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Models of Helping and Coping
PHILIP BRICKMAN VITA CARULLI RABINOWITZ JURGIS KARUZA, JR. DAN COATES ELLEN COHN LOUISE KIDDER
University of Michigan Hunter College State University of New York College at Buffalo University of Wisconsin University of New Hampshire Temple University
ABSTRACT: By drawing a distinction between attri- bution of responsibility for a problem (who is to blame for a past event) and attribution of responsibility for a solution (who is to control future events), we derive four general models that specify what form people's behavior will take when they try either to help others or to help themselves. In the first, (called the moral model because of past usage of this term), actors are held responsible for both problems and solutions and are believed to need only proper motivation. In the compensatory model, people are seen as not responsible for problems but responsible for solutions, and are be- lieved to need power. In the medical model, individuals are seen as responsible for neither problems nor solu- tions and are believed to need treatment. In the en- lightenment model, actors are seen as responsible for problems but as unable or unwilling to provide solu- tions, and are believed to need discipline. It is our gen- eral hypothesis that each set of assumptions has .char- acteristic consequences for the competence, status, and well-being of actors, and that the wrong choice of model in a situation will undermine effective helping and cop- ing. Competing models of responsibility in education, psychotherapy, law, and welfare are described, and re- search on attribution of responsibility is recommended as a way of addressing problems of both theoretical and
There are now two distinct bodies of literature on helping, one in social psychology and one in clin- ical psychology. The literature in social psychology focuses on the question of when people try to help, on material or instrumental aid as the critical form of help, and on help in short-term relationships or experimental situations. Darley and Latane's (1968) work on group influences on bystander interven- tion is a prototypical example. The literature in clinical psychology focuses on the question of when attempts to help produce changes in recipients, on instruction and emotional support as the critical forms of help, and on help in long-term or ongoing relationships. The many studies evaluating the suc- cess of psychotherapy (see Smith & Glass, 1977) exemplify this research.
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It is our belief that (1) a general theory of help- ing and coping must build a bridge between these two literatures; (2) the critical factor on which such a bridge must be built concerns the form people's behavior takes once they decide to help; and (3) the critical determinants of the form of their be- havior are their attributions of responsibility for problems and solutions. Part of the reason the social and clinical literatures have not reached out to one another is that each, in its own way, has taken for granted the form people's behavior will take when they decide to help. In social psychological exper- iments, helping is typically constrained by the ex- perimental situation; for example, if the response of interest is donating money, this is the only means of helping that subjects are allowed to exhibit. In clinical settings, choices of how to help are typi- cally determined by professional training and in- stitutional context. What we are focusing on is how people decide whether material aid, instruction, exhortation, dis- cipline, emotional support, or some other form of help is most appropriate and what the conse- quences of these choices are. We begin with a brief discussion of our view of responsibility and how this differs from past views in the field. We then derive four general models of helping and coping, review findings bearing on the consequences of the
Many people have contributed to the development of this ar- ticle—not the least by restraining its excesses. Conversations with Richard Nisbett and Jeffrey Paige were especially helpful. The influence of other members of the social psychology com- munity at Northwestern University working on related prob- lems—especially Ronnie Janoff-Bulman, Christine Dunkel- Schetter, Roxane Silver, and Camille Wortman—will be ap- parent at many points. Thoughtful responses to earlier drafts were also received from Lawrence Becker, Marilynn Brewer, Faye Crosby, Robyn Dawes, Robert Folger, Lita Furby, Jolene Galegher, Lee Hamilton, William Ickes, Joan Linsenmeier, Jo- seph McGrath, Paul Rosenblatt, Clive Seligman, and Mary Beth Shinn. Requests for reprints should be sent to Philip Brickman, Re- search Center for Group Dynamics, Institute for Social Re- search, University of Michigan, Ann Arbor, Michigan 48106.
Vol. 37, No. 4, 368- Copyright 1982 by the American Psychological Association, Inc.0003-066X/82/3704-0368$00.
choice of models for help givers and help recipi- ents, and present the implications of these models for research and practice in a variety of real-world settings.
