by William Van Ornum, Ph.D. on
Sandy Sheller, coordinator of the Salvation Army of Greater Philadelphia, tells of a client who wouldn’t go for treatment at a drug-treatment center. Her case worker simply labeled her as resistant and noncompliant, and closed the case.
When Sheller worked with this client, she asked in s caring manner why it was that the client was unable to get to the meetings. The client said it was because of her fears about the new and lengthy bus trips. The client, like many of us, had a hard time starting something which provoked anxiety. The client told Sheller it would be a great aid if Sheller could help her get on the bus in the morning. This in the field intervention worked, and was more effective than weeks of counseling about her “fear of getting on the bus on the new bus route.”
Sheller’s observations recall similar types of interventions in other mental health professions: behavior therapists helping someone proceed over a bridge, family therapists making a home visit, or child-care workers talking to an upset young person in a hallway. All of these counselors know the wisdom of working beyond the office walls.
This approach has proved effective when working with homeless persons in Salvation Army.
Sheller reports that being present with these persons, and talking to them at various points and times in the shelter, fosters trust. When this occurs, clients speak more openly about some of their traumatic past events, which are often associated with why they are in the shelter.
Concrete actions and fulfilled promises are essential to counseling in these settings: “Much of our convincing,” says Sheller, “will not be in words but rather in our deeds”
The highly recommended full article may be read at