Direct Services
Human Services professionals are in the business of supporting, encouraging, serving, and advocating for clients. This concept of direct services is one I’ve carried with me since I was a young child. Through all the different phases of occupations I wanted “when I grew up,” there was always the same theme: Helping. The heart and passion of the Human Services field lies with directly impacting clients, whether it’s through intervention, prevention, counseling, referrals, or other forms of change.
The dichotomy of indirect and direct services works together in power and love (Kahane, 2010) to establish a strong foundation for clients. The systems-change mentality and administration of programs needs to support the daily occurrences that clients experience in a program. Indirect services cannot exist without direct, and direct services will not be adequate without indirect. It is so critical to grasp this reality so clients can be served with the utmost efficiency.
My previous direct services with people ranged from leading youth groups, counseling at Bible camp, working with children in various settings, and caregiving for people with developmental and physical disabilities. As I moved through the Human Services curriculum, I became enlightened to the vast knowledge and theory available to guide the practice of direct service. Not only is building rapport, setting boundaries, dealing effectively with conflict, and confidentiality important, but also recognizing every client is an individual and has a story to tell (CSHSE, 2009, Standard 14: Information Management, Standard 16: Interventions, & Standard 17: Interpersonal Communication). Best practices guide the direct service work, but it is of utmost importance to keep client-centered amidst the protocol.
Direct service looks different in every organization, because of the various systems influencing practice. The individual receiving services may be in a one-on-one or group setting, with people who may have similar or very different backgrounds (CSHSE, 2009, Standard 12: Human Systems). In a one-on-one counseling session, a client may experience various intervention models, including, but not limited to: medical, social, mental health, medical/social, wrap-around, individually tailored services, or strength-based (Summers, 2009; HSP 345 Final Paper).
Group facilitations may also be an effective model of change for clients. In a group setting, the dynamics between individuals can often spur different learning. For example, during HSP 305, HS Professionals and Small Group Systems, we had the opportunity to work in a small group of ten for the duration of the quarter. Each person had the chance to facilitate the discussions we held, and learned active listening skills. It was also important to cultivate the skill of asking the collective whole what direction the group wanted to follow in order to build consensus. It was valuable for the individuals in the group to hear other people’s ideas and build on each other in order to accomplish our final presentation (HSP 305 Group Process Paper).
Beyond the systems of individual counseling and group facilitation, all direct services are influenced by laws at the local, state, and national levels (CSHSE, 2009, Standard 12: Human Systems). When policy and laws are altered, programs change, and clients are ultimately affected. I was able to experience this process directly in HSP 404, HS Professionals and Community Systems, as we had the opportunity to lobby in Olympia for bills that affect specific populations. (HSP 404 Legislative Reflection). All levels of systems are connected, and individuals will always be connected to the larger systemic decisions made.
Even when direct service is impacted by policy, clients are still served in whatever ways the organization can manage. Agencies must have a system of information management in order to function effectively (CSHSE, 2009, Standard 14: Information Management). Again, this system may look differently according to the specific organization, however, there often are overlapping methods in obtaining information. When clients initially encounter assistance, often, there will be some type of intake interview that gathers basic data, followed by some kind of needs assessment. This process of interviewing a client to understand their story requires not only interpersonal communication skills, but also a background in the concept of informed consent (CSHSE, 2009, Standard 17: Interpersonal Communication; HSP 325 Interview Paper). Through HSP 325, Interviewing for Human Services, I was able to practice informed consent with the individual I interviewed from Cascade Vocational Services. I told him the timeframe we had, who I was, the freedom he had to stop the interview at any point; and everything he said would be confidential unless there is a concern that he might hurt himself or others (CSHSE, 2009, Standard 14: Information Management).
During my first internship at Dorothy Place, I was able to see firsthand the information and case management process from my supervisor. The Opportunity Council uses the HMIS System to keep all of their clients organized. These files contain all confidential material that will not leave the office and is only accessed by staff members (CSHSE, 2009, Standard 21: Field Experience, HSP 341 Summative Observation and Reflection Paper). In the same way, during the Life Book project in HSP 315, Human Development and Human Services, we had the opportunity to see the DCFS case files in their current information system.
