Also by Pauline Connolly:
Trust in the
actualizing tendency
The 'as if' quality of
empathy
The Here and Now in Gestalt therapy
An Ethical way of Being:
Implications of the
Person-centred approach
What
is the Person-Centred Approach?
The Person-centred approach (PCA)[1] is an emotional and
psychological approach to the person; a ‘way of being’, from which perception
of self, reality and behaviour may be reorganized (
The actualizing tendency is the cornerstone
of the approach and viewed as the ‘mainspring of life’ and tendency on which
all therapy depends (Schmid, 2001, p.2).
In order to ‘release’ this growth force,
certain relational conditions must exist.
View
of human nature
‘That the basic nature of the human being,
when functioning freely, is constructive and trustworthy’ (Rogers, 1961,
p.194), is implicit in person centred philosophy. While oft-criticized as being
overly optimistic and naïve, such an image does not deny the capacity for
destructive thought or action, but rather, stresses the potential of the person
for growth (Merry, 2000). In process, and moving toward actualizing their
potential – to the extent their environment permits – individuals are viewed as
capable of developing socially and emotionally in ‘self-enhancing ways and in a
manner which will advance the common good’ (Thorne, 1991, p.97). In
(therapeutic) practice this means that the client has the ‘strength to devise,
quite unguided, the steps which will lead him to a more mature and more
comfortable relationship with his reality’ (Rogers, 1946, p.419, my italics).
A belief in the trustworthiness, inherent
goodness and wisdom of the client is considered fundamental to the therapeutic
relationship[2], in which the client
(having experienced the counsellor’s attitudes to some degree[3]) is viewed as having
the capacity for perceptual and consequently behavioural reorganization
(Rogers, 1947). Operating on these assumptions, the best way to ‘help’ the
client is through the provision of a relationship (imbued with values/
attitudes inherent in the PCA[4]) wherein he[5] may discover his
strengths, move toward finding his own answers and make personal sense of himself
and life.
Limitations: inherent in the approach or the
individual counsellor?
While maintaining that, ‘the limitations of
person-centred therapy reside not in the approach itself, but in the
limitations of particular therapists and their ability or lack of it to offer
their clients the necessary conditions for change and development’ (Thorne,
1991, p.36), Thorne, nevertheless, freely admits that in his own experience,
there are certain kinds of clients who are unlikely to be much helped by the approach
(ibid). Similarly, Rogers himself, was of the opinion ‘that psychotherapy of
any kind, including person-centred therapy, is probably of the greatest help to
people who are closest to a reasonable adjustment to life’ (ibid).That is not
to imply however, that the approach – only applicable to neurotic individuals –
is inappropriate for and ineffective with more severely disturbed and/or
psychotic clients[6]. Research has
countered this myth (see Shlien, 2003; Joseph and Worsley, 2005); including the
problem laden Wisconsin research project, which provided sufficient evidence to
indicate that, the presence of Rogers’ conditions, had some positive impact
with (hospitalized psychotic) clients.[7]
Regarding the effectiveness of
client-centred therapy, I was very struck by the following words of
Sometimes people feel that client-centered
therapy is good for going only so far, and when you really strike difficult
problems you should probably be more confronting or more this or more that. I
think – and I feel quite strongly from my experience – that that is really a
mistaken line of thought. I think that when the situation is most difficult,
that’s when a client-centered approach is most needed, and what is needed there
is a deepening of the conditions…not trying something more technique oriented.
(Rogers and Russell, 2002, pp. 258-9)
Principled
non-directiveness: the nature of influence
A central attitude expressing trust in the
client’s organismic self-determination and authority is that of principled
non-directiveness. As the ‘very fibre of the core conditions’ (Levitt, 2005,
p.6), and a consequence of living person-centred philosophy, this (counsellor)
posture offers the client a safe, growth-promoting environment that serves to
undermine conditions of worth, enhance self-worth and facilitate congruence
and/or psychological adjustment. As ‘an active and pro-active way of
interaction’ (Mearns and Thorne, 2000, p.81), non-directivity implies accepting
the client’s subjective reality and self-authority[9],
respecting his sense of direction (in terms of process and content), and
relying upon his capacity (increasingly guided by his organismic valuing
process) to explore and resolve his issues. As a ‘facilitative responsiveness’
enabling clients to discover their strengths and become directive of their own
lives, the non-directive stance emphasizes that the ‘changing factor’ in
therapy, rather than particular therapist skills, interventions, techniques, is
in fact the client (Schmid, 2000).
