Egan Chapter 11

Chapter 11 STAGE III: PLANNING—HELP CLIENTS DESIGN THE WAY FORWARD

Stage III is an important part of the helping process wherein clients find solutions and reach

resolutions. Once clients are helped to establish goals, they often still need help to plan the

actions or strategies that will enable them to accomplish their goals. These actions or strategies

are solutions with a small “s.” Stage III has three tasks, all aimed at helping clients move to goal-

accomplishing action.

Task III-A: Help Clients Develop Possible Strategies. Help clients brainstorm strategies for

accomplishing their goals. “What kind of actions will help me get what I need and want?” Task

III-B: Help Clients Choose Best-Fit Problem-Managing Strategies. Help clients choose strategies

tailored to their preferences and resources. “What set of actions are best for me?” Task III-C:

Help Clients Plans Turn Strategies into Viable Plans. Help clients formulate actionable plans.

“What should my campaign for constructive change look like? What do I need to do first?

Second? Third?”

Stage III adds the final pieces to a client’s planning a program for constructive change. Stage III

deals with the “game plan.” However, these three “tasks” constitute planning for action and

should not be confused with action itself. Without action, a program for constructive change is

nothing more than a wish list.

TASK III-A: HELP CLIENTS DEVELOP STRATEGIES FOR ACCOMPLISHING THEIR

GOALS:

There is usually more than one way to accomplish a goal. However, clients often focus on a

single strategy or just a few. The task of the counselor in Task III-A is to help clients discover a

number of different routes to goal accomplishment. Clients tend to choose a better strategy or set

of strategies if they choose from among a number of possibilities. Read Chapter 11 before doing

the exercises in this section.

EXERCISE 11.1: BRAINSTORM ACTION STRATEGIES FOR YOUR OWN GOALS

Brainstorming is a technique you can use to help yourself and your clients move beyond

constricted to imaginative or inventive thinking. Recall the rules of brainstorming but remember

this one caution: Remain focused on the issue at hand; let your imagination roam freely but stay

within the broad confines of the problem situation. Brainstorming is a technique. Use only if you

think it fits the needs of the client. Don’t force clients into using a technique that you think is

useful but they see as foreign. That said, nudging is still a possibility.

• Encourage focused quantity. Deal with the quality of suggestions later

• Do not criticize any suggestion. Merely record it.

• Combine suggestions to make new ones.

• Encourage even wild possibilities that stay focused on the problem situation. For instance,

“One way to keep to my diet and lose weight is to have some part of my eating apparatus sewn

up.”

• When you feel you have said all you can say, put the list aside and come back to it later and add

fresh ideas, but remain focused.

Example: Sam, a retired Caucasian lawyer in training to be a counselor, is in a high-risk category

for a heart attack. Some of his relatives have died relatively early in life from heart attacks, he is

overweight, he exercises very little, he is under a great deal of pressure in his job, and he smokes

over a pack of cigarettes a day. One of his goals is to stop smoking within a month. With the help

of a nurse practitioner friend, he comes up with the following list of strategies:

• just stop cold turkey. • shame myself into it, “How can I be a helper if I engage in self-

destructive practices such as smoking?”

• cut down, one less per day until zero is reached. • use the new nicotine-based aids, such as

patches and gum. • look at movies of people dying with lung cancer. • pray for help from God to

quit. • use those progressive filters which gradually squeeze all taste from cigarettes. • switch to a

brand that doesn’t taste good. • switch to a brand that is so heavy in tars and nicotine that even I

see it as too much. • smoke constantly until I can’t stand it anymore. • let people know that I’m

quitting. • put an ad in the paper in which I commit myself to stopping. • send a dollar for each

cigarette smoked to a cause I don’t believe in, for instance, the “other” political party.

• get hypnotized; through a variety of posthypnotic suggestions have the craving for smoking

lessened. • pair smoking with painful electric shocks. • take a pledge before my minister to stop

smoking. • join a group for professionals who want to stop smoking. • visit the hospital and talk

to people dying of lung cancer. • if I buy cigarettes and have one or two, throw the rest away as

soon as I come to my senses. • hire someone to follow me around and make fun of me whenever

I have a cigarette. • have my hands put in casts so I can’t hold a cigarette. • don’t allow myself to

watch television on the days in which I have even one cigarette. • reward myself with a weekend

fishing trip once I have not smoked for two weeks. • avoid friends who smoke. • have a

ceremony in which I ritually burn whatever cigarettes I have and commit myself to living

without them.