A crucial aspect of direct service is the intervention process (CSHSE, 2009, Standard 16: Interventions). As previously mentioned, there are many models of intervention used within Human Services. Within the HSP 325, Interviewing for Human Services course, we studied different motivational interviewing techniques. It is important to actively listen for “change talk” (Sommers & Flanagan, 2009). When a client is expressing a desire to change a behavior, there are ways to build on that realization and continue to support self-determination with the client (CSHSE, 2009, Standard 17: Interpersonal Communication; Standard 19: Client-Related Values and Attitudes). In a similar way, the strength-based model of intervention is often used in Human Services settings. In HSP 345, Case Management and Interventions, we focused on drawing out an individual’s strengths and building from that foundation. Rather than always finding a need and filling someone’s problem, looking at someone’s assets can help re-frame the goals set (Deutschman, 2007; HSP 345 Final Paper). During the case study assignments in HSP 315, Human Development and Human Services, I had a chance to look at the fictional Barton family’s strengths and make recommendations for services to help support them (HSP 315 Case Study #1).
While I interned at Dorothy Place, I had the opportunity of sitting in on a couple different home visits with residents. It was enlightening to see the strength-based model at work while the case manager would talk through the different goals the resident had accomplished. The different residents were able to take pride in their progress and continue to look forward to how their strengths would be used in the next set of goals (CSHSE, 2009, Standard 21: Field Experience; HSP 341 Summative Observation and Reflection Paper).
Direct service is laced together with the skill of interpersonal communication (CSHSE, 2009, Standard 17: Interpersonal Communication). In the beginning process of working with a client, it is so crucial to spend time building rapport (HSP 325 Interview Paper). When the relationship is built on a foundation of understanding and caring for the client, they are able to own their choices, power, and decisions in life. Part of understanding a client is getting to know their background and history. Everyone has a different story and comes from unique and diverse situation. In HSP 455, Diversity and Social Justice Dynamics, we were able to explore our own heritage backgrounds in order to help understand ourselves better (HSP 455 Heritage Paper). It may be beneficial to explore a client’s heritage and history to help build a bridge of understanding.
Along with building rapport, another important part of interpersonal communication is dealing effectively with conflict (CSHSE, 2009, Standard 17: Interpersonal Communication). There are different strategies to work with clients who are experiencing frustration. In HSP 325, Interviewing for Human Services, we talked about drawing out ambivalence and rolling with resistance. If a client is feeling a certain way, but seems to have some indication they aren’t satisfied with that conclusion, re-phrasing their ambivalence may guide the conversation in a new direction. Rolling with resistance is another strategy that will allow the client to express their feelings without being told “what to do.”
There was an instance at my internship with Dorothy Place where one of the kids during Children’s Program was not following the expectations set for the group time. I spent a few minutes talking to him outside of the room, and encouraged him to change his behavior in order to join the group. He decided he’d rather go home, so we brought him back to his mom and let him try again the next week. It was hard to see him leave, but it was beneficial to roll with resistance, and let him make his own choice (CSHSE, 2009, Standard 21: Field Experience).
Engaging in direct service is no easy task. However, with best practices to follow and the desire to actively listen to an individual’s story, the process will continually become more natural. Building rapport, maintaining confidentiality, working within conflict, and creating boundaries will all become second nature. I now have confidence in my foundation in theory, knowledge, and skills in order to effectively practice direct services as a Human Services professional.
References
Council for Standards in Human Service Education (CSHSE). (2009).
CSHSE national standards for human services education. Available from:
http://www.cshse.org.standards.html
Deutschman, A. (2007). Change or die: Could you change when change matters most?
New York, NY: HarperCollins.
Kahane, A. (2010). Power and love: A theory and practice of social change.
San Francisco, CA: Berrett-Koehler.
Sommers-Flanagan, J. & Sommers-Flanagan, R. (2008). Clinical interviewing (4th ed.). New
York, NY: John Wiley & Sons.
Summers, N. (2009). Fundamentals of case management practice: Skills for the
human services. Belmont, CA: Brooks/Cole.