The counsellor’s conscious relinquishing of
power – ‘surrender’ of control (Prouty, 2000), through congruence,
unconditional acceptance and sensitive empathic understanding, follow from
subscribing to a philosophy that genuinely ‘identifies the client as his best
expert about his life’ (Bozarth, 1998, p.4). This logical mode of response,
serves to protect client autonomy, promote freedom and trust within the
relationship, and enable clients to explore, reorganize and identify the value
system and lifestyle that they discern (through dialogue) as being important to
them (Merry, 2002). Further, since practitioners have an ethical responsibility
to strive to mitigate (even unintended) harm to the client, non-directivity in
limiting the ‘iatrogenic influence’ (Witty, 2005, p.237) reflects a commitment
to the principle of non-maleficence (BACP 2001), thus serving ethical and
therapeutic aims.
The crux of non-directivity relates to the
nature and extent of the counsellor’s influence and its compatibility with
Rogerian philosophy. Perspectives such as those of Patterson and others
(mentioned throughout), view non-directivity as a central distinguishing
characteristic of the PCA (and a defining criterion of their identity and way
of relating with clients). In their practice, there is no room for directivity;
not even the ‘instrumental’ kind, which directive in intent, is used to effect
change (see Patterson, 2000). For Levitt (2005), it implies ‘only one kind of
intent: a shedding of power over the client and his or her process, and letting
go of the expert stance or role’ (p.8). When a counsellor presumes to know what
is wrong with and best for the client, she has failed to maintain an
‘uncontaminated dedication’ (Bozarth, 1998, p.100) to the client’s narrative
and allow the locus of decision-making and responsibility (i.e. internal locus
of evaluation) to remain with him.
Consequently, ‘the potency of the approach can not be fully realized if
the trust of the client by the therapist is short-circuited with interventions
and with the therapist’s ideas of what is ‘really’ best for the client’ (ibid,
p.5).
In order to facilitate self-ownership and
direction, then, counsellors strive not to behave in ways likely to distract the
client from focusing on his own experiencing.
Nevertheless,
since ‘all psychotherapies may be analyzed
as occasions of social influence’ (Witty, 2005, p.228), it is generally
accepted that influence of some kind is an inevitable part of the counselling
process and consequence of ‘being in relationship.’ In fact, as Merry (2000)
and others have noted, if this were not a reality, there would be little point,
let alone a demand for this type of ‘psychological opportunity’. However, as a
person-centred practitioner, one hopes that the nature and extent of influence
is consistent with philosophy; that is, ‘the goal of this influence is to free
and foster the process of self-actualization in the client. This goal is not
chosen by either the therapist or the client – it is given by the nature of the
client as a living organism’ (Patterson, 2000, p.182).
Experience
as a person-centred counsellor
While I aim to create a collaborative,
empowering relationship which validates client’s feelings/needs, enhances self-worth
and agency, reduces the power imbalance[10],
etc, I am aware of my perceived expert status (often in the initial stages of
the relationship). In my experience, however, clients soon learn, through my
non-directiveness, that I am not an authority on them/their lives, can and will
not ‘rescue’ them (in the sense of becoming a disempowering, external locus of
evaluation), and essentially, can not alleviate the suffering that has prompted
them to seek help and occasioned our encounter.
I myself have been influenced and at times,
deeply affected by the clients I work with. While the experience can be
uncomfortable/painful, it also offers rich learning, enhancing my understanding
of self (professionally and personally, in terms limitations and capabilities),
the client and his unique process, and an opportunity to witness the many
fruits of a person-centred relationship.
