Behavior change in the human services

Human Services Values Resources

After reading this chapter, you will be able to:

· • Write a description of the five commonly accepted human service values.

· • List four characteristics or qualities of helpers.

· • Distinguish among the three categories of helpers.

· • Identify the other helping professionals with whom a human service professional may interact.

· • List the three areas of job responsibilities for human service professionals.

· • Provide examples of the roles included in each of the three areas of professional responsibilities.

Helping means assisting other people to understand, overcome, or cope with problems. The helper is the person who offers this assistance. This chapter’s discussion of the motivations for choosing a helping profession, the values and philosophies of helpers, and the special characteristics and traits helpers have assists in establishing an identity for the helper. We also define helpers as human service professionals, as well as introduce other professionals with whom they may interact. An important key to understanding human service professionals is an awareness of the many roles they engage in as they work with their clients and with other professionals.

In this chapter you will meet two human service professionals, Beth Bruce and Carmen Rodriguez. Beth is a counselor at a mental health center and has previous experience working with the elderly and adolescents. Carmen is a case manager at a state human service agency. She has varied responsibilities related to preparing clients for and finding gainful employment.

WHO IS THE HELPER?

In human services, the helper is an individual who assists others. This very broad definition includes professional helpers with extensive training, such as psychiatrists and psychologists, as well as those who have little or no training, such as volunteers and other nonprofessional helpers . Regardless of the length or intensity of the helper’s training, his or her basic focus is to assist clients with their problems and help them help themselves (Chang, Scott, & Decker, 2013; Okun & Kantrowitz, 2008).

The human service professional is a helper who can be described in many different ways. For example, effective helpers are people whose thinking, emotions, and behaviors are integrated (Cochran & Cochran, 2006). Such a helper, believing that each client is a unique individual different from all other clients, will greet each one by name, with a handshake and a smile. Others view a helping person as an individual whose life experiences most closely match those of the person to be helped. The recovering alcoholic working with substance abusers is an example of this perspective. Still another view of the helper, and the one with which you are most familiar from your reading of this text, is the generalist human service professional who brings together knowledge and skills from a variety of disciplines to work with the client as a whole person.

Your understanding of the human service professional will become clearer as this section examines the reasons why individuals choose this type of work, the traits and characteristics they share, and the different categories of their actual job functions.

MOTIVATIONS FOR CHOOSING A HELPING PROFESSION

Work is an important part of life in the United States. It is a valued activity that provides many individuals with a sense of identity as well as a livelihood. It is also a means for individuals to experience satisfying relationships with others, under agreeable conditions.

Understanding vocational choice is as complex and difficult a process as actually choosing a vocation. Factors that have been found to influence career choice include individuals’ needs, their aptitudes and interests, and their self-concepts. Special personal or social experiences also influence the choice of a career. There have been attempts to establish a relationship between vocational choice and certain factors such as interests, values, and attitudes, but it is generally agreed that no one factor can explain or predict a person’s vocational choice. Donald Super, a leader in vocational development theory, believes that the vocational development process is one of implementing a self-concept. This occurs through the interaction of social and individual factors, the opportunity to try various roles, and the perceived amount of approval from peers and supervisors for the roles assumed. There are many other views of this process, but most theorists agree that vocational choice is a developmental process.

How do people choose helping professions as careers? Among the factors that influence career choice are direct work experience, college courses and instructors, and the involvement of friends, acquaintances, or relatives in helping professions. Money or salary is a small concern compared with the goals and functions of the work itself. In other words, for individuals who choose helping as their life’s work, the kind of work they will do is more important than the pay they will receive.

There are several reasons why people choose the helping professions. It is important to be aware of these motivations because each may have positive and negative aspects. One primary reason why individuals choose helping professions (and the reason that most will admit) is the desire to help others. To feel worthwhile as a result of contributing to another’s growth is exciting; however, helpers must also ask themselves the following questions: To what extent am I meeting my own needs? Even more important, do my needs to feel worthwhile and to be a caring person take precedence over the client’s needs?

Related to this primary motivation is the desire for self-exploration. The wish to find out more about themselves as thinking, feeling individuals leads some people to major in psychology, sociology, or human services. This is a positive factor, because these people will most likely be concerned with gaining insights into their own behaviors and improving their knowledge and skills. After employment, it may become a negative factor if the helper’s needs for self-exploration or self-development take precedence over the clients’ needs. When this happens, either the helper becomes the client and the client the helper, or there are two clients, neither of whose needs are met. This situation can be avoided when the helper is aware that self-exploration is a personal motivation and can be fulfilled more appropriately outside the helping relationship.

