Social work students’ experiences of using the Egan Skilled Helper model

Social work students’ experiences

of using the Egan Skilled Helper
model
Sally Riggall1
Abstract: This paper aims to assess the value of the Egan Skilled Helper model
in helping social workers in training to develop their communication skills with
service users. The model was taught to first year BSc Social Work students.
During their subsequent first assessed practice placement fifteen volunteers
participated in focus groups. Here they discussed how useful the Egan model
was as a communication and problem management tool for working with service
users. A key finding is that students were able to transfer their skills learning into
practice. Further findings are that students improved their communication skills
and were better able to place service users at the centre of decision making. The
implications of these findings for social work training are discussed together with
some of the challenges of working with the model.

Key Words: communication skills; Egan model; service user empowerment; social
work; teaching and learning.

1. Senior Lecturer, School of Health and Social Care, Universit of Lincoln

Address for correspondence: School of Health and Social Care, Faculty of Health,
Life and Social Sciences, University of Lincoln, Brayford Pool, Lincoln, LN6 7TS.
sriggall@lincoln.ac.uk

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 Sally Riggall

Introduction
This paper examines how learning the Egan Skilled Helper model equips
BSc Social Work students with effective communication skills which
place service users at the centre of the helping process. An additional
aim is to find out whether this learning can be transferred into practice.
Helping students to develop effective, empathic communication skills
is an established tradition within social work teaching programmes.
However, there is little research which explores the process and effect
of teaching and learning in terms of communication skills and their
theoretical base. Trevithick et al. (2004) undertook for the Social Care
Institute for Excellence a knowledge review of teaching and learning
of communication skills in social work education. In their review
Trevithick et al. found that out of 8023 relevant papers only 16 addressed
a theoretical underpinning to communication skills development. No
papers were identified that commented on students’ experience of
different communication models or their preferences. Trevithick et al.
(2004) found there was little evidence of evaluation of underpinning
knowledge being carried out and even less consideration relating to how
successful the transfer of learning is into practice. Trevithick et al. argue
that skills learning needs to be based on a proven knowledge base that
is relevant to social work and that skills learned should be integrated
into practice learning. The Social Work Taskforce Report (2010 p. 21)
emphasises the importance of social workers being able to work in a
person-centred manner ‘to support people to manage their own affairs
where possible and to assist in finding solutions which balance choice
and control for the individual.’
Social work students commonly and mistakenly believe their role is
to tell service users what to do. The Skilled Helper model, developed
by Gerard Egan, was chosen for this study because it specifically
addresses this values issue. The model helps students to enable service
users to take responsibility for their own decision making. The three-
stage model is complex and cumulative in its development of skills. It
emphasises the importance of developing empathic relationships with
service users, describes how to encourage people to talk about their lives
and to establish exactly what their needs are. Solutions to problems are
then sought together. Egan refers throughout his work to ‘clients’ rather
than ‘service users’ and this paper uses these terms interchangeably.
The overall project has been influenced by a number of papers
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 Social work students’ experiences of using the Egan Skilled Helper model

which investigate social workers’ use of empathy and the teaching of

communication skills. Forrester et al. (2008 p. 41-51) highlighted the
importance of empathic responding skills in social work and especially
in forming good working relationships with service users and their
families. Their findings established that social workers who were skilled
in using empathic responses encouraged parents to be much more open
about what was happening in their families than social workers who
lacked these skills. Forrester et al. commented that most social workers
did not use empathy and reflection or summarising skills, favouring
instead interventions which consisted in the main of a series of closed
questions. They found that questions outnumbered complex empathic
reflections by more than fifteen to one. Complex reflections are where
information, feelings, behaviours and thoughts from input other than
the immediately preceding sentence from the client is reflected back.
These were rarely used. Forrester et al. emphasised the importance of
raising concerns in a climate which highlights to service users their
existing strengths, a factor which is seldom prioritised by social workers.
The authors found a relationship between the use of complex reflections
and increased client disclosure. They concluded that raising concerns
in an empathic manner would increase social workers’ likelihood of
keeping and maintaining their relationship with both the parent and
child.
The importance of empathic responding is also highlighted in a
survey of communications skills teaching undertaken by Dinham et al.
(2003) who stressed the importance of understanding the problems of
service users. The authors also emphasised the essentiality of a coherent
knowledge framework to underpin skills teaching and learning. They
indicate that the framework should have a well established base of
values and principles that encompass service user empowerment,
i.e. working with service users to produce agreed outcomes. In their
work with children with disabilities, Woodcock and Tregaskis (2008)
highlighted the need for social workers in training to develop active
listening skills which help parents to express their feelings of anger and
frustration in a safe and non-judgemental environment. The authors
focused on the finding from Trevithick et al. (2004) which established
the centrality of communications skills teaching within the social work
degree. Woodcock and Tregaskis agreed with Trevithick that a lack of
an underpinning knowledge base when teaching communications skills
was a serious omission and if this was addressed, it would enable skills
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 Sally Riggall

