Six Categoriesof Interventions

Mark Stancombe, Psychotherapist & Counsellormstancombe@move-forward.org

Why is This Relevant• Because when we are with a client it is imperative to understand

how we are interacting with them

• Because we need to understand how we are received/experienced

• Because we need to understand ourselves so that we can understand our client [“how am I experienced?”]

• Because understanding empowers us in the therapeutic relationship

• Because how we deliver ‘help’ determines success & impacts the relationship we are building with the client

• Because NOT ALL INTERVENTIONS ARE SUPPORTIVE*

* let’s choose carefully then

Just A Thought…

If the idea of categories seems a little technical or

impersonal [after-all, we are looking at people in a

relationship] then replace the word with ‘style’ instead..

The six styles of interventions………

Heron’s Approach…• A conceptual framework for understanding

interpersonal relationships

• A means of analysing a range of possible therapeutic interactions between a client & their helper

“ An intervention* is an identifiable piece of verbal and/or non-verbal behaviour that is part of the practitioner’s service to the client ”

Heron 2001

IMPORTANT: Emphasis is on what the practitioner intended to achieve in the interaction/intervention rather than on the actual effect

* How many interventions can you name..?

The 6 Styles Explained• Two Fundamental Styles - Authoritative and Facilitative. These sub-

divide into six styles

Authoritative

Therapist is giving information, challenging the other person or suggesting what the other person should do – We can say that the therapist is taking a more assertive/dominant role, taking responsibility for and on behalf of the client

Facilitative

Therapist is drawing out ideas, solutions, self-confidence, and so on, from the client that can help them to reach their own solutions or decisions. The therapist is seeking to enable the client to become more autonomous and take more self-responsibility

Authoritative• Prescriptive

Explicitly direct the client by giving advice and direction

• Informative

Provide information to instruct and guide the client

• Confronting

Challenge* the client’s behaviour or attitude

* not aggressive. Positive & constructive. Helping client see behaviour they have been unaware of

Authoritative

Facilitative• Cathartic

helping the client to express/overcome thoughts or emotions that they have not previously confronted

• Catalytic

help the client reflect, discover and learn for them-self. Towards self-actualisation. Self-reflection, self-direction, self-awareness

• Supportive

build up the confidence of the client by focusing on their competences, qualities and achievements

Facilitative

6 Degenerate StylesDEGENERATE: An inappropriate intervention which is delivered in a misguided manner. Ineffective / Potentially Harmful Interventions

“ Degenerate interventions are rooted in lack of awareness, in lack of experience, lack of personal growth, lack of training “

Heron 2001

Types Of Degenerate• Unsolicited

Formal relationship hasn’t been established and proceeds without the client’s consent

Intervention is overly intrusive or disrespectful despite the relationship having been established

• Manipulative

Inappropriate interventions motivated by self-interest or any interest other than those of the client

Being in control is most obvious. Where the therapist always wants to lead and never follow the client

Types Of Degenerate• Compulsive

Therapist projects their own unresolved psychological problems onto the client during the intervention. Could involve inappropriately attacking the client, colluding with the client or overlooking important aspects of the client’s welfare

• Unskilled

Incompetent interventions caused because the therapist has never had appropriate training and so has no grasp of the quality, scope or suitability of their intervention

Authoritative Degenerate• Prescriptive Degeneration: -

* Benevolent take-over

Creating dependency by giving advice to an insecure client who needs encouragement to be self-directing

* Moralistic Oppression

Creating rebelliousness by imposing authoritarian ‘shoulds’ ‘oughts’ ‘musts’ on a client who might appreciate the rationale but feels emotionally compelled to reject the way in which it is presented

• Informative Degeneration: -

* Seductive Over-teach

Excessive information giving such that the client is seduced into passivity and away from self-directed learning * Oppressive Over-teach

Therapist goes-on too long, giving out too much information, insensitive to any evidence of the client becoming fatigued or needing to contribute. The client is held back from self-direction

Authoritative Degenerate

• Confronting Degeneration: -

* Sledgehammer

Therapist raises issues aggressively, displacing their own anxiety into a punitive attack on the client rather than on the client’s attitude or behaviour * Smiling Demolition

Therapist says hurtful things to the client in a smiling, friendly or jocular way. The feedback is indirect, therefore, confusing to the client who may deny hurting badly

Authoritative Degenerate

Facilitative Degenerate• Cathartic Degeneration: -

* Encouraging Dramatisation

Therapist mistakes dramatisation for catharsis then colludes and encourages the client to act out in disruptive and destructive ways. The drama that created the original hurt is re-enacted rather than the release of harmful emotions

* Nut Cracking [too deep too soon]

Therapist takes the client’s defences by storm & makes a steep intervention into deeply buried stress, which the client isn’t ready to handle. This can cause the client to defend more intensely or dramatise in an uncontrolled way

Facilitative Degenerate• Catalytic Degeneration: -

* Implicit Take-Over [compulsive search for order]

Therapist unwarily imposes meaning & order onto the client’s story. The catalytic intervention centres on the practitioners’ search for meaning & not the client

* Scraping The Bowl

The therapist, with discreet compulsion goes beyond productive enabling & tries to enable the client to find more to talk about in the same area. Therapist becomes a Ferret

Facilitative Degenerate• Supportive Degeneration: -

* Moral Patronage [or ‘your character is coming along nicely’]

Therapist handles the anxiety associated with true caring & sharing by climbing into the pulpit to congratulate the client on their self-improvement. Result is client feeling subtly insulted & put down

* Qualified Support

Therapist can only give support if at the same time the client is reminded of their inadequacy in some respect

6 Perverted StylesPerverted: -

An inappropriate intervention which is deliberately malicious & intentionally seeks to do harm to the client. It can leave a client disabled, disadvantaged and in distress. A perverted intervention damages!

Authoritative Perverted• Perverted Prescription: -

“The deliberate use of force, threat, pain, compulsion in constraining a person to act against that persons’ needs and interests”

Heron 2001

• Perverted Information

“The deliberate use of misrepresentation, lies, calumny and slander to harm the person about whom they are put forth, or to whom they are addressed”

Heron 2001

Authoritative Perverted• Perverted Confrontation: -

“Deliberate, punitive psychological attack on a person to wound and incapacitate him or her emotionally. Torturing a person to tell the truth or to confess to things never said or done”

Heron 2001

Facilitative Perverted• Perverted catharsis: -

“Deliberately producing cathartic collapse and disintegration through subjecting a person to extreme mental and physical stress and pain. The disintegrated person may then be re-integrated in terms of imposed suggestions and indoctrination”

Heron 2001

• Perverted Catalysis

“Deliberate and malicious seduction. Both in the sexual and in the wider sense; intentionally leading a person on to his or her own undoing by eliciting self-indulgent and self-destructive tendencies”

Heron 2001

Facilitative Perverted• Perverted Support: -

“Affirming, supporting or encouraging the weak, distorted and corrupted behaviour of a person”

Heron 2001