The topic is Wells FargoThe key to this assignment is to demon.docx
1. The topic is Wells Fargo
The key to this assignment is to demonstrate your understanding
of the topics, not to re-word the text or reference material.
Please complete the scenario below following these guidelines
for your deliverable.
This portion of the Case Study assignment must be a minimum
of 2 pages double spaced; plus a title page and a reference page
for a total of 6 pages.
Make sure you are using at least two (2) academic references
for this phase.
This submission should be created following APA 6th edition
guidelines.
A) PROPOSE A RISK ASSESSMENT METHODOLOGY
WHICH CAN BE USED ALONG WITH YOUR CHOSEN
COMPANY IN CASE STUDY PHASE 1 .
B) MAKE SURE YOUR REFERENCES LIST CONTAINS AT
LEAST 4 SOURCES
Note: Running Size of your deliverable should include the 2
Pages of content for the second case study, a title page, the
references page, plus 2 pages of content from Case Study 1 for a
total of 6 pages. Please remember that you are building a case
study for your company. As a result, the first case study is an
introduction to the second case study. This week's case study
requires you to discuss the risk assessment methodology that
you will use for the case study.
2. Title
ABC/123 Version X
1
Helping Process Worksheet
CPSS/370 Version 2
1
University of Phoenix Material
Helping Process Worksheet
Part 1: Matching
Complete the following table by matching the phase in the
helping process on the right with the component on the left.
You may use each stage in the helping process more than once.
Write your answer in the Answer Column.
Component
Answer Column
Phase in the helping process
1. Plan development
A. Assessment
2. Gathering and assessing information
B. Planning
3. Making initial contact
C. Implementation
4. Arranging for services
4. placements, homeless, or in crisis. Individual and family
therapy, psycho-educational groups, health assessments, and
food, clothing, and shelter are provided by the agency.
— A caseworker in St. Louis, MO
There is a variety of helping professions committed to helping
those in need. Those professions in settings such as mental
health, substance abuse, criminal justice, welfare, education,
child and youth services, and legal aid, to name a few, are
committed to helping clients address issues that emerge from
problems in living. These professionals, committed to viewing
clients from a holistic point of view, support client growth in
areas such as social, physical, and mental health and financial,
spiritual, educational, and vocational issues. The helping
process is a fundamental way that professionals reach out to
those in need and provide the support and structure necessary to
influence their potential to develop and grow in positive ways.
In this text we present knowledge and skills that will help you
prepare to help others.
This chapter introduces you to a model of helping that guides
many professionals who work in human service delivery.
Helping is a purposeful undertaking that generally moves
through three phases. We say “generally” because people are
often unpredictable, problems or situations change, or services
are disrupted for other reasons. The three phases of this helping
model are not discrete categories with specific time limits.
Rather, they illustrate the flow of the helping process that is
individualized to each person, situation, or both.
This chapter also introduces the three components of the
helping process: case review, documentation and report writing,
and client participation. Both a strengths-based approach to the
process and the ethical considerations that undergird the process
are important parts of this chapter. Focus your reading and
study on the following objectives, which you should be able to
accomplish after reading the chapter.
Phases of the Helping Process
· ■ List the three phases of the helping process.
5. · ■ Identify the two activities of the assessment phase.
· ■ Illustrate the role of data gathering in assessment and
planning.
· ■ Describe the helper’s role in implementation.
Three Components of the Helping Process
· ■ Define case review and list its benefits.
· ■ Support the need for documentation and report writing.
· ■ Trace the client’s participation in the three phases of the
helping process.
Strengths-Based Approach to the Helping Process
· ■ Describe this approach as it relates to each phase of the
helping process.
· ■ Discuss the advantages of this approach.
Ethical Considerations
· ■ List the principles that undergird professional practice.
· ■ Summarize the limitations of codes of ethics.
At times, learning about a new concept or process is difficult
without a concrete example to illustrate what the process looks
like in the real world. With this in mind, we would like to
introduce you to the phases of the helping process through the
experience of Roy Johnson, a client working with several
helping professionals to address major difficulties he
encounters. Roy’s experience is based upon a client that we
know who has been involved in the human service delivery
system for years. He has given us permission to adapt his
experiences to illustrate the nature of the helping process.
The section that follows introduces the three phases of the
helping process. The case of Roy Johnson illustrates each phase.
Phases of the Helping Process
The three phases of the helping process are assessment,
planning, and implementation (see Figure 1.1). Each phase will
be discussed in detail in later chapters. Human service delivery
has become increasingly complex in terms of the number of
organizations involved, government regulations, policy
guidelines, accountability, and clients with multiple problems.
Therefore, the helping professional needs an extensive
6. repertoire of knowledge, skills, techniques, and strategies to
serve clients effectively.
