23 Mar 2015
The Person Centred relationship with a client is a unique one. The counsellor does not have different strategies, techniques or goals with which to support the client. She/He has only herself/himself to use. The approach therefore does not 'hide' behind a 'professional facade'; It does not require the counsellor to be the 'expert' and be there to guide or direct the client in how they should resolve their particular difficulties. If the counsellor is the 'expert' then the client by definition is then less equal than the counsellor.
The Person Centred approach, on the other hand, requires the counsellor to be fully present within the relationship as someone who never wishes to hold more power than the client. Therefore, the relationship is an equal one in which the counsellor strives always to foster and nurture the clients sense of personal power. This, hopefully, increasing sense of personal power over the clients own life is the only 'goal' which the person centred counsellor has.
It must be also said that the client has the absolute right (and in a way this is also personal power) to decide whether or not they wish to move towards this attainment of self power.The person centred counsellor trusts the client to know when and how (or not) to embrace personal power. He/She accepts it is the client who is ultimately the 'expert' over their own lives.
Person centred counselling provides the client with the opportunity to have a deep and meaningful relationship based on genuine warmth, regard and acceptance. Through such a relationship the client can gradually begin to explore difficult facets of their experience which are challenging to their self-concept.
This has been an extremely brief focus on person centred counselling and due to its brevity, cannot hope to adequately convey the deep humanity and compassion the approach it engenders; both in relation to client and counsellor.
Some of the central tenets of this new type of therapy were first outlined in 1942 (Rogers, 1942). As is clear from the name, the most important aspect of person-centred counselling is that the client is always at the centre of the process, unlike some other forms of counselling where technique is more pronounced. The approach has previously been called 'non-directive' which helps to emphasise that the counsellor is not providing advice, but rather the forum within which the client can explore themselves. Rogers encouraged his fellow therapists to concentrate on the present rather than the past, as well as a closer focus on feelings. Rogers began calling what had been the 'patient' the 'client' to emphasise the fact that the person being treated had to take responsibility for themselves rather than becoming a dependent who had to be treated.
Dryden & Mytton (1999) describes three stages in the historical development of person-centred counselling. The first stage emphasised providing the right atmosphere in which the client could release their emotions. Further, it emphasised the importance of understanding and acceptance on the part of the therapist. In the second stage Rogers concentrated on the attitude of the therapist. Here, he emphasised the idea that the therapist should believe that the client has the means of change within them and this should not be imposed from the outside. The therapist's role was to enter the client's world and to be empathetic and provide support. The third stage was developed through a troublesome therapeutic relationship Rogers had with a client. The client became overly dependent on him and later, having referred the patient to a psychiatrist, discovered deep, unresolved issues within himself. As a result of this experience, Rogers emphasised the importance of the therapist's own feelings. It is only through a real acceptance of the therapist's feelings towards the client that the therapy can proceed effectively. Rogers later called this idea 'congruence' between therapist and client and it represents a genuineness of emotion.
These historical developments in person-centred counselling are placed in their present theoretical arrangement by Dryden & Mytton (1999). Person-centred counselling is a humanistic approach, focussing on the present moment rather than the past. It is fundamentally based on the idea that every living thing has a self-actualising tendency. This is the drive to survive in even the most difficult circumstances. This, Rogers saw, manifested itself throughout the natural world, and human beings are no exception. Rogers explains that this tendency 'maintains and enhances', working towards, but never ultimately achieving, our full potential. Life, for Rogers, is about steady progress towards self-actualisation.
Also fundamental to the person-centred approach is the idea that we all perceive reality in different ways. In other words, the world doesn't look the same to each of us. This is simply because we all have different experiences, which in turn affects our behaviour in different ways. We each filter our senses differently according to our experiences and our way of interacting with the world.
Important in the development of person-centred counselling is the idea of self and it is closely related to the self-actualising tendency discussed above. In the development of self, Rogers does not argue that there are any stages but instead that aspects of personality and self arise through a combination of innate preferences interacting with environment. A child has a basic need to be seen positively - a need for positive regard. Inconsistencies arise when there is a conflict between the inner self and the self-concept. This may arise as others' regard for the growing child and its behaviour is not always congruent with its own inner self. The child can resolve this inconsistency through introjection. This means taking the beliefs and values of others and internalising them so that they become the child's beliefs and values. A mentally healthy person, therefore, manages to balance these conflicts and accept themselves and others unconditionally.
