We
can conceptualize human effectiveness as the ability to obtain long term
control over the significant features of an individual’s physical, social, and
psychological environment. In this sense human effectiveness is not purely an
intrapsychic trait; rather it is a measure of the quality of the
person-environment interaction at particular times and in specific
circumstances.
We
can categorize person-environment transactions within a unitary model that
specifies five levels of interaction that include the cognitive, affective, and
behavioral components of that interaction.
Panic
The
lowest level of human effectiveness is aptly described by the term “panic.”
This level is characterized by a major loss of the individual’s control over
effective responses and by a significant loss of control over even the
immediate and short-term environment. In situations of extreme panic the
individual may require hospitalization or careful supervision for his or her
own protection.
People
in the extreme my be suicidal or even violent. Panic is characterized by
intense feelings of being helpless, out of control, and at the mercy of random,
malevolent forces in the environment. Panic may be accompanied by crying, rage,
or by intense physical symptoms, such us hyperventilation, rapid pulse,
increased blood pressure, frequency of urination, faintness, sweating, and
shaking.
Panic
is reaction to intense, uncontrolled, or uncontrollable stress. It is not
automatically an indication of an intrapsychic deficit or inadequate personality
development. Almost any individual can be reduced to panic is stressful stimuli
are intense and prolonged enough and if no control of the situation seems
possible.
Panic
is the lowest level of human effectiveness precisely because the individual’s
affective arousal is so intense that cognitive functioning, including
problem-solving and actual coping behaviors, are severely impaired. When panic
sets in, an individual may be unable to operate simple safety device, may
become disoriented, and may be temporarily unable to accomplish previously
learned skills, such as driving a car, using a machine, or operating other
kinds of equipment.
Exposure
to extreme danger in natural disasters, wars, violent crimes, or accidents
frequently triggers panic reactions. Panic can also result from prolonged
exposure to moderate stress levels when these levels are perceived as totally
uncontrollable. Providing constant care for an emotionally disturbed or acutely
ill person, performing very demanding, complex task for long hours under very
adverse working conditions, or experiencing chronic pain or discomfort for long
periods can all trigger panic.
Panic
reactions may be made more likely and heightened when exposure to very
demanding or threatening situations is accompanied by noxious environmental
conditions, such as oppressive heat, high-noise levels, or intense lighting.
Panic is socially contagious in that exposure to a panicked individual may
trigger a similar level of arousal in others.
When
dealing with panicked individuals in counseling situations, rational and highly
introspective counseling approaches will be ineffective until the panic has
subsided. Withdrawing the individual from the stressful situation, providing
positive reassurance and support in a calm and composed way, and offering
direct, structured advice or instruction about how to control the stressful
situation may be helpful. In cases of extreme panic, sedation by physician, or
even short-term hospitalization, may called for.
Panic
reactions may be prevented from occurring by a variety of counseling procedures.
These procedures are sometimes termed stress
inoculations, or stress-management procedures.
Such procedures include behavioral
rehearsal, in which the client practices a set of coping responses in
advance of the anticipated stressful situation. Learning to analyze identify
threatening or emergency situations and having a set of coping procedures available
seem effective ways to prevent panic. When stress is prolonged and unavoidable,
training in progressive relaxation is also helpful. Good physical condition,
including good sleeping habits, nutrition, and exercise help individuals to
resist panic in stressful situations.
People
in a state of panic seldom approach professional counselors directly and
voluntarily. Rather they are often referred to counselors by others. Victims of
rape, assault, or other violent crimes are frequently referred for counseling.
Sometimes people who are facing surgery or life threatening illnesses, who are
suffering from very painful, disabling injuries and illnesses, who are experiencing
bereavement, and who have attempted or threatened suicide are also referred to
counselors.
Counseling
with clients who are or have recently been in a state of panic, or who are on
the verge of such states is often called crisis
intervention. Crisis intervention tries to help people cope with extremely
stressful short-term situations by helping them to control their emotions and
too cope with the immediate problem. In many crisis situations “insight-oriented”
counseling approaches may be premature, or even counter-productive, until the
crisis has been resolved.
