Many clients have a range of issues. Mara certainly does. In that case help them choose issues that will make a significant difference in their lives. If a client wants to work only on trivial things or does not want to work at all, then it might be better to defer counseling.

At one point Carlos says to Mara, “So there are a number of things you would like to do to reset your life. What’s most important for you? If you could work on only one or two things, what would that be?” As they talk, three areas of concern emerge. First, Mara tends to take things as they are. She is reactive rather than proactive. Except for getting a business degree, she has done nothing about developing a career. She feels she has talents she is not using. In one session she notes, “Everyone sees me as a good worker. I do all my assigned tasks well and on time. I’m a good example for others there. But I don’t really add to the business. There’s a lot of things we could do to make the business more viable, but I’ve left all that to my father. But he’s not going to do it. Given what’s happening in the automotive industry, we could go out of business.” Furthermore, she is on automatic pilot in her dealings with her parents, doing what she is “supposed” to do. She gets on with the everyday task of life quite well. Her parents have never faulted her for not being a contributor.

Second, she has not come to grips with being an Iranian-American. She has no social life outside the family and work and has a vague sense of taboo when it comes to developing an intimate relationship with a man. She does not know what kind of social being she is or wants to be. She realizes that she has come to hate what she calls her “cultural neutrality.”

Third, she realizes she lacks “enthusiasm,” perhaps her way of saying that she feels depressed much of the time. Carlos is quite hesitant to suggest that she work on her “depression” directly. She seems to be depressed because she feels that she is going nowhere rather than being unable to go anywhere because she is depressed. His best bet is that it will diminish or disappear once she begins to make headway in the substantive areas of her life.

At one point Mara say, “I’ve often thought that my work life and my social life were going nowhere because I’m depressed. To tell you the truth I think it’s the opposite.” This is her way of saying that she has to do something about her work life and her social life with work life taking precedence.

At the beginning of each session Carlos gets feedback from Mara as to the impact of the previous session. At the end of the session Carlos gets feedback with respect to how the relationship is going, what she has learned during the session, and how she intends to make use of what she has learned as she goes about her life between sessions. As a result Mara feels like she is getting somewhere.

Helping is expensive both financially and psychologically. It should not be undertaken lightly. Therefore, a word is in order about what might be called the “economics” of helping, helping clients set priorities. The term “value” is used to introduce the economics of helping. How can we help our clients get the most out of the helping process? Helpers need to ask themselves, “Am I adding value through each of my interactions with this client?” Clients need to be helped to ask themselves, “Am I working on the right things? Am I spending my time well in these sessions and between sessions?” The question here is not “Does helping help?” but “Is helping working in this situation? Is it worth it?” There are many ways that we can help clients create value. First of all, they create value by working on the right things, addressing issues that will make some kind of substantive difference in their lives. They also create value through the quality of their participation in the helping process and by making the right decisions. In the end it is their process and they can make it value-added or not.

Consider the case of a 41-year-old depressed man with a failing marriage, a boring, run-of-the-mill job, deteriorating interpersonal relationships, health concerns, and a drinking problem. He cannot work on everything at once. Priorities need to be set. The blunt questions go something like this: Where is the biggest payoff? Where should the limited resources of both client and helper be invested? Where to start?

Or take the case of Andrea, a woman in her mid-30s, who has been referred to a neighborhood mental health clinic by a social worker. During her first visit, she pours out a story of woe both historical and current—brutal parents, teenage drug abuse, a poor marriage, unemployment, poverty, and the like. Andrea is so taken up with getting it all out that the helper can do little more than sit and listen. Where is Andrea to start? How can the time, effort, and money invested in helping provide a reasonable return to her? What are the economics of helping in Andrea’s case?

< Prev   CONTENTS   Source   Next >