I am often touched by how individuals are
able to assimilate and poignantly express their grief, gradually become
reconciled with their history, return from the brink of utter despair or chaos,
experience greater positive self-regard, etc. I have also been amazed, humbled
(feeling inferior and duly reminded of my ignorance), even a little in awe at
how enlightened, humorous and intelligent some individuals/clients are; how
their wealth of general and specialized knowledge/expertise (e.g. in art,
music, politics, technology, etc) far extends my own. In practice, I have found
that it is the client who in fact frequently constitutes a tremendous learning
resource for me; and who when allowed to develop in the kind of social
environment espoused by Rogers, naturally redresses the (often alluded to)
imbalance of power in the therapeutic relationship. I find myself resonating
with the following words of Majorie Witty (2005):
The therapeutic situation is a social
situation… a human relationship subject to interpersonal, contextual, social
and situational influences which arise when two persons are communicating with
each other…in which social influence flows bidirectionally from therapist to
client, and from client to therapist, in a fluid, dynamic way. (p.229)
Facing the suffering, the unique humanness
of the individual – with his vulnerability, neurosis, doubts, etc, as well as,
inner strengths, I am frequently confronted with my own vulnerability and
shortcomings (including a sense of powerlessness); a reality check that if ever
there was an ‘expert’ in the room, it is clearly not I!
In my experience, the according of expertise/authority
(to myself) by clients, is largely dependant on the individual (his/her
perceptions of me, stage in the therapeutic process and/or recovery,
personality, prior social learning, including experience of therapy, etc.) Some
clients, for example – yet to discover or fully trust their internal resources
– are vulnerable and overly keen to be influenced; and their experience of
being helped, ‘moving on’, is synonymous with being guided/directed. Here,
experiencing something of an equal relationship is evermore of a challenge, and
a reality less frequently or consistently realized. However, given the fluid,
dynamic nature of the interpersonal process, including one’s commitment to
relating in ways that protect, as much as possible, the vulnerability of
clients and weaken any perceived/actual power differential, I believe there can
be a genuine interpersonal encounter involving ‘relational depth’ (even if it is ‘moments’ rather than a
continuing relationship; Mearns, 2006, p.2).
Thus, as Witty (2005) notes, despite Buber
contending that, ‘the structure of the therapeutic relationship situation –
it’s cultural, social and political meanings – trumped the personal differences
in power which might characterize the two persons in the therapy dyad’ (p.242),
my experience teaches me that an authentic, egalitarian meeting of two persons,
of a dialogic, ‘I-Thou’ nature is possible.
Personal
value system
Adopting a person centred way of being will
reflect my personal (including professional) values (and biases!); notions of
trust, respect, autonomy, assumptions regarding un/healthy functioning,
growth-promoting relationships, etc; and necessarily reveal something of my own
‘moral visions’ (Christopher, 1996); as well as, affect how and what I respond
to. Regardless then of how non-directively I realize the conditions, my
engagement with clients will, in some way, impact on the nature and direction
of the therapeutic encounter.
The point, however, as Merry (2002)
remarks, ‘is not to deny that unintended influence and direction might result
from the ways in which we respond to clients[11]but
to acknowledge the intention to maintain an attitude as free as possible of the
desire to control or direct people towards particular predetermined goals’
(p.91)Accordingly, remaining cognizant of how one’s internal process affects
one’s ability to attend to the client, including the fact that one’s setting
aside (bracketing) of theories, moral visions, will be incomplete or partial
(although hopefully, sufficient to be/remain open to the client’s experiencing)
is vital (Brazier, 1992).
A
different way of being
The person centred counsellor works on the
understanding that:
the constructive forces in the individual
can be trusted, and relied upon…that the client knows the areas of concern
which he is ready to explore…is the best judge as to the most desirable
frequency of interviews…can lead the way more efficiently than the therapist
into deeper concerns…will protect himself from panic by ceasing to explore an
area which is becoming too painful…can achieve for himself far truer and more
sensitive and accurate insights into constructive behaviour. (Rogers 1946,
p.420)
From this perspective the counsellor’s
‘response-ability’ (Schmid, 2000) to the person of the client, her participation
or ‘presence’ (Thorne, 1991) in the relationship reflect the reality that ‘the
client-centered therapist stands at an opposite pole, both theoretically and
practically’ (Rogers, 1946, p.420) (to other/expert-oriented modalities). In
offering a permissive and understanding environment which can allow for ‘a
process of communication and encounter which moves towards mutuality and
dialogue’, (Schmid, 2000, p.10) the interpersonal relationship is essentially
about equality, respect and trust; and as Wilkins (2005) notes, about
communicating to the client that he is capable of making decisions about the
process and content of his therapy.