Apathy
The second level of
human effectiveness can be called “apathy.” At this level there is some control
of the short-term, immediate aspects of the environment. In comparison to
panic, the immediate level of affective arousal here is much lower, and there are fewer symptoms of
emotional arousal. At this level individuals often try to exert control over
their environment largely by avoiding the stress of threatening interactions,
even when these might lead to greater long-term control. While the individual
may not require institutionalization, he or she is unlike to be economically or
socially self-sufficient or independent. The will to make plans and pursue
goals is almost totally absent, and even the degree of organization required to
hold a low-level job is often missing.
The individual in the
grip of apathy tends to avoid or ignore demands from the environment. Because
the emphasis is on avoiding immediate punishments or preventing obvious
failures, the individual has great difficultly in following through on even the
n carefully structured plans and in accepting responsibility for his or her own
behavior and its consequences. Others will be blamed and a wide variety of
excuses will be found to rationalize lost opportunities or failures. Typically,
individuals at this level have very low self-esteem and often feel at the mercy
of fate or luck, so that in interpersonal relationships they tend to show
distrust and indifference.
Like people at the
panic level, these individuals can be very hard to reach. They rarely approach
counseling on their own. Often they are referred by relatives or others who
simply do not know how to cope with them.
People at the apathy
stage often have histories of long-term hospitalization, imprisonment,
unemployment, invalidism, or have experienced a long series of tragedies and
failures that have led them to abandon efforts to control their environment.
They respond to the positive and negative stimuli of their environment in
lethargic ways, and at deeper emotional levels there may be feelings of
despair, alienation, and abandonment.
This type of client is
often referred involuntarily by courts, probation officers, parole service, or
welfare agencies. In some ways this client is even more difficult than the
panicked individual. Clients at the apathy stage typically require a great deal
of counselor-initiated structure, even to the point of setting and reminding
the client of specific times and places for appointments. When goals are set
and action planned, they must be very explicit and short-term. Often this means
breaking down goals into a series of very short-term, readily accomplished
objective.
Striving
At
this level of human effectiveness the individual is able to maintain control over
most of the short-term transactions with his or her environment and is actively
engaged in seeking more long-term control. The individual has some control over
affective responses, but may vacillate between feelings of hope and confidence
and feelings of resignation and despair.
The “striving” individual is capable of a
limited amount of planning and gratification deferral, but is easily discouraged
by failure to attain results quickly. Often this kind of client tends to set
goals and objectives that are unrealistic with regard to their scope or to the
time that would be required to accomplish them, and then becomes discouraged
when they are not attained. This individual’s life is likely to be
characterized by a series of crisis and emergencies that are preventable with
more consistent, careful planning.
At this stage clients
may self-refer, but they may also have unrealistic and grandiose expectations
of immediate results. They are frequently referred by teachers or supervisors
because of inconsistent performances or underachievement in school or on the
job, but they also tend to withdraw from counseling prematurely.
Although clients at the
striving level may wan considerable counselor initiated structure, they are
usually able to accept a gradual increase in responsibility for the counseling
process. They may be able to profit from insight-oriented approaches that move
very slowly and are accompanied by considerable support. Sudden attempts at
confrontation with these clients can result in premature termination of
counseling.
Coping
At
this level of human effectiveness the individual has control over large
segments of long-term transactions with the environment. Behavioral is purposeful
and largely goal-oriented. The individual reacts to life’s problems more as
challenges than as treats. Problems and difficulties tend to be readily
identifiable in terms of specific roles or relationships, or particular
developmental tasks.
Clients
at this level tend self-refer and to articulate their concerns and problems
fairly well. Yet they tend to have considerable anxiety about the outcome of
ego-involving problems and situations.
However, their anxiety is not crippling, but rather provides motivation
for them to work actively in behalf of their goals. At this level clients
generally have fairly realistic perceptions of themselves and their life
situations. However, they may have “blind spots” about certain relationships or
situations.