Let’s see how these phases occur in three different settings.
· I am a case coordinator. My agency has initial responsibility
for all children who come through the juvenile court system. We
begin each case with an assessment. I gather school and medical
records and prior psychological evaluations. Because I want to
find out as much as possible about a child, I will visit the home,
interview teachers and school counselors, or arrange for an
evaluation.
Figure 1.1 The Helping Process
The planning process helps the staff at another agency located
in the Bronx, NY, decide how and why to provide services. The
agency director says:
· It seems like our clients want to do everything all at once but
we encourage them to take one day at a time. Steps are very
important so that they don’t get overwhelmed and end up
failing. This is something we talk with them about and
encourage them to do.
A social worker who provides frontline assessments and
referrals for emergency admissions at a metropolitan Houston
hospital describes patient placements as the implementation
phase of his work.
· In a nutshell, my job is to figure out what’s going on and
where the patient can go. Most of the people I work with come
to the emergency room involuntarily, often brought by the
police. I do all the paperwork and then I find a placement.
As you can see, the responsibilities at each phase vary,
depending on the setting and the helper’s job description. It is
important to understand that the three phases represent the flow
of the helping process rather than rigidly defined steps to
successful case closure. An activity that occurs in the first
phase may also appear in the second or third phases of planning
and implementation. Other key components appear throughout
the process, including case review, report writing and
7. documentation, and client participation. Ultimately, the goal of
the helping process is to empower clients to manage their own
lives as well as they are able. The case of Roy Johnson shows
how this happens.
As stated earlier, Roy Johnson is a real person, but his name
and other identifying information have been changed. The case
as presented here is an accurate account of Roy’s experience
with the human service delivery system. His case exemplifies
the three phases of the helping process. The following
background information will help you follow his case through
assessment, planning, and implementation.
Roy referred himself for services after suffering a back injury at
work. He was 29 years old and had been employed for five
years as a plumber’s assistant; he hurt his back lifting plumbing
materials. After back surgery, he wanted help finding work.
Although he had received a settlement, he knew that the money
would not last long, especially since he had contracted to have a
house built. He heard about the agency from a friend who knew
someone who had received services there and was now working.
The agency helps people with disabilities that limit the kind of
work they can do. An important consideration in accepting a
person for services at the agency is determining whether
services will enable that person to return to work. Roy’s case
was opened at the agency; we will follow it to closure.
Assessment
The assessment phase of the helping process is the diagnostic
study of the client and the client’s environment. It involves
initial contact with an applicant as well as gathering and
assessing information. These two activities focus on evaluating
the need or request for services, assessing their appropriateness,
and determining eligibility for services. Until eligibility is
established, the individual is considered an applicant. When
eligibility criteria have been met, the appropriateness of service
is determined and the individual is accepted for services, then
he or she becomes a client. You will read more about
assessment in Chapters Two and Three.
8. The initial contact is the starting point for gathering and
assessing information about the applicant to establish eligibility
and evaluate the need for services. In most organizations, the
data gathered during the initial contact is basic and
demographic: age, marital status, educational level, employment
information, and the like. Other information may be obtained to
provide detail about aspects of the client’s life, such as medical
evaluations, social histories, educational reports, and references
from employers.
· Roy was self-referred to the agency. He initiated contact by
telephoning for an appointment. Fortunately, a helping
professional was able to see him that week, so he made an
appointment for May 24 at 10:30 A.M. He was sent a brochure
about the agency and a confirmation of his appointment. When
he arrived at the agency, Roy completed an application for
services. The agency believes the applicant should supply the
information in this initial information gathering. Roy was able
to complete the form without too much trouble, although he
wasn’t sure how to answer the question about where he had
heard about the agency. He didn’t know the name of his friend’s
friend. The receptionist helpfully told him to write in “self-
referral.” She suggested that he leave any questions blank if he
wasn’t sure about the response. She also asked him not to sign.
· Roy had brought a copy of a letter prepared by his orthopedic
surgeon, Dr. Alderman, for his attorney a year earlier
(see Figure 1.2). Dr. Alderman had expressed the opinion that
Roy would be left 10 percent disabled as a result of the injury.
Dr. Alderman was also careful to clarify that Roy’s condition
did not reflect a preexisting disability, even though he had
suffered back problems previously. Tom Chapman, the helper
who saw Roy, made a copy of the letter and returned Roy’s
copy to him.
During the initial contact, the helper determines who the
applicant is, begins to establish a relationship, and takes care of
such routine matters as filling out the initial intake form. An
important part of getting to know the applicant is learning about
9. the individual’s previous experiences with helping, his or her
strengths, his or her perception of the presenting problem, the
referral source, and the applicant’s expectations. As these
matters are discussed, the helper uses appropriate verbal and
nonverbal communication skills to establish rapport with the
applicant.