• suck on hard candy made with one of the nonsugar sweeteners instead of smoking. • give

myself points each time I want to smoke a cigarette and don’t; when I have saved up a number of

points reward myself with some kind of “luxury.”

Note that Sam includes a number of wild but focused possibilities in his brainstorming session.

Now follow these steps.

1. On separate paper, develop two goals and then, by brainstorming, create a list of ways to

achieve each of the goals. Add wilder possibilities at the end.

2. After you have finished your list, take one of the goals and the brainstorming list, sit down

with a learning partner, and through dialogue expand your list. Follow the rules of brainstorming.

3. Switch roles. Through empathic highlights, probing, summarizing, and challenge, help your

partner expand his or her list.

4. Keep both lists of brainstormed strategies. You will use them in a later exercise.

Goal # 1.

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EXERCISE 11.2: DEVELOP ACTION STRATEGIES—PUT YOURSELF IN THE CLIENT’S

SHOES

Here are a number of cases in which the client has formulated a goal and needs help in

determining how to accomplish it. You are asked to put yourself in the client’s shoes and

brainstorm action strategies that you yourself might think of using were you that particular client.

Example: Renalda, 53 years old, has been a very active person—career-wise, physically,

socially, and intellectually. In fact, she has always prided herself on the balance she has been

able to maintain in her life. However, an auto accident that was not her fault has left her a

paraplegic. With the help of a counselor, she has begun to manage the depression that almost

inevitably follows such a tragedy. In the process of redirecting her life, she has set some goals.

Since her job and her recreational activities involved a great deal of physical activity, a great deal

of redirection is called for. One of her goals is to write a book called “The Book of Hope” about

ordinary people who have

creatively reset their lives after some kind of tragedy. The book has two purposes. Since it would

be partly autobiographical, it would be a kind of chronicle of her redirection efforts. This will

help her commit herself to some of the grueling rehabilitation work that is in store for her.

Second, since the book would also be about others struggling with their own tragedies, these

people will be models for her. Renalda has never published anything, so the “how” is more

difficult. For her, writing the book is more important than publishing it. Anyway, these days self-

publishing is always a legitimate option. Therefore, finding a publisher is not part of the “how.”

Here is one person’s set of brainstormed possibilities for the “if I were Renalda” case.

• Get a book on writing and learn the basics. • Start writing short bits on my own experience,

anything that comes to mind. • Read books written by those who conquered some kind of

tragedy. • Talk to the authors of these books. • Find out what the pitfalls of writing are like, for

instance, writer’s block. • Get a ghost writer who can translate my ideas into words. • Write a

number of very short, to-the-point pamphlets, and then turn them into a book. • Do rough drafts

of topics that interest me and let someone else put them into shape. • Record discussions about

my own experiences with the counselor, the rehabilitation professionals, and friends and then

have these transcribed for editing.

• Interview people who have turned tragedies like mine around. • Interview professionals and the

relatives and friends of people involved in personal tragedies. Record their points of view.

• Through discussion with friends, get a clear idea of what this book will be about. • Find some

way of making it a bit different from similar books. Brainstorm what I could do to give such a

book a special slant.

Now do the same kind of work for each of the following cases.

Case 1. Emma, 27 years old, has been addicted to heroin. Her life has revolved around her habit.

She has been told by her employer, an ad agency, that despite her creativity, her erratic

performance at work will no longer be tolerated. She opts for a treatment known as ultrarapid

opiate detoxification in which the drug naltrexone replaces heroin in the clients’ opium receptors

within six hours or so. Treatment with naltrexone is to continue for six months. Once she is free

of opiates, her challenge is to build a very different lifestyle—one that will focus her talents and

energies. She is in opportunity-development mode. This includes a new social life since,

currently, she has no social life to speak of. One of her goals is reconciliation with her family,

including her parents, one sister, and two brothers together with their families. She has seen very

little of them over the past three years apart from attending two weddings. She wants to start the

work on reconciliation while she is still feeling well. She realizes that reconciliation is a two-way

street and that she cannot set goals for others.

