Clergy, accountants, teachers, business managers, social workers, parents – that’s just the beginning of a long list of vocations whose job involves solving problems face to face. You would think that much of their training would be focussed on how to do this best. But various studies have suggested that this is often not the case. Their intellectual training has prepared them with all the professional knowledge they require but has rarely taught them the skills for actually helping their clients.
When I was first trained as a marriage counsellor the emphasis was on a psychoanalytic approach, but I was fortunate in encountering Gerry Egan’s Skilled Helper which enabled me, I believe, to become much more effective. I found that his methodology was universal, and I was able to incorporate it into my managerial work. Later, I was able to write my own book which focussed on it as a managerial skill.
The essence of the approach was that helper and client worked as a team, and, in doing so, they followed some simple stages necessary to achieve the desired result. I devised the mnemonic: LEGUP. This stood for listening, exploring, goal-setting, underpinning and pursuit. Your first reaction may be that this is naïve. How can the same stages suit a penitent with a moral problem in the confessional and your 10 year old son who won’t do his homework? Let’s see.
Listening means that the helper should hear the client – both the facts and the feelings. These must be reflected so that the client knows he or she has been understood. This is a difficult skill for those whose habitual reaction is to comment on what is being said. Instead, the helper’s brain should be whirring away taking in the full picture from the client’s viewpoint. Throughout the whole process listening must continue.
Exploration is a dialogue in which the helper draws attention to aspects of what has been said. For example there may appear to be patterns of behaviour which need to be explored. The helper, tentatively of course, will identify these and suggest their possible relevance. But if they are significant it is the client who must recognise this if anything is to change. There may well be contradictions or inconsistencies which the client must think through, and perhaps extend their understanding of the situation. There may be aspects of the account which have a stronger emotional effect than others. Again, these must be illuminated so that their contribution can be gauged.
There is no ideal timescale for these two stages. They may take five minutes or be spread out over five days. The objective is that by the end both helper and client have discovered what has been going on and what has to be changed to achieve improvement. So the third stage is Goal-setting. There is no place for vague objectives such as “I’ll try to do better at this or that.” They must be concrete, realistic, observable and worthwhile. I feel another mnemonic coming on: CROW. If there are several objectives it usually helps to start with easy ones to give confidence.
Support refers to any action needed to make the objectives possible. For instance the client may need training, or new information, and administrative changes may be required. But we know how good intentions fail, so this is where Pursuit comes in. Helper and client should arrange further occasions where the client will report on the success of objectives. Scheduling such reports is strongly motivating, but it also provides opportunities to modify objectives. Difficulties experienced can be ironed out, and new insights derived from new experiences can be considered.
You will have noticed from my account that I emphasise the importance of the client recognising what has to change and approving the objectives which will achieve success. The helper is primarily acting as coach, using the skills of problem solving to help the client to find the best way to succeed. Instructions are few: gentle questions which help clients to reach the undertakings and the decisions for themselves are many. This will still apply even when the dialogue is disciplinary. Imposed instructions are less effective than voluntary acceptance.
You may think that the five elements I have described are over the top in many minor cases – which might be dealt with in five minutes. You may test this by considering how likely it is that change will happen when the client does not feel understood, or has not thought about the causes of the problem, or has nothing more than hopeful resolutions, or is without the facilities to put the change into action, or is without an opportunity to report back for approval and further help. Even in the simplest problems — when some stages of LEGUP take only seconds – the same process applies. Once that is second nature a helper will wonder how success could have been achieved without it.
secondsightblogdotnet 
Quentin’s recent blog accurately assembles the methodology that is to be used for successful treatment of emotional distress and upset which we may have even benefitted from personally.
Reading the carefully assembled methods my thoughts went back to a large family I knew who had to deal with a succession of divorces, marital and financial problems,a fatal accident in the home, a still birth and the loss of a son during WW2 overseas. These all happened during the first half of the last century when professional help was perhaps not so readily available. So you ask how without help were these problems handled and how did the people involved cope with it all?
The answer lay in the existence of a closely knit family structure that was there giving emotional support and help – a structure that is perhaps not found so much today as it is and hence producing the growth of the professional helpers that is necessary to help folk just cope let alone understand how to deal with life’s problems and troubles.