Another strong motivation for pursuing a career in helping is the desire to exert control. For those who admit to this motivation, administrative or managerial positions in helping professions are the goal. This desire may become a problem, however, if helpers seek to control or dominate clients with the intent of making them dependent or having them conform to an external standard.

For many people, the experience of being helped provides a strong demonstration of the value of helping. Such people often wish to be like those who helped them when they were clients. This appears to be especially true for the fields of teaching and medicine. Unfortunately, this noble motivation may create unrealistic expectations of what being a helper will be like. For example, unsuccessful clients do not become helpers; rather, those who have had positive helping experiences are the ones who will choose this type of profession. Because they were cooperative and motivated clients, they may expect all clients to be like they were, and they may also expect all helpers to be as competent and caring as their helpers were. Such expectations of both the helper and the client are unrealistic and may leave the helper frustrated and angry.

When asked about making the choices, many helpers describe the process as a journey. Regardless of their primary or secondary motivation, they see individuals and experiences in their lives leading them to become helpers. For some the journey begins early in their lives while others appear to have discovered the field as adults. Consider your own journey to becoming a helper; think about your motivations and the people and experiences that led to your study of the human services. See Table 6.1 .

TABLE 6.1: SUMMARY POINTS: WHY INDIVIDUALS CHOOSE TO WORK INHELPING PROFESSIONS

Help others

Contribute to another’s growth

Self-exploration

Discover more about self

Exert control

Good in administration and organization

Positive role models

Inspired by help from others

Copyright © Cengage Learning®

VALUES AND HELPING

Values are important to the practice of human services because they are the criteria by which helpers and clients make choices. Every individual has a set of values. Both human service professionals and clients have sets of values. Sometimes they are similar, but often they differ; in some situations, they conflict. Human service professionals should know something about values and how they influence the relationship between the helper and the client.

Where do our values originate? Culture helps establish some values and standards of behavior. As we grow and learn through our different experiences, general guides to behavior emerge. These guides are values , and they give direction to our behavior. As different experiences lead to different values, individuals do not have the same value systems. Also, as individuals have more life experiences, their values may change. What exactly are values? Values are statements of what is desirable—of the way we would like the world to be. They are not statements of fact.

Values provide a basis for choice. It is important for human service professionals to know what their own values are and how they influence relationships with coworkers and the delivery of services to clients. For example, professionals who value truth will give the client as much feedback as possible from the results of an employment check or a home-visitation report. Because human service delivery is a team effort in many agencies and communities, there have to be some common values that will assist helpers in working together effectively. The following are the most commonly held values in human services: acceptance, tolerance, individuality, self-determination, and confidentiality.

The next paragraph introduces Beth Bruce, a human service professional with a variety of experiences. In this section, her experiences are used to illustrate the values that are important to the human service profession.

Beth Bruce is a human service professional at the Estes Mental Health Center, a comprehensive center serving seven counties. She has been a counselor at Estes for the past eight months and has really enjoyed her first year’s work in mental health. Her first job was as a social service provider in a local nursing home, where she worked for two years. She then worked with adolescents as a teacher and counselor at a local mental health institution before joining the Estes staff.

Let’s see how human service values relate to Beth Bruce’s experience as a human service professional.

Acceptance is the ability of the helper to be receptive to another person regardless of dress or behavior. Professionals act on the value of acceptance when they are able to maintain an attitude of goodwill toward clients and others and to refrain from judging them by factors such as the way they live, or whether they have likable personalities. Being accepting also means learning to appreciate a person’s culture and family background.

One of the most important values that Beth Bruce holds is accepting her clients for who they are. She has worked with the elderly, teenagers, and now people with mental illness. These populations are different, but they retain one important quality for her: They are all human beings. Her acceptance of others was put to the test at the nursing home when she encountered a staff who were mainly from Kenya, Ruanda, and Tanzania, all places unfamiliar to her. Sometimes it was difficult for her to understand their lilting accents. What she learned though was that these women were gentle, patient, and natural caretakers who were beloved by the patients.

The second value of human service work is tolerance : the helper’s ability to be patient and fair toward each client rather than judging, blaming, or punishing the client for prior behavior. A helper who embodies this value will work with the client to plan for the future, rather than continually focusing on the client’s past mistakes.

· Beth works with a friend and coworker who is not very tolerant of people with mental illness. Several times, this coworker’s intolerance of client behavior has caused problems for the client. Just yesterday, a problem arose with Ms. Mendoza, a 26-year-old woman with schizophrenia who is currently receiving day treatment and lives in a group home. She refused to see her parents when they came to see her at the day treatment center. Mr. Martin, Beth’s coworker, forced Ms. Mendoza to see them because he believes that family is very important and that parents have a right to see their children. Now the parents are upset because Ms. Mendoza threw a chair at them.

