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Article by Anna Keyter
The Process Model of Helping (PMH) as introduced by Clara Hill (2014), can be defined as three stages of intervention: Exploration, Insight, and Action. It incorporates client-centred, psychoanalytic, and cognitive–behavioral approaches. The PMH foundation (exploration stage) is based on the client-centred model due to its facilitative aspects of helping (Hill, 2014). People seek help for various reasons, whether it is problems with peers or living with parents. The goal to find therapy is based on difficult situations (Carkhuff, 1987), by addressing sensitive issues clients can understand themselves in new ways.
When the self-concept and ideal-self are similar (congruent) self-actualisation (optimal-self) can be achieved (Chodorkoff, 1954). Through a supportive relationship, the congruent and incongruent perception of the self that stems from interactions with others (previous experiences) can be addressed. People have an innate need for self-actualisation which refers to the need to reach their full potential (Rogers, 1959). Hill (2014) highlights the facilitative and healing aspects of helping in terms of using skills (natural ability and learning), creating facilitative conditions (empathy, warmth and congruence) and self-awareness (knowledge and insight).
Stage 1 | The Exploration Stage
Maslow (1968) was the first to use the term ‘self-actualisation’ when it came to a person’s ability to become what he or she is capable of becoming. According to Hill (2014), the exploration phase is based on the client-centred model, hence the focus is on attending, observing, listening and exploring thoughts and feelings. Rogers (1961) suggested that it was important to focus on building nonjudgmental therapeutic relationships, listening to the clients’ narratives and assisting them to experience feelings. The helper would display skills by observing non-verbal and minimal verbal behaviours, exploring by using restatements, asking open questions and considering feelings through reflections, disclosures and open-ended questions (Hill, 2014).
Stage 2 | Insight Stage
Summarising from Hill (2014), in some instances, stage one may be all a helpee needs to make important changes. However, in other situations, the exploration stage is the foundation on which to build the insight stage. Insights draw on the psychodynamic and attachment models. Psychodynamic theories do not focus on behavioural change, but look deeply into troubling issues such as early relationships, the importance of early childhood experiences and place emphasis on defence mechanisms. During the insights stage, the goals are to foster awareness (challenge), facilitate insights (probe, interpret, disclose insights), and working on the therapeutic relationship (immediacy). This stage set the foundation for the action stage where Hill departs from psychodynamic models and applies behavioural theories.
Stage 3 | Action Stage
According to Hill (2014), the action stage is the practical section of the PMH. There are two reasons action is needed, firstly people seek assistance to feel better or change behaviours. The second, to consolidate new thinking patterns into existing schemas and to ensure old habits do not resurface. This part of the intervention still has a client-centered underpinning, and the helper remains a supporter and coach and does not give advice. Hill (2014) draws on Behavioural and Cognitive theories including learning and treatment strategies. The Goals of the Action stage is to explore new behaviours, deciding on and developing new skills, assisting clients to evaluate and modify action plans and processing feelings about change. Types of action include relaxation for behaviour change, rehearsal, and decision making. Helper skills are displayed through open action questions, providing information and feedback to clients, advising on the process, directing guidance and disclosing strategies.
Hill’s (2014) aim was to provide a helping model, integrating affect cognition and behaviour as a framework for exploring helpee concerns, gaining insight into their issues and enabling them to make desired changes. The Three-Stage Model is based on an eclectic perspective (integrating diverse philosophies), that is grounding practice and theory on the philosophies of Rogers, Erikson, Maheler, Skinner and Ellis & Beck.
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Rogers, C.R. (1959). A theory of therapy, personality and interpersonal relationships, as developed in the client-centered framework. In S. Koch (ed.). Psychology: A study of science. (pp. 84-256). N.Y.: McGraw Hill.