In this fifth edition of her best‑selling textbook, Clara Hill presents an updated model of essential helping skills for undergraduate and first‑year graduate students. Hill’s model consists of three stages—exploration, insight, and action—in which helpers guide clients in exploring their thoughts and feelings, discovering the origins and consequences of maladaptive thoughts and behaviors, and acting on those discoveries to create positive long‑term change.
This book synthesizes the author’s extensive clinical and classroom experience into an easy‑to‑read guide to the helping process. Aspiring helping professionals will learn the theoretical principles behind the three‑stage model and fundamental clinical skills for working with diverse clients. Hill also challenges students to think critically about the helping process, their own biases, and what approach best aligns with their therapeutic skills and goals.
New to this edition are
- detailed guidelines for developing and revising case conceptualizations,
- expanded coverage of cultural awareness,
- updated case examples that reflect greater diversity among clients and helpers, and
- additional strategies for addressing therapeutic challenges.
Clara E. Hill, PhD, is a professor in the Department of Psychology, University of Maryland. Her awards include the Leona Tyler Award, the Distinguished Psychologist Award, the Distinguished Research Career Award, and the Outstanding Lifetime Achievement Award. Her major research interests are helping skills, the psychotherapy process, training and supervising therapists, dream work, meaning in life, and qualitative research. Dr. Hill has published over 220 journal articles, more than 75 book chapters, and 14 books, including Dream Work in Therapy (2004), and Consensual Qualitative Research (2012), and Meaning in Life (2018). She lives in Silver Spring, MD.
Preface
Acknowledgments
I. OVERVIEW
1. Introduction to Helping
What Is Helping?
Is Psychotherapy Effective?
Facilitative Aspects of Helping
Problematic Aspects of Helping
When Do People Seek Help From Others?
On Becoming a Helper
The Process of Learning to Be a Helper
Ethics
Overview of This Book
Concluding Comments
What Do You Think?
Key Terms
2. A Model of the Helping Process
My Theory of Personality Development
My Theory of How People Change
Background Variables That Contribute to the Helping Process
The Three Stages of Exploration, Insight, and Action
Moment-by-Moment Interactional Sequence
In Between Sessions
Outcomes of Helping for Clients
Concluding Comments
What Do You Think?
Key Terms
3. Self-Awareness
Self-Knowledge and Self-Insight
Strategies to Increase Self-Knowledge and Self-Insight
An Exercise to Promote Self-Awareness
What Do You Think?
Key Terms
4. Cultural Awareness
Defining Culture
Dimensions of Culture
Cultural Issues in the Helping Process
Disclosure About Minority Status
Ethical Behavior Related to Culture and Helping
Integrating Multicultural Knowledge, Skills, and Attitudes
Into One’s Style as a Helper
Difficulties Helpers Have Related to Cultural Issues
My Own Experiences of Culture
What Do You Think?
Key Terms
II. EXPLORATION STAGE
5. Overview of the Exploration Stage
Theoretical Background: Rogers’s Client-Centered Theory
Goals for the Exploration Stage
Preexploration Education
Concluding Comments
What Do You Think?
Key Terms
6. Skills for Providing Support
Overview of Attending and Listening
Cultural Rules for Nonverbal Communication
Nonverbal Behaviors That Facilitate Attending
Paraverbal Behaviors That Facilitate Attending
Minimal Verbal Behaviors That Facilitate Client Exploration
Examples of Attending and Listening
Relax and Be Natural but Professional
Concluding Comments
What Do You Think?
Key Terms
7. Skills for Exploring Nonaffective Content, Thoughts, Narratives, and Stories
Rationale for Exploring Nonaffective Content, Thoughts, Narratives, and Stories
Restatements and Summaries
Open Questions and Probes for Thoughts
Closed Questions for Information or Facts
Distinguishing Between Open and Closed Questions
A Comparison of Skills for Exploring Nonaffective Content, Thoughts, Narratives, and Stories
What Do You Think?
