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1 - DO NOT COPY - THIS ASSIGNMENT EXEMPLAR IS FOR REFERENCE PURPOSES ONLY Many organisations, including awarding bodies, use software to check that your content is original. Use this assignment exemplar as a reference to guide you when compiling your own original work. Level 4 Assignment Exemplar 2 Counselling theory Student: xxxxxx Word count total 3595 Bibliography 151 Titles and quotes 231 Actual words used 3364 (Excluding titles, bibliography & references) 1. The historical development and basic philosophy of the main therapeutic model used by the centre Carl Ranson Rogers, 8th January , is credited as founding the person centered approach (PCA). Rogers felt frustrated with the analytical approaches, where therapists hide behind diagnostic theory. Following work with children in Rochester, Rogers experienced a fundamental change captured by this quote. "In my early professional years I was asking the question: How can I treat, or cure, or change this person? Now I would phrase the question in this way: How can I provide a relationship which this person may use for his own personal growth? Carl R Rogers LEVEL 4 ASSIGNMENT EXEMPLAR 2 COUNSELLING THEORY 1

2 Thus began a quiet revolution of non-directive therapy that put trust in the client. Based on humanistic philosophy, considered to be a third force after Behaviorism and Psychoanalysis, Rodgers developed a non-interpretive model with the client as the expert. The presence of six necessary and sufficient conditions, encourages clients to self actuate, towards being a fully functioning person. Self actualisation was the theory of Abraham Maslow famous for his hierarchy of needs. Maslow theorised we all have a biological and social needs. When these needs are satisfied we can move on, or actualise, to the next goal. Rogers also drew on influence from Rollo May , considered the father of existential psychotherapy, who theorized people are an organized bundle of potentialities. Otto Rank and Charlotte Buhler also influenced the foundations of the PCA model. 2. The key concepts, principles and practice of the model, including a critical appraisal of its validity, relevance and effectiveness PCA is based on humanistic philosophy that all people are born good. PCA is a way of being that s more about the counsellor s attitudes, character and relationship with a client, than academic qualification. PCA is phenomenological meaning, we view the world as a sum of our experiences, needs, history and expectations and this becomes our subjective reality. Based on client autonomy and equality between the practitioner and the client where the client holds the answers and sets the pace and agenda. It is argued that this is an idealist, over optimistic view of human nature and that allowing the client to direct, puts a non skilled individual at the wheel and robs them of the theoretical information available in the psychodynamic and behavioral models. The PCA therapist acts as a non-authoritarian facilitator as the client moves from incongruence and rigidity through seven stages of process to a state of fluidity and acceptance resulting in a more accepting, fully functioning person. Carl Rogers famously identified six very specific conditions that bring about client change that he labeled, necessary and sufficient. Brian Mearns and David Thorne later named empathy, unconditional positive regard and congruence as the core conditions. The core conditions are the client s conditions needed for growth and the remaining three, outlined below, are the counsellor s conditions, or the lost conditions, because they are sometimes overlooked. If we fail to recognise the hidden conditions, we run the risk of not checking that the process is working. LEVEL 4 ASSIGNMENT EXEMPLAR 2 COUNSELLING THEORY 2

3 "Thus the relationship which I have found helpful is characterized by a sort of transparency on my part, in which my real feelings are evident; by an acceptance of this other person as a separate person with value in his own right; and by a deep empathic understanding which enables me to see his private world through his eyes. When these conditions are achieved, I become a companion to my client, accompanying him in the frightening search for himself, which he now feels free to undertake." Carl R Rogers 1. Two persons are in psychological contact The client is present in the relationship and understands their involvement in a therapeutic relationship. It s important to check with the client that they can work with you. An example is a female who was abused as a child by a male; she may display emotional issues and be referred to me by her Doctor without him checking if she is ok to work with a male. If she feels uncomfortable with me we may not form psychological contact. This renders PCA ineffective in treating psychotic clients, clients impaired under the influence of drugs and alcohol or those that are catatonic thus limiting the clients a PCA therapist can work with. 2. The first, who we shall term the client, is in a state of incongruence, being vulnerable or anxious. The client comes into counselling in a state of distress, feelings within them may be mismatched causing turmoil. If the client feels no incongruence, it may be worth exploring whether the client has come of their own free will. I have had an example where parents brought their 19 year old son. They were concerned that he wanted to lie in bed all day and not get a job. When I spoke to the son, he was quite happy with his life, no counselling was offered. 3. The second person, who we shall term the counsellor, is congruent or integrated in the relationship. The therapist is committed and present, being as transparent, authentic and as truthful as is appropriate. PCA encourages integration at a deep level, immediacy is truthfully bringing your feelings to the client unfiltered, this helps develop emotional depth. The danger of this level of unfiltered congruence is that it can backfire; the comment may be incorrect or inappropriate. 4. The counsellor experiences unconditional positive regard (UPR) for the client. The practitioner must fully embrace the whole being of the client without judgment or agenda. The client-counsellor relationship is fragile and can fracture if the counsellor has prejudice or does not fully understand the client s diversity in customs, sexuality, religion or frame of reference. LEVEL 4 ASSIGNMENT EXEMPLAR 2 COUNSELLING THEORY 3

