Helping Skills Training for Nonprofessional Counselors

The LifeRAFT Model—Providing Relief through Actions, Feelings, and Thoughts

Elizabeth L. Campbell

• Publisher: Routledge
• Year: 2019
• ISBN:
  9780429631900
• Edition: 1
• Topic: Psychology
• Subtopic: Applied Psychology
• Index: Psychology

Helping Skills Training for Nonprofessional Counselors provides comprehensive training in mental health first aid.

Through a trusted approach, grounded in evidence-based psychological research and counseling theory, this training manual provides step-by-step instruction in helping skills written exclusively for nonprofessionals. Focusing on the basics of nonprofessional counseling, the author has written an easy-to-read text that pinpoints strategies, action steps, and investigation procedures to be used by nonprofessionals to effectively aid those in distress. The LifeRAFT model integrates multi-theoretical bases, microskills training, evidence-based techniques, and instruction on ethical appropriateness. It also includes case studies, session transcripts, and practice exercises.

With undergraduate students in applied psychology and nonprofessional counselors being the primary beneficiaries of this text, it is also ideal for anyone seeking training to effectively respond to mental health crises encountered in their everyday lives.

1
Introduction to Helping

Chapter Goals

This chapter will prepare you to:

• Consider what characterizes psychological distress, including significant factors in its causes and triggers.
• Gain an understanding of what constitutes nonprofessional helping for psychological distress and what does not.
• Identify the different roles and occupations of nonprofessional helpers in the mental health field.

Introduction

We are each a vessel navigating the stormy seas of life. Whether floating on calm waters or fighting treacherous rapids, we occasionally find ourselves stuck in a whirlpool of crisis. Thankfully, humans are relational and interdependent beings who never have to sail alone. When drowning in emotional turmoil and stress, sometimes we need someone to throw us a life raft, to see our pain and pull us out of the whirlpool, so we can adjust our sails and restore our life flow once again. It is through these moments of being lovingly rescued by another that we learn, grow, and are transformed. We can raise each other up to be stronger and more capable navigators of our own lives.

I find inspiration from the words of Louisa May Alcott (1953) in Little Women: “I am not afraid of storms for I am learning to sail my ship.” The thematic expression of water as a representation of our life and struggles is found everywhere. It resonates with us, for it expresses the range of human experience and how we learn to navigate our life journey. The metaphor extends further into emergency preparedness: just as we need trained lifeguards and water rescuers who can throw us a life raft, we also need trained helpers who can offer an emotional lifeline when needed.

This is what inspired me to create the LifeRAFT helping skills model and share it with you. Throughout this book, we will continue to use the life/water metaphor to elucidate the experience of distress as drowning and the helping process as water rescue.

This book will train you in how to help others save themselves from sinking into emotional turmoil by teaching you the skills of nonprofessional counseling, also called “mental health first aid” (Quinnett, 1995). Although people generally want to provide help, many people do not know what to do when they witness someone flooded by psychological distress (Myers, 2010). If they are already prepared, they are likely a mental health professional. These trained professional helpers are available to see clients only on an occasional basis, usually for just one hour per week. Everyday people are not trained in helping skills, the interpersonal interventions that have been empirically demonstrated to help those in distress. While helping skills training is often reserved only for mental health professionals, such skills are available and appropriate for everyone to use (Hill, 2014). Although everyday people usually do not have formal helping skills training, they can do something to help. They are the ones who are in contact with people most often, and although they cannot diagnose or treat problems, they can help address crises, aid with immediate needs, and refer for additional treatment. Just as everyday people are taught basic first aid, they too can be taught the “mental health first aid” techniques that we call “helping skills.”

Personal Reflection

Congratulations on your decision to become a LifeRAFT trained helper! This book will teach you how to help people in all kinds of challenging psychological situations. The first thing you must do is choose to commit to your training as an effective helper.

• What are your reasons for engaging in helping skills training?
• Is it worth it to complete LifeRAFT training? For what reasons?

We need more people who can help in this world. Cheers in advance to you!

Psychological Distress

To understand how to help someone, it is useful to first recognize what people need rescuing from. In other words, we need to understand what psychological distress is and where it comes from.