to be applied more easily in different settings. This point was also raised
by Moss et al. (2007:711) whose research found that ‘communication
skills have been taught but not reflected upon; experienced but not
theorised.’
The Egan Skilled Helper model provides an underpinning framework
which provides structure for students in their communication with
service users.
Egan (2010) draws from a number of theorists in presenting his
model, including Carl Rogers who, as Egan states in an interview with
Sugarman (1995), was highly influential. Rogers writes at length about
the power of empathic responding and how difficult it is to accomplish.
However, this one skill is the key factor that enables the client to
grow and change in a climate of understanding or a good attempt at
understanding (Rogers, 1961). While Egan draws widely from Rogers’s
theory in his analysis of the importance of building a non-judgemental
relationship with the client in stage one of his model, he nevertheless
states clearly in his interview with Sugarman that empathic responding,
unconditional positive regard and congruence are not enough to evoke
change. As a result of this thinking, Egan developed his Skilled Helper
model which emphasises both the relationship and client action. Within
the model, stage one skills involve finding out what is currently going on
for the client. The client is listened to with empathy; challenging skills
are used, again with empathy not only to help the client learn about
their own ways of being but also to help them acknowledge and build
on their own strengths. In stage two, the preferred picture is identified
and goals devised. At all times the client is encouraged to state what
they want or need that might help them. Finally, in stage three, the
client, with assistance from the helper, develops strategies to achieve
their goals. Using the model may enable the student social worker to
maintain a client-centred approach by empathically responding to
service users, challenging them appropriately and placing them at the
centre of decision making. The study which forms the basis for this
paper sets out to investigate the way that students make use of this
model in practice.

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 Social work students’ experiences of using the Egan Skilled Helper model

Study aims and methodology

This is a small scale study, the aim of which is to assess how valuable
the Egan Skilled Helper Model is in helping social workers in training to
develop their communication skills. The study primarily explores ways of
keeping the service user at the centre of decision making. The study also
investigates whether learning was effectively transferred into practice with
service users.
The model was taught to two different groups. The first comprised
full-time social work students (who had little experience of working
with service users) and the second consisted of part-time students on the
employment-based course (who had substantial experience and held a
case-load). Both groups learned the model within the Communicating and
Engaging with Others module.

Methodology: Full-time students

The model was taught to the full-time students in the term prior to their first
practice placement. The module consisted of five full days of workshops,
over a five week period, where students learned and practised the model
with each other. Six groups, 115 students in total, attended. On the final
day of the module, a request was made to the whole group for volunteers
to take part in focus group sessions which would be held during their first
social work practice placement. The objective was for students to employ the
Egan model with service users during their placement and reflect on how the
model had helped them to place decision making control with service users.
A limitation of the study is that only five students from this group (three
women and two men) subsequently took part in each of four focus groups.
All the students were white British (a further limitation), and aged in their
twenties and thirties. None of the students had any previous social work
experience. In the focus groups, students gave feedback on how useful they
had found the model. The sessions lasted between 30 and 60 minutes and
were recorded electronically and then transcribed.
Approval for the project was given by the Ethics Committee at the
University of Lincoln. The students maintained the confidentiality of service
users with whom they worked and no information was used which would
have identified any individual.

