Being responsive to what clients ask for directly and tailoring services to their current needs and level of readiness is central to operationalising a client-centred orientation to practice. Researchers and commentators on service provision for hard to reach populations have emphasised the importance of ‘providing services that clients want’ in making services accessible (Statham, 2004). Particularly in the early stages of engagement, this generally involves providing support through crises, meeting basic needs, primary medical care, and other forms of practical assistance (Barry et al., 2002; Holmes et al., 2005; Klee & Reid, 1998; Statham, 2004).
Many youth AOD practitioners place very strong value on their ability to be responsive to the needs that young people present with on any particular day. This often involves responding to crises and providing for basic needs but our commitment to responsiveness goes deeper than this, reaching into the interpersonal interactions between young people and staff members. At the interpersonal level, responsiveness requires staff to be present with young people, focused on the quality and content of interaction, have an ability to make accurate empathic assessments of need, and the capacity to formulate appropriate responses. This orientation yields a readiness to provide appropriate therapeutic interventions in a timely manner when natural opportunities arise.
This practice is consistent with Geldard and Geldard’s view of proactive counselling for adolescents. They point out that adults generally cope well with structured sessions in which the counsellor stays within the well-defined boundaries of a quiet listener. In contrast adolescents are often restless and uncertain when involved in counseling. They quickly become impatient and bored, so the counselling relationship needs to be dynamic and actively engaging. “It is essential to proactive counselling that the counsellor should be active, lively, spontaneous and creative. Most importantly, the counselor needs to be quick, flexible and opportunistic. This means responding quickly and actively through the selection and use of appropriate skills and strategies, so that opportunities are not lost” (Geldard & Geldard, 2004; p.77).
Another aspect of the orientation to responsiveness is based on the commitment to empowerment and self-determination. A responsive stance provides space and encouragement for young people to take responsibility for identifying and expressing their own needs and wishes, and driving their own development process. This response involves making sure that young people know the practitioner is available, providing information about options, and helping them to think through their issues. There is a large body of evidence that in any therapeutic process it is the client, and not the therapist, who is the primary driver of change (Hubble et al., 1999). Acknowledging this fact, our responsive stance is consistent with Hubble et al’s view that effective therapy works by enabling the mobilisation and application of clients’ own resources. Providers should seek to support the agency of the client by acting as consultants and relying more heavily on client creativity.
This aspect of responsiveness provides another pointer to the subtle balance and tension between being responsive and proactive. Higher order intentions such as empowering the young person, and specific potential objectives such as safer management of drug use – are always at play – but the strategy of responsiveness is one of the instruments used to pro-actively work towards these higher order objectives. On the surface, being responsive and proactive may seem contradictory and incompatible but they can actually work in a synergistic manner. Achieving one without sacrificing the other requires a high degree of consciousness on the part of practitioners about our higher order intentions or objectives. Being responsive often requires a conscious effort to put some higher order intentions to one side, but maintaining an awareness of them ensures they are not lost and forgotten in the pressure of responding to immediate demands. Bruun and Hynan (2006) describe this as ‘keeping one eye on the present and another on the path’.
The nature of this balance between responsivity and proactivity is made clearer by contrast with alternative models in which the practitioner adopts a clearly pro-active stance. Hubble, Duncan and Miller (1999) point to the medical model of therapy in which the therapist is seen as the expert who diagnoses the nature of the client’s problem and then prescribes a particular standardised treatment for that problem. They argue that this model leaves little room for mobilisation of clients’ own thinking-exploring-experiencing process that is so vital to their capacity for ongoing change and development.
A commitment to responsiveness operates at multiple levels throughout an organisation. At the level of teams, responsiveness includes an ability to respond promptly to new referrals and provide appropriate responses to the diversity of needs presented. This requires pooling of knowledge and sharing of expertise across team members. Achieving this requires a pro-active approach to ensuring capacity is maintained. Managers have a responsibility to make sure staff are safe and adequately supported. This sometimes requires recognition of the limits of our capacity to respond to all the needs presented by young people.