Unfortunately most of us are not so completely balanced and well-developed and problems do occur in this balancing process. One imbalance which Rogers often saw was that the need for positive self-regard was often so strong that it outweighed what he called 'organismic needs'. It is these organismic needs that automatically tell us what is good for us so that we can obtain the things that we need. This means that if there is a serious conflict then we will tend to distort or deny what is actually happening to us. Dryden & Mytton (1999) quote the example given by Rogers (1951) of an adolescent boy brought up by over-controlling parents. While he loves his parents, he is also extremely resentful of the control they exert over him. To resolve this conflict the boy may disown the anger, or misattribute it to a different cause. While this is effective in removing the immediate discomfort, it serves to maintain psychological inner conflict.
The process by which counselling takes place is very important in the person-centred approach. There should be no suggestion that the therapist is taking the upper hand and, in any way has privileged information about the client. Rogers (1961) found when the necessary conditions were set up, the change that was required in the client happened automatically.
Empirical investigations into outcomes have been limited within person-centred counselling as those involved in the approach are not generally predisposed to scientific evaluation. The notable exception is that research carried out by Rogers himself in the development of his therapeutic process.
One of the major advantages of the person-centred approach that has been backed up in the research literature is its concentration on the therapeutic relationship. Research, for example, that has looked at the common versus specific factors that are important in outcomes for psychotherapeutic interventions has found that client-therapist relationship is extremely important. Strupp (1996) has estimated from research that 85% of the outcome variability from different types of psychotherapies can be explained by common factors. These common factors are largely the same ones espoused by Rogers (1951).
Practical criticisms of the person-centred approach have tended to concentrate on the fact that it doesn't provide particular approaches for particular needs. Person-centred counselling is considered to be good for more low-level or basic problems, but is perhaps not suited for more serious mental disturbances. For example, it is less likely that those suffering from severe psychosis will be able to benefit from this type of counselling. Its fundamental assumption is that a person entering counselling needs to be motivated to change. It is questionable whether this will be the case for the more seriously disturbed client. The other line of criticism is more centred on its philosophy. Because of the vague nature of its central tenets it is very difficult to test, and some critics have argued that its central ideas of self-actualisation are impossibly optimistic views of human nature.
Gestalt therapy is based on some of the principles of Gestalt psychology, which has at its core the idea that something, like, for example, the human mind, should be considered as a whole rather than broken down into its component parts. Like person-centred counselling, gestalt therapy is also a humanistic approach. It is also similar in that its genesis was in the reaction against the authoritarian version of psychotherapy that had been created by Freud. It aims to put the client and therapist on similar footing and concentrates on the client's view of the world, particularly their view as it is at that very moment.Â
The two names most associated with gestalt therapy are Fritz and Laura Perls. Fall, Holden & Marquis (2004) explain that the self, in gestalt therapy, is seen as relational, the person does not exist outside their relationships with other people. Gestalt therapy is often associated with practical experiments, such as the empty chair technique in which the client is asked to have a conversation with a person imagined to be in an empty chair. While gestalt has many things in common with person-centred counselling, it concentrates more on the experiential aspect - so that experiments may form a part of the counselling process. It is also much more active in nature than person-centred counselling and in this sense can provide a useful adjunct to a person-centred approach, especially since many of its basic tenets are similar.
Transactional analysis was developed by Eric Berne and concentrates on analysing the dysfunctional social interactions that people have with each other, characterising these as 'games' (Berne, 2001). Berne took Freud's ideas of the ego, superego and id and turned it into a tripartite structure with adult, parent and child, theorising that in our everyday life we move from one 'ego-state' to another. This theory, like the two mentioned previously has, at its base, the idea that we have a number of needs that have to be satisfied. A person is considered happy or well-adjusted if they can satisfy these needs without interference with other people's needs. Change is addressed in transactional analysis by creating a contract between the client and therapist - like the other therapies discussed motivation for change is seen to be centred within the client, and the client is seen to understand what is best for them. Transactional analysis in counselling is usually focussed more tightly on solving particular problems and, in this, can be contrasted from person-centred counselling which does not focus on problems. Ideas and techniques from transactional analysis, however, do lend themselves to incorporation in an integrative approach.