Goal. If you were Emma, what would “reconciliation with my family” look like? If

accomplished, what would be in place? What would social life with the family look like? How is

the goal conditioned by the fact that reconciliation is a two-way street?

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Brainstorming Strategies. What are some of the things you might do to achieve the kind of

reconciliation with your family that you have outlined above? Do the focused brainstorming on a

separate sheet of paper. Remember to include some “wild,” but still focused, possibilities.

1. After you have developed your list, first share your goal with a learning partner. Give each

other feedback on the quality of the goal. Note especially how you and your partner interpret

“reconciliation.”

2. Next, share the lists of brainstormed possibilities. Working together, add several more

possibilities to the combined lists.

3. Discuss with your partner what you have learned from this exercise.

Case 2. A priest was wrongfully accused of molesting a boy in his parish at a time when

everyone who was suspected was considered guilty. Working with a counselor, he set three

goals. His “now” goal was to maintain his equilibrium under stress. He knew that in the eyes of

many he would be seen to be guilty until proved innocent. With the help of the counselor and

some close friends, both lay and clerical, he kept his head above water. A near-term goal was to

win the case in court. He also accomplished this goal. He was acquitted and all charges were

dropped. After the trial, the bishop wanted to send him to a different parish “to start fresh.” He

had been removed from his pastorate and was living at the seminary. But he wanted to return to

the same parish and reestablish his relationship with his parishioners. After all, he had done

nothing wrong. The bishop agreed to reinstate him in his parish.

Goal. If you were this man, what would “re-establishing my relationship with my

parishioners” look like? What would be in place that is not now in place? Formulate a goal that

has the characteristics of a viable goal outlined in Chapter 12.

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Brainstorming Strategies. What are some of the things you might do to reestablish your

relationship with your parishioners, especially in view of the fact that some might still see you as

tainted by the whole affair? Do the brainstorming on a separate sheet of paper. Include some

“wild” possibilities. Now, as in Case 1, complete steps 1–3.

EXERCISE 11.3: HELP OTHERS DISCUSS OR BRAINSTORM STRATEGIES FOR

ACTION

As a counselor, you can help your fellow trainees stimulate their imaginations to come up with

creative ways of achieving their goals. In this exercise, use probes and challenges based on

questions such as the following:

How: How can you get where you’d like to go? How many different ways are there to

accomplish what you want to accomplish? Who: Who can help you achieve your goal? What

people can serve as resources for the accomplishment of this goal? What: What resources both

inside yourself and outside can help you accomplish your goals? Where: What places can help

you achieve your goal? When: What times or what kind of timing can help you achieve your

goal? What times might be better than others?

Example: What follows are bits and pieces of a counseling session in which Angie, the counselor

trainee, is helping Meredith, a volunteer client, develop strategies to accomplish one of his goals.

One of Meredith’s problems is that he procrastinates a great deal. He feels that he needs to

manage this problem in his own life if he is to help future clients move from inertia to action.

Therefore, his “good intention” is to reduce the amount of procrastination in his life. In exploring

his problem, he realizes that he puts off many of the assignments he receives in class. The result

is that he is overloaded at the end of the semester, experiences a great deal of stress, does many

of the tasks poorly, and receives lower grades than he is capable of. While his overall goal is to

reduce the total amount of procrastination in his life, his immediate goal is to be up-to-date every

week in all assignments for the counseling course in which he is enrolled. He also wants to finish

the major paper for the course one full week before it is due. He chooses this course as his target

because he finds it the most interesting and has many incentives for doing the work on time. He

presents his list of the strategies he has brainstormed on his own to Angie. After they discussed

the list, their conversation went something like this:

ANGIE: You said that you waste a lot of time. Tell me more about that. MEREDITH: Well, I go

to the library a lot to study. And I go with the best intentions. But I meet friends, we kid around,

and time slips away. I guess the library is not the best place to study.

