Helping and Human Relations Theory - ROBERT R. CARKHUFF

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Helping and Human Relations Theory

ROBERT  R. CARKHUFF

Introduction

  • Robert R. Carkhuff, Ph.D., a social scientist, who developed “The Science of Human Generativity”

  • When adults have reached full maturity, they can communicate fully, they have satisfied their needs for fullness in all aspects of life and become full persons.

  • They are now prepared to help others to achieve their own levels of wholeness.

  • They will become the models and the agents for the growth of others.

  • They will create new life through their helping skills.

  • The cycle of life continues.

Concepts

Helping
  • Helping is a process leading to new behavior for the person being helped .

  • An effective helper is initially nourishing or responsive.

  • This nourishment   prepares the person being helped for the more directionful or initiative behavior of the helper.

  •  Children as they become capable of both nourishing and directionful behavior.

  • They can act constructively in the lives of their own and others.

  • Persons who are fully alive help other persons to become fully alive.

  • Responsive and initiative behaviours are the basic dimensions of helping and development.

  • Potentially all relationships are helping relationships. It depends upon the helping skills one has, the effects of skills depend upon how we sequence them.

  • Thus  helping in real sense is a developmental process.

  • Helpers who are fully responsive and fully initiative teach their helpees to be fully responsive and fully initiative.
Human Relationships
  • Human Relationships may be facilitative or retarding effects. e.g a marriage.

  • Consequences may be constructive or destructive, may produce persons and non persons; health care provider-patient; employee-employer etc.

  • The effects may be positive or negative or any of the degrees in between these extremes. 

Power and human relationships
  • The effects of human relationships depend upon the power relationship. .

  • The effects of the power relationships depend upon the skills.

Skills
  • There are two sets of skills which are the basic ingredients of all human relationships in the areas of endeavor: responding and initiating skills.

  • These skills are cycled in an individual’s personal development before his or her interpersonal development
Responsiveness
  • Responsiveness is the basic ingredient of human relations, which involves empathy.

  • Responsive  skills involve experiencing another’s condition and communicating to her own experience.

Initiative
  • Initiative is the basic ingredient of human functionality, which involves operationalizing the goal or breaking it down into it’s components.

New Behaviour
  • New behavior is the overall goal of helping.

Evolution of dimensions

i. Helping Sources
  • There are two approaches to effective helping -insight and action.
ii. Helping Process
In order to demonstrate gain in behaviour, the helpees must act differently from the way they did before.

     Exploration -----------Understanding------------Action-----------Feedback
     Feedback-------further exploration----self understanding--------real understanding
     Real Understanding-----------modification of action (effective action).

iii. Helper Skills
  • accurate empathy
  • respect and genuineness.
  • specificity or concreteness
  • self disclosure
  • confrontation and
  • immediacy
  • responsive dimensions (empathy, respect, specificity of expression)
  • initiative dimensions (genuineness, self disclosure, confrontation, immediacy and concreteness
iv. Helpee Outcomes
  • the emotional changes or gains of he helpee's
  • outcome assessments measured the changes in the helpee’s level of emotional insights
  • dimension of physical functioning to measure fitness and energy
  • intellectual  dimension to measure the intellectual achievement and capabilities.

Levels and styles of functioning

Carkhuff and Berenson(1967) described five levels of dimensions.

  • The dimensions are empathy, respect or regard, genuineness, concreteness, warmth.
Levels:
  1. First: no empathy is taking place( no evidence of the helper characteristic)
  2. Second: Empathizing very little and at a level that detracts from helpee functioning(10% of time)
  3. Third: minimum level of feeling response necessary to be efective(50% of time)
  4. Fourth and fifth: Higher levels of helper empathy(4th – 75%; 5th – consistently present)

The responsive and initiative factors of helping

  1. Attending : “Being attentive to to the helpee”
  2. Responding: Responding to the helpee’ s expression of her experience.
  3. Personalizing: “To enable the helpee to understand where she is in relation to where she wants or needs to be”,
  4. Initiating: ”Finding direction in life or acting in following the direction, bringing direction to culmination – giving life meaning in productivity and creativity”..

