SOCP121 Session 3 Person-Centered Therapy Department of Social Sciences Endeavour College of Natural Health endeavour.edu.au 1
Person-Centered Therapy Session Aim: This session introduces students to Person-Centered Therapy, and its humanistic underpinnings. It emphasizes the role of the self, the core conditions of change, and the importance of the client/practitioner relationship Endeavour College of Natural Health endeavour.edu.au 2
Person-Centered Therapy Learning Objectives: At the end of this session, you should: Be able to utilise a client-centered approach in your practice which focuses on the client s ability to grow and change in a positive way Be aware of the importance of the client/practitioner relationship Understand the key conditions for change and growth in clients Endeavour College of Natural Health endeavour.edu.au 3
Person - Centered Therapy The curious paradox is that when I accept myself just as I am, then I can change. (Carl Rogers) The good life is a process, not a state of being. It is a direction, not a destination (Carl Rogers) Endeavour College of Natural Health endeavour.edu.au 4
Key Figures in Person-Centered Therapy CARL ROGERS (1902-1987) Training in Clinical psychology Father of Client-centered therapy A model of therapy with ideas adopted by numerous theoretical approaches. Belief on human s potential for growth Father of psychotherapy research 1 st therapist to study the counselling process by transcribing & analysing transcripts of actual sessions 1 st clinician to use quantitative methods to conduct psychotherapy studies Nominated for the Nobel Peace Prize in 1987 Endeavour College of Natural Health endeavour.edu.au 5
CARL ROGERS (cont.) Early fascination with growth and research. Rogers loved spending time on the farm as a young man. He first enrolled in agricultural science at the University of Wisconsin Held academic positions in education, social work, counselling, psychotherapy, group therapy, peace & interpersonal relations. Developed the humanistic movement in psychotherapy. Rogers focussed on individuals strengths & resources, de-emphasising pathology Considered a courageous pioneer who was about 50 years ahead of his time. Endeavour College of Natural Health endeavour.edu.au 6
Carl Roger s Influences o Rogers was heavily influenced by certain ideas of Otto Rank (1884 1939), a Post-Freudian psychoanalyst: The client as his/her own therapist Self-acceptance resulting in therapeutic gains An emphasis on the present, not the past The importance of self-reliance The importance of human potential o Rogers borrowed from Rankian philosophy as well as his own experiences and research to mould his client-centered approach Endeavour College of Natural Health endeavour.edu.au 7
Focus of Person-Centered Therapy o Developed from Humanistic Philosophy & Psychology (strong similarities with Existential Philosophy & Psychology) Focus: The client s current state of being, their self-concept, and their ability to change and self-improve. The therapist/client relationship rather than techniques: The therapeutic relationship is of paramount importance. It is through this relationship that the client experiences the core conditions necessary for change. o Belief in Self-actualisation: The inherent tendency of the person to develop all of his/her capacities in ways which serve to maintain or enhance that person. Endeavour College of Natural Health endeavour.edu.au 8
Why Person-Centered Therapy? o o Dissatisfaction with previous therapies such as behaviorism (very deterministic) PCT: An alternative to directive & interpretative psychotherapeutic approaches practiced at the time. Meaning and purpose of life are emphasized rather than mechanistic responses to stimuli The Humanistic approach emphasizes growth, expansion, individual control & self-actualization The cousellor works in a non-directive way, challenging: The traditional belief that the counsellor knows best The value of advice, suggestion, direction, teaching, interpretation & diagnosis in psychotherapy Endeavour College of Natural Health endeavour.edu.au 9
Personality Traits o Is personality fixed or fluid? Can people change? o Many theories of personality are based around stable / fixed traits that are consistent over a person s lifespan o Person Centered Therapy assumes that people: are trustworthy; have the potential for understanding themselves; can resolve their own problems w/o direct intervention from the therapist Are capable of self-directed growth if involved in an optimal therapeutic relationship Endeavour College of Natural Health endeavour.edu.au 10
Person-Centered Personality (Fluid Personality) Experiential therapies acknowledge the presence of more stable personality structures, but also believe personality is evolving Past actions are indicative of how a person may behave but People also have the potential to act creatively, to change, and to improve who we are as people. e.g. when a person is confronted by a novel situation and has no past experience to call on to guide them, they must create a novel/creative solution. Endeavour College of Natural Health endeavour.edu.au 11
Fluidity via Reflective Learning Learning occurs through living Feedback loops We can change our behaviours on a moment to moment basis Attempt Something With awareness we can evolve in lasting ways Make Adjustments Assess Effectiveness Endeavour College of Natural Health endeavour.edu.au 12
Balancing Fixed and Fluid Models So how can personality be stable AND evolving? Bohart (2005) uses the analogy of looking at the coastlines of the continents over 20 years. Broadly the coastlines looks the same over time. From a closer perspective they are constantly changing and developing New buildings are built, ports are dredged, buildings are painted and renovated, other structures are pulled down, etc. Endeavour College of Natural Health endeavour.edu.au 13
Wellbeing Continuum Dysfunctional Static Unaware Unfeeling Fully Functional Fluid Aware Owning feelings, thoughts Endeavour College of Natural Health endeavour.edu.au 14