Skillful use of interviewing techniques facilitates the gathering
of information and puts the applicant at ease. The helper makes
the point at the conference that the client is considered an
expert and that self-reported information is very important. By
providing information about routine matters, the helper
demystifies the process for the applicant and makes him or her
more comfortable in the agency setting. Some of the routine
matters addressed during the initial meeting are completing
forms, gathering insurance information, outlining the purpose
and services of the agency, giving assurances of confidentiality,
and obtaining information releases.
Documentation records the initial contact. In the agency Roy
went to, helpers fill out a Helping Professional’s Page
(see Figure 1.3), which describes the initial meeting.
· Although Dr. Alderman’s letter provided helpful information
about Roy’s presenting problem, agency guidelines stated that
all applicants must have a physical examination by a physician
on the agency’s approved list. Mr. Chapman also felt that a
psychological evaluation would provide important information
about Roy’s mental capabilities. He discussed both of these
with Roy, who was eager to get started. Mr. Chapman asked
Roy to sign a form that permits release of information from the
external evaluation. As Roy prepared to leave, Mr. Chapman
explained that it would take time to process the forms and
review his application for services. He would be in touch with
Roy very soon, explaining the next steps.
Figure 1.2 Dr. Alderman’s Letter
If the applicant is accepted for services, the client and the
helper will become partners in reaching the goals that are
10. established. Therefore, as they work through the
initial information gathering and routine agency matters, it is
important that they identify and clarify their respective roles, as
well as their expectations for each other and the agency. From
the first contact, client participation and service coordination
are critical components in the success of the process. The helper
must make clear that the client is to be involved in all phases of
the process. A skillful helper makes sure that client involvement
begins during the initial meeting (see Figure 1.4).
Figure 1.3 Helping Professional’s Page
In Roy’s case, the helper reviewed the application with him.
There were some blanks on the application, and they completed
them together. Roy had not been sure how to respond to the
questions about primary source of support and member of his
household. As Roy elaborated on his family situation, the helper
completed these items. Roy felt positive about his interactions
with Tom Chapman because Tom listened to what he said,
accepted his explanations, and showed insight, empathy, and
good humor.
Figure 1.4 Tom Chapman’s Memo
In gathering data, the helper must determine what types of
information are needed to establish eligibility and to evaluate
the need for services. Once the types of information are
identified, the helper decides on appropriate sources of
information and data-collection methods. His or her next task is
making sense of the information and data-collection methods. In
these tasks, assessment is involved: The helper addresses the
relevance and validity of data and pieces together information
about problem identification, eligibility for services,
appropriateness of services, plan development, service
provision, and outcomes evaluation. During this process the
helper checks and rechecks the accuracy of the data, continually
asking, “Does the data provide a consistent picture of the
client?”
11. Client participation continues to play an important role
throughout the information-gathering and assessment activities.
In many cases, the client is the primary source of information,
giving historical data, perceptions about the presenting problem,
and desired outcomes. The client also participates as an
evaluator of information, agreeing with or challenging
information from other sources. This participation establishes
the atmosphere to foster future client empowerment.
· The helper needed other information before a certification of
eligibility could be written. In addition to Dr. Alderman’s letter,
a general medical examination, and a psychological evaluation,
the helper requested a period of vocational evaluation at a
regional center that assesses people’s vocational capabilities,
interests, and aptitudes. Tom Chapman had worked with all
these professionals before, so he followed up the written reports
he received with further conversations and consultations.
Following a two-week period at the vocational center, the
evaluators met with Roy and Mr. Chapman to discuss his
performance and make recommendations for vocational
objectives. When the report was completed, Mr. Chapman and
Roy met several times to review information, identify
possibilities, and discuss the choices available to Roy. Mr.
Chapman’s knowledge of career counseling served him well as
he and Roy discussed the future. Unfortunately, an unforeseen
complication occurred, delaying the delivery of services. Tom
Chapman changed districts, and another helper, Susan Fields,
assumed his caseload. Meanwhile, Roy moved to another town
to attend school. Although he was still in the same state, Roy
was now about 200 miles from the helping professional with
whom he worked. While Roy was attending his first semester at
school in January, Ms. Fields completed a certificate of
eligibility for him. This meant that he was accepted as a client
of the agency and could now receive services. In May, his case
was transferred to another helper (his third) in the town where
he lived and attended school.
Planning
12. The second phase of the helping process is planning, which is
the process of determining future services in an organized way.
When planning begins, the agency has usually accepted the
applicant for services. The individual has met the eligibility
criteria and is now a client of the agency. During this planning
process, the helper and the client turn their attention to
developing a service plan and arranging for service delivery.