Human Services professionals are in the business of supporting, encouraging, serving, and advocating for clients. This concept of direct services is one I’ve carried with me since I was a young child. Through all the different phases of occupations I wanted “when I grew up,” there was always the same theme: Helping. The heart and passion of the Human Services field lies with directly impacting clients, whether it’s through intervention, prevention, counseling, referrals, or other forms of change.
The dichotomy of indirect and direct services works together in power and love (Kahane, 2010) to establish a strong foundation for clients. The systems-change mentality and administration of programs needs to support the daily occurrences that clients experience in a program. Indirect services cannot exist without direct, and direct services will not be adequate without indirect. It is so critical to grasp this reality so clients can be served with the utmost efficiency.
My previous direct services with people ranged from leading youth groups, counseling at Bible camp, working with children in various settings, and caregiving for people with developmental and physical disabilities. As I moved through the Human Services curriculum, I became enlightened to the vast knowledge and theory available to guide the practice of direct service. Not only is building rapport, setting boundaries, dealing effectively with conflict, and confidentiality important, but also recognizing every client is an individual and has a story to tell (CSHSE, 2009, Standard 14: Information Management, Standard 16: Interventions, & Standard 17: Interpersonal Communication). Best practices guide the direct service work, but it is of utmost importance to keep client-centered amidst the protocol.
Direct service looks different in every organization, because of the various systems influencing practice. The individual receiving services may be in a one-on-one or group setting, with people who may have similar or very different backgrounds (CSHSE, 2009, Standard 12: Human Systems). In a one-on-one counseling session, a client may experience various intervention models, including, but not limited to: medical, social, mental health, medical/social, wrap-around, individually tailored services, or strength-based (Summers, 2009; HSP 345 Final Paper).
Group facilitations may also be an effective model of change for clients. In a group setting, the dynamics between individuals can often spur different learning. For example, during HSP 305, HS Professionals and Small Group Systems, we had the opportunity to work in a small group of ten for the duration of the quarter. Each person had the chance to facilitate the discussions we held, and learned active listening skills. It was also important to cultivate the skill of asking the collective whole what direction the group wanted to follow in order to build consensus. It was valuable for the individuals in the group to hear other people’s ideas and build on each other in order to accomplish our final presentation (HSP 305 Group Process Paper).
Beyond the systems of individual counseling and group facilitation, all direct services are influenced by laws at the local, state, and national levels (CSHSE, 2009, Standard 12: Human Systems). When policy and laws are altered, programs change, and clients are ultimately affected. I was able to experience this process directly in HSP 404, HS Professionals and Community Systems, as we had the opportunity to lobby in Olympia for bills that affect specific populations. (HSP 404 Legislative Reflection). All levels of systems are connected, and individuals will always be connected to the larger systemic decisions made.
Even when direct service is impacted by policy, clients are still served in whatever ways the organization can manage. Agencies must have a system of information management in order to function effectively (CSHSE, 2009, Standard 14: Information Management). Again, this system may look differently according to the specific organization, however, there often are overlapping methods in obtaining information. When clients initially encounter assistance, often, there will be some type of intake interview that gathers basic data, followed by some kind of needs assessment. This process of interviewing a client to understand their story requires not only interpersonal communication skills, but also a background in the concept of informed consent (CSHSE, 2009, Standard 17: Interpersonal Communication; HSP 325 Interview Paper). Through HSP 325, Interviewing for Human Services, I was able to practice informed consent with the individual I interviewed from Cascade Vocational Services. I told him the timeframe we had, who I was, the freedom he had to stop the interview at any point; and everything he said would be confidential unless there is a concern that he might hurt himself or others (CSHSE, 2009, Standard 14: Information Management).
During my first internship at Dorothy Place, I was able to see firsthand the information and case management process from my supervisor. The Opportunity Council uses the HMIS System to keep all of their clients organized. These files contain all confidential material that will not leave the office and is only accessed by staff members (CSHSE, 2009, Standard 21: Field Experience, HSP 341 Summative Observation and Reflection Paper). In the same way, during the Life Book project in HSP 315, Human Development and Human Services, we had the opportunity to see the DCFS case files in their current information system.
