Volume 24, Issue 6: December, 1997

Abstract

DEVELOPING EFFECTIVE HELPING RELATIONSHIPS IN HEALTH EDUCATION PRACTICE

Michelle van Ryn, Ph.D., M.P.H.
Catherine A. Heaney, Ph.D., M.P.H.

All correspondence should be sent to: Michelle van Ryn, Department of Health Policy, Management, and Behavior, Room 183, One University Place, School of Public Health, University at Albany, Rensselaer, New York 12144-3456; e-mail: MVR01@albnydh2.health.state.ny.us.

Health educators who interact directly with the people they serve must be able to establish effective interpersonal relationships. Helping relationships are effective if they facilitate clients' progress toward health-promoting goals. Health educators are usually well versed in learning activities and spend a significant proportion of their professional time planning for and engaging in interpersonal interactions. However, many health educators have never received explicit training in how to relate to clients, that is, how to establish effective interpersonal relationships within the context of formal helping relationships. Extensive research on social influence processes has provided a rich set of empirical findings that suggest specific interpersonal behaviors that are most likely to maximize the effectiveness of formal helping relationships. Evidence from this literature suggests that formal helping relationships characterized by interpersonal behaviors that enhance client self-esteem and feelings of control are most effective in helping clients achieve specific behavior goals. Interestingly, enhancement of self-esteem and feelings of control are consistent with many definitions of personal empowerment. Since the social influence and empowerment literatures come from very different intellectual roots and have different approaches to the definition of and use of power, their convergence is especially notable. These literatures combine to establish the conceptual and empirical bases for proposing two essential components of effective helping relationships at all levels of practice: (1) providing unconditional acceptance and positive regard for clients, and (2) sharing power and control through participatory processes.