Client participation continues to be important as desired
outcomes are identified, services suggested, and the need for
additional information determined. The actual plan addresses
what services will be provided and how they will be arranged,
what outcomes are expected, and how success will be evaluated.
A plan for services may call for the collection of additional
information to round out the agency’s knowledge of the client.
Some helping professionals suggest that the service-delivery
process is like a jigsaw puzzle, with each piece of the
information providing another clue to the big picture. During
this stage, the helper may realize that a social history, a
psychological evaluation, a medical evaluation, or educational
information might provide the missing pieces. You will read
more about this information in a later chapter. The plan
identifies what services are needed, who will provide them, and
when they will be given. The helper must then make the
appropriate arrangements for the services.
During the assessment phase, Tom Chapman did a
comprehensive job of gathering information about Roy. When
Roy was accepted for services, the task facing him and his new
helper was to develop a plan of services. Clarity and
succinctness characterize the service plan, which the helper and
the client complete together, emphasizing the client’s input in
the process. The plan lists each objective, the services needed to
reach that objective, and the method or methods of checking
progress.
Suppose that Tom Chapman had believed that a psychological
evaluation was unnecessary and had been able to establish
eligibility solely on the basis of the medical and vocational
13. evaluations. Susan Fields, the new helper, might find that a
psychological evaluation would be beneficial, especially since
the agency was contemplating providing tuition and support for
training. One objective of the plan would then be to provide a
psychological evaluation of the client. This is an example of
continuing to gather data during the planning phase, as well as
continuing to assess the reliability and validity of the data.
Roy’s plan indicates that he is eligible for services and meets
agency criteria. His program objective, business
communications, was established as a result of evaluation
services, counseling sessions with Mr. Chapman, and Roy’s
stated vocational interests (see Figure 1.5). The three stated
intermediate objectives will help Roy achieve the program
objective.
Figure 1.5 Service Plan
The plan also provides a place to identify the responsibilities of
Roy and the agency in carrying out the plan. Many agencies
take very seriously the participation of the client in the
development of the plan, even asking that the client sign it, as
well as the helper.
Once the plan is completed, the helper begins to arrange for the
provision of services. He or she must review the established
network of service providers. Experienced helpers know who
provides what services and who does the best work.
Nonetheless, they should continue to develop their networks.
For beginning helpers, the challenge is to develop their own
networks: identifying their own resources and building their
own files of contacts, agencies, and services. A later chapter
provides information about developing, maintaining, and
evaluating a network of community resources.
Implementation
The third phase of the helping process is implementation, when
the service plan is carried out and evaluated. It starts when
service delivery begins, and the helper’s task becomes either
14. providing services or overseeing services and assessing the
quality of services. He or she addresses the questions of who
provides each service, how to monitor implementation, how to
work with other professionals, and how to evaluate outcomes.
In general, the approval of a supervisor may be needed before
services can be delivered, particularly when funds will be
expended. Many agencies, in fact, have a cap (a fee limit) for
particular services. In addition, a written rationale is often
required to justify the service and the funds. As resources
become increasingly limited, agencies redouble their efforts to
contain the costs of service delivery. In Roy’s case, the
agency’s commitment to pay his training tuition represented a
significant expenditure. Susan Fields submitted the plan and a
written rationale to the agency’s statewide central office for
approval.
Who provides services to clients? The answer to this question
often depends on the nature of the agency. Some are full-service
operations that offer a client whatever services are needed in-
house. For example, the helper might provide counseling, career
exploration, or education. As a rule, however, the client does
not receive all services from a single helper or agency. It is
usually necessary for him or her to go to other agencies or
organizations for needed services. This makes it essential for
the helper to possess referral skills, knowledge of the client’s
capabilities, and information about community resources.
No doubt you remember that Roy’s first helper, Tom Chapman,
arranged for a psychological evaluation. Many agencies like
Tom’s have so many clients needing psychological evaluations
that they hire a staff psychologist to do in-house evaluations of
applicants and clients. School systems, for example, employ
their own school psychologists. Other agencies simply contract
with individuals—in this case, licensed psychological examiners
or licensed psychologists—or with other agencies to provide the
service. Whatever the situation, the helper’s skills in referral
and in framing the evaluation request help determine the quality
of the resulting evaluation.
15. Another task of the helper at this stage is to monitor services as
they are delivered. This is important in several respects: for
client satisfaction, for the effectiveness of service delivery, and
for the development of a network. Monitoring is doubly
important because of the personnel changes that constantly
occur in human service agencies. Moreover, there may be a need
to revise the plan as problems arise and situations change.