4 5. The counsellor experiences an empathic understanding of the client s internal frame of reference and endeavours to communicate this experience to the client. The therapist enters the client s world being fully emerged in their frame of reference and stands with them in their internal, subjective world no matter how hard the going gets, it s important that the client feels this. The counsellor runs the risk of sometimes getting it wrong, with no textbook theory to hide behind. It is then necessary to attempt to repair the fracture. The Counsellor is only human. 6. The communication to the client of the counsellor s empathic understanding and unconditional positive regard is to a minimal degree achieved. If the client doesn t feel prized or understood, they will not trust, relational depth will not come, the client will feel alone and vulnerable. It is therefore important to communicate understanding. To say the 6 conditions are necessary and sufficient means nothing else is needed; this is a main criticism of the PCA. Other modalities adopt aspects of the 6 conditions but do not deem them necessary or sufficient. PCA theorises that clients naturally actualise; moving towards their full potential, but growth is interrupted or stunted by a conflict of incongruence between self and experience. This is known as developing conditions of worth as the client seeks external positive regard. Clients may adopt other views as their own, undermining their own organismic valuing system and acting from an external locus of evaluation, meaning undermining and mistrusting self to allow for another s view which is valued as true. The presence of the core conditions allows the client to be heard and begin to trust their own inner voice or organismic voice and begin to operate from an internal locus of evaluation, meaning trust their own process. This is the basis on which the PCA works. It is easy to become blinkered into thinking that the PCA model works for all situations. Even Brian Thorne found he had to execute Rogers in his psyche after studying under him to gain his own perspective and distance himself from the awe he felt for Rogers. Evidence shows the PCA is ineffective in a number of situations, including addressing phobias, alcoholism and substance misuse dependence. Even Rogers failed using the PCA when working in Wisconsin with clients suffering from schizophrenia. It could be said that the non-directive approach and lack of substantial theory makes the model appear shallow and woolly. The progress is dependent on the relationship between counsellor and client with the client wanting positive change, thus limiting the scope of who can be worked with. The model opens the counsellor to a high risk of counter transference as by its very definition, empathy, a core condition, relies on counter transference to be effective. Assessment is not used, meaning the counsellor may well be working in the dark, relying only on what the client chooses to bring. LEVEL 4 ASSIGNMENT EXEMPLAR 2 COUNSELLING THEORY 4

5 Let us consider a case A client presents saying his life is falling apart and he is losing everything as a result of his inability to stop drinking. This client may well be experiencing emotional turmoil but the main presenting issue is both psychological and physiological. Being with this client in a person centred manner in his subjective reality offers this client no assistance whatsoever and can even worsen the situation. A behavioural, psychosocial approach that is directive and prescriptive would be more appropriate. To put it bluntly this client needs to be taught how to stop drinking before they can ever look at sorting emotional issues out. The person centred approach is also ineffective in treating post-traumatic stress disorder, phobias and other conditions which are considered more behavioural than emotional. I am mindful of the limitations of the PCA from a cultural and socio-economic perspective. Developed by a white, middle-class, Christian in the USA at the time of great optimism and prosperity, the model does not reflect the best interests of those bound by cultural collectivism. An example may be to consider a Shi'ite Muslim woman; her culture dictates that the woman plays second fiddle to the man. It could be viewed that she is oppressed by her femininity within her culture and that self actualisation would be to throw down the oppression and break free becoming her own person. In reality this could result in the client being outcast from her society. The reality may be completely different, she may be happy with her place in her society. This is a good example of the phenomenological approach, her place in society is her reality and based on her experience, history and how she finds and views her subjective world. Taking into consideration the pros and cons, I am mindful that the practice of PCA will vary from practitioner to practitioner. By its very nature, PCA is idiosyncratic and its practice will be as diverse as those that choose to practice this model. I find this both exciting and frightening. 3. Illustrate various aspects of the concept of self and the development of self-concept in terms of the chosen model. Rogers theory of self is phenomenological, based on the subjective reality of the client, referred to as phenomenal field and idiographic meaning to see a person as an individual with characteristics that distinguish them from others. Rogers identified two forms of self. The ideal self constructed from incongruence and external locus of evaluation, an unrealistic view of how we believe that we should be, based on others values. It can be described as "I should be" as opposed to the "I am. The real self "I am" is accepting of how it is in the here and now, it s open, congruent and it is able to self actualise. Real self is fluid and subject to change and reconstruction as the individual s experience and views change. This is outlined in Rogers personality LEVEL 4 ASSIGNMENT EXEMPLAR 2 COUNSELLING THEORY 5