Stages in helping process

There are eight stages contained in the two basic phases of the helping process.

Phase 1: Building relationships:
  • Entry: preparing the helpee and opening relationship

  • Clarification: state the problem or concern and reasons for seeking help

  • Structure: formulating the contract and the structure

  • Relationship: building the helping relationship

Phase 2: Facilitating Positive Action
  • Exploration: exploring problems, formulating goals, planning strategies, gathering facts, expressing deeper feelings, learning new skills.

  • Consolidation: exploring alternatives, working through feelings, practicing new skills

  • Planning: developing a plan of action using strategies to resolve conflicts, reducing painful feelings, and consolidating and generalizing new skills or behaviours to continue self-directed activities.

  • Termination: evaluating outcomes and terminating the relationship.

Helping skills for understanding: of self and others

i. Listening skills
  • Attending – noting verbal and nonverbal behaviours
  • Paraphrasing – responding to basic messages
  • Clarifying – self disclosing and focusing discussion
  • Perception checking – determining accuracy of learning
ii. Leading Skills
  • Indirect leading – getting started
  • Direct leading – encouraging and elaborating discussion
  • Focusing – controlling confusion, diffusion and vagueness
  • Questioning – conducting open and closed inquiries
iii. Reflecting skills
  • Reflecting feeling – responding to feelings
  • Reflecting experience – responding to toal experience
  • Reflecting content – repeating ideas in fresh words or for emphasis
iv. Confronting skills:
  • Recognising feelings in oneself – being aware of helper experience
  • Describing and sharing feelings – modeling feeling expression
  • Feeding back opinions – reacting honestly to helpee expressions
  • Self-confrontation
v. Interpreting skills
  • INTERPRETIVE QUESTIONS – FACILITATING AWARENESS
  • FANTASY AND METAPHOR- SYMBOLIZING IDEAS AND FEELINGS
vi.    Informing skills
  • Advising – giving suggestions and opinions based on experience
  • Informing- giving valid information based on expertise
vii.  Summarising Skills
  • Pulling themes together.

Conclusion

  • Our task in life is to improve the quantity and quality of human experience, our own as well as others which is growth.
  • Life is process, is growth and growth is learning skills. When we use the helping skills effectively, we can be healthy and we can help each other to actualize our human potential. The only meaning to life is to grow for growing is life.

References

  1. Carkhuff R. The art of helping. 4th ed. Amherst: Human Resource Development press; 1983.
  2. Carkhuff, R. R. Helping and Human Relations, Vols. I and II . 1969.
  3. Brammer L M, Macdonald G. Helping relationship process and skills. 6th ed. Boston: Allyn and Bacon; 1996.
  4. Shea C A, Pelletier L R, Poster E C, Stuart G W, Verhey M P. Advanced practice nursing in psychiatric and mental health care. St. Louis: Mosby; 1999
  5. Topalis M, Aguilera D C. Psychiatric nursing. 7th ed. St Louis: C V Mosby; 1978.
  6. Morrison M. Foundations of mental health nursing. St. Louis: Mosby; 1997.
  7. Taylor C, Lillis C, Le Mone P, Lynn P. Fundamentals of nursing. 6th ed. Philadelphis: Lippincott Williams & Wilkins; 2005.
  8. Dexter G, Walsh M.  Psychiatric skills a pateint centred approach. 2nd ed. London: Chapman & Hall; 1995.
  9. Stuart G W, Laraia M T. Principles and practice of psychiatric nursing. St Louis: Mosby Harcourt  Pvt. Limited; 2001.
  10. Boon NA, Colledge NR, Walker BR, Hunter JAA. Davidson’s principle and practices of medicine. 20th ed. London: Churchill Livingstone Elsevier; 2006.

This page was last updated on: 30/11/2020