The implementation phase also involves working closely with
other professionals, whether they are employees of the same
agency or another organization. A helper who knows how to
work successfully with other professionals is in a better
position to make referrals that are beneficial to the client. These
skills also contribute to effective communication among
professionals about policy limitations and procedures that
govern service delivery, the development of new services, and
expansion of the service delivery network.
Perhaps there is no other point in service delivery at which the
need for flexibility is so pronounced. For example, during the
implementation stage it often becomes necessary to revise the
service plan, which must be regarded as a dynamic document to
be changed as necessary to improve service delivery to the
client. Changes in the presenting problem or in the client’s life
circumstances, or the development or discovery of other
problems, may make plan modification necessary. Such
developments may also call for additional data gathering.
· In his second semester at school, Roy heard about a course of
study that prepared individuals to be interpreters for the deaf.
This intrigued him, because he was already proficient in sign
language. His mother was severely hearing impaired, and as a
child, Roy signed before he talked. He also thought back to the
evaluation staff meeting, at which the team discussed the
possibility of making interpreter certification a vocational
objective for him. Roy liked the interpreting program and the
instructors, so he applied to the program. The change in
vocational objective made it necessary to modify his plan. His
helper (by now, his fourth) revised the plan at the next annual
16. review to include his new vocational objective of educational
interpreting.
Three Components of the Helping Process
Case review, report writing and documentation, and client
participation appear in all three phases of the helping process;
they are discussed in detail in later chapters. Here we introduce
the concepts by examining how each applies to Roy’s case.
Case review is the periodic examination of a client’s case. It
may occur in meetings between the helper and the client,
between the helper and a supervisor, or in an interdisciplinary
group of helpers, called a staffing or case conference. A case
review may occur at any point in the helping process, but it is
most common whenever an assessment of the case takes place.
Case review is an integral part of the accountability structure of
an organization; its objective is to ensure effective service
delivery to the client and to maintain standards of quality care.
Roy’s case was reviewed in several ways. Each time a new
helper assumed the case (unfortunately, this was often), a
review was conducted. There were also reviews on the occasion
of the two professional contacts Roy had per semester. At the
end of each semester, his grades were checked—also part of the
case review. The staffing related to Roy’s vocational evaluation
is an example of case review by a team. In this case, the client
was an active participant in the case review. Roy also
participated in developing the service plan, which involved a
review of the information gathered, the eligibility criteria, and
the setting of objectives. The agency serving Roy implemented
the important component of case review in various ways at
different times throughout the process.
An important part of case review is the documentation of the
case. Documentation is the written record of the work with the
client, including the initial intake, assessment of information,
planning, implementation, evaluation, and termination of the
case. It also includes written reports, forms, letters, and other
material that furnish additional information and evidence about
the client. The particular form of documentation used depends
17. on the nature of the agency, the services offered, the length of
the program, and the providers. A record is any information
relating to a client’s case, including history, observations,
examinations, diagnoses, consultations, and financial and social
information. Also important are “all reports pertaining to a
client’s care by the provider, reports originating from orders
written within the facility for tests completed elsewhere, client
instruction sheets, and forms documenting emergency treatment,
stabilization, and transfer” (Mitchell, 1991, p. 17). The helper’s
professional expertise must include documenting appropriately
and in a timely manner and preparing reports and summaries
concisely but comprehensively.
Roy’s file includes many different types of documentation. The
written record may include computer forms, applications for
services, helpers’ notes, medical evaluations, reports, and
letters. Other documentation in Roy’s file might be a
psychological evaluation, a vocational evaluation, specialized
medical reports, and medical updates. In Roy’s case, all this
documentation may turn out to be indispensable because, during
his time as a client, he worked with five different helpers. For
continuity of service, good case documentation is essential.
Client participation means the client takes an active part in the
helping process, thereby making service delivery more
responsive to client needs and enhancing its effectiveness. In
some cases a partnership is formed between the helper and the
client; an important result of this partnership is client
empowerment. One of the many factors involved in forming a
partnership with the client is clear communication, or two-way
communication. The helper must explain to the client his or her
goals, purposes, and roles as defined by the agency. The helper
encourages the client to define his or her goals, priorities,
interests, strengths, and desired outcomes. At this point the
client also commits to assuming responsibility within the
helping process. As client participation continues and the
partnership develops, it is helpful to have knowledge of
subcultures, deviant groups, reference groups, and ethnic
18. minorities so as to communicate effectively with the client
about roles and responsibilities. Other factors can affect client
involvement, including the timing, setting, and structure of the
helping process. Minimizing interruptions, inconveniences, and
distractions enhances client participation.
Encouraging client participation has identifiable components.
The first is the initial contact between the client and the helper.
