Differences between styles of therapeutic relationships

23 Mar 2015

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In order to answer the above, I will first outline the key principles of psychodynamic and person centred counselling, next I will discuss the similarities and differences between the therapeutic relationships in the two approaches. I will then move on to highlighting the challenges that would be involved if a counsellor chose to integrate the two approaches.

The Person centred approach was devised by Carl Rogers in the 1950's (McLeod, 2004), it had emerged from the humanistic tradition. According to Mearnes and Thornes (2007) Roger's strongly believed humans were good natured and emphasised on the notion of self actualisation, this means every person has the capacity to control and regulate themselves to reach their full potential and if they require therapy, they are in a state of incongruence (which refers to not being genuine or fully accepting themselves). It is the therapist's role using the core conditions (congruence, unconditional positive regard and empathy) which helps to encourage the individual to reach their full potential and reflect their learning on other relationships (Mearns &Thornes 2007).

The Psychodynamic approach originated from the work by Sigmund Freud (1856-1939), this approach stresses that many problems in adulthood are caused by sexual repressed thoughts in childhood. Freud emphasized the role of the unconscious (Hough, 2006) and employs an active role in order to explore how past experiences influence present behaviour. The aim of this therapy is to increase the client's awareness and reflect their behaviour onto new relationships, this is achieved by using transference (which refers to unconscious feelings directed from one person to another) and analysing the unconscious patterns (Hough, 2006). I will now discuss the similarities between the therapeutic relationships in both approaches.

Similar to most approaches, building a therapeutic alliance is the core to both person centred and psychodynamic counselling; they facilitate mutual trust, respect, purpose and dedication (Worsley, 2007). Mitchell and Cormack (1998, p50) summarises the notion by saying that "patients themselves value therapeutic relationships which offer respect, trust and care and it seems that such relationships may in themselves prove to be healing in the broadest sense". It has been acknowledged that both forms of practice use conversation and dialogue throughout the sessions, in addition, both types of counselling have quite strict time boundaries, which consist of fifty minutes per session (Jacobs, 1999). The process of successful therapy can be lengthy which can take months or even years for a full recovery (Jacobs, 1999). I will now move on to discuss the differences in the therapeutic relationship that is advocated between the two approaches.

Research has indicated considerable differences in the styles of therapeutic relationship between the person centred and psychodynamic counselling. In person centred counselling the counsellor employs a non-directive role, it has been said the therapist express themselves more like a companion rather than an authority figure, and places the client in a position to take lead (Owen,1999). In contrast, psychodynamic counsellors adopt an active role, this leads to being more of an authority figure in the relationship (McLeod &Wheeler, 1995).

The person centred way of working firmly believes by using the core conditions therapeutic change occurs (Owen,1999). However, according to psychodynamic therapists, Hough (2006) views the key of transference is to make interpretation to the client and then effective psychological change occurs. From a person centred view, using a technique such as transference would seem aimless and defeat the object of creating a genuine relationship between client and counsellor (McLeod, 2004). According to Mearnes and Thornes (2007) one of the central theme's in person centred counselling is that it emphasises on the present behaviours of the client and was concerned of the attitude portrayed to the client. This was one of the major differences found between the two approaches as Hough (2006) asserted psychodynamic counselling focuses on the past and how it determines present behaviours, also traditionally, psychodynamic counsellors chose to remain neutral during sessions, as this way of working encouraged feelings of transference. McLeod (2004) points out that in person centred counselling, questions are only asked to clients when necessary and may also answer questions if asked by clients, as this was supports to create the quality of the relationship. This again differs to the way Psychodynamic counsellors' work; as asking questions are pivotal during therapy as this helps to explore and build up relevant material, furthermore, it would be unlikely for a psychodynamic counsellor to answer any personal questions by the client and instead try to figure out why the question is important (McLeod &Wheeler, 1995). I will now address some of the challenges involved if a counsellor chose to integrate the psychodynamic and person centred approach.

It could be suggested that by combining these methods could strengthen any areas of weaknesses and provide a more holistic therapy. However, McLeod and Wheeler (1995) argue that by integrating these approaches will only cause confusion for the clients, as according to them, different theories have different explanations of human nature. For instance, psychodynamic theory uses the notion of being a blank slate in order to achieve transference for meaning; In contrast, the person centred theory firmly believe by using the core conditions and the idea of self-concept in order to heal (Jacobs,1999; Mearnes and Thornes,2007). Therefore, according to Worsley (2007) it would be disastrous for an integrative counsellor to use the core conditions as well as remaining a blank slate to a client; as the person centred approach does not agree with remaining neutral towards clients as this contradicts with using the core conditions. In addition, individual theories have their own specific language; and as a result it will be difficult for counsellors and indeed for a client to understand the terminologies of different theories (Worsley, 2007; McLeod, & Wheeler, 2004).

To summarise, I have outlined the key aspects of both- person centred and psychodynamic counselling, I have then discussed the similarities and differences between the styles of therapeutic relationship in the two approaches. Worsley (2007) shows that there are some similarities where general principles are shared, these are that both person centred and psychodynamic counsellors would agree that great importance is placed in the therapeutic relationship in order to facilitate client awareness and development. However, a considerable amount of differences were aired, the fundamental difference between the two approaches were; a psychodynamic way of working is to employ an active role in order to interpret meaning to the client, this way effective psychological change occurs (Hough, 2006). In contrast, person centred counselling employs a non-directive role, whereby the counsellor believes by using the core conditions therapeutic change occurs (McLeod & Wheeler, 1995). Lastly, it has been discussed when integrating the person centred and psychodynamic approach; both would result in difficulties and confusion for counsellors and clients, as both theories contradict each other, therefore they are seen as incompatible (Worsley, 2007; McLeod, & Wheeler, 2004).



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