Practising
‘client-centredly’: a personal challenge
Counsellors experiencing empathy and
respectful of the client’s (self-expertise) internal directive, ‘can not be up
to other things, have other intentions without violating the essence of
person-centered therapy. To be up to other things…whatever that might be – is a
‘yes, but’ reaction to the essence of the approach (Bozarth, 1998, p.11).
In the process of attempting to grasp the
client’s inner experience, there have been occasions when I have become a
little distracted, and possibly (probably!) been ‘up to other things.’ While my
response may spontaneously emerge from our interaction, I am aware of my
‘conditional’ trusting of the client’s ability to grow; a real sense that their
‘getting in touch’ with their AT and movement toward ‘full functionality’, is
dependant on their willingness/readiness to explore what ‘I’ conceive to be
their ‘blocks to development’. Although a felt sense, or (persistent) concern
about some aspect of the client’s story may be shared within the parameters of
congruence[12], I am also conscious
of my desire for clients, particularly at ‘stuck points’ to at least try and
look at the underling issues, gain a more accurate perception of aspects of
themselves, their current reality, as well as, alternative, more healthy ways
of responding/behaving.
On reflection – in and outside the
counselling relationship – I have occasionally felt that my experiences and
theories about people, growth, life, etc, rather than, as Mearns (2006, p.15)
advocates, expanding my imagination and availability of self in the counselling
room, interfere with (or ‘contaminate’; Bozarth, 1998) the therapeutic process;
resulting in my communicating not only my understanding of the client’s
phenomenological world, but also my ideas (dare I say ‘expertise’) of how they
might improve it! While sincere and tentative in my occasional need to offer
back to the client more than his understanding, to go beyond what he has given
me, I seriously wonder if my function as a facilitator might be better served
if I relinquished (at least during sessions) my penchant for analysis, keenness
for ‘advanced empathy’ (Egan, 1994) and facilitating the client’s connecting
with his ‘edge of awareness’ (Barret-Lennard, 1993). Although I feel such
situations/clients elicit – and I might justifiably add, merit – a greater
‘transparency’ (on my part), I, nevertheless, experience conflict between, my
wanting to remain faithful to the PCA, and my failing to allow the client to
lead and ultimately do his own work. I acknowledge, always in theory at least
(!), that a disciplined following of the client’s process, without subtly
intervening/steering the process, with intentions ‘to get him somewhere’
(Bozarth, 1998), is a requisite on my part. Yet, the reality is, there are
times when despite my ‘subtlety’, it is clear (to me at least) that whatever I
am being/doing, it is not client-centred.
Evidently, remaining in the responsive mode
(i.e., being consistently non-directive) is not without its tensions, and/or
even ‘always’ possible. It can at times pose a considerable challenge; one that
tests my faith in self, other(s), and invites me recognize the ‘yes, but’
aspect, which I judge in others, in myself. On those occasions, when a client
experience/situation has caused me to question the AT (in fact, seriously
wonder if it exists at all!) and the efficacy of the conditions (essentially
me) in activating it, I experience a wavering, less resolute internal ‘yes’ to
the essence of the PCA. Fortunately, client process/outcome, personal
reflection including dialogue with clients (colleagues and supervisor) is
generally suffice to restore my faith in client capacity for change and the
role of PCT in facilitating this process. In some sense, it is the entirety of
my experience – in and beyond counselling – which helps answer questions, such
as, ‘Am I doing all I can to help this individual whilst remaining true to the
spirit PCT?’; ‘How does the theory fare in application, i.e., when put to the
test, does this approach fundamentally work?’
Despite this, there are nevertheless, those
experiences which serve to (painfully) remind me that even when giving one’s
all to the relationship, the client is a free agent, with choices and a unique
journey; and what we have, i.e. the hour or so a week client-counsellor
experience (taking place within the wider community/context), may not
ultimately be enough. Highlighting the reality of individual autonomy, the less
favourable client outcomes are also a poignant reminder of the ‘uncertainty’
inherent in the profession; the limitations inherent in the role of helper
(even a person centred one!) and probably, in being human.