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 Sally Riggall

Methodology: Part-time, employment-based students

A separate group of ten part-time students taking part in this study were
day-released from their workplaces and already held a case load of service
users. These students studied and practised the model in a similar way to
the full-time students over a period of four weeks for one day per week. A
request was made for volunteers to participate in one focus group session
one month after the module finished. All ten students (eight women and
two men, all white British with an average age of 30) agreed to take part.
In the focus group they reflected on their experience of using the model
with service users and commented on how it had changed their practice.
The session lasted for one hour and was again recorded electronically.
Participants in this group had considerably more experience of working
with service users than the full-time group.
A distinction is made between the two groups in the presentation of
the data. This is because the employment-based students already had an
existing relationship with service users and were changing the way they
used communication skills. This contrasted with the full-time students
who were beginning their first practice placement and thus forming new
relationships.

Methodology applicable to both groups

Participants of both focus groups were asked to comment on the following:

• How had students developed their communication skills as a result of

learning the Egan model?
• What impact did using the model have on placing the service user at
the centre of the helping process?
• How effective was the transfer of knowledge from the classroom into
practice?

An oral method of collecting data as opposed to written feedback was

chosen for the study because it placed less pressure on students and at the
same time promoted a far more detailed and dynamic response which was
in line with the model itself. All of the participants were keen to contribute
their experiences to the study.

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 Social work students’ experiences of using the Egan Skilled Helper model

Findings
The students who took part in this study were working in a variety
of settings, some statutory, some voluntary. In order to maintain
confidentiality, quotations from the full-time students are given the prefi x
‘F’ and the employment-based, part-time students are prefixed with ‘P’.

How students developed their communication skills as a

result of learning the Egan model
The importance of having a framework to follow

The first point raised by the students concerned how the model helped
them to develop confidence in their communication skills and understand
how their relationship with the service user was progressing. A factor
that contributed to developing students’ confidence was having a ‘map’ to
follow. Egan (2010) writes about helpers holding the model in their heads
as a map so they know where they are going with it and this was echoed
by a student from group F who stated:

It’s my bible that guides me to be the way I want to be. It’s good.

This was also confirmed by another group F student who stated that having
a model from which to work was useful:

It has definitely helped having a model in your head when doing assessments, when
we were first told we would be doing assessments that’s the first thing I thought about.
It was worth learning.

Developing relationships

The students reported that the Egan model also helped them to gain rapport
with service users. As mentioned previously, Egan’s humanistic relationship
building skills are taken from Carl Rogers’s (1961) work where Rogers states
that it is the attempt at empathy that develops the relationship rather than
getting it right. He states that the client will soon clarify what they really
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 Sally Riggall

feel and mean if the helper tries to be empathic. The following point from
a group F student illustrated his developing skills:

The first time I tried to use an empathic response she replied ‘of course it isn’t!’ So I
thought, ‘OK, she’s put me right’. I know it is about having a go at being empathic
though.

As stated, students from the part-time Employment-based BSc in Social

Work were more experienced in working with service users and already
had their own ways of working. One student from this group demonstrated
the effect of learning active listening skills from the Egan model:

I used the model with the whole family. What I found was that they all got a chance,
without anybody criticising them, to say what they felt and to just have someone
there as a medium to sit and allow them to do that. It really worked for that family.

Developing empathic responding skills

Gaining rapport with the client by using empathic reflections is an essential

skill (Forrester et al., 2008) and an important part of the Egan model. A
group P student demonstrated she was able to reflect on using empathic
responses:

I worked with a person whose husband had been diagnosed with a terminal illness. It
was hard to get through to her. When she had unloaded, I used the empathic response:
‘from what you have said to me I think you are really scared and you are really
trying to protect your husband but you are worried about what is going to happen’.
I didn’t realise at the time but I said what she was feeling. And she got my hands
and kind of cried and that bit, I wasn’t actually comfortable with. I think if I hadn’t
used that response… I don’t think I would have been where I was with that lady or
her husband and I don’t think we would have got things right to be perfectly honest
so it was really useful for that but on the other hand it took a bit of, you know ….

The above participant has highlighted the effect of employing Egan’s

skills of fully engaging with what a client might be thinking and feeling.
She demonstrated how unused clients might be to a demonstration of
understanding at this level and also how challenging this was for her
too. Currer (2007) comments that social workers often find it difficult to
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 Social work students’ experiences of using the Egan Skilled Helper model

respond to strong emotional reactions from service users fearing opening

the floodgates and causing more harm than good. Assisting students to
first anticipate and then work with strong emotional reactions would need
to be included in the teaching of the Egan model.