It is easier to involve clients who initiate the contact for help,
as Roy did, because they usually have a clearer idea of what the
problem is and are motivated to do something about it. In Roy’s
case, the clarification of roles and responsibilities occurred at
three points in the assessment phase. Roy and his helper were
able to talk about the agency and the services available, and the
helper encouraged Roy to talk about his goals, motivations, and
interests. When Roy completed his application, the helper
reviewed it with him, especially the statement at the bottom of
the second page. On signing the statement, the client voluntarily
places himself or herself in the care of the agency. With this
agreement come roles and responsibilities for both the client
and the helper, which the helper reviews at that point. A second
opportunity to clarify roles and responsibilities comes with the
completion of a service plan. Both the client and the helper sign
the service plan, which designates the responsibility for each
task and the time frame for completion of each service.
The final phase of client participation comes at the termination
of the case. At this time, the client and the helper together
review the problem, the goals, the service plan, the delivery of
services, and the outcomes. They may also discuss their roles in
the process. Thus, in terms of client participation, termination
means more than just closing the case. It is an assessment of the
client’s progress toward self-sufficiency, the ultimate goal of
client empowerment. Self-sufficiency is defined differently for
each client.
Strengths-Based Approach to the Helping Process
A strengths-based approach to helping focuses on the talents,
skills, knowledge, interests, and dreams of an individual as a
19. way to empower, motivate, and engage internal and
environmental supports (Saleebey, 2008). Helpers use a
strengths-based approach during assessment, planning, and
implementation as a way to engage the client in the helping
process. In this section are exercises that will help you apply
the strengths-based approach to the helping process.
Assessment
A strengths-based approach to the assessment phase focuses on
the positive characteristics, abilities, and experiences of the
client to build upon them in addressing current problems. The
counselor identifies these by asking clients to recall how they
have solved problems in the past and to describe successes at
home, school, work, and in relationships. This discussion is part
of the problem-identification phase but shifts the emphasis from
problems or deficit thinking to a more positive, client-focused
position.
This approach to assessment takes time and calls for patience
and facilitation from the helper. There is a dual focus at this
point. One is to collect information about the client’s needs and
resources; the second is to assess client functioning and the
client’s social network, for example. In the strengths-based
approach, the helper is most interested in the client’s resources
and abilities. To identify these, the client may need prompting
to recall past successful behaviors and situations. The following
examples of statements or questions encourage this recall: “Tell
me about a time when you faced a similar problem.” “What do
you consider your most important ability?” “What have you
learned from your friends and family?” “What do you enjoy
doing?”
Taking time to explore the client’s responses has other benefits.
Identifying strengths fosters motivation. For example, focusing
on positives rather than negatives empowers the client to
believe that change is possible and that he or she has the
abilities and resources to make this happen. This positive
approach also helps build rapport and the relationship between
the client and the helper. The client leaves this session with
20. hope that his or her needs will be met and with confidence in
the helper and the relationship.
During this phase, the helper also assesses the client’s readiness
for change in the areas the client has identified. Older models of
helping depended on the helper to inform the client what to do.
The noncompliant client was then labeled as resistant.
Strengths-based approaches consider change as a process that
begins with two stages. The first is precontemplation, at which
point there has been no thought about change, and the second is
contemplation, where considering change begins, although
probably with some ambivalence (Norcross, Prochaska, &
DiClemente, 1994).
There are a number of tools to assist with strengths
identification. They include questionnaires, surveys, and forms
that may be completed by the client, the family, the helper, or a
combination of those involved. Figure 1.6 is an example of a
simple strengths-identification form. Guidelines of assessing
strengths, detailed in Figure 1.7, help client and helper identify
areas of perceived strength. These guidelines are based upon the
sources of strengths (Saleebey, 2008). Other approaches are
more complex and encompass the following seven domains:
living arrangements, leisure/recreational,
vocational/educational, health/medical, social support,
emotional/behavioral, and financial (Rapp & Goscha, 2006).
Whatever the approach during the assessment phase, the goal of
the strengths-based approach is the identification of client
strengths and resources.
Planning
The second phase of the helping process is planning. An
understanding of strengths is essential to effectively plan. The
strengths, abilities, and resources of the client become part of
the plan development. In addition, all environments contain
resources, and these are identified and incorporated into the
planning process. These may exist in the home, the extended
family, the place of employment, the place of worship, the
community, or a mix of several of these. Increasing the number
21. of available resources identified has a direct bearing on the
success of the plan: the more resources to support the client’s
efforts, the greater the possibilities for change.
During this phase the client–helper collaboration continues and
becomes a stronger and more positive force in the helping
process. A critical part of this collaboration is client
participation in determining both short-term and long-term
goals that are compatible with the client’s values and strengths.
These goals are formulated realistically given the client’s
abilities and available resources. And they are stated
positively—again, a basic tenet of the strengths-based approach.