ANGIE: Does that suggest another strategy? MEREDITH: Yeah, study someplace where

none of my friends is around. But then I might not . . . . ANGIE (interrupting): We’ll evaluate

this later. Right now let’s just add it to the list. (Then later in the dialogue.) ANGIE: I know it’s

your job to manage your own problems, but I assume that you could get help from others and

still stay in charge of yourself. Could anyone help you achieve your goal? MEREDITH: I’ve

been thinking about that. I have one friend. We make a bit of fun of him because he makes sure

he gets everything done on time. He’s not the smartest one of our group, but he gets good grades

because he knows how to study. I’d like to pair up with him in some way, maybe even anticipate

deadlines the way he does. (Then later in the dialogue) ANGIE: Your strategy list sounds good

but a bit tame. Maybe it sounds wild to you because you’re trying to change what you do.

MEREDITH: I guess I could get wilder. Hmmm. I could make a contract with my counseling

prof to get the written assignments in early! That would be wild for me.

Note here that Angie uses probes based on the how, who, what, when, and where probes outlined

above. She also uses the “wilder possibilities” probe. If you were Meredith, how would you react

to Angie? Angie chose to use brainstorming. Critique how she did this. What other approach

might she have taken? Share your thoughts with your two partners. Then, move on to the

exercise.

1. Divide up into groups of three: client, helper, and observer. 2. Decide in which order you will

play these roles. 3. The client will briefly summarize a concern or problem and a specific goal

that, if accomplished, will help him or her manage the problem or develop the unused

opportunity more fully. Make sure that the client states the goal in such a way that it fulfills the

criteria for a viable goal. Video the session.

4. Help the client discuss ways that he or she might go about achieving the goal. Use

brainstorming only if the client seems to be stuck. If the client is stuck, give him or her a few

minutes to write down a few possibilities. If the client does not seem to be stuck, do not use

brainstorming. If you use brainstorming, explain what you are doing and why. Remember to

keep the client in the driver’s seat.

5. If the client is not stuck, simply help him or her discuss possible ways of achieving his or her

goal. Use empathy, probes, and invitations to self-challenge to help the client move forward.

6. At the end of the session, stop and receive feedback from your client and the observer as to the

helpfulness of your empathy, probes, and invitations to self-challenge. Use video in the debrief.

7. Switch roles and repeat the process until each has played all three roles. TASK III-B:

HELP CLIENTS CHOOSE BEST-FIT PROBLEM-MANAGING STRATEGIES “What Actions

Are Best For Me?”

The principle is simple. Strategies for action chosen from a large pool of strategies tend to be

more effective than those chosen from a small pool. However, if brainstorming is successful,

clients are sometimes left with more possibilities than they can handle. Therefore, once clients

have been helped to brainstorm a range of strategies, they might also need help in choosing the

most useful. These exercises are designed to help you help clients choose “best-fit” strategies,

that is, strategies that best fit the resources, style, circumstances, and motivation level of clients.

EXERCISE 11.4: USE CRITERIA TO CHOOSE BEST-FIT STRATEGIES

Just as there are criteria for crafting goals, so are there criteria for choosing best-fit strategies.

The following questions can be asked especially when the client is having difficulty choosing

from among a number of possibilities. These criteria complement rather than take the place of

common sense.

Clarity. Is the strategy clear? Relevance. Is it relevant to my problem situation and goal?

Realism. Is it realistic? Can I do it? Appeal. Does it appeal to me? Values. Is it consistent with

my values? Efficacy. Is it effective enough? Does it have bite? Will it get me there?

Example: Sam, the counselor trainee who wanted to quit smoking, considered the following

possibility on his list: “Cut down gradually, that is, every other day eliminate one cigarette from

the 30 I smoke daily. In two months, I would be free.” Clarity: “This strategy is very clear; I can

actually see the number diminishing.” Relevance: “It leads inevitably to the elimination of my

smoking habit, but only if I stick with it.” Realism: “I could probably pull this off. It would be

like a game; that would keep me at it. But maybe too much like a game. But I know others who

have done it.” Appeal: “Although I like the idea of easing into it, I’m quitting because I now am

personally convinced that smoking is very dangerous for me. I should stop at once.” Values:

“There is something in me that says that I should be able to quit cold turkey. That has more

moral appeal to me. For me there’s something phony about gradually cutting down.”