Causal and Moral Elements in
Attribution of Responsibility
Until recently, research on attribution of respon- sibility has presumed that people are primarily in- terested in arriving at an accurate understanding of the causes of events (cf. Fincham & Jaspars, 1980, for a review of this literature). Save for ef- forts to protect their own ego, the exact extent of which remains controversial (Zuckerman, 1979), people are presumed to assign responsibility for events in a way that best reflects this understand- ing. It is our contention, on the contrary, that peo- ple are less concerned about understanding the causes of events than about controlling behavior, both their own and other people's, to maximize desired outcomes. People control behavior by mak- ing rewards and punishments contingent on the occurrence of that behavior. They assign respon- sibility in order to notify others and themselves that this is the case. People who feel morally re- sponsible in the eyes of others believe that others would feel entitled, and even obliged, to reward or punish them depending on how they acted and what happened (Hamilton, 1978). People who feel morally responsible in their own eyes believe that they would be entitled or obliged to think better or worse of themselves as a function of how they acted and what happened (Schwartz ,'1977). Furthermore, the question of moral responsibil- ity can be conceptualized as involving two separate issues—blame and control (cf. Feinberg, 1970). We assign blame to people when we hold them re- sponsible for having created problems. We assign control to people when we hold them responsible for influencing or changing events. In the language of causal attribution, blame and control are not spoken of directly. Blame arises as a concern in- directly in the question of whether an event was internally caused or externally caused. People are blamed for failing an exam if the cause of the failure was internal (lack of effort), but not if it was external (an impossibly difficult exam). Con- trol arises as a concern indirectly in the question of whether a cause is stable or unstable. People are thought to be able to control an unstable cause (lack of effort, which could be increased in the future), but not a stable cause (lack of ability, which ordinarily cannot be increased).
But this causal representation of moral concerns quickly breaks down on closer inspection, as a number of authors (Kruglanski, 1975; Pettigrew, 1979; Weiner, 1979) have already recognized. There are internal causes, such as disease or lack of ability, for which a person is not blamed, and external causes, such as hostility by others or a car with faulty brakes, for which a person can be blamed (cf. Brickman, Ryan, & Wortman, 1975). There are unstable causes that a person is not held responsible for controlling, like bad luck, and sta- ble ones that a person is supposed to be able to control; such as habitual carelessness or slovenli- ness. We need a conceptual framework that makes the questions of blame and control the explicit focus. Fortunately, such a framework already exists in the language we use when talking about problems and solutions. Responsibility for the origin of a problem, generally responsibility for a past event, clearly involves the question of deserving and , blame. Responsibility for the solution to a problem, generally responsibility for future events, clearly involves an assessment of who might be able to control events. The answers to these two questions are often correlated. If a person has no responsi- bility for a problem, we may be inclined not to assign them any responsibility for a solution. Thus we say, "You got yourself into this—now get your- self out," or "It's my fault—let me fix it." This may account for why the two have not been clearly distinguished in the past. It is also, however, quite unfortunate because it leads people to think that looking for a solution to a problem means finding who is to blame for it, or that discovering who was at fault means that a solution will be found. It also leads people to think that the solution to a problem must necessarily be found on the same level as the origin of that problem (e.g., that a problem with a biological origin must have a biological solu- tion)—or, if the variables producing that problem cannot be changed, that no solution is possible.
Four Models of Helping and Coping
Whether or not people are held responsible for causing their problems and whether or not they are held responsible for solving these problems are the factors determining four fundamentally dif- ferent orientations to the world, each internally coherent, each in some measure incompatible with the other three. These different models of helping and coping exist in the rninds of helpers, aggressors,
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briety and respectability. Over the last century we have gradually changed our treatment of alcohol- ics, homosexuals, and mental patients from a moral basis to a medical one (Albee, 1969; Gusfield, 1967). The gains and losses of this change, as we will see, are still under debate. Under the moral model, we suggest, actors see themselves and are seen by others as lazy or as failing to make the critical effort that is the nec- essary and sufficient condition for their progress. The attribution to lack of effort is made despite the fact that the person may be working very hard and that strenuous effort or active striving is the dominant style of actors who apply the moral model to themselves. However strenuous the ef- fort, it is seen somehow as either not enough or misdirected, with the fault for the error again lying with the individual. Under the moral model, no one besides the individual must act for the indi- vidual to be able to change, if he or she wants to, although it may be helpful to actors if they have peers who exhort them to change and improve, as in self-help groups. • The helping that takes place within the moral model consists of reminding people of how re- sponsible they are for their own fate and how im- portant it is that they help themselves. Help of this sort is, of course, more likely to benefit people who have the resources to use it. Thus it is star players that are most likely to profit from moral exhor- tations from their managers—for example, the dis- pensation of either a kick in the pants or a pat on the back when such reinforcers are needed. Help in the moral model—help in the form of rewards and punishments for appropriate behavior—is often not even called help and, thus disguised, can flow more readily to the advantaged. Brickman and Stearns (1978) have shown that subjects con- sider subsidies to the wealthiest group in a popu- lation fair if they are called incentives for invest- ment, rather than relief. It is in such forms—crop subsidies, urban renewal programs, tax write-offs, support for public institutions like universities, which are used mainly by the advantaged—that our own society helps the already well-off (Tussing, 1974). The value of the moral model for coping is that it compels people to take an unequivocal stance toward their lives. If they do not like the way things are, they should recognize that they are re- sponsible for changing them and should start changing them, rather than sitting around com- plaining or waiting for someone else to do some- thing. If change does not seem worth the effort,