Naturally, one hopes that the experience of
a counselling relationship will be therapeutic, reparative, and change the
client/his life for the better. Change, however, could be any direction, and although
the prediction (Rogers, 1961, pp.125-128) is a positive one, the nature of
freedom and life – offering no guarantees – imply a degree of unpredictability
/uncertainty. While Rogers (1946, p.416) draws our attention to ‘the
predictability of the therapeutic process’ in PCT, I suspect that most person
centred practitioners, have yet to ‘become so clinically accustomed to this
predictable quality’ that they ‘can take it for granted’ (ibid, my italics).
Application
and manifestation of the conditions
Adopting the client’s phenomenological
experience as a basis for dialogue, the therapist’s experience and expression
of empathic understanding is the primary means of offering the conditions.
However, rather than imply a rigid/exclusive adherence to empathic
understanding responses[13], the non-systematic
nature of the interaction, (counsellor’s) personal, idiosyncratic embodiment of
the attitudes, result in the practitioner’s unique way of being with each
client, within each session (Witty, 2005).[14]
Whether in the form of images, metaphors,
inferential guesses, inquiries, sensitive impressions, hunches, etc, arising
from counsellor attunement (Brodley, 1985), empathic understanding, can convey
a deep responsive awareness of the client’s experience (Barrett-Lennard, 1993);
indicate the counsellor’s willingness and ability to meet the client at
relational depth (Mearns, 2006); and openness to fully participating in the
encounter process. However conveyed, these non-systematic, (non-prescriptive)
authentic expressions – always in some way relating to client narrative or
self-experiencing – allow the client an
opportunity to confirm/reject the counsellor’s immediate (inter- and
intrapersonal) experiencing[15].Uniquely realized by
the counsellor’s continuing receptivity and attention to the client’s
experiencing, non-directive empathic understanding, is a caring, direct,
active, existential response on the part of the counsellor; quite contrary to
the stereotypical image of a passive, neutral or wooden practitioner stance.
The conditions, as Schmid (2000) notes:
Say nothing about how communication between
therapist and client should take place… verbal communication is not preferred
to other ways of interacting, e.g. with the body or by playing or by artistic
means. Later
Fundamentally, it is the attitude present
in the counsellor’s way of relating, which is key; and which, transcending
behaviour or mode of response (Bozarth, 1998) becomes manifest according to the
idiosyncrasies (resourcefulness, capabilities, imagination, etc) of the
individual counsellor, the client and the interpersonal relationship (Brodley,
1987). In short, the conditions ‘exist as an attitudinal embodiment in the
experiencing of one person for another. It is a personal and person-to-person
level of a certain type of experiencing’ (Bozarth, 1998, p.107). Incidentally,
differences in counsellor response, are essentially in the application of, not
commitment to, Rogerian principles (ibid).
With practitioners being encouraged to find
their own ways of working (whether in counselling, supervision, large group
work, play-, (expressive) art therapy, education, etc) rather than ‘according
to a method or formula, or…any systematic intention’ (Schmid, 2000, p.5), there
is considerable scope for authentic, creative expression of person-centred values/ethics. As a disciplined, ethical approach,
however, it does not involve doing what we want, as long as we consider it to
be ‘person-centred’ (ibid). There is variability and latitude in practice;
there is room for extending one’s therapeutic role without forgoing ethical
boundaries; but there are also certain constant values which preclude certain
ways of being. In other words, there are limits to what one can do while
remaining client-centred (Bozarth, 1998). Conceptions of self (on the part of
the counsellor) as an expert on the client and his problems, for example,
preconceived or systematic use of techniques/interventions ‘not rooted in the
immediate experience of the relationship’ (Schmid, 2000, p.8), used to direct
client process, are behaviours that are at variance with the approach’s philosophy.
As Patterson (2000) affirms:
The client-centered conditions can be
implemented in different ways by different therapists with different clients.
However, these must always be consistent with the basic philosophy and the
nature of the conditions themselves. There is some freedom. But there are
limits. The freedom of the therapist stops when it infringes on the freedom of
the client to be responsible for and direct his or her own life. (p.179)
Limitations
to respect for autonomy
Accepting the rationale for the therapeutic
process and honouring the client’s freedom, can become especially challenging
when working with clients experiencing suicidal ideation. Sommerbeck’s (2003)
experience of working with (psychotic) suicidal clients highlights the dilemma
faced by person-centred practitioners; prompting me to think about how I might
respond when faced with a client who is bent on self-destruction or death. When
deciding to disclose her client’s suicidal intentions to others (which
Sommerbeck admits is increasingly rare[16]),
she feels that she is deviating – from trusting the core conditions to
facilitate change – and saying ‘yes, but’ to the essence of CCT. Regarding my
own position however, the nature of such a dilemma (including my organization’s
policy as a BACP member, the Law) may demand that I act in opposition to
Sommerbeck’s preferred response, i.e., ‘to trust the facilitative potential of
the core conditions’ (ibid, p.62).