All of the therapeutic techniques require a thorough understanding of the theory and practice before they can be used. In any type of therapy there are usually powerful emotions at work and these need to be dealt with in the right way to help the client grow. But, like any situation, it is only through some kind of engagement with these issues and the associated dangers, that progress can be made.
There are many different qualities that must be explored during self-counselling, in order for it to provide an effective method of increasing self-awareness and self-development.
Without being able to access these key elements of self-exploration, self-counselling becomes more difficult and may not provide a beneficial alternative to one-to-one counselling with a trained therapist or counsellor.
Being person-centred must not be confused with being self-centred. If someone is self-centred they are obsessed and engrossed with themselves and their own affairs. To be person-centred however, means an individual is aware of their own worth and their personal limitations.
Person-centred self-counselling allows the individual to look at each of the essential qualities separately, and to identify specific areas that require more understanding and acceptance. Person-centred self-counselling also emphasises an individual's personal strengths, and their ability to direct the course of counselling.
There are a number of key qualities that form the core of person-centred counselling. These include: self-acceptance, self-empathy, self-judgment, self-regard and self-genuineness. In order for self-counselling to be effective all of these qualities must be combined and explored by the individual who is embarking on a course of extended personal awareness.
Self-acceptance allows the acceptance of all of the parts of an individual's personality and behaviour, and provides a better understanding of the things that most need to be changed. Having a high self-regard will also encourage self-expression of emotions and issues. An unconditional self-regard enables an individual to identify positive opportunities more readily, and works in tandem with the other essential qualities.
Free association - where an individual expresses random thoughts, words and imagery - and visualisation are effective skills that are used successfully during self-centred counselling. Being open to exploring inner feelings and emotions will open up person-centred counselling so that positive results are more accessible.
Being able to relate to yourself, by exploring feelings through visualisation, may initially feel difficult, but with practice this technique increases self-awareness and self-development considerably.
Maintaining an open, self dialogue - by listening to your psyche - is also a beneficial part of self-counselling, and can provide an opportunity to explore emotions and feelings further.
Being genuine towards yourself will enable you to reflect and revise the progress you are making. Checking progress, at regular intervals, will also help you identify areas that you may not feel as comfortable with, and will allow you to go over intentions and goals, which will create a more positive feeling towards continuing with person-centred techniques and ideas. Being able to see how much progress you are making will also encourage you to explore other ways of using the key techniques that work best for you.
Taking time to re-enforce intention provides clarity and insight, which you may be lacking through the process of self-counselling, but which would be readily available in a one-to-one counselling relationship with a trained counsellor. The opportunity to re-evaluate your goals and aims will also enable you to work on your personal limitations, and to stretch yourself even further.
This method of supportive therapy was developed by Carl Rogers, in the 1940s. He pioneered this non-directive approach to counselling, which focuses on the 'here and now' principle, and encourages counselling clients to explore and create positive change for themselves.
Person centred counselling focuses on the personal relationship between a counsellor and his/her client. The development of trust and understanding within this counsellor/client relationship encourages self-realisation, and enables the client to acknowledge the problems and issues they are disclosing, and to think up solutions, with gentle encouragement and guidance from the counsellor.
Working with clients in a person centred way allows the client to explore their thoughts, feelings and emotions in a confidential environment. It gives him/her the opportunity to express concerns and problems and to achieve clarity of thought.
Person centred counselling is a non-directive method of providing therapeutic support, and enables the client to utilise free-association and free-thinking during disclosure. It is based on the humanistic philosophy that every individual has the ability to create a more positive, and satisfying, way of living. By actively listening and mirroring, during the one-to-one counselling session, the counsellor provides the client with sufficient positive feedback to encourage him/her to further explore their difficulties.
Having exposed feelings and emotions the client is then more able to think the issues through, until clarity is achieved. This allows the client to understand the meaning behind their feelings and emotions, and to decide what positive steps, towards change, to take next. It also increases self-awareness and offers personal insights.
Although counselling in a person centred manner does not have as much structure, as some other methods of providing counselling support, it is a highly effective way of encouraging personal growth and understanding in a client. It is a non-judgmental, non-directive approach to assisting the client to find personal solutions, and avoids analysis.
The benefits a client receives, from a counsellor during person centred therapy, include unconditional positive regard, empathy and genuineness. All of these things combined create a positive, firm foundation for a trusting counselling relationship between the counsellor and his/her client.