Ms. Mendoza is upset with Mr. Martin for making her see her parents, and Mr. Martin is angry with his client because he feels he was right to insist that she see them.

BOX 6.1: AMANDA NALLS—EXPERIENCING IRAQ AS A MILITARY OFFICER

Inshallah. Throughout my two tours in Baghdad, Iraq as an Army officer, I heard this Arabic expression more times than I can count from native Iraqi citizens, Arabic contractors, and, eventually, from Army soldiers. Literally translated as “as god wills,” it is used to suggest that something in the future is uncertain, which, in retrospect aptly described the situation in Iraq for both its citizens and the American military forces.

My experiences in Iraq were not unlike those of many of the American soldiers: we spent long hours working (sometimes 18 hours a day) and looked forward to the occasional call home and letters from friends and family. The long months of staff work were often punctuated by memorial services for fellow soldiers who were unlucky enough to encounter enemy fire, improvised explosive devises, or suicide bombers while conducting their daily missions in the field. The daily routine for many officers in my situation was alternately boring, thrilling, and mentally exhausting.

Amidst the daily grind of paperwork, mission tracking, and planning for casualty evacuation, there were moments that I will not soon forget. As my unit’s public affairs officer, I was able to help plan several “special” events for our soldiers. Each month, for example, a handful of soldiers were able to take a much-needed rest from missions and tour the palaces located in the Baghdad International Airport Complex where we were stationed. The highlight of the trip was a stop at the Al-Faw Palace, one of the eight presidential palaces used for hunting and recreation by the Baathist Party members, as well as by Saddam Hussein and his family. The tours provided an opportunity to teach the soldiers about Iraq’s history and its culture, which, hopefully, allowed them to better identify with the Iraqi people that they were there to help.

Medical Capability Missions, or MEDCAPs, were another event that provided me with an opportunity to see Iraq and its citizens in a different light. During my time in Iraq, MEDCAP missions were conducted in conjunction with the Iraqi Army; both American and Iraqi medics and doctors spend a day at a particular site treating local citizens and providing much-needed antibiotics and medical advice. During one such mission, I had the opportunity to serve as a “patient administrator;” my job entailed meeting Iraqi citizens at the entrance to the site, determining (with the help of a translator) their ailment, and assigning them to one of the medical professionals for treatment. I met a wide variety of individuals that day. One woman brought her two-year-old son and requested help on how to get him to stop eating rocks. Families came seeking treatment for shrapnel and gunshot wounds, and children wandered in off the street hoping for a piece of candy from the medics. One family in particular stood out as being particularly unique; both teenage daughters spoke fluent English and were looking forward to attending school in Alaska the following month. Each individual I met helped put a face on the effort we were making to help Iraqi citizens achieve a free and peaceful nation.

Although my experiences in Iraq were often frustrating and exhausting, they were also incredibly rewarding. Few other times in my life have I gotten to be a part of something truly worthwhile and make a lasting impact on the world. The opportunities I had to meet with and work alongside Iraqi citizens helped me to better understand a culture vastly different from my own, and allowed me to use my helping skills in ways that most helping professionals do not have the chance to. Although the future of Iraq and its people truly is inshallah, I look back on my time in the Army and my contributions to the Iraqi people with pride and with the hope that one day they too will enjoy many of the freedoms that Americans experience on a daily basis.

Source: Amanda Nalls (2010). Used with permission.

Individuality is expressed in the qualities or characteristics that make each person unique, distinctive from all other people. Lifestyle, assets, problems, previous life experiences, and feelings are some areas that make this person different. Recognizing and treating each person individually rather than stereotypically is how helpers put this value into practice.

When Beth first started working with the elderly, she had had little contact with older individuals. What she knew about them she had learned from her grandparents. She thought of the elderly as lively and quick-witted like her grandmother or quiet and shy, living in the past, like her grandfather. During her first months at the nursing home, the clients she encountered continually surprised her. They represented a broad range of human attitudes, behaviors, and experiences. She learned to distinguish between the generalizations she had made about the elderly and the information she now possessed based on her experiences at the nursing home.

Deciding for oneself on a course of action or the resolution to a problem is self-determination . The helper allows clients to make up their own minds regarding a decision to be made or an action to be taken. The helper facilitates this action by objectively assisting clients to investigate alternatives and by remembering that the decision is theirs. In some cases, clients are limited by their situations or their choices. For example, a prison inmate may have restricted alternatives from which to choose recreational activities; however, it is the inmate’s right to choose from the available alternatives.

