may or may not have ulterior motives. For instance, one subtext is, “If I tell my story too clearly and reveal myself warts and all, then I will be expected to do something about it.” The accountability issue lurks in the background. Another issue is the accuracy of the story. At one end are clients who tell their stories as honestly as possible. At the other end are clients who, for whatever reason, lie or fudge. Anyone who has done any marital counseling doesn’t have to prove this. They just watch it.

Fudging seems to have something to do with self-image. Some clients are not especially concerned about what helpers think of them. They have no particular need to be seen in a favorable light. Other clients ask themselves, at least subconsciously, “What will the helper think of me?” Some are extremely concerned about what their helpers might think of them and therefore skew their stories to present themselves in the best light. A. E. Kelly (2000b, 2002; also see Kelly, Kahn, & Coulter, 1996) sees therapy, at least in part, as a self-presentational process. She suggests that clients benefit by perceiving that their therapists have favorable views of them. Therefore, if therapy contributes to clients’ positive identity development, then we should expect some fudging. Hiding some of the less desirable aspects of themselves, intentionally or otherwise (see Kelly, 2000a), becomes a means to an end. Hill, Gelso, and Mohr (2000) object to this hypothesis, suggesting that research shows that clients don’t hide much from their therapists. Arkin and Hermann (2000) suggest that all of this is really more complicated than the others realize.

Take an example: Relatively few male victims of childhood sexual abuse discuss the residue of that abuse in adulthood (Holmes, Offen, & Waller, 1997). This used to be explained by the now-discounted myths that few males are sexually abused and that abuse has little impact on males. Rather, it seems that it is just harder for males, at least in North American society, to admit both the abuse and its effects. We know that some clients fudge and some clients lie. We can only hypothesize why. But we do know that the vagaries of client self-presentation muddy the waters.

Assess the Severity of the Client’s Problems

Clients come to helpers with problems of every degree of severity. James Hicks (2005) has written an award-winning book in clear, straightforward language on the most common signs of mental illness. He provides a service that most books on abnormal psychology do not.

Objectively, problems run from the inconsequential to the life-threatening. Subjectively, however, a client can experience even a relatively inconsequential problem as severe. If a client thinks that a problem is critical, even though by objective standards the problem does not seem to be that bad, then for him or her it is critical. In such a case, the client’s tendency to “catastrophize”—to judge a problem situation to be more severe than it actually is—itself becomes an important part of the problem situation. One of the counselor’s tasks in this case will be to help the client put the problem in perspective or to teach him or her how to distinguish between degrees of problem severity. Howard (1991, p. 194) put it well:

Savvy therapists not only gain an understanding of the severity of a client’s problem or the extent of the client’s unused resources, but also understand the limits of helping. What has been this client’s highest lifetime level of functioning? What, then, are appropriate expectations? What Howard calls life-story adjustment or repair is not the same as attempting to redo the client’s personality.

Years ago Mehrabian and Reed (1969) suggested the following formula as a way of determining the severity of any given problem situation. Even though it is not a mathematical formula, it is still useful today.

Severity = Distress x Uncontrollability x Frequency

The multiplication signs in the formula indicate that these factors are not just additive. Even low-level anxiety, if it is uncontrollable or persistent, can constitute a severe problem; that is, it can severely interfere with the quality of a client’s life. In some cases, assessing for possible self-harm or harm to others is called for. The literature on suicide details possible self-harm signs that you need to look out for. You can also review the literature on violence in social relationships for signs of possible impending aggression. Even a casual reading of accounts of outbreaks of social violence such as fired employees gunning down superiors and colleagues tells us how easily signs can be missed.

Continuing efforts are being made to help therapists spot early warning signals. For instance, Cannon and his associates (2008) have come up with a new tool for predicting and therefore possibly preventing psychosis in youth at high clinical risk. They found that a package of risk factors or symptoms—a youth who has an immediate relative with a psychotic disorder, problems in functioning in everyday life, unusual thoughts or suspicions, growing difficulty in social interactions, and a history of substance abuse—predicted the likelihood, from 35% to 80%, that the person would have an episode of losing touch with reality within 30 months. Predictably, other members of the medical community did not see the findings as a breakthrough and called for brain scans and genetic tests to diagnose the disease. At any rate, because clients’ stories often unfold over time, assessment is not a one-time intervention at the beginning of the helping process, but should be ongoing.

Help Clients Clarify Key Issues

To clarify means to discuss problem situations and unused opportunities—including possibilities for the future, goals, strategies for accomplishing goals, plans, implementation issues, and feelings about all of these—as concretely as possible. Vagueness and ambiguity lead nowhere. Clarity means helping clients move from the general to the specific—specific experiences, thoughts, behaviors, intentions, points of view, and decisions.