Developing challenging skills

The model describes how to use challenging skills. However, challenging

was not alluded to so frequently by students and it seems this is a more
difficult aspect of the model with which to get to grips. Egan (2010)
writes at length about this area and states that good, effective challenging
is essential in helping clients to manage their situations better. Only one
student (from group P) discussed the area of challenging and it is clear that
she was hesitant in using this skill:

I think it’s about recognising when not to use it as well. I don’t know whether
it is because I recognised that it was not going to be useful or that I was
frightened of using it.

Although the student demonstrated the ability to be reflective there is

clearly a difficulty in using challenging skills. Raising concerns by using
challenging skills distinguishes social work from counselling (Forrester et
al., 2008) and as such, is an important skill for workers to develop. Assisting
students to develop confidence in practising challenging might be a useful
development with future groups.

Assisting service users to plan action

The study indicates that although some students found the first part of the
model (active listening skills) the easiest to remember, students who used
all three stages of the model experienced this as most beneficial in aiding
clients to action. One student from group P who worked with children with
profound learning disabilities demonstrated that using the model had had
an effect on both the client’s action and also on developing the relationship:

I started off using the first stage with children with their parents, talking to them and
using empathic responses when they are upset and I’ve been building a relationship

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 Sally Riggall

up with a parent to the point where in his review he pointed out he had a good bond
with me. We have started with the little things and we are building up to the bigger
things, for example getting pictures up on the walls. The little things build onto the
bigger things. It just seems to be working really well.

The above point illustrates that students learn from the model to set goals
with their service users and that these goals do not have to be huge, small
changes are useful in themselves (Egan, 2010).

Debating the usefulness of the model

One student from group P felt that learning the Egan model had taught
him nothing new. He felt that he employed the skills naturally, stating:

There isn’t the chance to sit back and empathise, as good and as useful as you would
say that would be. We are doing a lot of the Egan model anyway because it is what
we do.

The above student already had skills of which he was unaware but
according to Koprowska (2010) tutors need to help students to build
on communication skills they already possess. The comment above
demonstrates that helping students to develop conscious awareness of
the difference between skills they bring to the classroom already and new
skill development based on theory is a challenge for tutors. The student
also highlighted time pressures he was under and how he felt it was too
time-consuming to use empathic responses. However, other students
commented that time spent using these skills moved the client towards
action and resolution more quickly. This will be discussed later in the next
section of this paper.

Keeping the service user at the centre of the process

Empowerment
The study sought to find out whether using the Egan model helped students
to place the service user at the centre of decision making. This was found
to be the case with the following group F student:
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 Social work students’ experiences of using the Egan Skilled Helper model

Reflections are much better than asking direct questions, you’re prompting but it
flows nicely. They are making their own decisions. We’re asking them what they
would like and the responses are a lot better and we’re getting to action quite a lot
quicker and they are coming out thinking they’ve actually done the job. They’ve had
their own power there and made their own decisions and we’re just the helpers.

Another student from group F also commented on how the model helped
her to place the service user at the centre of the process and the importance
of enabling the client to take control and search out a way of managing
their problem more successfully:

With one client we looked at where was she at now, and through that we moved on
to what does she need or want. She wasn’t attending school and it turned out she
was worried about what was going on at home when she was at school and felt she
couldn’t attend all day. We talked about different options and in the end it turned
out she does want to stay in school and gain a diploma.

I like the model because they are finding the answer. She was saying where she
wanted to be. I felt because she had given a solution she had gone from her head being
down coming into the room, not really wanting to engage to being upbeat, open: her
complete body language had changed.

The same student illustrated that she can use the Egan model approach
of finding out what the client needs rather than telling the service user
what to do:

So much was going on in her life that you couldn’t really comprehend to be honest,
for someone of that age to be going through it, but deep down she did want to stay
in education and learnt that there was something out there. I don’t want to criticise,
but the person who has been working with her has been telling her what she should
be doing and telling her if she didn’t do that how it was going to affect her. I think
that is why she has not engaged.