Conscious that I bring my own moral visions
into practice[17]- including thoughts
on the issue of suicide, I know that I could not (remain neutral and) support
such thinking or action on the part of another; and that even without the
external demands (i.e. legal, professional /organizational), would when faced
with what is fundamentally an ethical dilemma, become directive. I agree that
the aim of counselling ‘is to help people arrive at what is right for them,
rather than attempting to impose a solution from outside’ (McLeod, 2003, p.383[18]); but in order to
ensure client safety and prevent loss of life, I would intervene and indeed
‘impose’ (as Clarkson 1995, cited in Jones, 2000, p.247, maintains I already
do!) my values on my client. Acting professionally and morally to best resolve
this (or any practice) dilemma would necessarily involve a balance between
non-intervention, allegiance to the PC model, my conscience, the Law, BACP,
organizational policy, client well-being and of course my ability to be
accountable for my actions. In light of the need for ‘ethical mindfulness’
(Bond, 2000, p.24) I find myself very much in favour of, and indeed heartened
by the response of Brian Thorne (1991); who, when working with clients facing a
life-death choice, adopts a posture of ‘ethical confrontation or moral
intervention’, as opposed to one of ‘silence and neutrality’ (p.99); without
feeling he is violating the essence of the PCA.
Moral
implications: from theory to practice
Since the creation of a preferable
interpersonal climate is for the sake of an intended therapeutic end[19] (ibid), the
counsellor’s ‘way of being’ is necessarily an ethical posture with a sense of
direction and purpose. Morality permeates every aspect of the therapeutic
process; from theory to application, including the kind of (hoped for/intended)
outcome that serves the interests of the individual client and society. With
this in mind, it is clear that as ‘a very special kind of intrinsically
ethically relating to another person’ (Bickhard, 1989, p.163), counselling,
despite its private/confidential nature (is not a closed system and) has a
potentially profound bearing on the community in which its participants live.
As Christopher (1996) maintains, ‘whether we admit it or not in our work with
clients, we are engaging in conversation about the good. Ultimately,
counselling is part of a cultural discussion about ethos and world view, about
the good life and the good person, and about moral visions’ (p.24).
As counsellors (person centred or
otherwise), it therefore incumbent on us, to act with discernment/wisdom,
humility, a clear sense of our own morals (including the importation of them in
our work); and if/when the occasion arises, to strive (avoiding moralism) to
take a stand. Being person-centred is about endeavouring to prize the core self
or personhood of the client, and be receptive and regardful of all ‘the
constituent self and their feelings’[20]
(Barrett-Lennard, 1993, p.5). It is not about denying that we ‘warm more to
some component self-systems, voices, or motivations with the other person than
others (ibid), despite our attempts to experience a ‘multi-directional
impartiality’ (Mearns, 2006), i.e. accept all configurations of the client’s
self; neither is it about condoning everything the client thinks and does.
Openly engaging with clients, colleagues
and life, will help us to refine our current understanding, better respond to
the challenge of hearing our clients’ narrative (including their moral
visions), and while not succumbing to relativism or imposing our own moral visions,
remain able to discriminate between what is good and unethical/immoral, healthy
and dysfunctional (Christopher, 1996). Sincere attempts to understand our own
motivations, theories, clients, and so forth, are best achieved through
considered and critical dialogue and reflection (ibid); even if, such
reflection is, as Christopher (1996, p.22) notes, ‘an interpretive process that
will always be thoroughly historically conditioned and take place in the
cultural and ethical terms of one’s particular cultural assumptions and
circumstances…be partial, incomplete, and subject to further revision’.