Effectiveness: “The more I draw this action program out, the more likely I am to give it up.

There are too many pitfalls spread out over a two-month period.”

In summary, Sam says, “I now see that only strategies related to stopping cold turkey have bite.

In fact, stopping is not the hard thing. Not taking smoking up again in the face of temptation,

that’s the real problem.” The above criteria not only helped Sam eliminate all strategies related to

a gradual reduction in smoking, but it helped him redefine his goal to “stopping and staying

stopped.” Sustainability is the real issue. He also noted that the brainstormed strategies he

preferred referred not just to stopping but also to sustainability. For instance, in the short term,

the nicotine-flavored gum would reduce the craving once he has stopped.

1. Read the following case, put yourself in this woman’s shoes, and, like Sam, use the criteria for

determining the viability of the strategy she proposes.

Case: A young woman has been having disagreements with a male friend. Because he is not the

kind of person she wants to marry, her goal is to establish a relationship with him that is less

intimate, for instance, one without sexual relations. She knows that she can be friends with him

but is not sure if he can be just a friend with her. She would rather not lose him as a friend. She

also knows that he sees other women. She uses the above criteria to evaluate the following

strategy: “I’ll call a moratorium on our relationship. I’ll tell him that I don’t want to see him for

four months. After that we will be in a better position to re-establish a different kind of

relationship, if that’s what we want.”

2. Once you have done your analysis, share your findings with a learning partner. See what the

two of you can learn from your differences.

3. Next, review the reasoning that the woman herself went through and her decision. Here, then,

is her analysis:

A brief description of the steps I would take to achieve this second subgoal.

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3. Meet with a learning partner and share your plans. 4. Get and give feedback on the viability of

the plans. What would you change?

EXERCISE 11.11: DEVELOP THE RESOURCES NEEDED TO IMPLEMENT YOUR

PLANS

Plans can be venturesome, but they must also be realistic. Most plans call for resources of one

kind or another. In this exercise, you are asked to review some of the goals you have established

for yourself in previous exercises and the plans you have been formulating to implement these

goals with a view to asking yourself, “What kind of resources do I need to develop to implement

these plans?” For instance, you may lack the kinds of skills needed to implement a program. If

this is a case, the required skills constitute the resources you need.

Goal. Indicate a goal you would like to implement in order to manage some problem situation or

develop some opportunity. Consider the following example. Mark is trying to manage his

physical well-being better. He has headaches that disrupt his life. “Frequency of headaches

reduced” is one of his goals, a major step toward getting into better physical shape. “The severity

of headaches reduced” is another. Plan. Outline a plan to achieve this goal. The plan may call for

resources you may not have or may not have as fully as you would like. Consider Mark once

more. Relaxing both physically and psychologically at times of stress and especially when he

feels the “aura” that indicates a headache is on its way is one strategy for achieving his goal.

Discovering and using the latest drugs to help him control his kind of headache is another part of

his plan. Resources. Indicate the resources you need to develop to implement the plan. For

instance, Mark needs the skills associated with relaxing. Furthermore, since he allows himself to

become the victim of stressful thoughts, he also needs some kind of thought-control skills. He

does not possess either set of skills. Finally, he needs a doctor with whom he can discuss the kind

of headaches he gets and possible drugs available for helping control them. Resources Plan.

Summarize a plan that would enable you to develop some of the resources you need to move

forward. In one program offered through the school, Mark learns the skills of systematic

relaxation and skills related to controlling self-defeating thoughts. The Center for Student

Services refers him to a doctor who specializes in headaches.

Problem situation #1: Your problem-managing or opportunity-developing goal.

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Skills or other resources such as social support you need to accomplish this goal.

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______ Problem situation #2. Your problem-managing or opportunity-developing goal.

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______ _Skills or other resources such as social support you need to accomplish this goal.

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Summarize a plan that can help you develop or get the resources you need.

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Share your goals and your resource-development plans with a learning partner and provide

feedback to each other.