they should accept the way things are—recogniz- ing,that they were responsible for creating them in the first place—and once again stop complaining or blaming others. The primary message of est training is that participants are totally responsible for everything they ever have been or will be and are fools (or worse) unless they realize this (Brewer, 1975; Frederick, 1974). It is understandable that something like est training might have great ap- peal to a generation that is struggling to reconcile the conventional adult roles they have moved into with their previous dreams of an alternative life- style. Est teaches them to resolve their ambivalence either by accepting what they are doing as their own personal choice—or (less likely) by breaking away and doing something different. The potential deficiency of the moral model (a disorder adherents of this model can but do not have to, fall into) is that it can lead its committed partisans to defend the idea that victims of leu- kemia chose their leukemia and victims of rape, at some level, chose to be raped (e.g., Schutz, 1979)—in other words, to take completely seriously the idea that the world is just (Lerner, 1980). More- over, in leading people to believe that they are responsible for all things, it may lead them to be- lieve that all things are possible: As'Donald Camp- bell once said, however, in his seminar on religion for skeptics, the belief in one's own omnipotence is even more incredible than the belief in God. Out of such a belief come mathematicians who ruin their Careers by staking them on the solution of an impossible problem and spouses who ruin their lives by staking them on the pursuit of an un- workable relationship (Janoff-Bulman & Brick- man, 1982). The moral model is also conducive to a pathology of loneliness. Success is one's own doing, lack of success means that one was not in the right frame of mind. People are at most cheer- leaders for one another.
COMPENSATORY MODEL: PEOPLE ARE NOT RESPONSIBLE FOR PROBLEMS BUT ARE RESPONSIBLE FOR SOLUTIONS
We call the model in which people are not blamed for their problems but are still held responsible for solving these problems the compensatory model. People in this model see themselves, and are seen by others, as having to compensate for the hand- icaps or obstacles imposed on them by their situ- ation with a special kind of effort, ingenuity, or collaboration with others. People who help others under the assumptions of this model likewise see
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themselves as compensating by their help for re- sources or opportunities that the recipients of the help deserve'but somehow do not have. The re- sponsibility for using this help, however, or the critical responsibility for determining whether this help is successful is seen to lie with the recipients. Under the compensatory model, by our analysis, actors see themselves arid are seen by others as deprived or as suffering, not from their own de- ficiencies, but from the failure of their social en- vironment to provide them with goods and services to which they are entitled. To solve their problems, and perhaps to compel an unwilling social envi- ronment to yield the resources necessary to solve them, actors must be assertive, In this they may need the help of peers or subordinates. If they receive training, it is training designed to empower
. them to deal more effectively with their environ- ment. A nurse or a therapist who approaches a patient in the spirit of the compensatory model says to the patient, in effect, "I am your servant. How can I help you?," rather than "Do what I say." The typical response of observers who assume the compensatory model is to mobilize on behalf of the deprived person—at least for a time, or until the missing resources have apparently been sup- plied and the person can (and should) be respon- sible for his or her own fate. The Reverend Jesse Jackson has, in recent years, been forcefully articulating the spirit of the com- pensatory model with his repeated assertion to black audiences that "You are not responsible for being down, but you are responsible for getting up." The same message is carried in different words when he says, "Both tears and sweat are wet and salty, but they render a different result. Tears will get you sympathy, but sweat will get you change" ("Learning to Excel," 1978). Parents em- body the compensatory model when they tell their children that they do not care who made the mess, they just want it cleaned up, and that they, the parents, often take responsibility for cleaning up messes around the house that they did not make. Wives adopt the compensatory model by seeing their husbands as the source of the problems that need to be solved in the marital relationship and themselves as responsible for finding the solutions (Madden & Janoff-Bulman, 1981). The strength of the compensatory model for coping is that it allows people to direct their ener- gies outward, working on trying to solve problems or transform their environment without berating themselves for their role in creating these prob- lems, or permitting others to create them, in the
first place. The compensatory model also allows help recipients to command the maximum possible respect from their social environment. They are not blamed for their problems, but are given credit for coming up with solutions. Bosses, superiors, and everyone else with the power to do so tries to make sure that any help they receive is received under the assumptions of the compensatory model— something they need in order to discharge their official duties rather than something they need because of personal deficiency. The potential deficiency of the compensatory model lies in the fact that those who see themselves as continually having to solve problems that they did not create are likely to feel a great deal of pressure in their lives and to wind up with a rather negative or even paranoid view of the world. This seems to be the endemic form of disorder among political leaders, who are commonly given credit for solving problems they did not create and who also commonly come to see the world as a series of conspiracies against them. This kind of problem- solving orientation also appears to govern the Type A behavior pattern in which actors display a great sense of time pressure, competitive achievement striving, high expectations for control, hostility when thwarted—and a greater vulnerability to heart attacks (Friedman & Rosenman, 1974; Jen- kins, 1971).
