Helping clients tell their stories

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.

2 ii: Communication Methods Employed in Interview

This certainly helps to inform the interview that we shared, with Mr. Smith using this as an opportunity to renew his commitment to an emotional honesty and maturity about the conditions which predisposed him to abuse and about the value inherent in opening up to others. This is something which he views as both a responsibility to caution others and as a part of an ongoing therapy in which he appeals to others for their support and acceptance of his mistakes, his redemption and his internal struggle to remain in abstention from his old habits. Thus, I would be highly conscious of the role which I played in his ongoing therapy as I conducted the interview, therefore appealing to certain verbal and non-verbal strategies to help incline the type of comfort necessary to facilitate the process.

The challenges imposed by my task are defined by such articles at that by Myers (2003) which denotes the need for an inherently empathetic response to the needs of the subject. For the counselor and the interviewer alike, the subject must feel a true connection therewith in order to share sentiments which are to be of any value in providing a clarity of perspective and in providing therapeutic assistance. Myers denotes that "getting 'inside' the therapeutic relationship to explore empathic connections and experiences of healing is not a simple task. However, exploring clients' perceptions of the therapeutic relationship and of how if influence their growth and developments may provide valuable insights into the therapeutic process." (Myers, 89) Therefore, I employed a verbal strategy designed to promote the benefits of the interview to Mr. Smith himself.

A did this by initiating the discussion with a focus on his current state of mind and emotional disposition. Rather than pose my inquiries as a line of interview questions, I allowed the interview to take a more natural form according to that which Mr. Smith desired to discuss. I opened by asking him how he was feeling on the day of the interview. This was a very easy segue into the subject's discussion on personal state of mind, allowing me to improvise many of my questions according to the line of his thought. I would find that, as Myers denotes, the benefits of getting 'inside' the patient-counselor relationship are realized by capitalizing on the interviewee's own expressed talking-point interests.