Basic Helping Process Case Study

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HP) is a workable, respected program designed to offer support for those whose needs are not being met. The various settings in which the HP is put in action include people in a mental health setting, criminal justice, substance abuse issues, educational environments, legal aid, welfare and child and youth services. This paper uses the example of an immigrant who has serious problems and who will be provided helping process services and care, as an example of how the system works.

The Helping Process -- How it Works

The professionals that provide helping process-related services to people in need are actually reaching out with both support and a structured plan for that support. According to a book written by Marianne Woodside and Tricia McClam, both affiliated with mental health counseling services, the three phases of the helping process are assessment, planning, and implementation. Those helping professionals "…need an extensive repertoire of knowledge, skills, techniques, and strategies" in order to effectively serve those whose needs are great (Woodside, et al., p. 2).

In the assessment phase the social worker makes initial contact with the client, identifies the problem and needs, and gathers information. The second phase, planning, entails having the social worker developing a very complete picture of the client and his needs. A plan is then formulated that will take a step-by-step approach and begin arranging the various services that will be needed. The third phase, implementation, is clearly the pivotal phase as the services, the counseling, the holistic approach to the client must be put in motion literally. The problem resolution is to be applied and a careful monitoring of the delivery of the services must be appropriately done on a continuing basis (Woodside).

Dean H. Hepworth and colleagues suggest a slightly different approach to the helping process. Their first phase entails "exploration, engagement, assessment and planning…"; their second phase is "implementation and goal attainment"; and their third phase is simply "termination" (Hepworth, et al., 2009, p. 34). Clearly there is more than one way to launch a helping process, and the Hepworth strategy appears to be more comprehensive than the Woodside approach.

Thirty-Year-old Immigrant (Chinese) Issues / Helping Process

The problems facing a thirty-year-old Chinese immigrant are serious and this person is in great need of intervention. He has been abandoned by his family and is living on the street. His problems are multiplied by the fact that he is an addict and can't keep a job. It is a very serious matter in Chinese culture when a family has reached the point of tossing a brother or father out in the street due to his substance abuse problems.

Exploration, Engagement, Assessment and Planning

In Hepworth's first phase the issues here with this homeless man should be fully explored. For example, in the Chinese culture (not always followed exactly within the Chinese immigrant community) drinking alcohol can cause "flushing and other vasomotor symptoms" because of "acetaldehyde dehydrogenase type I deficiency" (Tom, University of Hawaii, 2005). This problem (abuse of alcohol) almost always is paired with drug abuse and so a social worker could assume at the outset that substance abuse problem has both a drug and alcohol problem.

The instructions do not specify what specific drugs the 30-year-old man is addicted to, nor whether he was the father or brother or uncle or son in this family. But in the exploration and assessment phase, it must be understood that there is a role that Confucianism plays in people of Chinese heritage. The son is expected to be obligated to respect and care for his parents. If this 30-year-old man is a son, his drug problems may well have prevented him from serving as the traditional son; moreover, if the family embraces Buddhism they adhere to the concept of "saving face" or saving the dignity. "An individual's wrongdoing causes immediate family to lose face," Tom explains (p. 5).

The family may have lost "face" and their pride would not let them keep the man in the immediate household. In addition, Tom continues, certain health problems -- "especially mental health problems" -- can bring shame on a Chinese family, and hence, they have expelled the man from the household. Moreover, in the Chinese culture "saving face" makes it hard for a man to admit he has health problems, and the concept of "karma" posits that it is bad luck to talk about illness or death (Tom, 2005).

All these cultural matters need to be taken into consideration by the social worker.

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In the engagement part of Phase I the social worker must understand a conflict can exist between a Western-style social worker and a person of Asian extraction. A sense of rapport must be created if possible, and as the social worker begins to formulate "…a multidimensional assessment of the problem" the social worker must also "identify systems that play a significant role in the difficulties" (Hepworth, 34). Referrals must be made, and goals must be set at this point. Also, as Hepworth explains on page 36, a social worker who can show "empathy" is more able to foster rapport and show the man on the street that his pain is understood, and he can freely express whatever he is feeling and thinking, and through empathy and good listening skills, a relationship can be built, if only superficial at this point.

Once a basic sense of rapport is established, so there is at least a sense of trust (that the social worker is not punishing him or taking him to some kind of incarceration) the man must be taken off the streets and moved to a care facility. If he does not have a strong command of the English language, a Chinese interpreter must be brought in to help coax him off the street. It's not important at this stage to know all about how he got there; what is important is that he has to be in a care facility and evaluated there from a medical perspective. In time, a psychological evaluation must be done. But from here on out good planning must precede all helping processes.

Raymond Fox writes that a social worker should "educate the client about the helping process itself" and also the social worker should "provide practical information" (Fox, 2001, p. 10). Probably the client in this case should first be asked if he would like a warm place to stay off the chilly streets. Since this Chinese man needs an immediate medical checkup -- before drug rehabilitation is put on the agenda -- he needs to be assessed medically. Fox offers page after page of generalizations in terms of how to interact with the client; he suggests the social worker "recognize clients as their own best key resource," albeit that is not necessarily pivotal in the early stages of the helping process.

The second phase, implementation and goal attainment, starts with moving the man off the street and into a care facility. There he will be assessed from an empirical medical standpoint and given fluids and food that is culturally appropriate. Fox urges the social worker to "be patient," to "keep a sense of humor," to always "remain compassionate" and also to "be flexible" (Fox, 13). While the Chinese man is in a care facility, it is the social work's duty to stay in touch, to make frequent visits to the facility, and to "…guide clients' efforts toward goal attainment" (Hepworth). There will be barriers to goal accomplishment, but a competent social worker should know out in front that there will be anxiety, uncertainty, fears and other cultural reactions from the Chinese man as the process plays out. At this point the information provided about the Chinese man are not sufficient to know: a) what drugs is he addicted to; b) why precisely did the family toss him out, which in the Chinese culture is a very serious psychological blow to a family member; and c) what support the family might offer as he becomes sober and is moved to a safe house off the streets.

In any event, the client in this case may refuse helping processes and even wish to commit suicide. If the social worker in this case is mature and calm in the carrying out of his duties, he can relate professionally to the barriers that the client may put up. Prior to the phase three portion of the helping process -- termination -- the social worker should make contact with the family and see if there is any way to reunite the man with his family. In Chinese culture, the family is more important as a unit than the individual is as a person.

If there is any way to bring the family to his place of recovery, not forcibly or with any pressure, it can help smooth the process and give the client real hope that he can make it through his addiction, get a job, and become a productive part of.....

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