6 theory where he identifies 19 propositions or axioms of personality that underpin the person centred theory. In the 19 propositions, Rogers identifies the need for congruence between the phenomenal field of experience and the conceptual structure of self in order for an organism to fully actuate. Actualising tendency is key and is a universal constant applying to all organisms striving to be the best they can, in their circumstances. biological pressure to fulfill the genetic blueprint Maddi 1996 Rogers theorised, in the absence of interruption, a person would self actualise to complete fluidity, richness, acceptance and self-awareness, calling this the fully functioning person. Self actualisation is interrupted when internal feelings contrast external actions; causing incongruence. Conditions of worth are adopted when the view of another is valued over your own internal voice. External locus of evaluation is valuing from the outside in, using somebody else's valuing system as opposed from inside out trusting your own internal voice. Operating from an external locus of evaluation causes a clash between internal feeling and external action and this presents as emotional turmoil as we ignore our organismic valuing. A child falls over and hurts himself, his immediate reaction is to begin to cry and to seek the reassurance of his mother, internally he feels scared and in need of love, he is reacting to his internal locus of evaluation. The mother rejects him saying, big boys don't cry. This confuses the child, he relies on the mother for his love and care and what she is saying is in direct conflict what he's feeling. He loses trust in his own inner experience and represses his feelings. His experiences show this gains him positive regard from others. He now operates from an external locus of evaluation and ignores his own organismic valuing causing psychological distress. Seven stages of process were identified by Rogers to track a client moving from a rigid, incongruent state, towards the fluidity of a fully functioning person. It is unlikely the client would even enter therapy at stage 1 and 2, they are in complete denial that there is anything that can change, and any distress within their lives is accredited to other people and factors beyond their own control. At stage 3 we find the client becomes more flexible they will enter therapy, they may reference themselves objectively and will avoid speaking about present situations. At stage 4 we begin to see psychological contact, trust begins to develop in the relationship and the client is able to speak of deeper more meaningful emotion. The client is now able to recognise the conditions that the therapist is offering. LEVEL 4 ASSIGNMENT EXEMPLAR 2 COUNSELLING THEORY 6

7 Stage 5 sees the client bringing current emotion, self actualisation, becomes evident and the client begins to trust more in their own feelings and begins to act from an internal locus of evaluation. The client is now more readily accepting conditions as they are and take responsibility for how they feel. Stage 6 the client now acts from a position of congruence, what they feeling internally is mirrored by how they react externally; the client accepts full responsibility for their life and exhibits positive regard for others. The presence of these qualities within the therapeutic relationship would clearly indicate that therapy has come to an end and that the client is now self-sufficient and a fully functioning person. Stage 7 this represents a fully functioning individual. They can relate the therapy that they have undertaken to new situations that arise within their lives. This person exhibits the quality of empathy, congruence and unconditional positive regard. They are able to accept life on life's terms no matter what may arise. The study of self continues with the introduction of the dialogical self. Configurations of self identifies multiplicity within the person and says we are made up of many voices that make up the complete self. This exciting development introduces the opportunity to speak directly to a certain part of self part of me wants to just leave him but there is another part that can t bear to be without him. The counsellor may say tell me about the part of you that can t bear to be without him. This is an invite to speak to one aspect individually and this could be an exciting tool. 4. Comparison with material from two other therapeutic schools. There are three schools of thought influencing psychology: behavioural, psychodynamic and humanistic. Here we examine and draw similarities and differences between them. Behavioral Rational emotive behavioral therapy, REBT, developed by Albert Ellis ( ) is a model of problem identification and solving by addressing behavior. REBT is ideal intervention for phobias, post dramatic stress disorder, substance misuse treatment and areas where behavior needs changing. PCA deals with emotion underlying behavior and non-directive. REBT argues that humans are hedonistic striving to stay alive to achieve a degree of happiness; REBT is humanistic at its core as are PCA and TA. REBT challenges and changes beliefs saying it s not what happens that affects us, but how we react. Beliefs are challenged by explaining theory to the client, and undertaking worksheets and home-work to address self defeating beliefs such as I must and it's not fair. REBT challenges the client; PCA is a non-challenging model, trusting in the client to be the solution. LEVEL 4 ASSIGNMENT EXEMPLAR 2 COUNSELLING THEORY 7