MEDICAL MODEL: PEOPLE ARE NOT RESPONSIBLE FOR PROBLEMS OR SOLUTIONS
We call the model in which people are not held responsible for either the origin of their problems or the solution to their problems the medical model because the practice of modern medicine is the most striking and familiar embodiment of these assumptions. Patients are collections of organs that can malfunction or become infected. Drugs, sur- gery, and other treatments can be aimed directly at the distressed organs, ignoring the patient as a person. Neither the illness nor the treatrnent is the person's responsibility. It should be noted, how- ever, that our formulation of the medical model includes the practice of medicine only as a special case of a more general set of assumptions about human behavior. The medical model in our sense refers not only to cases in which people are thought to be victims of disease but "to all cases in which people are considered subject to forces that were and will continue to be beyond their control. Thus a Skinnerian view of determinism (Skinner, 1971), that human behavior is determined by rewards and
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submit to the stern or sympathetic .discipline pro- vided by agents who represent the authoritative moral (and if necessary physical) force of the com- munity. Since the solution to these problems lies outside the person, the solution can be maintained only so long as the relationship with this external authority or spiritual community is maintained. As testimony to this continuing relationship, past re- cipients of help under the enlightenment model (e.g., alcoholics; see below) often actively prose- lytize others to take the same steps that they have taken. The enlightenment model is the basis of coping whenever people are unable to control what they experience as undesirable behavior on their part. When a drug addict or an alcoholic tells people, for the forty-second time, that he or she has turned over a new leaf and is about to change his or her life, this claim of future responsibility is treated with understandable skepticism. With a repeated history of failures to change, addicts themselves may find it impossible to credit any more promises that rest on their own capacity for self-control. The "Who are you kidding?" response may be short- circuited, however, if 'the troubled person can point to a powerful and respected external agency— God, a religious cult, a new set of duties—as the source of change, especially if this attribution is supported by others who also believe in this agency. Thus Malcolm X, St. Paul, or Charles Col- son may be able to make their claims of having changed more credible by pointing to an irresist- ible external force as the basis of change. Alcoholics Anonymous (AA), one of the most successful examples of an enlightenment model organization, explicitly requires new recruits both to take responsibility for their past history of drink- ing (rather than blaming it on a spouse, a job, or other stressful circumstances) and to admit that it is beyond their power to control their drinking— without the help of God and the community of ex- alcoholics in Alcoholics Anonymous (see Antze, 1976; Gartner, 1976). The group is familiar with all of the usual excuses for alcoholism, and the fate of all of the usual promises to reform, and makes short work of "'them when they are offered by a newcomer: "At the first meeting, I was asked to tell my story... I gave a detailed account of all the stresses that drove me to drink... and sat back to wait for compliments. The leader asked this neat Irish gal sitting next to me, 'Well, what do you think of his talk?' She said, 'It sounds like bull to me' Everyone agreed with her" (Breo,
1978). Consistent with the assumptions of the en- lightenment model, alcoholics who join Alcoholics .Anonymous have been found to have a stronger sense of guilt and responsibility for their past trou- bles (Trice & Roman, 1970) and a higher need for affiliation and community (Trice, 1959). The deficiency of the enlightenment model lies in the fact that it can lead to a fanatical or obsessive concern with certain problems and a reconstruc- tion of people's entire lives around the behaviors or the relationships designed to help them deal with these problems. This is the criticism that has most frequently been leveled against A A (e.g., Cummings, 1979), against agencies for the blind that require participants to renounce the visual ability they have lost and become "born again blind men" (Scott, 1969), against cults and religious revival movements, and against what dieting means for so many dieters. Alcoholics Anonymous reorganizes people's lives so that they stay away from their old drinking places and drinking part- ners, but they retain their concern for drinking as an issue in their lives and spend much of their time at AA meetings with new AA friends. What is more serious, the enlightenment model can place great power in the hands of the agents who control what participants believe is their ability to cope with their lives. Converts are asked to repudiate their old, evil ways and to repeatedly perform acts that bear witness to this repudiation (Kanter, 1972; Lofland & Stark, 1965). All bad things are blamed on the residue of the old life and good things cred- ited to the experience of the new (Proudfoot & Shaver, 1975). Under these circumstances enor- mous power lies in'the threat to withdraw access to the new life and send people back to the old. In most of the foregoing examples, such as Alco- holics Anonymous, this power is diffused in the hands of a variety of friends and fellow sufferers. In some instances, however, it is concentrated in a single charismatic authority—a Charles Manson, a Jim Jones, a Charles Dederich—who seeks in- creasingly extreme forms of commitment from followers, culminating in the acts of murder or suicide that shock the rest of the world.