When Beth worked with teenagers, she was constantly aware that their use of social media was important to them. Even though she frequently cautioned them about its abuses, she realized they needed to take responsibility for their sites and their postings.

The last human service value is confidentiality . This is the helper’s assurance to clients that the helper will not discuss their cases with other people—that what they discuss between them will not be the subject of conversation with the helper’s friends, family, or other clients. The exception to this is the sharing of information with supervisors or in staff meetings where the client’s best interests are being served.

Lucas, a 15-year-old with whom Beth worked at the mental health center, confessed to her that he has been smoking marijuana just about every day and is afraid he can’t quit. Beth reminded him of their very first meeting when they discussed confidentiality and its limits. So she said their next meeting would involve both Lucas and his parents. She would also share with them the reason for the meeting.

You should consider the following questions as you think about the meaning of these values in your own life and practice.

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What kinds of client behaviors would be the most difficult for you to accept? How would you meet the challenge of working with these clients?

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When was the last time you felt uncomfortable sharing information about another person? How did you resolve the situation?

As you think about these five values in relation to yourself as a future human service professional, consider the possibility of working with many different clients. As you think about the following list of clients, place a check beside those clients who would be difficult for you to work with. Which values might present problems or conflicts for you? Try to respond honestly, not what you think would be socially or professionally desirable.

· 1. __________ A man with religious beliefs that cause him to refuse treatment for a life-threatening illness.

· 2. __________ A same-sex couple who want to resolve some conflicts they are having in their relationship.

· 3. __________ A man who wants to leave his wife and two children in order to have sexual adventures with other women.

· 4. __________ A young woman who wants an abortion but is seeking your help in making the decision.

· 5. __________ A person who has severe burn scars on the face, shoulders, arms, and hands.

· 6. __________ A man or woman from a culture where the male is dominant and the female is submissive.

· 7. __________ A person who does not want to work.

· 8. __________ A man who strongly believes the only way to bring up his children is by punishing them severely.

· 9. __________ A woman who wants to leave her husband and children in order to have a career and independence but is afraid to do it.

· 10. __________ A person who is so physically attractive that you cannot concentrate on what the person is saying.

· 11. __________ A person who speaks no English and makes no effort to do so.

Values are the groundwork for creating a philosophy of helping, which in turn provides a basis for working with people. A philosophy of helping embodies beliefs about human nature, the nature of change, and the process of helping. As individuals grow and develop and as their values change, their helping philosophy and style also develop. An example is the way Beth Bruce’s values translate into her philosophy of helping, which influences her human service practice.

Beth believes that all human beings are good and that all behavior is directed to the good. She thinks that violence to others, cruelty, and self-abuse are all behaviors that the perpetrators consider to be positive ways to meet their personal needs. She also believes that people have the capacity to change, if only they believe they can change. Hence, the helper’s responsibility is to develop clients’ belief in themselves and help provide alternatives for change, practical assistance, and support. Because of these views, Beth has high hopes for her clients, and she believes that her major responsibility is to educate and motivate them. She is frustrated when she works with clients who have tried to hurt others, and she is puzzled when those clients do not want to change. In spite of her frustration, she has maintained her belief in the goodness of human beings.

CHARACTERISTICS OF THE HELPER

To be an effective helper demands the use of the helper’s whole self, not just the professional segment alone. This requirement creates difficulty when one tries to generalize about the values and characteristics that helpers ought to have. Ideas differ widely about what helpers should be like and what they bring to their work with others. In this section, you will read about some of these ideas. You will also be encouraged to think about the qualities you possess that might be important to your work as a helping professional, as well as qualities you may want to develop more fully to increase your effectiveness. Box 6.2 outlines how a mental health professional thinks about helping and the helping process.

BOX 6.2: A PRACTITIONER’S VIEW OF HELPING

Working in community mental health provides me with opportunities to interact with clients in their home environment. Seeing my clients where they live helps me gain perspective on how their daily life affects their overall sense of well-being. As a mental health professional, I believe that the “systems” we find ourselves in have an impact on how we view the world around us. From a systems perspective, I can understand how the external environment my clients experience affects their level of stress, their basic needs, and their emotional state.

In addition to understanding each client in his or her own unique system, I have found that the most important aspect of helping is the relationship. Each of us is a social creature, and we need connection with others. For my clients who are chronically and persistently mentally ill, being calm, consistent, and somewhat transparent has been therapeutically valuable. By approaching each relationship from a nonjudgmental perspective, I give my clients the opportunity to teach me how to best help them. In order for a person to take risks towards change, there must be a firm foundation (i.e., relationship) on which to land.