Resisting problem solving

Learning the Egan model enabled students to curb their natural tendencies
of trying to solve things for the service user and of giving advice. Egan
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 Sally Riggall

(2010) writes about power and control in the relationship and how telling
the service user what they should be doing embeds this power differential.
This is reflected in the student’s comments above.
A group F participant demonstrated she could help the client to own
their progress and to move towards becoming a more independent decision
maker which is a key aspect of the model:

At the end of the day it is their life and if they have achieved that all themselves
with you helping them, then they can take all the credit for that and it helps them
feel better. And if they feel better and can see the possibilities that they could have
and they achieve them themselves: they are more likely to stick to that way of life
and it’s more positive for them.

Another group F student demonstrated she had absorbed the model

into her way of working while at the same time reflecting on her struggle
to stay within the client’s frame of reference:

I use the model and let them talk but in the back of my head or when I reflect,
sometimes I think, ‘Oh God, please, just leave the relationship’ but you can’t say
that. It is still there and I’ve got to do something about that.

The theme highlighted above is one of the barriers which tutors have
encountered in teaching the Egan Skilled Helper model, namely, helping
students to learn that their role is not to tell the client what to do but to
find out what the client wants or needs and from this to establish realistic
and achievable goals. Tutors work with students who frequently ask ‘But
when can we tell the client what to do?’ and ‘But what if you know what the
client ought to do?’ Helping students make this leap has been a challenge
but one which is fundamental to enabling students to place the service
user at the centre of decision making. This is an area that the Egan model
addresses clearly by emphasising that the client is the expert on themselves
(Egan 2010).

Maintaining the transfer of knowledge from the classroom into

practice

Each of the students demonstrated that they had absorbed and remembered
the skills they had learned and that they could employ these skills at a
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 Social work students’ experiences of using the Egan Skilled Helper model

later date, several months after the module ended. One group P student
demonstrated this by referring to stage three forcefield analysis which is
a method of helping the client to assess what would help them adhere to
their chosen strategy and what might hinder them in this process:

The bit I have used quite a bit is actually the last stage, looking at change and using
forcefield analysis and also possibilities where they choose some and what will help
them.

Another student from group P demonstrated sustained knowledge by

commenting on Egan’s (2010) ‘SOLER’ technique (Sitting squarely, Open
body language, Leaning forward, maintaining Eye contact, staying Relaxed)
and also the latter stages of the model:

I’ve used stages two and three in addition to the stage one skills. I’m working with
people with learning disability: we use a person-centred approach. I’ve been helping
people look at what they want to do and formulating plans and the best way forward.
The model has also had a positive response from colleagues.

Some students demonstrated they developed lasting skills in all three

stages of the model. One, an experienced practitioner from group P, talked
about how he had adopted the whole model and how this had had an impact
on his workplace practices over a period of time:

Managers come from outside saying ‘we are going to do this and that’ and you say
‘no’. It’s made you think, ‘no, you don’t do that: you’ve got to listen to what they
want’ so we’ve put that into practice quite a lot. It has changed working practices.
Really, it has. We imposed, or I imposed my own wants, I wanted them to do things,
as my own values, ‘you should be doing this and going there’ and now I step back
and find out what they want. I knew what they should be doing and am trying to
think differently. It is working and proving to be useful.

The above example shows how this student’s values have been influenced
by the model. His analysis shows that this way of working is of value to both
himself as a helper and to the service user. His comments also illustrate
that a change in approach has been adopted and maintained by him in
the workplace.
More research into transferring skills from the classroom into the
workplace is planned. Students who took part in this study will be
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 Sally Riggall

interviewed in their second social work practice placement to establish

whether their new knowledge and skills have been maintained. Engaging
interested practice educators by teaching them the model is also planned.
Including practice educators would enable students to discuss their progress
with the model during supervision. Findings from this planned project will
be discussed in a future paper.

