In light of the person centred theme this year, quick recap of the approach is very much needed. I am still struggling to see how being fully person centred could help clients’ with their dilemmas. Also, how would I communicate to clients what I’m doing is more than just ‘accepting’ them and letting them ‘facilitate the growth themselves’. When said out loud, it almost seems like all the responsibility is on the client. Would they like to hear that? Hm, needs some reframing.
I took some excerpts from an article (below) which I found particularly useful and perhaps will help me with gaining a better picture of counselling practice:
Italics are my comments
An Introduction to Person-Centred Counselling
The person-centred approach views the client as their own best authority on their own experience, and it views the client as being fully capable of fulfilling their own potential for growth. It recognizes, however, that achieving potential requires favourable conditions and that under adverse conditions, individuals may well not grow and develop in the ways that they otherwise could. In particular, when individuals are denied acceptance and positive regard from others — or when that positive regard is made conditional upon the individual behaving in particular ways — they may begin to lose touch with what their own experience means for them, and their innate tendency to grow in a direction consistent with that meaning may be stifled.
So it’s something about exploring the reasons behind the presenting issue without judgement – with positive regard
Psychological disturbance occurs when the individual’s ‘self-concept’ begins to clash with immediate personal experience — i.e., when the evidence of the individual’s own senses or the individual’s own judgement clashes with what the self-concept says ‘ought’ to be the case. Unfortunately, disturbance is apt to continue as long as the individual depends on the conditionally positive judgements of others for their sense of self-worth and as long as the individual relies on a self-concept designed in part to earn those positive judgements. Experiences which challenge the self-concept are apt to be distorted or even denied altogether in order to preserve it.
Therapeutic Approach of Person-Centred Counselling
- Unconditional positive regard
- Empathic understanding
These three core conditions provide a climate conducive to growth and therapeutic change. They contrast starkly with those conditions believed to be responsible for psychological disturbance.
Interpreting it as such means that as therapists we are looking at the positive regards/ negative regards that were offered to the client. Also, we are to offer the clients positive regard in not imposing rules on their behaviour (contradictory in a way, for instance, what if a client turns up very drunk etc).
Empathic understanding: We had a practice session during teachings, I couldn’t get to an empathic understanding of the other person’s story. It’s quite difficult to grasp the layers of meanings and feelings from an account especially when done in 5 minutes. When the counsellor perceives what the world is like from the client’s point of view, it demonstrates not only that that view has value, but also that the client is being accepted.
Congruence: The counsellor is authentic and genuine. The counsellor does not present an aloof professional facade, but is present and transparent to the client. There is no air of authority or hidden knowledge, and the client does not have to speculate about what the counsellor is ‘really like’. How much congruence is appropriate? Would the client be put off by too much self-disclosure? I am in favour of bringing the feelings evoked in me by the client into the room to be explored, but I have also seen instances where it clients don’t want to know what’s going on in the therapist.
Notably, person-centred theory suggests that there is nothing essentially unique about the counselling relationship and that in fact healthy relationships with significant others may well manifest the core conditions and thus be therapeutic, although normally in a transitory sort of way, rather than consistently and continually.
Criticisms of Person-Centred Counselling
A frequent criticism of the person-centred approach is that delivering the core conditions is what all good therapists do anyway, before they move on to applying their expertise and doing the real work of ‘making clients better’.
Theoretically that’s the case, I have studied the person centred approach prior to practicing and understood it. Or so I thought. When in therapy I realised it is not easy to bracket off my continuous assessment and formulation of this person in front of me. It is also contradictory to ‘identifying blind spots’ in client’s thinking (Egan’s Skilled Helper Approach) which we were taught. However, as it is the person centred ‘year’, we have to immerse ourselves in it; be mindful about the techniques used in therapy for process reports, transcripts etc. Having said that, I am aware that positive regard seems to be an important facilitator in helping clients explore their issues in depth.
Also, if just bringing the congruent self is sufficient, what of the knowledge therapists has in relation to the field? Isn’t that more useful? But if the self is bringing knowledge into the therapeutic relationship. What knowledge is right? The author of the article gave a very good example:
Another way to understand this point is this: given two counsellors, each of whom manifests the core conditions to some specified degree, what else, if anything, matters? Would it be better for a given client to have the one who is an expert at astrophysics or the one who is an economist? Would it be better for a given client to have the one who struggled through a decade of ethnic cleansing in a war-torn country or the one who went to private school in an affluent suburb and subsequently worked as a stockbroker? Aside from academic expertise and personal history, what about personal philosophy, parenthood, and other factors?
Below is perhaps the best part of the article:
Best Fit With Clients
Clients who have a strong urge in the direction of exploring themselves and their feelings and who value personal responsibility may be particularly attracted to the person-centred approach. Those who would like a counsellor to offer them extensive advice, to diagnose their problems, or to analyse their psyches will probably find the person-centred approach less helpful. Clients who would like to address specific psychological habits or patterns of thinking may find some variation in the helpfulness of the person-centred approach, as the individual therapeutic styles of person-centred counsellors vary widely, and some will feel more able than others to engage directly with these types of concerns.
I am in agreement, that it up to the needs of the client. I have came across some who would benefit from the therapist who brings him/herself and explore the issue with the client from their frame of reference. Others might require more challenging and reframing. The most difficult part is in identifying the most suitable approach in the time given.