Finally, the client provides input about updates based on
changes in any conditions that affect the client, the plan, and
the process. Assuming this responsibility engenders client
participation and is one way that the transfer of helping
responsibilities to the client occurs.
Implementation
Several approaches to implementation are grounded in client
strengths. Among them are harm reduction, solution-focused
intervention, cognitive-behavioral strategies, and motivational
interviewing. The hallmark of any strengths-based intervention
is choice. Specifically, the client has options in terms of the
goals determined during the planning phase, the interventions or
methods employed to bring about change, and the context of
intervention (e.g., outpatient, inpatient, group, individual). The
possibilities available to the client emphasize the values of self-
determination and responsibility. The helper maximizes any
benefits of these choices by respecting the client’s preferences
and choice, further solidifying the relationship and affirming
the client’s active role in the helping process.
Figure 1.6 Strengths Identification Form
Figure 1.7 Sources of Strengths
Another critical component of intervention is incorporating the
resources that have been identified. These may be community-
22. based resources, such as services provided by other agencies for
which the client is eligible, or the resource may be one or more
family members who will support the client’s efforts. In fact,
the resource may have already been available but not directed to
or activated for the client’s benefit. Making use of every
available support enhances the client’s chances for success.
Let’s examine a specific intervention to see how it
works. Motivational interviewing is a strategy that enhances the
client’s desire to change by exploring and resolving
ambivalence (Van Wormer & Davis, 2003). Although first used
with problem drinkers, its use has expanded to a number of
different problems, including smoking, bulimia, and domestic
violence, and to a variety of settings such as medical practice,
child welfare, and community-based organizations. Its goal is to
help clients change by providing a way for them to see
themselves and the costs of their behavior and to find the
motivation to change the targeted behaviors. Motivational
interviewing facilitates client change not by admitting the
problem or finding solutions but rather by focusing on
identifying what is preventing the client from changing.
The goal of motivational interviewing strategies is to increase
motivation, not to get answers. The interview begins by
determining the client’s current level of motivation or readiness
to change. One way to determine this is to ask, “If on a scale of
1 to 10, 1 is not at all motivated to give up smoking and 10 is
100% motivated to give it up, what number would you give
yourself at the moment?” (Van Wormer & Davis, 2003, p. 80).
Following up with an inquiry about “why a 4 rather than a 1”
will lead to the identification of positive reasons for change.
Asking “What would it take for your confidence or motivation
to move from a 4 to a 5,” is another way to get the client to
think about what he or she needs to increase motivation. These
techniques encourage the client to identify values and goals for
behavior change and to resolve any ambivalence about
changing.
The helper’s role during this process is to be empathic, avoiding
23. judgments and arguments. It is also important for the helper to
articulate discrepancies between the client’s words, behaviors,
and goals and to direct the client’s attention to an exploration of
these discrepancies: “You say you want to quit smoking yet you
keep a pack of cigarettes in your car. Tell me about that.” Using
the client’s own words makes an impact on the client and
prompts the client’s recognition and exploration of the
discrepancy. Any resistance or reluctance is a natural part of
change and is met with “It is up to you” or “What you do is
really your decision.”
This brief overview of motivational interviewing enables you to
see how it uses client strengths and client participation in
changing. It differs from the traditional approaches or
interventions that begin with problem identification, end with
resolution, and involve confronting clients or persuading them
that they must change. Often, these approaches actually increase
resistance.
Ethical Considerations
Permeating the helping process is a commitment to ethical
standards. Whatever the profession, whether it be counseling,
health, human services, nursing, psychology, or social work,
helping behavior is grounded in similar principles that focus on
the way helpers work with the recipients of their services. These
principles represent commitments to the client’s right to self-
determination, to do no harm, to promote fairness and equal
access to services, to be responsible to the client, and to be
honest.
Codes of ethics, or ethical standards, have been developed by
professions to operationalize these commitments in order to
provide guidelines for practice. Examples are the Ethical
Standards for Psychologists (American Psychological
Association), the Ethical Standards for School Counselors
(American School Counselor Association), the Code of Ethics
for Rehabilitation Counselors (Commission on Rehabilitation
Counselor Certification), and the Ethical Standards of Human
Service Professionals (National Organization for Human
24. Services). Their purpose is to clarify the helper’s responsibility
to clients, employers, and society.
Codes of ethics pose two challenges. First, a profession’s code
of ethics is binding only on members of the group that adopts it.
Those who are not members are not bound by the code. Second,
it is impossible for a code to cover every possible situation that
could arise in the helping process. The following quotes present
some real ethical dilemmas that helpers encounter:
· All the people we work with want everything to be
confidential. This is a problem for them and for us when we
have to report something.