Psychological Distress Defined

For our purposes, we will define psychological distress as unpleasant thoughts, actions, and/or feelings that impact a person’s ability to function in a healthy and adaptive way (Mirowsky & Ross, 2002). For example, if Annie was spending the evening with her friends, we would expect she would have a reasonably good time. If instead she experienced severe fear all evening that kept her from connecting and enjoying herself, we might label this as “psychological distress.” Here, “severe fear” is a form of upset or unpleasant feelings, and “kept her from connecting and enjoying herself” indicates a negative impact on her ability to function.

Unpleasant thoughts, actions, and feelings can manifest in countless forms and are unique to each individual. In general, unpleasant thoughts are characterized by excessively broad and negative ideas about oneself or the world (Beck, 2011). “I am stupid” and “people are not to be trusted” are examples of broad, negative generalizations about oneself and the world that lead to distress.

Unpleasant actions are conceptualized as the sabotaging behaviors that make us feel bad in some regard, either immediately or after a delay (Martell, Dimidjian, Herman-Dunn, & Lewinsohn, 2010). For example, watching a sad movie when you are already sad results in increased hurt immediately, while binge eating may feel soothing in the moment but causes delayed discomforts and health problems in the long term.

Unpleasant feelings are negative emotions that cause pain and suffering. There are numerous examples of these, but the most common types include variations of sadness, anger, and fear (Greenberg, 2002). Note that “negative” is not synonymous with “bad,” because these emotions serve a vital function in our lives. Instead, “negative” refers to the fact that these emotions produce uncomfortable sensations. Feeling angry when a coworker gossips behind your back does not feel good, which characterizes it as a negative feeling. This anger can even disrupt your daily routine by causing you to be irritable and curt toward others, thus impacting functioning. Although negative and disruptive, the anger may also mobilize you to confront your coworker directly to resolve the issue, thereby serving a vital function. Negative thoughts, feelings, and actions not only are unpleasant, distressful, and disruptive but can also serve an essential and valuable part of the human experience.

Causes of Psychological Distress

The causes of psychological distress can be as varied as the reactions they cause. Origins of distress, much like the distress itself, vary between individuals, and what prompts feelings of distress in one person may not in another (Durand & Barlow, 2013).

How much distress a person experiences from a given situation, or whether a situation translates into psychological distress at all, is a highly individualized and multidimensional process based on a myriad of factors. For example, Ramsey may experience psychological distress in the form of intense anger and rage after receiving a credit card bill that he is unable to pay. The cause of Ramsey’s distress might seem obvious, but the nature and intensity of his distress may be different than other people who may instead feel frightened about their financial future or even inspired to make changes in the face of consequences.

The primary factors involved in causation of psychological distress are called “predispositions,” meaning a person’s liabilities or their likelihood to experience distress in response to situations (Abela, Sakellaropoulo, & Taxel, 2007). As a baseline tendency for situational reactions, predispositions to psychological distress include factors such as genetics, physiology, environment, behavior, emotion, and cognition. We will use the case of Ramsey to further illuminate each of these predispositions.

Genetic Factors

Genetic factors are inherited tendencies that make distress more or less likely to occur (Durand & Barlow, 2013). Ramsey’s intense anger reaction to the credit card bill may be related to genes he inherited that predispose him to reacting with anger to stressors. Sudden increases in blood pressure in response to stress, for instance, have been linked to genetics and heritability (Ost, 1992), as have a variety of other functions involved with stress (AIS, 2014).

Physiological Factors

Physiological factors include how the chemicals in the brain operate and respond (Durand & Barlow, 2013). Ramsey’s brain may have an imbalance of neurotransmitters or hormones that predispose him to reacting to situations with rage. Improper levels of neurotransmitters, such as serotonin and norepinephrine, as well as hormones, such as testosterone, have been linked to aggressive impulses (Moeller, 2009).

Environmental Factors

Environmental factors include anything in people’s surroundings that can impact them, including their family and friends, geographical location, and cultural norms (Durand & Barlow, 2013). For example, Ramsey is part of the mainstream culture in the United States, and as a man, he experiences certain cultural expectations and stigmas regarding his reaction and expression of distress. In general, it is considered more socially acceptable for a man to be angry than to show fear, so men are predisposed to admit and embrace anger reactions in stressful situations, as opposed to admitting they are afraid (Durand & Barlow, 2013). This predisposition may have been further reinforced by family members, particularly if Ramsey grew up in an angry or abusive household (Akande, 2000).

Behavioral, Emotional, and Cognitive Factors

While we have already explored how psychological distress itself is characterized by unpleasant behaviors, emotions, and thoughts, baseline behavioral, emotional, and cognitive characteristics can also be causes of distress.

