Clinical Presenting Issues

Helping Professional

The theoretical and empirical contributions of Stanley Strong, Charlie Gelso, and Howard E. A. Tinsley have been instrumental in demonstrating the influence of the helping professional on the presenting problem. The name by which the “helper” is known influences the likelihood an individual will seek assistance from that person. The typical individual is more likely to seek help for personal problems involving a spouse, family member, or member of the opposite sex from a counseling psychologist. Psychiatrists, clinical psychologists, and peer counselors are less likely to be seen by persons with those presenting problems. Psychiatrists and counseling psychologists are most likely to be seen by individuals who are troubled by thoughts of suicide or concern about their emotional stability. People who desire help with career plans, problems on the job, or developing a life plan are most likely to seek the assistance of a career counselor, a college counselor, a close friend, or a relative. In general, therefore, people tend to have a general idea of the relative areas of expertise offered by the different potential helpers and to base their help-seeking decisions on those beliefs.

Although this is a sound, common-sense approach, people seeking help do not always understand (or may not be ready to admit) the true nature of their concerns. For this reason, helping professionals must be broadly trained and stand ready to refer clients when they conclude that another helper is better prepared to help the client.

Clients are in a state of vulnerability or even crisis at the time they are stating their presenting problem. For this reason, Randolph Pipes and Donna Davenport have underscored the importance of therapist sensitivity and competence in crisis management. Skilled therapists understand that in addition to the pain caused by their personal situation, clients typically experience some trepidation about disclosing the [Page 492]relevant personal information to a therapist (and many clients are troubled by the nagging doubt that no one—and especially not the therapist they do not yet know—could understand what they are experiencing. A substantial number of clients do not return after their first interview with a therapist. For this reason, experiencing and communicating respect for clients and their experiences is a key therapeutic factor when considering the referral problem. Although that may sound like a fundamental social skill, skilled psychologists understand that respect is deeply embedded in a cultural context. Multicultural competency is critical clinical skill expected of therapists, and psychologists are called upon to exercise this competency from the clinician's first reading of a phone message to their more formal assessment of the reason for referral.

...