A crucial aspect of direct service is the intervention process (CSHSE, 2009, Standard 16: Interventions). As previously mentioned, there are many models of intervention used within Human Services. Within the HSP 325, Interviewing for Human Services course, we studied different motivational interviewing techniques. It is important to actively listen for “change talk” (Sommers & Flanagan, 2009). When a client is expressing a desire to change a behavior, there are ways to build on that realization and continue to support self-determination with the client (CSHSE, 2009, Standard 17: Interpersonal Communication; Standard 19: Client-Related Values and Attitudes). In a similar way, the strength-based model of intervention is often used in Human Services settings. In HSP 345, Case Management and Interventions, we focused on drawing out an individual’s strengths and building from that foundation. Rather than always finding a need and filling someone’s problem, looking at someone’s assets can help re-frame the goals set (Deutschman, 2007; HSP 345 Final Paper). During the case study assignments in HSP 315, Human Development and Human Services, I had a chance to look at the fictional Barton family’s strengths and make recommendations for services to help support them (HSP 315 Case Study #1).
While I interned at Dorothy Place, I had the opportunity of sitting in on a couple different home visits with residents. It was enlightening to see the strength-based model at work while the case manager would talk through the different goals the resident had accomplished. The different residents were able to take pride in their progress and continue to look forward to how their strengths would be used in the next set of goals (CSHSE, 2009, Standard 21: Field Experience; HSP 341 Summative Observation and Reflection Paper).
Direct service is laced together with the skill of interpersonal communication (CSHSE, 2009, Standard 17: Interpersonal Communication). In the beginning process of working with a client, it is so crucial to spend time building rapport (HSP 325 Interview Paper). When the relationship is built on a foundation of understanding and caring for the client, they are able to own their choices, power, and decisions in life. Part of understanding a client is getting to know their background and history. Everyone has a different story and comes from unique and diverse situation. In HSP 455, Diversity and Social Justice Dynamics, we were able to explore our own heritage backgrounds in order to help understand ourselves better (HSP 455 Heritage Paper). It may be beneficial to explore a client’s heritage and history to help build a bridge of understanding.
Along with building rapport, another important part of interpersonal communication is dealing effectively with conflict (CSHSE, 2009, Standard 17: Interpersonal Communication). There are different strategies to work with clients who are experiencing frustration. In HSP 325, Interviewing for Human Services, we talked about drawing out ambivalence and rolling with resistance. If a client is feeling a certain way, but seems to have some indication they aren’t satisfied with that conclusion, re-phrasing their ambivalence may guide the conversation in a new direction. Rolling with resistance is another strategy that will allow the client to express their feelings without being told “what to do.”
There was an instance at my internship with Dorothy Place where one of the kids during Children’s Program was not following the expectations set for the group time. I spent a few minutes talking to him outside of the room, and encouraged him to change his behavior in order to join the group. He decided he’d rather go home, so we brought him back to his mom and let him try again the next week. It was hard to see him leave, but it was beneficial to roll with resistance, and let him make his own choice (CSHSE, 2009, Standard 21: Field Experience).
Engaging in direct service is no easy task. However, with best practices to follow and the desire to actively listen to an individual’s story, the process will continually become more natural. Building rapport, maintaining confidentiality, working within conflict, and creating boundaries will all become second nature. I now have confidence in my foundation in theory, knowledge, and skills in order to effectively practice direct services as a Human Services professional.
References
Council for Standards in Human Service Education (CSHSE). (2009).
CSHSE national standards for human services education. Available from:
http://www.cshse.org.standards.html
Deutschman, A. (2007). Change or die: Could you change when change matters most?
New York, NY: HarperCollins.
Kahane, A. (2010). Power and love: A theory and practice of social change.
San Francisco, CA: Berrett-Koehler.
Sommers-Flanagan, J. & Sommers-Flanagan, R. (2008). Clinical interviewing (4th ed.). New
York, NY: John Wiley & Sons.
Summers, N. (2009). Fundamentals of case management practice: Skills for the
human services. Belmont, CA: Brooks/Cole.