THE MODELS IN FOUR REAL-WORLD SETTINGS
Although real-world settings may often contain a mixture of the assumptions that characterize our various models, it would be most encouraging for our analysis to isolate settings that exemplify the models in relatively pure form. This is what Ra-
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binowitz (1978) set out to do in her dissertation. To represent the moral model, she tracked down and interviewed 12 graduates of erhard seminars training (est); to represent the enlightenment model, she interviewed 12 members of a national evangelical group called Campus Crusade for Christ; to represent the compensatory model, she interviewed 12 participants in a job training pro- gram sponsored under the Comprehensive Em- ployment and Training Act (GETA); and to rep- resent the medical model, she interviewed 12 stu- dents seated in the waiting room of a college infirmary. Consistent with the assumptions of each model, est participants and Campus Crusade for Christ participants rated themselves as more responsible for their problems and past lives than CETA par- ticipants or infirmary patients. CETA and est par- ticipants rated themselves as more responsible for finding solutions to their problems than did Cam- pus Crusade members and infirmary patients. Fur- thermore (and all differences reported here are highly significant), est participants saw themselves as stubborn individuals who were themselves the essential agents of change. CETA participants saw themselves as deprived individuals who needed someone in the role of a tutor to assist them for a short period of time. Infirmary patients saw themselves as sick and needing the help of skilled professionals. Campus Crusade for Christ partici- pants saw themselves as self-destructive and re- quiring guidance from others who have "been there" and subsequently-come to grips with their problems. Clearly these results can only be consid- ered preliminary. But they are highly encouraging to the notion that these models actually exist, in relatively coherent form, in a variety of real-world settings.
Consequences of the Choice of Models
In this section we will attempt to show that attri- bution of responsibility for problems has very dif- ferent consequences from attribution of responsi- bility for solutions to those problems, for those who are the targets of such attributions and for those making such attributions; that, ironically, the as- sumptions made by help givers to justify their help often undermine the very effectiveness of this help; and, finally, that many of the problems charac- terizing relationships between help givers and help recipients arise from the fact that the two parties are applying models that are out of phase with one another.
COMPETENCE AND BURNOUT
We hypothesize that models in which people are held responsible for solutions (the compensatory and moral models) are more likely to increase peo- ple's competence than models in which they are not held responsible for solutions (the medical and enlightenment models). It may also be beneficial not to hold people responsible for problems, though the evidence for this is less clear. Data that bear on these hypotheses can be de- rived from a comparison of studies that have looked at the effects of attributing symptoms to external causes with studies that have looked at the effects of attributing progress or improvement to external causes (cf. Valins & Nisbett, 1971). The evidence on symptom attribution or attribution of responsibility for problems is equivocal. Some stud- ies (Barefoot & Girodo, 1972; Rodin & Langer, 1980; Ross, Rodin, & Zimbardo, 1969; Storms & Nisbett, 1970) have found therapeutic gains when subjects are induced to believe that their symptoms (anxiety, insomnia, physical decline) have external rather than internal causes. Other studies have found that highlighting possible external causes for symptoms has no effects or negative effects (Boot- zin, Herman, & Nicassio, 1976; Chambliss & Mur- ray, 1979a; Singerman, Borkovec, & Baron, 1976). These contradictory results may be due to the fact that mentioning an external cause for symptoms relieves anxiety, but also undermines the degree to which subjects give themselves credit for any subsequent improvement. Results in any particular experiment would depend on which of these two factors was stronger. With regard to attribution of responsibility for improvement, on the other hand, benefits derive from making internal rather than external causes salient (to use the causal language employed in past studies), and the evidence for this is quite clear. In the same study of smoking reduction in which they found no effects of what subjects were told about the causes of their symptoms (like ir- ritability), Chambliss and Murray (1979a) found that informing subjects that their gains (reduced smoking) were due to their own efforts, rather than a drug, did indeed help subjects to reduce their smoking. Earlier, Davison arid Valins (1969) found that subjects who believed that a solution (an im- provement in their ability to tolerate painful shocks) was due to them rather than to a pill they had taken were better able to endure shocks in the future. Working with psychiatric outpatients, Lib-
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Our preference for the compensatory model rests on our conviction that it is the only one that re- solves this dilemma of helping—justifying the act of helping (since recipients are not responsible for their problems) but still leaving help recipients with an active sense of control over their lives (since they are held responsible for using this help to find solutions). Ironic support for the value of the compensatory model comes from evidence that help givers (who assume that they are responsible for solving a prob- lem they did not create) often benefit from helping even when the recipients of that help (who are not attributed responsibility for a solution, whether or not they are blamed for the problem) do not. School children who are in trouble academically have been found to profit from being given the responsibility for tutoring a young child (Allen, 1976). Zajonc (1976) has shown that the pattern of IQ development in families, as revealed by a number of national surveys, requires the assump- tion that all children except the last born profit intellectually from having a younger sibling whom they can teach. Bargh and Schul (1980) have shown that people learn more effectively when they an- ticipate having to teach someone else in the future, and new college professors are commonly im- pressed with how much more they learn from pre- paring a course than from taking one. On an af- fective level, college students working to help mental patients (Holzberg, Gewirtz, & Ebner,