8 REBT identifies Action (A), what happens. Belief (B), how we view action based on our beliefs causing us to react and Consequence (C), what happens as a result of our belief and action. We are powerless to change what happens to us, A, but we can alter the consequence, by addressing the belief. The core conditions of PCA, UPR, congruence and empathy or present in the practice of REBT but are not necessary or sufficient, this is also the case with TA. Psychodynamic Transactional Analysis, TA, began with Erick Berne ( ) is a theory-heavy model that s humanistic believing people ore ok and have worth which reflects the PCA. TA relies on an equal relationship between counsellor and client with the counsellor exhibiting UPR for self and the client, I m OK your OK. TA is a decisional model with client being responsible for his behavior, thoughts and feelings; again we see similarities with the PCA. TA relies heavily on contracting believing both parties share responsibility for the process, in PCA contracting is handing the client the power and letting them know what s on offer whereas TA contracting is integral to the therapy including contracting against suicide. TA case notes are available to the client and used as part of therapy, in PCA it is unusual for the notes to be shown unless specifically asked for by the client. The key ideas of TA include the ego state model or PAC model. P refers to parent ego, related to Freud's super ego (conscious) dealing with values and thought; A refers to adult ego, dealing with the here and now and direct response to thinking based both on past experience and acceptance of the fluidity of the present. C refers to the child ego state and deals with behaviors deployed from childhood, we are looking at feelings and subconscious or Freudian ID. In comparing TA with PCA, A represents a fully functioning person, C represents interjected values, a client working from an external locus of evaluation. TA looks at transactions between different ego states, complimentary transactions exist between child and parent where one person assumes the parent ego state, either nurturing or controlling parent and the other take on the child ego which may be the free child who is freethinking or the adaptive child who has adapted to gain love. There is a parallel between the adaptive child in TA and someone operating within conditions of worth in PCA. A complimentary transaction does not mean a healthy transaction but means the transaction can theoretically go on indefinitely. A cross transaction is both individuals acting from the same ego state, if both parties are working from parent to child to parent to child this transaction is said to be crossed. A crossed transaction will be short lived and volatile resulting in one person changing ego state or both avoiding further contact. TA strives to bring people's thinking into the adult state where the person is reacting in the here and now in a fluid and accepting manner mirroring PCA were a client s self actuate to becoming a fully functioning person working from an internal locus of evaluation. TA theory also looks at the life script, stating that we continually act out LEVEL 4 ASSIGNMENT EXEMPLAR 2 COUNSELLING THEORY 8

9 scripts that were formed during childhood to gain positive regard. Here we see similarities to interjected values and conditions of worth. There is too much theory to cover in this short space but hopefully you can see the comparisons drawn between the behavioural, psychodynamic and humanistic models are used by counsellors. Recognition of the dangers of using interventions without adequate training Eclectic is to randomly use pieces of different philosophies, integrative is a range of complimentary tools that work well together. Example, a PCA therapist s client seems not to be responding, the therapist introduces REBT worksheets in an attempt to jumpstart the process. This client could feel failure and confused at being taken from autonomy to a point where the counsellor is now directing. PCA specifically relies on trusting the client to find their own way, if the therapist shows they have no trust in the model, how can the client be expected to trust? A client confused by a therapist randomly using different interventions may seek to end therapy. They may feel they have failed and that therapy is not working for them, leading to continuing unhappiness or even worse, considering suicide. Counselling is about ultimate respect to the client, to maintain that respect and give the best level of service I can. I need to be well-trained in the model I practice. This ensures best practice, due care to my clients and also protects me as a practitioner. Referencing and bibliography Reference Dryden, W. (2000) Key issues for counselling in action. London: Sage Publications Stewart, I. (1996) Transactional Analysis Counselling in Action. London: Sage Publications Merry, T. (2002) Learning and being in Person Centred Counselling, second edition. Herefordshire: PCCS Books Ltd Dryden, W and Neenan, M (2004) Rational Emotive Behavioural Counselling in Action. London: Sage Publications Bibliography Carl R Rogers. (1967), On Becoming a Person. Houghton Mifflin company, New York, New York Stewart, I. (1996) Transactional Analysis Counselling in Action. London: Sage Publications Merry, T. (2002) Learning and being in Person Centred Counselling, second edition. Herefordshire: PCCS Books Ltd Dryden, W and Neenan, M (2004) Rational Emotive Behavioural Counselling in Action. LEVEL 4 ASSIGNMENT EXEMPLAR 2 COUNSELLING THEORY 9

10 London: Sage Publications Maddi, S.R. (1996). Personality theories: A comparative analysis (6th ed.). Toronto: Brooks/Cole Publishing Co Dryden, W. (2000) Key issues for counselling in action. London: Sage Publications Rogers, C. (2008) The Carl Rogers reader. London: Constable & Robinson Ltd Tolan, J. (2008) Skills in Person-Centred Counselling & Psychotherapy. London: Sage Publications LEVEL 4 ASSIGNMENT EXEMPLAR 2 COUNSELLING THEORY