The Stages of the Helping Relationship
The application of the helping skills we just examined can vary considerably as a function of the helperâ€™s job role, setting, and theoretical orientation. Despite these differences, many commonalities can be identified within various types of helping relationships. For instance, all helpers have to address technical issues unique to the first session (e.g., meeting times, length of session, payment issues, and frequency of sessions). Likewise, all helpers will face issues of trust. All helpers will need to identify client concerns, develop goals, and assist their clients in working on identified goals. Finally, all helpers will have to deal with termination.
These commonalities can be organized into a series of stages of the helping relationship through which all clients will passâ€”namely, the rapport and trust building stage, the problem identification stage, the deepening understanding and goal-setting stage, the work stage, and the closure stage (Neukrug & Schwitzer, 2006). Progress through these stages can vary dramatically as a function of setting, and helpers should recognize the stages through which their clients are passing.
Stage 1: Rapport and Trust Building
Clients come to the helper with one major agenda: â€œCan I trust my helper enough to discuss with him or her what I need to discuss?â€ The helper, on his or her part, is dealing with a number of issues that are crucial to the development of an effective working relationship.Â For instance, the helper is concerned about using basic skills to build trust in the relationship, assuring that the physical environment feels safe, and informing the client about the counseling process (Brammer & MacDonald, 2003; Hackney & Cormier, 2012). Recently, the use of a writtenÂ Â professional disclosure statementÂ to cover many of these issues, as listed here, has become increasingly popular (Remley & Herlihy, 2014):
1. Limits of confidentiality
2. Length of the interview
3. Purpose of the interview
4. Professionalâ€™s credentials
5. Limits of the relationship
6. Professionalâ€™s theoretical orientation
7. Legal issues of concern to the professional and the client
8. Fees for services
9. Agency rules that might affect the client (e.g., reporting a clientâ€™s use of illegal drugs)
After providing the professional disclosure statement to the client, it is important to obtainÂ Â informed consentÂ from the client. Informed consent indicates that the client has been given this information and agrees to participate in the helping relationship. Although such consent can be obtained verbally, it is better to have clients sign a statement indicating that they have given their informed consent.
Human service professionals obtain informed consent to provide services to clients at the beginning of the helping relationship. Clients should be informed that they may withdraw consent at any time except where denied by court order and should be able to ask questions before agreeing to the services. Clients who are unable to give consent should have those who are legally able to give consent for them review an informed consent statement and provide appropriate consent. (NOHS, 2015a, Standard 2; see Appendix B)
During the first stage, the development of a comfortable, trusting, and facilitative relationship can be accomplished through the use of listening skills, empathic understanding, cultural sensitivity, and a fair amount of good social skills (Hackney & Cormier, 2012). As this stage continues, the helper will begin to identify and delineate the issues presented by the client.
Stage 2: Problem Identification
The building of a trusting relationship and the ability to do an assessment of client problems are signs that you are moving into the second stage, in which you and your client will validate your initial identification of the problem(s). Perhaps the reason that the client initially provided for coming in for counseling actually masked other issues. Or perhaps additional issues arise as you explore the clientâ€™s situationâ€”even issues of which the client was not fully aware. In either case, during these sessions you validate your original assessment and make appropriate changes as necessary. During this stage, the use of questions is often important as the helper attempts to clearly focus on the problems the client wishes to work on. It is also at this stage that client and helper begin to work collaboratively in the sense that the helper is â€œchecking inâ€ with the client so that the client agrees with the identification of the problem(s).
Stage 3: Deepening Understanding and Goal Setting
Although your basic helping skills are still important, the fact that trust has been built in the earlier stages means that other skills can now be addedâ€”skills that will allow you to understandÂ your client in deeper ways. For instance, the client will now allow you to confront him or her, ask probing questions, and give advanced empathic responses. You can increasingly push the envelope and move into the inner world of the client. However, it is always crucial to maintain sensitivity to the clientâ€™s needs and to maintain a supportive and nurturing base. Move too fast and the client will rebuff your attempts to expose his or her inner world. Move at the right pace and the counseling relationship will deepen, and you might consider using advanced skills based on your expertise and the clientâ€™s issues. The result of your continued probing and analysis of the situation should be anything from an informal verbal agreement concerning goals to a collaboratively written contract that is signed by both the client and the helper.
Stage 4: Work
During the fourth stage, the client begins to work on the issues that were identified in Stage 3 and agreed upon between the helper and the client. The helper applies his or her helping skills to facilitate progress, and, if necessary, the helper and client may want to revisit and, in a collaborative manner, reevaluate some of the goals set earlier. During this stage, it is not uncommon to find the helper using a variety of skills. For instance, the helper may use empathy, to assure deep understanding and self-reflection; modeling, to demonstrate new kinds of behaviors with which to experiment; self-disclosure, to bond with the client and offer hope for change; questions, to assure he or she is on track with client issues; confrontation, to gently encourage the client to continue working; and affirmations and encouragement, to reinforce client behavior. The client, meanwhile, takes responsibility for and actively works on his or her identified issues and themes and generally builds higher self-esteem as he or she accomplishes the identified goals.
Stage 5: Closure
As the client accomplishes some or most of his or her goals, both client and helper will logically think about ending the helping relationship. Because the helping relationship is one of the few intimate relationships that is time limited, clients and helpers will inevitably have to work through their feelings of loss about the ending of the relationship (Murdin, 2000). Termination should be a gradual process in which the client and the helper have time to deal with the loss involved and discuss whether the stated goals have been met. Successful termination is more likely if
clients discuss termination early,
goals are clear so clients know when counseling is near completion,
the helper respects the clientâ€™s desire to terminate yet feels free to discuss feelings that termination may be happening too soon,
the relationship remains professional (e.g., does not move into a friendship),
clients know they can return,
clients are able to review the success they had in counseling, and
clients can discuss feelings of loss around termination (Hill, 2014; Sommers-Flanagan & Sommers-Flanagan, 2014).
During this stage, a number of skills will be used. For instance, helpers will use empathy to summarize client accomplishments. In addition, they will affirm clients for reaching their goals and encourage clients to continue on a positive track, even after the helping relationship ends. Finally, some helpers feel comfortable during this stage with making a small amount of self-disclosure, as they share their good feelings about their clientâ€™s accomplishments and their sad feelings about saying good-bye.
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