Not denigrating (at all) the invaluable help that many sincere professional helpers give to people in many varying ways; nor the moral obligations & accountability most follow; but is also easily ignored by many!). ….. But …..
Is there a tendency to make the ‘professional’ the only acceptable ‘authority’ for solving problems? And anyone with a natural ability to be of service ignored?
It seems to me, whatever ‘common sense’ within the ‘extended family/social unit’ and ‘natural wisdom/talents’ some may have been gifted with (and learned from a life of experience maybe) are no longer given value or credence within society; and lost, not ‘apprenticed’, to future generations? (Not just in the areas of social/theraputic care either).
So the ‘professional’ and those that govern the rules of the professional bodies are becoming the only respected ‘body’, able to treat ‘clients’ as they deem fit? (Again, i reiterate, i am not denigrating the many sincere and genuine helpers who do relate to the ‘real person’).
Is the ‘common human’ responsibility/ability to help one another be ‘humanE’ becoming obsolete due to this professionalisation?
Unless it’s the ‘professionally trained’ acting in the expected professional format, laid down by ‘guidelines’ from professional bodies (people who don’t know the individuals or situations involved) it’s not acceptable practice. Hence many ‘clients’ are not given the personal individual credence deserved.
The ‘professional body’ say’s anyone like this ‘client’ is helped in accordance with these blanket solutions.
(Look at the ‘professional’ guidelines for generalised disability cuts of late, and education ‘stats’. Which many (most?) trained helpers/teachers on the coal face abhor).
I feel there is a danger in this attitude that overrides the responsibility of familiar/social relationship for the ‘common good’; and the subtle negation of responsibility (of the ‘common’ person) to act morally FOR each other in general.
“Others not known to me are ‘clients’ and the responsibility of the professionals”.
Further – is that ‘ethos’ being used as a means of social control?
“You (common person) know the professional is right; don’t let any ‘common sensibilities’ of your own get in the way of that rule; your invalid, and won’t be listened too.”
Your words of warning are wise. But I hope that the methodology I have described gives you some comfort. Psychoanalysis (Freud and others) did start with theories which were then used in treatment. But LEGUP is an example in which the helper assists the patient to discover for himself what has been happening, and how the problem may be ameliorated. The helper is non judgmental, but skilled in posing the questions which help the discovery. Far from dampening the autonomy of the patient it leads to a greater autonomy. The therapy relates to cognitive behavioral therapy. Somewhat oversimplifying, the cognitive is the realisation part; the behavioral is the change part.
Yes, Quentin, i know what you say, and LEGUP seems a sound system as a foundation. (Among many others. Including ‘client centered therapy’ which it seems to relate to?) and i am not denigrating it.
It’s “professioalism only” that i am sighting.
In my own training (Westminster Pastoral Foundation, not completed; should have stuck with the Jungian analysis!) there was an incident where i questioned my own therapists ‘direction’ and his response was ‘but I’m your therapist’ and wouldn’t accept any further discourse. Denial! ( A transference of his own am convinced). And an inability to put aside the ‘standard training’.
One can only take one as far as one has ‘traveled’ themselves, and dealt with ‘the Cross … transference’, no matter what system, or not, is followed.
Yes, your methodology is sound. Yet, there are circumstances (in any given situation) that need the courage to ‘step outside the boxes’ of systems. (Nonprofessional). Which is becoming unacceptable, and damning for anyone that dares.
I’m not discounting the wise use of any learned ‘systems’. Eclectic is good!
But some times people with no official ‘training’ are more able to communicate (share) the needed ‘content’ to various individuals. Someone who doesn’t adhere to a ‘system’ can facilitate what a system can’t.
The common humane touch – “I am who I am, who are you, who are we in relationship, and how can that benefit both of us, and everybody else?” – all supposing the question is posited by an ‘aware’ individual of course – can be more apt. And lets the client know it’s a shared journey.
As you are well aware, any given therapeutic meeting calls into question the unconscious contents of the ‘helper’ as well as the client. No system can compensate for that.
To produce the ongoing development of the individuals (helper & client) concerned some times it’s …. other than systems??
CBT, as far as i understand it, looks to the intellectual ‘aberrations’ that cause ‘unhelpful behaviour’ which is helpful for immediate ‘alteration’ of reaction – sometimes a long standing solution for specific responses – but does it touch the ‘change’ needed for the unconscious motives. Which are likely to return in other ‘manifestations’?