Consider this case. Janice’s husband has been suffering from severe depression for over a year. One day, after Janice suffers a fainting spell, she too talks with a counselor. At first, feeling guilty about her husband, she is hesitant to discuss her own concerns. In the beginning she says only that her social life is “a bit restricted by my husband’s illness.” With the help of empathic highlights and probing on the part of the helper, her story emerges. “A bit restricted” turns, bit by bit, into the following, much fuller story. This is a summary. Janice did not say this all at once.

This is the fuller story spelled out in terms of specific experiences, thoughts, behaviors, and feelings. The actions Janice takes—staying at home, covering her feelings up—are part of the problem, not the solution. But now that the story is out in the open, there is some possibility of doing something about it.

In another case, a woman suffering from bulimia and is now under psychiatric care, says that she acted “a little erratically at times” with some of her classmates in law school. The counselor, sharing highlights and using probes, helps her tell her story in much greater detail. Like Janice, she does not say all of this at once, but this is a fuller picture of “a little erratic.”

She was not really delusional, but gradually her external behavior, with a kind of twisted logic, began to reinforce her internal fantasies. However, once her story became “public”—that is, once she began talking openly with her helper—she began to take back control of her life.

Help Clients Discuss the Context of Their Concerns

Sometimes helping clients explore the background or context of the concerns they bring up helps clarify things. This is a further application of a people-in-systems approach to listening (Conyne & Cook, 2004; Egan & Coman, 1979; Hutchison, 2003). Consider the following case:

So far we have a garden-variety story, one that could be repeated thousands of times throughout the world. The counselor, however, suspects there is more to this. Because the counselor is Canadian, he wants to learn about Tarik’s Middle Eastern culture to get the full picture. He knows that there is an overlay of Western culture in these consulting firms, but he wants to deal with his client as a full person. And so in sharing highlights and by using a few probes, he learns enough about the background of the manager’s story to cast a new light on the problem situation. Here is the fuller story that emerges.

A search of some background quickly takes the client’s story out of the “routine” category. Of course, you should not be looking for background just for the sake of looking. The right kind and amount of background provides both richness and context.

Help Clients Talk Productively About the Past

Some schools of psychology suggest that problem situations are not clear and fully comprehended until they are understood in the context of their historic roots. Therefore, helpers in these schools spend a great deal of time helping clients uncover their past. Others disagree with that point of view. Glasser (2000, p. 23) puts it this way: “Although many of us have been traumatized in the past, we are not the victims of the past unless we presently choose to be. The solution to our problem is rarely found in explorations of the past unless the focus is on past successes.”

Fish (1995) suggested that attempts to discover the hidden root causes of current problem behavior may be unnecessary, misguided, or even counterproductive. Constructive change does not depend on casual connections in the past. There is evidence to support Fish’s contention. Long ago Deutsch (1954) noted that it is often almost impossible, even in carefully controlled laboratory situations, to determine whether event B, which follows event A in time, is actually caused by event A. Trying to connect present complicated patterns of current behavior with complicated events that took place in the past is an exercise in frustration.

Therefore, asking clients to come up with causal connections between current unproductive behavior and past events could be an exercise in futility for a number of reasons. First, causal connections cannot be proved; they remain hypothetical. Second, there is little evidence suggesting that understanding past behavior causes changes in present behavior. Third, talking about the past often focuses mostly on what happened to the client (their experiences) rather than on what they did about what happened to them (their thoughts, intentions, decisions, and behaviors) and therefore interferes with the “bias toward action” clients need to manage current problems.

This is not to say that a person’s past does not influence current behavior. Nor does it imply that a client’s past should not be discussed. Quite often being stuck in the past is a function of rejection and resentment. But the fact that past experiences may well influence current behavior does not mean that they necessarily determine present behavior. Kagan (1996) has challenged what may be called the “scarred for life” assumption: “If orphans who spent their first years in a Nazi concentration camp can become productive adults and if young children made homeless by war can learn adaptive strategies after being adopted by nurturing families” (p. 901), that means that there is hope for us all. As you can imagine, this is one of those issues that members of the helping professions argue about endlessly. Therefore, this is not a debate that is to be settled with a few words here. Here are some suggestions for helping clients talk meaningfully and productively about the past.