BEHAVIORAL FACTORS

Behavioral factors include how people generally tend to conduct themselves (Durand & Barlow, 2013). Ramsey may frequently engage in actions that make a rage response more likely. Excessive alcohol use and other risky behaviors have been linked to increased likelihood of anger (Moeller, 2009).

EMOTIONAL FACTORS

Emotional factors are the baseline range and intensity with which people experience and express feelings (Durand & Barlow, 2013). Ramsey may be a particularly animated or dramatic person in his day-to-day life, which could predispose him to an even more intense reaction to stress (Greenberg, 2002).

COGNITIVE FACTORS

Cognitive factors refer to how people regularly perceive themselves and the world around them (Durand & Barlow, 2013). Ramsey may tend to see himself as a failure with money. For others who see themselves as generally responsible and view a financial error as a one-time mistake, the bill may not be as distressing. For Ramsey, however, the bill may serve to confirm his existing negative self-views, which will likely result in higher levels of distress (Beck, 2011).

Acknowledging these predispositions aids us as helpers in having compassion and understanding for people in immediate psychological distress (Batson, Ahmad, & Stocks, 2004). It is natural to attribute other people’s problems as somehow their “fault,” yet unpacking the complexity of predispositions helps us to see how distress naturally occurs for some people and not others. While predisposing factors do not absolve individuals of responsibility for appropriately managing themselves, they can assist helpers in understanding causes of distress and remaining sensitive to the individual’s presence and the challenges they face. Maintaining awareness of predispositions is crucial when helping people stuck in a mental health predicament. It helps us to identify tendencies people may have regarding psychological distress and have compassion for those who repeatedly get stuck in seemingly similar whirlpools of distress. With these contextual factors as a backdrop, we can turn our attention to triggers that tend to invoke psychological distress reactions.

Problem Triggers

Problem triggers are immediate crisis situations that prompt distress responses. These tend to be complex and messy problems that the distressed person is not handling well. Oftentimes, there are so many stressors at one time that it can be challenging for a person to differentiate and identify exactly what is “causing” their psychological distress (Durand & Barlow, 2013), and it becomes a case of “the straw that broke the camel’s back”; seemingly small problem triggers can build up over time until something unexpected results in a distress response. Although the origins of these feelings are sometimes obvious, we are more often aware only of the distress itself and the unpleasant feelings associated with it (Beck, 2011).

As a helper, it is valuable to understand common causes of distress reactions to better anticipate and recognize psychological distress when it occurs. According to the American Institute of Stress (AIS, 2014), the primary causes of stress in the United States are (1) job pressures, including coworker tension, bosses, and work overload; (2) money, including lack of funds and financial disagreements; (3) health crises, including illness and death; (4) relationships, including conflicts, separation, divorce, and loneliness; and (5) wellness challenges, including sleep deprivation, inadequate nutrition, and media overload. These are broad categories that often overlap with one another. Difficulty sleeping (i.e., wellness challenges) because of stress at work (i.e., job pressures) and loneliness (i.e., relationships) due to the death of a partner (i.e., health) are examples of causal overlaps. The saying “when it rains, it pours” is certainly true regarding problem triggers: psychological distress often includes multiple life challenges in more than one category (Durand & Barlow, 2013).

Personal Reflection

Consider how distress operates in your own life. Reflecting on your experience of distressing triggers in your life can further help you to gain empathy and understanding for psychological distress experienced by others. To identify your current sources of stress, take the Holmes–Rahe Stress Inventory (1967), available online at www.stress.org/holmes-rahe-stress-inventory.

Holmes and Rahe were psychiatrists interested in understanding how stress contributes to illness. They surveyed over 5,000 medical patients and based on their findings developed a scale of life events, weighted by their typical impact on health. By taking this inventory, you will gain a better understand...

Table of contents

• Cover
• Half Title
• Title
• Copyright
• Dedication
• Contents
• Acknowledgments
• 1 Introduction to Helping
• 2 Ethical Issues in Nonprofessional Counseling
• 3 The LifeRAFT Training Approach
• 4 Stage One: Support
• 5 Stage Two: Watch
• 6 Stage Three: Investigate
• 7 Stage Four: Modify
• 8 Stage Four: Modifying through Actions
• 9 Stage Four: Modifying through Feelings
• 10 Stage Four: Modifying through Thoughts
• 11 LifeRAFT Integration
• 12 Your Future as a Nonprofessional Counselor
• Index