The goal of PCT – although it could easily
pertain to other, perhaps, even most psychological therapies – is the
development of more self-actualizing persons.[21] From the objective, throughout the process,
to the end point of therapy, values such as, respect, honesty, trust and
autonomy are emphasized. This necessarily requires on the part of the
developing counsellor, a continuing reflection and reappraisal of one’s belief
system – its impact on self and the therapeutic relationship, the efficacy of
one’s chosen orientation (bearing in mind the social context in which it is
applied), and so forth; in other words, an ethical way of being, involving the
kind of ‘openness to experience’ as described by Rogers (1961).
Counselling, regardless of modality, is a
serious, morally imbued activity, which as Bond (2000) maintains, must be
provided on an ethical basis, by practitioners committed to a professional and principled
use of relationship; lest it does a disservice to the client, the profession
including its reputation, and society.
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[1] Also known as
non-directive, client-, person-centred therapy (CCT, PCT); does not distinguish
counselling from psychotherapy.
[2] Without a
belief in the AT (i.e., client resources and ability to relate), the counsellor’s
attitudes (core conditions) make no sense (Schmid, 2000).
[3] If the conditions or counsellor’s attitudes are to be instrumental (i.e. influence client and effect positive change), the client’s capacity to perceive/receive them, at least to a minimal degree, is crucial (Barrett-Lennard, 1993).
[4] I.e. the
AT/growth principle, theory of the necessary & sufficient conditions
(Rogers, 1957), and the additional beliefs central to the PCA – explicated by
Brodley (1986); Mearns & Thorne (1999, pp. 15-18).
[5] For
convenience, reference to the ‘client’ is masc.;
‘counsellor’, fem.
[6] Where ‘psychological contact’ (the pre-condition) is difficult/improbable, grounding or pre-therapy techniques may be employed (see Prouty 2005).
[7] Rogers, in Rogers and Russell’s (2002) highly readable autobiographical work, mentions some of the difficulties/challenges he and colleagues encountered throughout the Mendota State Hospital Study.
[8] Most of my ‘integrative’ practicing colleagues are somewhat resistant to PCT, as I understand it. While selecting some aspects of the approach, they are more accepting of the ‘Specificity Myth’ (Bozarth, 1998) and medical model.
[9] That the
authority of the person rests in him,
is a basic value emphasizing the internal rather than an external (i.e.
counsellor’s) view/locus of evaluation (Bozarth, 1998).
[10] Perceived and actual, given the natural power
dynamics or inequality which structurally defines professional/helping
relationships.
[11] Even when
using the empathic understanding response process (EURP) (Brodley, 1987),
selective reinforcement of aspects of the client’s narrative occurs (Witty
2005).
[12] Congruence includes awareness of inner unfolding processes, but does not necessarily imply ‘transparency’ in all respects (Brazier, 1993b).
[13] For Brodley (1986), the ‘Empathic Understanding Response Process’ (EURP) – mostly used and effective with voluntary clients able to engage in self-exploration – is the principle way of experiencing and communicating the conditions.
[14] Further,
Rogers (1957) suggests that a technique (e.g. dream analysis, free association,
interpretation, etc) that is conceptually antithetical to the concept of EU,
may in context, become a channel for communicating the conditions. Bozarth’s
(1996b) helpful article explores the issue of techniques and CCT.
[15]The wholeness of the empathic dialogue includes counsellor’s sensory awareness of
client non-verbal language.
[16] Incidently, Sommerbeck – a clinical psychologist, accredited by the Danish Psychological Association, works in a psychiatric hospital in Denmark; where legislation distinguishes between ‘existential’ and ‘psychotic’ suicide, and obliges those working within psychiatry to try to prevent the latter (ibid, 2003).
[17] E.g. my
conception of the ‘good life’, good/moral person, and how I would like my
client to be/come as a result of counselling.
[18] McLeod
(2003), raises the pertinent question of whether counselling should be ‘seen as
a form of socialization into a particular set of values?’(p.386).
[19] Rogers
(1961, pp. 167-181) has explicated the general directions taken by clients towards
their true/real self.
[20] We can respect the client’s positioning, ‘but we do not collude with a superficiality norm’ (Mearns, 2006, p.3).
[21] The kind of
personal development and growth experienced in counselling, can come about
through a ‘variety of vehicles of change’; from religious to traumatic
experiences (Joseph, 2003), including what Mearns (2006) calls ‘existential
touchstones’.