Lay mental health counseling: prospects and problems.

Reviews of training and treatment programs employing lay per sonnel as " helpers" yield provocati ve findings. While there now are numerous nonprofession al training programs, only a few have system atically assessed their effects in terms of therapeutic process variables, and fewer still have pr esented systematic compa risons of the differential effects of lay and professional training (4, 5). An analysis of the training programs in the few directly comparable studies indicates that following training, lay trainees function at levels as high or higher th an professional trainees on dimensions of facilitative interpersonal functioning (empathy, respect, genuineness, concreteness, self-disclosure) tha t have been found to be rela ted to a variety of construc tive client-change indices (6, 17). In addition, lay trainees engage clients in th erapuetic process movement (depth of self-explorat ion, immediacy of experiencing, problem expression) as much or more than do pro fessional trainees (2, 3, 6, 7, 8, 12, 14). Similarly, although ongoing treatment programs are of necessity much more numerous than the training programs, few have systematically assessed th eir effects, and fewer still have compared the differential effectiven ess of lay and professional treatment . However, in dir ectly comparable studies of treatment, with both inpatients and ou tpatients, lay persons have patients who demonstrate change as great or greater than the patients of professional practitioners (1, 10, II, 13, IS, 16, 18). At a minimum, then, lay per sonnel are as effective as the products of our tradi tional training programs. At a maximum, under many circumstances th ey are more effecti ve than professional practitioners. These findings will be briefly summarized with regard to training and to treatment, and prospects and problem s will be pres en ted.