At this “coping” level clients are able
to take considerable responsibility for choosing goals and setting directions
in the counseling process, and in turn the counselor is able to utilize a
rather wide range of counseling approaches. Once a reasonably good relationship
has been established, a “working partnership” between counselor and client
often result.
Mastery
This level of
person-environment transactions represents the highest category of human
effectiveness. The individual is in active control large and important segments
of the environment on both a short-term and long-term basis. Such people
typically enter into active interaction with the environment, anticipating
rather than merely reacting to events. At the mastery level people tend to
experience feelings of adequacy and self confidence in most of their roles and
relationships. They experience problems or obstacles as challenges and may show
real zest and enthusiasm in setting goals and planning activities.
At
the mastery level clients my self-refer or be referred by others, often for
very specific information or assistance. They may seek assistance to do
educational and vocational planning prior to graduation from college, or later
in midlife at the point of a major career change. They may contact counselors
for assistance in planning for retirement, or in seeking to prepare for some
other major life change. Difficult life transitions, occasioned by death or
divorce, or by disabling illnesses, or injuries, may move an individual back
temporarily into the coping level.
People
at mastery level may experience difficulty when new roles are thrust upon them
that involve forming empathic or nurturing roles with less effective and
self-confidence people. Sometimes the counselor who works with client systems
in organizational development or process consultation must help administrators
and executives adjust to functioning in new roles at a mastery level.
Interventions, such us human relations training or “sensitivity” training, are
sometimes useful in this kind of situation.
In working with clients who function
at the mastery level the counselor has the problem of establishing his or her
credibility. This kind of client usually extends credibility primarily on the
basis of perceived expertness.
This kind of client is usually also
active in communicating expectations about both the counseling process and the
outcome. Such clients may resist or resent what they perceive as
“spoon-feeding” or “talking down.” In order to obtain cooperation the rationale
and purpose of an approach or technique often must be explained in advance.
Failure to be direct and open with such clients can lead to abrupt termination.
However when mastery level clients are fully informed an committed, they often
involve themselves enthusiastically in such task as homework assignments,
information searches, vocational information, and bibliotherapy.
In a sense, the human effectiveness
framework we have considered constitutes both a unitary diagnostic system and a
goal structure for counseling. Obviously, we would like to see our clients
eventually functioning at the coping and mastery levels.
The framework also provides a useful
basis on which counselor can begin to shape his or her own initial approach to
the client. The degree of client responsibility that can be expected, the
amount of counselor-intiated structure that is appropriate, the degree of
counselor attention to emotional factors, and even the ways in which
appointments are scheduled and task assigned may all vary in terms of the clients’
level of effectiveness and functioning.
For example, it may be inappropriate
to begin a contact with a client at the apathy level by asking him or her to
free associate or give detailed information. Similarly, a client verging upon
panic may not be expected to give a detailed history or to engage in logical
problem-solving exercises.
A unitary system of diagnosis, then,
seems a more useful tool for the counselor than is the intrapsychic, disease
entity approach. When such a system is rooted in observations about the quality
of the client’s transactions with the environment, such systems are especially germane.
After all, the counselor is a part of the environment, so that beginning, at
least, the client will interact with the counselor in a similar fashion to his
or her other transactions.
However, even a unitary system of
diagnosis is not without its limitations and disadvantages. Like other
diagnostic frameworks, the human effectiveness model is a system of categories.
That is, it assigns clients to boxes and categories based on a set of
previously defined characteristics. Whenever we assign a complex,
ever-changing, and essentially unique individual to a single category, we run
the risk of ignoring other vital factors. We may oversimplify in the face of
complexity, or prematurely close ourselves of from new information.
In counseling, then, diagnosis is
much more than an event or stage in the counseling process that is completed
before moving on. As we said earlier, diagnosis involves the entire process by
which the counselor seeks to understand a client and that client’s world.
For this reason the question of
whether to diagnose or not has little meaning so longs as the counselor is
engaged in a serious effort to understand his or her client.
Reference :
Donald H. Blocher. (1987). The Professional Counselor. New York:
Macmillan Publishing
Company.
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