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The Cycle of Caring: a model of expertise in the helping professions.

Publication: Journal of Mental Health Counseling
Publication Date: 01-JAN-05
Format: Online - approximately 4703 words
Delivery: Immediate Online Access
Full Article Title: The Cycle of Caring: a model of expertise in the helping professions.(Special section: master therapists)

Article Excerpt
The core of the helping professions, including counseling, is a relational process, a one-way helping relationship that serves as an incubator for the client's development. In counselor practice, the one-way helping relationship occurs again and again with client after client. The Cycle of Caring--of Empathetic Attachment, Active Involvement, and Felt Separation--describes the continual relational process that summarizes the work of the counselor. Doing the Cycle of Caring proficiently, over and over and over again with each and every client, constitutes a model of expertise.

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The core of the helping professions is the work of the practitioner when he or she makes a series of optimal professional attachments and then separations with people in need. At the heart of these professional attachments is the essential ability to care that must be maintained by the helping professional throughout the process of helping. An inability to care is a dangerous sign of burnout, ineffectiveness, and incompetence.

The Cycle of Caring is a model of expert functioning that describes this continual series of professional attachments and separations, within the one-way helping relationship, that defines professions such as counseling. It is not a static technique applied to one counselor-client dyad. It is rather a dynamic model that takes into account scores of these helping connections. It is the ability to make positive attachments, to provide a relational process, and to do it over and over again that defines mastery.

This model is based on the linking of data from seven sources: work on the relational process of helping, including counseling outcomes and applied attachment theory (Hubble, Duncan, & Miller, 1999; Pistole, 1999; Wampold, 2001); work on normative counselor development (Ronnestad & Skovholt, 2003; Skovholt & McCarthy, 1988; Skovholt & Rivers, 2004; Skovholt & Ronnestad, 1995, 2003); work on master therapists (Skovholt & Jennings, 2004); work on practitioner resilience (Baker, 2003; Skovholt, 2001); learning from students during 30 years of teaching practice-focused courses; being an examiner for 45 exams for board certification in counseling psychology; and functioning as a practitioner and supervisor for many years while also learning from other practitioners at work.

SPECIFIC RESEARCH SUPPORT FOR THE RELATIONAL PROCESS

Outcome Research

The outcome evidence in counseling and related fields overwhelmingly concludes that the relational process is a key element (Wampold, 2001). It is difficult to come to this conclusion because process is such a nebulous idea and does not have the concreteness of a specific technique or method. To say the work is to engage in a relational process seems to be saying that anyone can do the work. Listening has the same problem. How can there be anything professional about a common human behavior like listening? Conversely, how can there be anything special about providing a series of relationships in which the goal is to cultivate human potential? Yet, the "quality of the counseling relationship has consistently been found to have the most significant impact on successful client outcome" (Sexton & Whiston, 1994, p. 6). Thus, how the counselor does the relational process is important. As Wampold wrote, "the particular treatment that the therapist delivers does not affect outcomes ... therapists within treatment account for a large proportion of the variance" (p. 202) in therapy outcome.

In a study of master therapists (Jennings & Skovholt, 1999; Skovholt & Jennings, 2004), three domains were identified that had been integrated to produce the highly functioning self. These domains--cognitive, emotional, and relational--provide a portrait of the many areas of functioning that are inherent to effective practitioner development. Cognitive characteristics include an ability to flexibly embrace complex ambiguity, accumulate wisdom, understand the human condition, and make learning a lifelong adventure. Emotional characteristics include an acceptance of self, genuine humility, self-awareness, a willingness to grow and gain competence, a passion for life, quiet strength, and an appreciation for life in the moment. Relational characteristics include the ability to intensively engage with others, keen interpersonal perception, being led by the well-being of the client, expressing compassion within limits, making accurate judgments, and remaining open to learning from others. These characteristics join together to make it possible for these masters to engage in the relational process repeatedly without losing themselves in the process.

One view of positive outcome focuses on...



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