Discussion and Conclusion

The majority of the fifteen students who took part in the study commented
that using Egan’s Skilled Helper model improved their communication
skills. The students particularly liked the framework offered by the model
of ‘where is the client now, where do they want or need to be and how are
they going to get there.’ Having this ‘map’ gave them confidence and actual,
practical ways of working collaboratively with service users and placing
them in charge of their own lives. Many students early in their training
struggle with the temptation to tell service users what to do and it is
encouraging that in this study participants found that using the Egan model
curbed these tendencies. Instead they worked collaboratively with clients
to help them find ways of managing their problems. Consequently they
found there was a move towards client self-determination more quickly. The
importance of such autonomy has been highlighted by a number of writers
including Cambridge (2004) and Cooper and Spencer-Dawe (2006). A key
finding of the study is that placing service users at the centre of decision
making promotes earlier resolution of issues. A further study will find out
whether using the Egan model enables cases to be closed more quickly.
Almost all of the study participants stated that using new skills contained
in the Egan model, such as empathic responding, has enabled them to
engage at a deeper level. Indeed, Forrester et al. (2008) and the DCSF’s
(2010) recommendations were that advanced empathy was a vital skill to
learn and should be taught in communication skills modules. One project
participant, however, described her use of an empathic reflection and then
spoke of her subsequent discomfiture at the intense emotional reaction
from the service user. Therefore, a point to note is that in teaching the Egan
model, students need to be alerted to the possibility that using empathy
can be overwhelming, both for themselves and the service user. Training
also needs to include skills for working with strongly expressed emotions.
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 Social work students’ experiences of using the Egan Skilled Helper model

The participants’ discussion of how they used the Egan model

demonstrates how they have transferred their knowledge from the classroom
into practice settings. The five full-time students continued to give feedback
on the model throughout their first practice placement demonstrating that
their learning from year one was sustained into practice. The feedback from
a whole group of ten, employment-based, part-time students has also been
useful in evaluating how knowledge has been transferred because these
students were already experienced practitioners and held a case-load of
service users. A key finding is that these participants have been willing
to change their approach by putting into practice a new model. A further
study is planned to establish whether their new skills have been sustained
over a longer period.
The study has limitations, mainly concerning its size which was
governed inevitably by the availability of students and their capacity
to give time to the project. The sample size was small and consisted of
exclusively white students, the majority of whom were female. Ashencaen
Crabtree and Baba (2001) comment that all Western counselling approaches
extoll the importance of individual needs and goals. They argue that in
some cultures, such as Islam, the needs of community outweigh those of
self-interest and that practitioners need to recognise such factors. Egan
comments that his theory may well not fit other cultures, or may need
adaptation. However, he also emphasises the importance of recognising
diversity within cultures, stating ‘clients are individuals, not subcultures
or groups’ and that practitioners need to use interventions which ‘factor in
key cultural and personal-culture variables’ (Egan, 2010 pp.51-52). Working
with these corollaries can be highly challenging for practitioners and since
there is little research in this area, further exploration would be useful.
Another limitation is that the interest in the subject by the author (who
also taught the module) may have influenced the members of the focus
group to give more positive feedback than they would have given to an
independent third party (Robson, 2002). This constraint will be addressed
in the next study by the inclusion of an independent interviewer.
A criticism of the Egan model is that it assumes service users will be able
to communicate verbally. Indeed, Rowland and McDonald (2009) in their
paper on communication skills with service users who have aphasia (people
who cannot form words but who have cognitive understanding) raise the
issue of how social work students are taught to communicate with people
who do not have verbal skills. The authors emphasise the importance of
enabling all service users to be able to express their needs and voice their
51 J. of Practice Teaching & Learning 11(1), pp.37-53. DOI: 10.1921/ 175951511X651940. © w&b
 Sally Riggall

concerns, often non-verbally. They also emphasise the crucial importance

in these instances of helpers using empathic responses. The Egan model
places the service user at the centre of decision making by encouraging
the helper to first find out their needs and then collaborate in establishing
achievable goals. This process does not have to consist of using purely
verbal skills. More creative approaches can be employed such as using
symbols, artwork and advocacy skills. One student in the study reported
using the Egan model when working with children with profound learning
disabilities to establish what they needed or wanted and this can be taken
as a starting point to a more detailed investigation in the future.
A planned development from the current project is to involve the same
group of students in assessing further the efficacy of the model including
whether it leads to cases being closed more quickly. It will also examine
whether students’ knowledge and skills from learning the model have been
sustained over time. A second planned project will find out whether learning
could be further embedded by involving practice educators. Trevithick et
al (2004) in their report for SCIE suggested social work educators should
embed communication skills into practice by working with practice
educators and service users in order to maximise student learning within
practice itself. Practice educators will have the opportunity to learn the
model so that they will be enabled to support the new sample of students
who have volunteered to give feedback on the Egan model during their
placement. These projects will explore further the usefulness of the Skilled
Helper model in enabling students to develop their communication skills.

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