The main goal of any form of counselling therapy is to release the client from any emotional distress, mental confusion and/or limiting beliefs. Person centred counselling arms the client with the opportunity to become more self-aware, and more in control of creating the sort of positive changes they want to see in their life.
A counsellor's positive attitude is important in facilitating a progressive counselling relationship, and it is their job to encourage, challenge and support the client at all times. Demonstrating empathy, congruence and unconditional positive regard, throughout the one-to-one counselling relationship with a client, will provide the client with understanding, clarity and support, in order to make steady progress to self-realisation.
This type of therapy concentrates on the here and now, and encourages the client to think in present time.
It recognises and values the client.
It encourages self-expression, self-awareness, self-development and a greater understanding of self.
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.
One reason this may occur is that individuals often cope with the conditional acceptance offered to them by others by gradually coming to incorporate these conditions into their own views about themselves. They may form a self-concept which includes views of themselves like, "I am the sort of person who must never be late", or "I am the sort of person who always respects others", or "I am the sort of person who always keeps the house clean". Because of a fundamental need for positive regard from others, it is easier to 'be' this sort of person -- and to receive positive regard from others as a result -- than it is to 'be' anything else and risk losing that positive regard. Over time, their intrinsic sense of their own identity and their own evaluations of experience and attributions of value may be replaced by creations partly or even entirely due to the pressures felt from other people. That is, the individual displaces personal judgements and meanings with those of others.
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.
The person-centred approach maintains that 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. The core conditions are:
Unconditional positive regard
The first -- unconditional positive regard -- means that the counsellor accepts the client unconditionally and non-judgementally. The client is free to explore all thoughts and feelings, positive or negative, without danger of rejection or condemnation. Crucially, the client is free to explore and to express without having to do anything in particular or meet any particular standards of behaviour to 'earn' positive regard from the counsellor. The second -- empathic understanding -- means that the counsellor accurately understands the client's thoughts, feelings, and meanings from the client's own perspective. 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. The third -- congruence -- means that 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'.
Together, these three core conditions are believed to enable the client to develop and grow in their own way -- to strengthen and expand their own identity and to become the person that they 'really' are independently of the pressures of others to act or think in particular ways.
As a result, person-centred theory takes these core conditions as both necessary and sufficient for therapeutic movement to occur -- i.e., that if these core conditions are provided, then the client will experience therapeutic change. (Indeed, the achievement of identifying and articulating these core conditions and launching a significant programme of scientific research to test hypotheses about them was one of the greatest contributions of Carl Rogers, the American psychologist who first began formulating the person-centred approach in the 1930s and 1940s.) 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.
Finally, as noted at the outset, the person-centred approach takes clients as their own best authorities. The focus of person-centred therapy is always on the client's own feelings and thoughts, not on those of the therapist -- and certainly not on diagnosis or categorization. The person-centred therapist makes every attempt to foster an environment in which clients can encounter themselves and become more intimate with their own thoughts, feelings and meanings.
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'. On the face of it, this criticism reflects a misunderstanding of the real challenges of consistently manifesting unconditional positive regard, empathic understanding and congruence. This is especially true of congruence: to the extent that some therapeutic techniques deployed in some other traditions depend on the counsellor's willingness to 'hold back', mentally formulate hypotheses about the client, or conceal their own personal reactions behind a consistent professional face, there is a real challenge in applying these techniques with the openness and honesty which defines congruence. It may also demonstrate something of a reluctance to take seriously the empirical research on counselling effectiveness and the conclusion that the quality of the client-counsellor relationship is a leading predictor of therapeutic effectiveness -- although this is somewhat more controversial, since one might argue that providing the core conditions is not the only way to achieve a quality relationship. (See the page on Comparing Effectiveness.)
At a deeper level, however, there is a more sophisticated point lurking, which many expositions of person-centred theory seem to avoid addressing head-on. Namely, given that the self is the single most important resource the person-centred counsellor brings to the therapeutic relationship, it makes sense to ask: what (if anything) is it important that this self has, apart from the three core conditions? I.e., manifesting of the core conditions does not by itself tell us what experiences or philosophies the counsellor is bringing to the relationship. It tells us that the client will have transparent access to that self -- because the counsellor is congruent -- but it doesn't tell us anything else about that self. Whether or not that self should be developed in any particular way, or whether that self should acquire any particular background knowledge, seems to me a question which is more often side-stepped than answered within the person-centred tradition.
(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?)
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.
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