- or troubled boys (Goodman, 1967) showed significantly more positive change in their self-ac- ceptance than control groups not involved in such helping. By the testimony of members, a major reason for the success of Alcoholics Anonymous is that participants not only try to solve their own problems (which, as we have seen, they can do in this context only by accepting the discipline of the organization) but increasingly take responsibility for helping other members with their drinking problems. There is, however, a further irony in this one- sided state whereby the assumptions in helping may benefit the helper more than the recipient of help. Helpers generally want to succeed in being helpful, just as people want to succeed in anything they do (cf. Weiss, Boyer, Lombardo, & Stich, 1973). Among professional helpers, liking for clients is consistently correlated with the belief that clients have improved or will improve (Doherty, 1.971; Thompson, 1969; Wills, 1978). Moreover, by the social definition of their role, therapists are supposed to be helpful. If they choose the wrong
model, however, they will not be, because the as- surtiptions they make will undermine the success of their very effort to help; and in the long run, their own sense of competence and self-esteem will decline along with those of their clients. This de- cline in self-esteem and involvement has been ob- served in numerous populations of helping profes- sionals—social workers, poverty lawyers, nurses, teachers-—and has even been given a name, burn- out (Freudenberger, 1974; Maslach, 1978).
COMMUNICATION AND SOCIAL SUPPORT
Since help threatens both a recipient's status and a donor's resources, it can also clearly be a threat to the solidarity of their relationship (cf. Brickman & Bulman, 1977). In general we hypothesize that help will contribute to the solidarity and stability of a relationship when it embodies assumptions that are congruent with the dominant assumptions of that relationship; it will undermine the stability of the relationship when it embodies assumptions that conflict with the dominant assumptions of the relationship. Thus unequal status relationships will be most stable when help in them flows from the superior to the inferior along the lines of the en- lightenment and the medical models (the two mod- els most likely to foster deference from the recip- ient) and from the inferior to the superior along the lines of the moral and the compensatory mod- els (the two models least demanding of deference from the recipient). Accordingly, lower class pa- tients are more likely to continue in therapy with a high-status, middle-class therapist when the ther- apist is controlling and directive (along the lines of helpers in the enlightenment and medical mod- els) than when the therapist is passiye or nondi- rective (Duckro, Beal, & George, 1979). High-sta- tus parties are less likely to have help forced on them for minor infractions (Hollander, 1958) or when they do not want it (Rushing, 1969) and less likely to be seen as accepting coercive or directive help (Thibaut & Riecken, 1955). The literature on helping and coping has em- phasized the positive aspects of having close per- sonal relationships (Cobb, 1976). People with such relationships have been found to cope better with, among other things, problems of pregnancy (Nuck- olls, Cassel, & Kaplan, 1972), physical disability (Smits, 1974), terminal illness (Weisman & Wor- den, 1975), and bereavement (Clayton, 1975). There are a number of recent indications, however, that this uncritical view of social support (the very label connotes something with positive effects) is
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too rosy. Pearlih and Schooler (1978) found that seeking help for marital and parental problems correlated with more, rather than less, distress, while Lieberman and Mullan (1978) found no ben- efits from use of a wide variety of both professional and nonprofessional sources of help. Wortman and her associates have described in compelling detail the difficulties experienced by cancer patients (Wortman & Dunkel-Schetter, 1979), rape victims (Coates, Wortman, & Abbey, 1979), and depressed people (Coates & Wortman, 1980) in trying to elicit a satisfactory response from others. The problem with much social support, in our view, comes from the fact that people trying to be supportive apply the wrong model to victims or misunderstand the model that victims are trying to apply to themselves. The process of what we might call secondary victimization (the process by which victims are victimized once again by awk- ward or ineffective efforts to help them) appears to have two major phases. In the first phase, when counselors or friends hear rape victims blaming themselves (Janoff^Bulman, 1979) or paraplegics saying that their accident was the result of an ac- tivity they had chosen and would choose again (Bulman & Wortman, 1977), they are baffled by what appears to be the victims' tendency to. blame themselves for something that was in no way their fault. .Friends fail to understand that what may seem to be the victims' need for blame is actually their need for control and that victims' belief that they have been and will be in control of their lives is more vital than ever to them as they attempt to explain and adapt to the traumatic event (illness, rape, bereavement) that has just befallen them. The plight of the victim makes others anxious as well as sympathetic, and they express this ambiv- alence by a complex pattern of approach and avoidance that is in fact quite confusing to victims (e.g.,, Wortman & Dunkel-Schetter, 1979), In the second phase, friends finally switch from trying to protect and take care of victims to want- ing victims to again take over responsibility for their own lives. Now, however, victims are no longer ready to do this. Having never been able to fully share their feelings about the traumatic event with supportive others, they are not yet ready to relinquish thinking and talking about it. Having learned that others are masking ambiva- lent feelings, they are no longer confident of their ability to share feelings or to master their social environment. Friends, increasingly puzzled by and impatient with victims' seemingly inexplicable, dependency, may now begin to blame them, for
their current behavior if not for their initial vic- timization, in a" way that they conspicuously avoided doing in the early days after the loss. It is important here to understand that the group that victims may draw on for sympathy about their problem may be quite different from the group that they need to provide useful information and support for possible solutions to this problem. Peo- ple may recognize that they have a problem by comparison with normal others, but need a group of similarly victimized others to determine who
- can realistically be held responsible for various possible solutions. Similarly, in the study of relative deprivation (cf. Crosby, 1976), we need to under- stand that people may determine that they are being unfairly treated by comparing themselves with one set of others (e.g., others apparently less qualified than they who are earning almost as much money) and yet look to an entirely different set of others to establish the feasibility of different possible solutions (e.g., other occupational groups who have coped with a similar status threat).
