Interview With Clara E. Hill About Helping Skills: Facilitating Exploration, Insight, and Action, Third Edition
Interviewer [female voice]: Your book, Helping Skills, is now in its third edition and has become a bestseller among books for trainee psychotherapists and other skilled helpers. Do you have any thoughts as to why it enjoys continued success?
Clara Hill: Well, I'm glad it does. What I've been told is that it's relatively easy to understand, it's pretty clearly written. But it also doesn't talk down to people. So, I think a problem with a lot of the other books in the field is either they get way too complicated and make therapy seem like it's too difficult to understand, or it's too simplistic. And so some of the authors really speak down to people and make it feel like they're not very smart.
And so I think — because I've taught Helping Skills for over four years now, and I really try to pay attention to my trainees and what levels they're at and take their feedback very seriously — I've been able to kind of aim it at an audience that can get it and can understand it.
Interviewer: Could you briefly explain your three-stage model of helping?
Clara Hill: Yes. The three stages are exploration, insight, and action. The idea is that exploration — the client needs to explore deeply and think deeply about their thoughts and feelings about an issue. And then once they've thought deeply about it, it kind of naturally moves in to insight, where they understand things at a deeper level. Sometimes with the therapist having to move back and give them alternate perspectives and challenge them, and work with the therapeutic relationship. And then once they understand themselves at a deep level, what we want to help people do is move to action, to try to figure out how they can change what they do. So it's important that you not just understand but that you move on to making changes in life.
Interviewer: How has your model evolved over time since you first began using it?
Clara Hill: I think the main thing is that at first it was relatively rigid. At first it was kind of like you do reflections of feelings, and then you do interpretations, and then you do action or interactional skills. And as I become more comfortable, I think, with myself and as a therapist, what I've realized is that things don't work that simply but that you need to be more flexible and more adaptive to doing what works at a given time.
So, what I think now is more we teach therapists these different skills, we help them learn when to use them and how to use them. And then once they kind of master the skills, then they go out and do what works for them. So it's not as much an automatic kind of thing as, "Here are some skills. Let's focus on you for a while." And then once you go out, try to work with a client, then you try to figure out what works with that particular client.
Interviewer: What are the most common challenges students struggle with in learning to become professional helpers?
Clara Hill: The biggest challenge is moving from a friendship role to a professional role. And by that I mean in a friendship role, we talk 50/50. In a professional role, the therapist often talks 15, 20 percent of the time. That's really difficult to shift. In a friendship role, we give lots of advice, we self-disclose. And those aren't things we do typically in a therapy relationship.
So, it's really difficult at the beginning for a therapist to shift that role. And then later, the more advanced skills are more difficult in terms of learning when to challenge, when to use immediacy, when to do interpretation. But that beginning thing is really making that major shift from a friendship to a professional role.
Interviewer: To what extent is becoming a skilled helper an innate gift or talent, and to what extent is it learned?
Clara Hill: Both. Certain people have more empathy than others. And people have — by the time they come in to wanting to be trained as a therapist — they've been interacting with people for all their lives. So, there are certain people who have more interactional skills, more emotional intelligence, more ability to be empathic. And those are the people we tend to take into training, both by our selection and by themselves selecting themselves.
And then we can shape them a little bit. We can get them to use more of some skills and less of some other ones. We can help them not interrupt as much, to not self-disclose as much but to use more reflections of feelings. But it really is an interaction between the two, such that we take talented people who are emotionally intelligent and then help them become more aware of their behaviors and figure out what effect they're having on clients.
And one of the things we always talk about is helping people look at their reaction to clients. Not that there are specific skills that are the right ones, but for a particular client, there are things that they could do that could help.