Settlement House Worker, Bronx, NY
· Clients who don’t want our help are challenging. It’s difficult
to watch a client fail, especially when there is potential for
improvement and stability.
Case Manager, Los Angeles
· It’s a difficult situation when the family is against us. For
example, we have a client whose family tells her she shouldn’t
be on medication. She listens to them but what they tell her
isn’t always in her best interest.
Mental Health Professional, Knoxville
As you can see from these quotes, the helping process often
requires a delicate balance of consideration to the client, the
family, the agency or organization, laws and regulations, and
professional codes of ethics. These conflicting interests can
create crises that require the helper to make difficult choices.
The situations just described reflect some of the tensions
helpers face. Because changes occur in laws and regulations,
professional practices, and standards of practice, codes of ethics
also change, adding complexity and presenting new challenges
to professionals. For example, the use of technology has
required a rethinking of assuring confidentiality, and the
realities of shifting population demographics have created the
need for competencies in multicultural counseling.
Ethics in helping professions is a complex issue that is
addressed both in courses and throughout curricula and is
25. mandated by academic accrediting bodies and certification and
licensure boards. As you read the following chapters about the
phases of the helping process, think about the ethical dilemmas
that might occur.
CHAPTER SUMMARY
Managing client services is an exciting and challenging
responsibility for helping professionals. To assist clients with
multiple problems, helping professionals must know the process
of helping and be able to use it. The process can be adapted to
many different settings, for work with a variety of populations.
The three phases of the helping process—assessment, planning,
and implementation—each represent specific responsibilities
assumed by the helper. The process of helping is nonlinear; for
example, a helper may make some assessments early on and
return to conduct assessment during the planning and
implementation work with the client. Three components of the
helping process appear in all three phases of helping: case
review, report writing and documentation, and client
participation. Note that the first two components also include
interaction with and participation by the client. These
components require ongoing evaluation and written
documentation of the helping process.
The strengths-based approach differs from older models of
helping that are problem-based or deficit-based assessments,
followed by planning and implementation that target the
problem(s). These older models have less client engagement and
participation, are often provider driven, and focus on negative
events or characteristics. They may actually lessen the client’s
ability to solve his or her own problems and encourage
dependency on the helper to define problems and identify
strategies to resolve the problem. Both older models and
strengths-based approaches attempt to match clients and
resources. The strengths-based approach also helps clients
become their own helpers, assuming responsibility for
themselves and their problems and motivating them to act in
their own best interests.
26. CHAPTER REVIEW
The key terms and the discussion questions will reinforce the
knowledge you gained about the helping process.
KEY TERMS
Assessment
Case review
Client empowerment
Client participation
Codes of ethics
Documentation
Implementation
Information gathering
Initial contact
Motivational interviewing
Planning
Record
Strengths-based approach
REVIEWING THE CHAPTER
1.
Distinguish between the terms applicant and client.
2.
What should be accomplished during the assessment phase?
3.
What occurs during the initial contact between the helper and
the individual seeking services?
4.
Describe the routine matters that are discussed during the initial
contact.
5.
Identify the types of information that are gathered during the
initial interview.
6.
Using the case of Roy Johnson, discuss the advantages of a
partnership between the helper and the client.
7.
Describe the helper’s activities during the planning phase.
27. 8.
Why is flexibility so important during the implementation
phase?
9.
Define case review.
10.
List the three keys to successful case review.
11.
Why is documentation important in service coordination?
12.
How can the helper promote client participation?
13.
Describe how the strengths-based approach applies to
assessment, planning, and implementation.
14.
How will a client’s resistance affect his or her participation in
the service coordination process?
15.
What is the purpose of a code of ethics or ethical standards?
QUESTIONS FOR DISCUSSION
1.
From your own work and study of helping, what evidence do
you have of the importance of assessment and planning?
2.
If you were a helper, what three principles would guide your
work? Provide a rationale for your choices.
3.
Describe Roy’s strengths and how they might impact the
helping process.
4.
What ethical dilemmas might you encounter in Roy’s case?
REFERENCES
Mitchell, R. W. (1991). Documentation in counseling records.
Alexandria, VA: American Association for Counseling and
Development.
Norcross, J. C., Prochaska, J. O., & DiClemente, C. C. (1994).
28. Changing for good. NY: Avon.
Rapp, C. A., & Goscha, R. J. (2006). The strengths model: Case
management with people with psychiatric disabilities (2nd ed.).
Oxford Press: Oxford.
Saleebey, D. (2008). The strengths perspective in social work
practice (5th ed.). Boston: Allyn & Bacon.
Van Wormer, K., & Davis, D. R. (2003). Addiction treatment: A
strengths perspective. Pacific Grove, CA:
Brooks/Cole/Thomson.