Implications for Research and Practice
We may have wrong models in place in a number of areas—and worse yet, the tendency to respond to trouble by prescribing larger doses of the same model, rather than considering a different One. Certainly we have many social programs that are not getting the intended.results. McCord (1978) recently reported the results of a 30-year follow- up to the famous Cambridge-Somerville delin- quency study, indicating that boys in the experi- mental group, who had been given counselors and support, appeared to be worse off on a variety of dimensions than did boys in the control group. Stebbins, St. Pierre, Proper, Anderson, and Cerva's (1978) analysis of the nationwide set of programs in compensatory education known as Follow Through found that children enrolled in such pro- grams were less likely to do well oh a number pf variables than were comparable children not en- rolled. At the very least we need to know exactly what models are in place in such social enterprises. In the following sections we discuss what we know and what we need to know about the models of helping and coping in a number of important areas of social practice.
EDUCATION
It seems reasonable to believe that the dominant model for student behavior changes as we move
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compensatory model. The role of the therapist is the limited but critical one of teaching clients how to alter maladaptive cognitive processes and en- vironmental contingencies (Mahoney & Arnkoff, 1978). Once taught how to recognize and control these contingencies, clients are expected to set their own standards, monitor their own performance, and reward or reinforce themselves appropriately (Kanfer, 1977). Future research can assess whether different models are actually more successful when applied to disorders in which they are congruent with the patient's or significant others' assumptions about who is responsible for what. Phobia, for example, is a state in which people are continually mobilized against what they feel is some external threat, whereas depression is a state in which people are preoccupied with themselves as the apparent source of insoluble problems. It may be no accident that behavior therapy has had its most striking suc- cess with phobias, while highly structured thera- peutic communities, mood-elevating drugs, and perhaps psychoanalysis may be most successful for people who are unhappy with their lives in general and uncertain what to do about it.
PRISONS
Although crime may have its ultimate cause in environmental conditions or in the fact that some segments of the population are denied access to legitimate means for achieving success (Merton, 1957), it is pointless to call for a compensatory model for treatment of offenders. The first demand of the law is that people be held responsible for their actions. The punishment that is administered to offenders, once they have been found guilty, is designed to reaffirm the validity of the rule that has been violated and to reassure onlookers that they will be protected against further violations in the future, either by the defendant (through in- capacitation or rehabilitation) or by other potential offenders (through deterrence). The medical model, like the compensatory model, suffers in the public eye as a basis for treat- ing offenders in that it does not hold offenders responsible for their past actions. The medical model leads to the idea that offenders should be released when they are cured, however long or short a time this may take, interestingly enough, this idea is also unpopular among offenders, be- cause it compels them to participate in rehabili- tation programs that they find worthless or de- meaning and also deprives them of any firm
knowledge of when they will be considered cured and released. The enlightenment model, as we have seen, is generally the model that guides responses to of- fenders. Since offenders are responsible for a prob- lem and—under this model—cannot be considered responsible for a solution, they must be isolated in a community that will provide them with the dis- cipline and self-control they seem to lack. Unfor- tunately prisons, as they now exist, meet none of the requirements for an effective therapeutic com- munity but, rather, create a situation in which offenders learn more about how to evade authority, in prison and in society, than about how to get what they want by legitimate means. Under the remaining model, the moral model, offenders are both blamed for their past actions— as required by our sense of justice (cf. Lerner, 1980)—and yet are still held responsible for some behavior that would contribute to the solution of the problem they have caused. The essential fea- ture of a moral model for offenders is the require- ment that offenders make some form of restitution either to victims or to society, as a way of rebuild- ing respect both in their own eyes and those of others. Brickman (1977) has discussed at length how restitution stands as a more compelling prin- ciple of justice than either deterrence or rehabil- itation and how many of the practical difficulties associated with restitution programs may be over- come (see also Fofer, 1980). For example, resti- tution programs may operate by allowing of- fenders to do useful work while in prison, thus protecting society from contact with people it re- gards as dangerous while still allowing such people to contribute to the general welfare.
