The skilled helper model in addiction recovery: Mr. Smith's case

Skilled Helping Interview

Clarifying the Client's Experience With Skilled Helpers

The immediate and long-term health of the patient undergoing treatment and recovery are impacted by the emotional state of the patient, the patient's access to support and an ability to retrieve the information, counsel and representation which are necessary during convalescence. This is verified in the motives of the fictitiously named Mr. Smith, who was recently discharged after a period of institutionalization and who expressed a desire to participate in the interview process. Given the numerous areas in which mental healthcare must be subjected to change and refinement to meet a diversity of demands, the goals of this interview process will be to provide anecdotal documentation of individual case experiences and, simultaneously, to provide qualitative data contributing to the assessment of quality of mental healthcare, counsel strategies and skilled helper approaches.

The patient's needs are defined by the addiction and depression which pushed him into institutionalization. At age 42, the subject -- 53 at the time of our interview -- had reached what he had defined as a 'breaking point' with alcohol and drug addiction. Arrested for narcotics possession, DUI and reckless endangerment after driving his car into an embankment while under the influence of alcohol and cocaine, Mr. Smith was remanded to a rehabilitation facility which we will anonymous refer to as Facility a. More specifically, Mr. Smith's needs in this context would be the ability to articulate the cause and basis of his addiction, to extricate himself from the negative lifestyle patterns underscoring this addiction, to find ways of coping with this new lifestyle that prevent relapses and to gain access to means of support that help to make long-term help possible. The interview process and the research focus here on the duties of a skilled-helper will help to reveal the value of subject representation relative to Mr. Smith's needs.

2i. Mr. Smith's Interview According to Egan

Mr. Smith noted at the outset of the interview that he was extremely grateful that he was remanded to rehabilitation rather than to jail. He considered this a greater fortune that would help to turn his life around while also offering him a much brighter alternative to the frequently bleak futures awaited those who have been circulated in an out of the prison system.

Thus, there is a positive connotation to his reflection of one-on-one sessions with counselors who were dispatched free from judgment to attempt to get to the bottom of his self-destructive tendencies. This comports with Egan's conception of Stage I in applying skilled therapeutic support, which reports a fundamental importance in helping patients to tell their own personal stories. Namely, there is a lack of clarity as to that which motivates the self-destructive and often socially destructive behavior of the addict because many have either been unable or unwilling to reach this individual.

Mr. Smith would be a meaningful endorsement of the implications of Stage I, reporting in our interview that he found "the environment of the rehabilitation center was better than any other that I had experienced in terms of feeling comfortable in talking about my problems." (Smith, 1) This would denote a novel experience for one who had reported to possessing no real place to outlet the fear, insecurities, depression and temptation that are permeated his psyche over the issue of addiction. The skilled helpers who worked as his personal counselors seemed by and large to leave a positive impression on him concerning their willingness to find clarity and importance in his perspective and to help him achieve leverage by channeling his emotional energies in the correct direction.

This is an orientation which comes into clearer view through a consideration of Rogers (1995) unearthed manuscript from a speaking engagement on relational counseling. Here, Rogers provides the case examination of Mr. Smith with a compelling undercurrent that would also impact the interview style here applied, imparting that "I have found it of enormous value when I can permit myself to understand another person." (Roger, 11) This forms nothing less than the core philosophical premise designing the qualified skilled helper. In the case of Mr. Smith, who reported to finding freedom and the ability to battle with his condition through the empowerment provided him by the understanding and acceptance of his counselors.

To this extent, we are assisted in our interpretation of the patient's experience by that which Egan tells us. According to his Model of Maturity, also identified as Full Human Functions, the ability of a Skilled Helper to truly represent a patient is less grounded in the actual ability to resolve a problem as it is in the ability to support the patient in his or her quest to resolve a problem. There is a degree to which helpers are intended to assist in constructing a maturation to the conditions of a treatment experience, whether the associated mental ailment is seen as clinical or circumstantial.

Referring to this as a social emotional intelligence, Egan contends that its refinement will hinge on the ability of the patient to self-manage, particularly in light of the demands placed upon the patient by the condition. (Egan, 11) This means the construction of new social parameters, lifestyle habits and perspective on the part of Mr. Smith, who in our interview would indicate that "I would tend to behave in negative patterns that were related to my substance abuses and that caused me to be even more depressed. This made me that much more likely to resort to alcohol or drugs, producing a negative cycle that I felt powerless to see, explain or stop." (Smith, 1) After more than a decade clean, Mr. Smith says that temptations are never completely removed from his mind, but that the ability for him to be honest about his story, both then and now, has helped him to feel that he has leverage over the addiction.

3. Conclusion

The helping model, according the research which was conducted in preparation for and in light of Mr. Smith's situation, would be further illuminated by the interview. Here, firsthand interaction illustrated that individuals who have undergone such institutional experiences are sometimes eager to share details and feelings directly related thereto. The way that Mr. Smith opted to open up would be especially revealing in verifying the value of allowing one's self to fully accept and understanding the nature of such conditions and experiences. The freedom from value judgment, condescension or superiority, which is communicated clearly through one's approach, tone, body language and perspective, will be tantamount to one's success in truly providing support and help to those who need it.

I would leave the experience of interviewing Mr. Smith with a greater appreciation for the value of empathy in approaching therapeutic scenarios, both by virtue of the positive experience and outcome demonstrated by Mr. Smith and by the extent to which this approach served to the effectiveness of my interview.