Help clients talk about the past to make sense of the present. Many clients come expecting to talk about the past or wanting to talk about the past. There are ways of talking about the past that help clients make sense of the present. But making sense of the present needs to remain center stage. Thus, how the past is discussed is more important than whether it is discussed. The following man has been discussing how his interpersonal style gets him into trouble. His father, now dead, played a key role in the development of his son’s style.

Helper:	So your father’s unproductive interpersonal style is, in some ways, alive and well in you.
Client:	Until we began talking I had no idea about how alive and well it is. For instance, even though I hated his cruelty, it lives on in me in much smaller ways. He beat my brother. But now I just cut him down to size verbally. He told my mother what she could and couldn’t do. I try to get my mother to adopt my “reasonable” proposals “for her own good”—without of course listening very carefully to her point of view. There’s a whole pattern that I haven’t noticed. I’ve inherited more than his genes.
Helper:	That’s quite an inheritance…. But now what?
Client:	Well, now that I see what’s happened, I’d like to change things. A lot of this is ingrained in me, but I don’t think it’s genetic in any scientific sense. I’ve developed a lot of bad habits.

It really does not make any difference whether the client’s behavior has been “caused” by his father or not. In fact, by hooking the present into the past, if he feels in some way that his current nasty style is not his fault, then he has a new problem. Helping is about the future. Now that the problem has been named and is out in the open, it is possible to do something about it. It is about “bad habits,” not sociobiological determinism.

Help clients talk about the past to be reconciled to or liberated from it. A potentially dangerous logic can underlie discussions of the past. It goes something like this: “I am what I am today because of my past. But I cannot change my past. So how can I be expected to change today?”

Client:

I was all right until I was about 13. I began to dislike myself as a teenager. I hated all the changes—the awkwardness, the different emotions, having to be as “cool” as my friends. I was so impressionable. I began to think that life actually must get worse and worse instead of better and better. I just got locked into that way of thinking. That’s the same mess I’m in today.

That is not liberation talk. The past is still casting its spell. Helpers need to understand that clients may see themselves as prisoners of their past, but then, in the spirit of Kagan’s earlier comments, help them move beyond such self-defeating beliefs.

The following case provides a different perspective. It is about the father of a boy who has been sexually abused by a minister of their church. He finds that he can’t deal with his son’s ordeal without revealing his own abuse by his father. In a tearful session he tells the whole story. In a second interview he has this to say:

Client:

Someone said that good things can come from evil things. What happened to my son was evil. But we’ll give him all the support he needs to get through this. Though I had the same thing happen to me, I kept it all in until now. It was all locked up inside. I was so ashamed, and my shame became part of me. When I let it all out last week, it was like throwing off a dirty cloak I’d been wearing for years. Getting it out was so painful, but now I feel so different, so good. I wonder why I had to hold it in for so long.

This is liberation talk. When counselors help or encourage clients to talk about the past, they should have a clear idea of what their objective is. Is it to learn from the past? Is it to be liberated from it? To assume that there is some “silver bullet” in the past that will solve today’s problem is probably asking too much of the past.

King and Hicks (2007) have shown that discussing lost opportunities and mistaken expectations and the regrets, disappointment, and humiliation associated with them can prove quite beneficial. Facing up to failure has its unpleasant side, but, as these authors note, “if contentment were the sole goal of adulthood, examining life’s regrettable experiences might seem to have little value” (p. 625). Their research shows that it is possible to learn and grow by reviewing what might have been. “Recognition of the losses that have led to one’s current place in the life story may open one up to a number of valuable and rich experiences, including a paradoxical sense of gratitude for loss itself” (p. 634).

Help clients talk about the past in order to prepare for action in the future. The well-known historian A. J. Toynbee had this to say about history: “History not used is nothing, for all intellectual life is action, like practical life, and if you don’t use the stuff—well, it might as well be dead.” As we will soon see, any discussion of problems or opportunities should lead to constructive action, starting with Stage I and going all the way through to implementation. The insights you help clients get from the past should in some way stir them into action. When one client, Christopher, realized how much his father and one of his high school teachers had done to make him feel inadequate, he made the resolve: “I’m not going to do anything to demean anyone around me. You know, up to now I think I have, but I called it something else—wit. I thought I was being funny when I was actually being mean.” Help clients invest the past productively in the future.

Finally, these guidelines are not set in stone. They do not imply that you should never talk to clients about the past unless they do it in a way that fits the guidelines reviewed here. Short (2006) put it well: “I don’t like to focus on the past or on a person’s symptoms, but people shouldn’t suffer alone, so I listen to these stories with respect and acceptance” (p. 72). To do otherwise you contribute to what Hanson (2005) called the “devaluation of [clients’] inner subjective experiences by the counseling profession” (p. 83).