WELFARE
Everyone appears to agree that the major problem with welfare is that it cuts people off from incen- tives for providing their own solutions. Usually the creation of this dependency is seen as the inad- vertent by-product of a generosity whose impli- cations have not been thought through. The West- erners who gave steel axes to Stone Age Australians, for example, may have been unaware that the re- placement of stone axes with steel ones, which the tribes themselves could not create, would unravel a good part of the kinship and exchange structure of the culture (Sharp; 1952). In other analyses, however, the dependency and humiliation created by welfare is seen as the deliberate result of a strat- egy of social control designed to motivate workers
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to stay at their low-paying jobs while convincing them that the system cares about their struggles to support themselves (Piven & Cloward, 1972). The dominant model for welfare, therefore, is either the medical model or the enlightenment model, both of which presume the recipient needs to be taken care of, though differing in the extent to which they blame the recipient for being in this predicament. The moral model is of little use for questions of welfare, since welfare usually involves providing recipients with some very specific re- sources that they need (such as food or shelter), not merely exhortation to work harder and to do better (though such sermons may, of course, ac- company welfare to make clear to recipients the moral universe from which theii; dependency has excluded them). The remaining model is the com- pensatory model, with whose virtues we are al- ready familiar. There is, interestingly enough, an outstandingly successful example of welfare that was run on the assumptions of the compensatory model: the G.I. Bill passed after World War II. Aid under this bill was given to people who were seen as entitled to it (veterans) for a specific pur- pose (education) and a limited period of time. It was not a gift or a privilege for which recipients had to be grateful. It was routinely available, not something recipients had to go out of their way to solicit (cf. Gross, Wallston, & Piliavin, 1979). Moreover, it was clear that recipients had the right to refuse this aid, if they experienced it as unnec- essary, and the ability to determine that it would be used by them in times, places, and quantities that they found suited to their own needs (cf. Gay- lin, Glasser, Marcus, & Rothman, 1978).
Conclusion
We have used a distinction between attribution of responsibility for a problem and attribution of re- sponsibility for a solution to derive four general models that specify what form people's behavior will take when they try to help others (or to help themselves) and what form they expect recipients' behavior to take. We have reviewed evidence from both social and clinical psychology indicating that these models are internally consistent, have sig- nificant consequences, and are reasonable descrip- tions of alternative approaches in education, psy- chotherapy, law, and welfare. The derivation and description of these models is, however, only a beginning. We need research to establish what factors determine the choice of model by different agents and what factors deter-
mine the effectiveness of each model in given sit- uations. For example:
- Are some helping models (e.g., those that attribute responsibility for solutions to clients) uni- formly better than others? Or are different models best for different clients?
- Are client-provider teams using the same models more effective, or are clients better moti- vated by providers whose models are somewhat discrepant from the client's initial assumptions?
- Is it better to apply one model to a help re- cipient consistently or to change models as the re- cipient becomes first more and then less involved in the helping relationship (e.g., to begin with models that imply little recipient responsibility and gradually increase the responsibility attributed to recipients; cf. Lemkau, Bryant, & Brickman, in press)?
- Do help givers burn out less using some mod- els than using others? Do congruent or consistently applied models reduce work stress for professional service providers?
- How do organizational structures (cf. Len- row, 1978) and professional role socialization de- termine the choice of helping model? How do the past experiences of recipient populations deter- mine recipients' choice of models?
- Has there been a historic evolution of the dominant models applied to different populations? Do new models arise out of the clash of older ones? For example, the prospective emergence of the compensatory model as the dominant one in child- bearing situations (Cronenwett & Brickman, Note
- may be seen as an evolving compromise between the competing claims of establishment medical models and natural childbirth movements initially taking the form of enlightenment models. The answers to these and similar questions will add substantially to our understanding of what happens when people try to help and why they are successful at this enterprise less often than they would like to be.
REFERENCE NOTES
- Dienstbier, R. A., & Leak, G. K. Effects of monetary reward on maintenance of weight loss: An extension of the over- justification effect. Paper presented at the meeting of the American Psychological Association, Washington, D.C., Sep- tember 1976.
- Cronenwett, L., & Brickman, P. Models of helping and cop- ing in childbirth. Manuscript under review.
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