Key Terms
8. Skills for Exploring Feelings
Rationale for Exploring Feelings
Cultural Considerations in Working With Feelings
Reflection of Feelings
Disclosure of Feelings
Open Questions and Probes About Feelings
A Comparison of Skills for Exploring Feelings
Concluding Comments
What Do You Think?
Key Terms
9. Integrating the Skills of the Exploration Stage
Case Conceptualization in the Exploration Stage
Choosing Goals and Intentions to Facilitate Exploration
Choosing Skills to Match the Goals and Intentions
Implementing the Skills of the Exploration Stage
Conducting a Practice Session Focusing on the Exploration Stage
Dealing With Difficult Clinical Situations in the Exploration Stage
Difficulties Implementing the Exploration Stage
Coping Strategies for Managing Difficulties in the Exploration Stage
Example of the Exploration Stage
Is It Time to Move to the Insight Stage?
What Do You Think?
Key Terms
III. INSIGHT STAGE
10. Overview of the Insight Stage
What Is Insight?
Why Is Insight Necessary?
Intellectual Versus Emotional Insight
Markers of Readiness for Insight
Theoretical Background: Psychoanalytic and Existential Theories
Setting Expectations in the Insight Stage
Goals and Skills of the Insight Stage
Concluding Comments
What Do You Think?
Key Terms
11. Skills for Fostering Awareness
Rationale for Using Challenges
Theoretical Perspectives on Fostering Awareness via Challenges
Markers of Readiness for Awareness
Types of Challenges
General Guidelines for How to Challenge
Difficulties Helpers Experience Using Challenges
Concluding Comments
What Do You Think?
Key Terms
12. Interpretive Skills
Rationale for Using Interpretive Skills
Open Questions and Probes for Insight
How to Do Open Questions and Probes for Insight
Interpretations
Disclosures of Insight
What Do You Think?
Key Terms
13. Skills for Processing the Therapeutic Relationship
Rationale for Using Immediacy
Markers of Readiness for Processing the Relationship
Client Markers Indicating Appropriateness of Processing the Relationship
Helper Markers for Processing the Relationship
Types of Immediacy
Guidelines for Using Immediacy
Example of Immediacy
Difficulties Helpers Have in Using Immediacy
What Do You Think?
Key Terms
14. Integrating the Skills of the Insight Stage
Case Conceptualization in the Insight Stage
Implementing the Skills of the Insight Stage
Caveats About Using Insight Skills
Difficulties Helpers Might Experience in the Insight Stage
Strategies for Overcoming Difficulties in Implementing the Insight Stage
Example of an Extended Interaction in the Insight Stage
What Do You Think?
Key Terms
IV. ACTION STAGE
15. Overview of the Action Stage
Rationale for the Action Stage
Deterrents to Action
Philosophical Underpinnings
Markers for Knowing When to Move to Action
Theoretical Background: Behavioral and Cognitive Theories
Goals of the Action Stage
Skills of the Action Stage
Concluding Comments
What Do You Think?
Key Terms
16. Steps for Working With Four Action Tasks
Rationale for Action Tasks
Relaxation
Behavior Change
Behavioral Rehearsal
Decision Making
What Do You Think?
Key Terms
17. Integrating the Skills of the Action Stage
Case Conceptualization in the Action Stage
Implementing the Action Skills
Difficulties Helpers Might Experience in the Action Stage
Strategies for Overcoming the Difficulties
What Do You Think?
Key Terms
V. INTEGRATION
18. Putting It All Together: Working With Clients in the Three-Stage Model
Intakes
Helper’s Work Between Sessions
Subsequent Sessions
Termination
Dealing With Difficult Clients and Clinical Situations
Example of the Three-Stage Model
Concluding Comments
What Do You Think?
Key Terms
Glossary
References
Index
About the Author
Feedback Form
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