Helping
When we use the word helping as a noun, one definition is “a portion or serving of food.” Of course, in this book, we are not really interested in talking about food! Here we are looking to understand the word helping used as a verb, when it is used as an action that is aimed toward others. Permit me to borrow the reference to food as a metaphor for what helping is, though, because ironically, the food metaphor is oddly fitting here, too. Food is the substance that enables us to grow. And helping is that which we give to others so that they may grow. Helping is the effort that we make to offer strength and support to people who want to learn, change, and grow, or who need something when times are hard. Helping is the plate of food that we lay before others to fortify them, offer nourishment, and help them feel cared for.
Counseling, Psychotherapy, and Therapy
Within the category of “helpers” exists an expansive array of clinical and nonclinical roles and professions. Clinical helpers are those who have received advanced level training (master's or doctoral degrees), typically including extensive supervised clinical practice experience, to offer therapeutic interventions for people who struggle with personal or interpersonal difficulties or mental health challenges. Examples of clinical helpers include mental health counselors, marriage and family therapists, psychologists, psychiatrists, and clinical social workers. While nonclinical helpers may also work in the area of mental health providing adjunct care, support, or instruction, they typically have a bachelor's level educational degree, and their work is under the close supervision of a clinical mental health professional. Job titles for these non-clinical positions include counselor, advocate, and therapy assistant. Nonclinical helpers may work in a variety of other settings, too, providing, for example, career guidance, nutrition counseling, exercise coaching, education, assisting with a multitude of daily living tasks, etc. Nonclinical helpers also occupy a vast variety of roles in the medical field. These latter positions may require advanced-level educational training or degrees. A list of many of these varied roles is included in Appendix A.
There is much confusion regarding the terms counseling and psychotherapy. You may notice that in some settings, they are used somewhat interchangeably, yet in other settings they have clear and distinct meanings. For example, a lawyer provides legal counsel, which is obviously very different from the counseling services provided by a mental health counselor. Most of us know not to go to a lawyer for therapeutic intervention regarding our mental health concerns, and not to seek mental health counseling for legal advice. Lawyers, then, are nonclinical professional helpers, and they have advanced degrees and training in the law and legal practice.
In this text, we will use the term counseling in reference to a helping practice that it conducted by clinical and nonclinical helpers and is aimed at assisting others with personal, social, or psychological issues or concerns. As mentioned, the distinction between clinical and nonclinical counseling has to do with training level and scope of practice. Psychotherapy typically refers to a mental health clinical practice, and therapy is just a shorted version of the word psychotherapy. So, clinical counseling and psychotherapy are two terms with virtually the same meaning and are often used interchangeably (Sommers-Flanagan & Sommers-Flanagan, 2004).
The work of counselors and psychotherapists has to do with symptom remission and improved everyday functioning (Lambert, 2013). They help people cope with interpersonal and mental health difficulties such as those posed by addictions, trauma, mental illness, experiences of stress, and difficulties in adjustment. They also help people develop healthy interpersonal relationships, which sometimes includes thinking about situations differently, developing better communication skills, or behaving in different ways. Additionally, counselors and psychotherapists work with individuals in decision-making for the present and future or developing healthy lifestyles, and they provide support for people experiencing crisis or challenges in their lives. The work of counselors and psychotherapists is based on training in psychology and human development theories, such as those discussed in Chapter 2, and also on practice theories such as those reviewed in Chapter 3. A list and descriptions of various clinical and nonclinical helping positions is included in Appendix A.
Advocacy
When we are witness to the adverse effects of social forces such as prejudice and discrimination (in all of their overt and subtle forms) that lead to problematic institutional practices and barriers in the lives of the people we serve, intervention should focus on those sources of problems rather than on the individual. What sets advocacy apart from counseling and psychotherapy, then, is that advocacy attempts to change variables that sit outside the individual—systems and institutions that hamper people in various ways (Funk, Minoletti, Drew, Taylor, & Saraceno, 2005; Lewis, Lewis, Daniels, and D'Andrea, 1998). Advocates are helpers who work with and/or on behalf of people or groups for a particular cause or policy, and the implicit goal of most advocacy efforts is to increase peoples’ sense of personal power or agency. Of course, advocacy is not limited to issues related to mental health. It is relevant in many other fields as well. There are patient advocates in hospitals, child advocates in court systems, advocates for individuals who have disabilities, etc. More about advocacy as a helping intervention is included in Chapter 8.