Does that not need the helper to be (God forbid!) ‘psychically’ involved with the client – beyond the system followed? For that any helper must go beyond the particular training or ‘system’ relied on and be humane (self) to the last. To dare to step outside the box. (Inclusive of the knowledge training has given). For which they are likely to be damned. An unneeded restriction?
(I wish i could be more concise, as you are, and apologise for my verbosity!).
I am reacting to Quentin’s offering (thank you Quentin) and responding to Barrie and G.D. All good, profound stuff.
Introducing the topic with a list of people “whose job involves solving problems face to face” – immediately got my gander up.
I recalled years helping people with finding work. At the end, I asked myself – how many jobs I had gotten for people?. The truth was, they all got their own jobs. I helped them achieve that for themselves.
My blood pressure went down when I read a bit more to see Quentin making the same point in places.
I thoroughly endorse the point that Barrie makes.More and more I realise how the “existence of a closely knit family structure” contributes to the anguish that people carry. The scarcity of communication based on familial trust, the absence of affirmation and that “Phronesis” which could be offered from significant members of the clan – they are just not there anymore.
What a keen observation you make, G.D. The real mastery of the technical processes available for this deep personal work is evident when going beyond them. Taking that extra step of “psychic” involvement is risky indeed, as you say, but I believe the well trained, life experienced, contemplative can do such things.
However – I better throw in a bone or two to keep the wagons rolling on this delightful journey.
Maybe I have a very romantic idea of the family and society of days gone by. And judging by the way I learned my history from so many biased authors, with little regard for factual detail or intellectual honesty – its no wonder. Were we really all that supportive of each other in days gone by?
Some of the biggest nut jobs I have come across were in “caring” roles. Armed with their degree these maniacs were unleashed into practices of transference and counter transference dealing with the fee paying, unsuspecting victims of their own (the practitioners) unaddressed needs. Needs for power, the love of early childhood, forgiveness, salvation and God knows what else.
I am sure you know W.H. Auden’s wonderful poem “As I walked out one evening”. I think it hits a relevant note here with the wonderful line – “you shall love your crooked neighbour, with your crooked heart”.
galerimo, it seems to me family/social support is less this day and age, and getting more so. It’s NOT that people DON’T care – for those they know – just that the ethos of it’s a professionals job to ACTUALLY DEAL with any problems, hamper the care they could give.
And the, so very apt, description of those ego driven professional ‘nut jobs’ with unhealed ‘Needs for power, the love of early childhood, forgiveness, salvation and God knows what else.’ as you so delicately put it, are only too eager to encourage that attitude – lucrative in power and wealth. Not all of whom are conscious of what they perpetuate, i assume.
We have professional politicians who are at the forefront of it! So much easier to legislate for controls & manipulations of ‘ordinary Joes and Marys!
But there are plenty of people that still ‘care’ and do what they feel able to. (including many professionals of course). Thank God for their ‘outside the box’ thinking and bravery.
Grateful for Quentin introducing us to the psychological use in the ‘ business/profesional world ‘ sense ; of notions of our self-understanding of ourselves, derived from his use of his own ‘LEGUP ‘ practice , out of time-served ‘ cognitive-behavioral therapies’. I too can see the advantage of these processes in all fields of human undertaking.
Especifically, from my own very recent experiences , Quentin would seem to echo what the psychology/psychiatric field are annunciating in the treatment of acute anxiety/depression cases and at present used under the general umbrella term, ‘ mindfulness’ therapy.
I am pleased that during my recent ‘ experiences ‘ through my local health authority , the world of secular psychology has acknowledged the debt it owes to the worlds religions ( if not Christian, in particular in the context of our Western Culture ).
” Mindfulness has a very long history. It has strong links with many different religious and spiritual traditions ( especially Eastern ) and also with martial arts . It has been used as a form of meditation for over 3,000 years. Over the past 20 years Mindfulness has been shown to be a powerful way of reducing the suffering generated by pain and emotional distress – So Mindfulness is now a key element in several psychological therapies including the mnemonic Act ( Acceptance Commitment Therapy ) ” – Abertawe Bro Morgannwg ( Swansea University Health Board ).
Apologies for not helping myself here …….but wonders will never cease ! Alleluia !