How do we decide when to offer aid? Brickman and his colleagues (1982) suggest that whether help is offered, as well as the form it takes, largely depends on how we answer two questions: (1) Who is responsible for the problem? and (2) Who is responsible for the solution? The answers to these two questions form the basis for four models of helping:

In the moral model, actors are held responsible both for problems and solutions and are believed to need proper motivation. Historically, we have viewed criminality and alcoholism in this way: "You got yourself into this mess, now get yourself out." Helpers simply exhort people to assume responsibility for their problems and to work their own way out.

In the compensatory model, people are not seen as responsible for problems, but they are responsible for solutions. People need power, and the helper may provide resources or opportunities that the recipients deserve. Nonetheless, the responsibility for using this assistance rests with the recipient.

In the medical model, individuals are seen as neither responsible for the problem or for the solution. Helpers say, "You are ill, and I will try to make you better." This approach, of course, characterizes the health care system in all modern societies. Helping involves providing treatment and care.

In the enlightenment model, actors are seen as responsible for problems but as unable or unwilling to provide solutions. They are viewed as needing discipline. Helping means earning their trust and giving them guidance. Alcoholics Anonymous explicitly requires new recruits both to take responsibility for their past history of drinking (rather than blaming it on something or someone else) and to admit that it is beyond their power to control the drinking without the help of a higher power and the community of ex-alcoholics.

Brickman suggests that the wrong choice of model in a given situation will undermine effective helping and coping. For example, the potential deficiency of the moral model is that it can lead its adherents to hold victims of leukemia and rape responsible for their fate. Those advocating the compensatory model may alienate the people they help. The recipients may come to see themselves as having to solve problems they did not create, thereby developing a rather negative, even paranoid view of the world. The deficiency of the medical model is that it fosters dependency, and people may lose the ability to do even something that they once did well. The possible drawback of the enlightenment model is that it can lead to a fanatical or obsessive concern with certain problems and a reconstruction of people's entire lives around the behaviours or the relationships designed to help them deal with these problems.

Philip, B., Vita Carulli, R., Jurgis, K., Jr., Dan, C., Ellen, C., & Louise, K. (1982). Models of helping and coping. American Psychologist, 37(4), 368–384. https://doi.org/10.1037/0003-066X.37.4.368