One of the most important lessons I’ve learned from working in community mental health is that I cannot expect people to change or grow at a rate or in the way I would like for them to change or grow. Learning how to keep my own values in check has allowed me to become a better helper. I constantly strive to understand each client in his or her system, and provide a solid place in which risk-taking can occur. However, I cannot take risks for my clients; I can only support their growth.

Source: Ellen Carruth, PhD, Mental Health Crisis Specialist, Seattle, WA. Used with permission from the author.

Individuals learn attitudes and behaviors as they respond to their circumstances. Some responses may even be unconscious. Through the learning process, a person internalizes these attitudes and behaviors and they become a pattern in his or her life. A major influence on how an individual reacts to these needs is culture. Families, schools, and peers are among the agents who communicate ways of behaving and help determine what an individual considers to be acceptable and unacceptable behavior in different situations. An increasing body of research supports the concept that the personal characteristics of helpers are largely responsible for the success or failure of their helping. In fact, numerous studies concluded that these personal characteristics are as significant in helping as the methods helpers use (Corey, 2012).

A number of researchers have examined these characteristics, and we studied this work to identify the traits that seem to be universal in effective helpers. The helping person should be able to hear the client and then use his or her knowledge, skills, values, and experience to provide help. To do this, the helper should be self-aware, objective, professionally competent, and actively involved in the enabling process. In a review of a number of research studies, Okun and Kantrowitz (2008) concluded that certain qualities, behaviors, and knowledge on the part of the helper most influence the behaviors, attitudes, and feelings of clients. Self-awareness, honesty, congruence, the ability to communicate, knowledge, and ethical integrity are also included in their list.

Effective helpers have definite traits. One way to discuss what these traits are is to use a framework that suggests two sets of attitudes: one related to self and the other to how one treats another person (Brammer & MacDonald, 2003). Personal congruence, empathy, cultural sensitivity, genuineness, respect, and communication are considered important traits.

TABLE 6.2: SUMMARY POINTS: VALUES THAT GUIDE PRACTICE

Acceptance

Maintain goodwill and refrain from judging

Tolerance

Be patient and fair

Respect for individuality

Respect differences, avoid stereotypes

Self-determination

Help clients make decisions

Confidentiality

Will not disclose client information

Copyright © Cengage Learning®

All the characteristics mentioned are important ones for helpers. Many other perspectives can be studied, but this brief discussion shows that certain characteristics tend to be common to most studies. In preparing this text, we have reviewed a number of perspectives. Our guiding question was “What characteristics are important for the beginning human service professional?” We identified the following qualities as important: self-awareness, the ability to communicate, empathy, professional commitment, and flexibility. Each of these is discussed in depth to help you understand what the quality is and why it is important for entry-level practice.

SELF-AWARENESS

Most authorities in the helping professions agree that helpers must know who they are because this self-knowledge affects what they do. Developing self-awareness is a lifelong process of learning about oneself by continually examining one’s beliefs, attitudes, values, and behaviors. Recognizing stereotypes, biases, and cultural and gender differences are part of the self-awareness process. So is our desire for acceptance and client success; “needing” our clients to like us and to do well may be a sign of trouble, however. Self-awareness, then, is a particularly critical process for helpers because it assists them in understanding and changing their attitudes and feelings that may hinder helping. The importance of self-acceptance is underscored by the helper’s use of self in the helping process.

Beth Bruce’s awareness of self expanded greatly when she began to work in the field full time. As she began to learn about the culture and beliefs of others, she developed a keener sense of who she was. It seemed that as she developed the patience to work with her first clients, she also became more patient with herself.

ABILITY TO COMMUNICATE

Helpers’ effectiveness depends in part on their ability to communicate to the client an understanding of the client’s feelings and behaviors (Okun & Kantrowitz, 2008). Listening, a critical helping skill, is the beginning of helping and is necessary for establishing trust, building rapport, and identifying the problem. Careful listening means being “tuned in” to all the nuances of the client’s message, including verbal and nonverbal aspects of what is said as well as what is not said. Such focused listening enables the helper to respond with thoughts and feelings to the client’s whole message.

Beth Bruce’s ability to communicate was challenged when she began her work with adolescents at the hospital. These young people were aggressive, belligerent, and violent. She worked hard to listen, gain their trust, and provide them honest, constructive feedback. One of the most important skills Beth learned was to listen to the client’s entire statement before formulating a response.