Autonomy / Control Control and awareness are key to well-being Self-reliance - Ability to handle things without help More a sense of control and agency. The feeling that one can meet the demands of a challenge. Endeavour College of Natural Health endeavour.edu.au 15
The Self Real self Who we think we are at any given moment Ideal self Who we want to be or think we need to be Self concept is fluid; Develops with our experiences Discrepancies between real and ideal self can lead to discomfort Endeavour College of Natural Health endeavour.edu.au 16
Awareness & Congruence The relevance of listening to your self People are rarely in perfect harmony Congruence is the reduction of competition between different thoughts, experiences, feelings Ideal self and actual self become the same difficult to achieve Awareness of inner states and responding to them is the goal of the therapeutic process Endeavour College of Natural Health endeavour.edu.au 17
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Incongruence Disparity between true self and ideal self AND failure to work at integrating the two Often there are differences between what we want, and what we have been taught is socially correct incongruence no sex before marriage must only date people of the opposite gender must be a surgeon and not an artist must always be polite to a customer even when they treat you poorly and you want to give them a piece of your mind Endeavour College of Natural Health endeavour.edu.au 19
Incongruence vs. Congruence The client Class discussion o Case Study A: Joel wants to be a nutritionist but doesn t like biology or chemistry and thinks they are a waste of time. He is miserable in the classes and continues failing them until he is excluded from uni. o Case Study B: Joel wants to be a nutritionist but doesn t like biology or chemistry and thinks they are a waste of time. He goes and seeks clarification from his lecturers about how the subjects are relevant to his chosen career, and after reading some of the articles they suggested he becomes clearer about their relevance and tries to engage with the subject matter a bit more. Endeavour College of Natural Health endeavour.edu.au 20
Incongruence vs. Congruence The therapist Class discussion Considering incongruence as a dimension of self-awareness, it is important to reflect how this can impact on your work as a therapist. These are some types of incongruence from the therapist s side: o Case Study A: When Sally, the therapist, is aware of her experiencing but deliberately decides not to communicate it to the patient (sometimes this is appropriate and sometimes not When do you think this might be inadequate?) o Case Study B: When John, the therapist, is not clearly aware of what he is fundamentally feeling and experiencing because he is too anxious about working for the first time with this case. Can you think of reasons adding to his incongruent state? Endeavour College of Natural Health endeavour.edu.au 21
Incongruence leading to Poor Wellbeing When learning fails to occur; We fail to change our behaviours and adapt Without awareness we fail to evolve Attempt Something Stuck in unhelpful states & patterns of behaviour Make Adjustments Assess Effectiveness Endeavour College of Natural Health endeavour.edu.au 22
Actualisation Actualization is a tendency to change and develop to a better / higher level of being Rogers believed people naturally adjust and develop self-righting often occurs without any outside influence Human capacity to develop and rise to a greater order key to therapy Endeavour College of Natural Health endeavour.edu.au 23
Carl Rogers on Experience Personal experience and the ability to change and develop are the key focus of Person-Centered Therapy: "Experience is, for me, the highest authority. The touchstone of validity is my own experience. No other person's ideas, and none of my own ideas, are as authoritative as my experience. It is to experience that I must return again and again, to discover a closer approximation to truth as it is in the process of becoming in me. Neither the Bible nor the prophets --neither Freud nor research neither the revelations of God nor man -- can take precedence over my own direct experience. My experience is not authoritative because it is infallible. It is the basis of authority because it can always be checked in new primary ways. In this way its frequent error or fallibility is always open to correction." Endeavour College of Natural Health endeavour.edu.au 24
A SESSION in Person-Centered Therapy Video Carl Rogers and Gloria Counselling PT 2 (9.57 min) https://www.youtube.com/watch?v=m30jszx_ngs PT 3 (9.47 min) https://www.youtube.com/watch?v=rx_y3zupzeo PT 4 (10 min) https://www.youtube.com/watch?v=zhxl5ntcdow PT 5 (1.45 min) Suggested: from 0 1.45min https://www.youtube.com/watch?v=l19nxmvbs8e Endeavour College of Natural Health endeavour.edu.au 25
Person-Centered Therapy Therapeutic Goals. To achieve a greater degree of independence & integration. Therapeutic focus: on the person, not the person s presenting problem. By helping clients to grow, they are better able to deal with current & future problems. To provide a climate conducive to helping the individual strive toward self-actualization. Not to choose specific goals for the client. The client decides on the direction of therapy. Endeavour College of Natural Health endeavour.edu.au 26
Person-Centered Therapy Therapeutic Goals (cont.). To recognise the loss of contact with oneself by using facades (masks) To focus on ways of being rather than techniques designed to get the client to do something To help the client loosen their defenses & move to a higher level of personal functioning Therapists seek to: Use themselves as a instrument of change To be a catalyst for change (by being congruent, real, accepting & empathic) Endeavour College of Natural Health endeavour.edu.au 27
Characteristics of a Helping Relationship Trustworthy, dependable, consistent Expressive, communicate unambiguously Warm, caring, curious, respectful Ability to permit the separateness of the other Enter into the world, feelings, meanings of the other Accept each facet of the other as presented Act sensitively and non-threateningly Recognise the other as in a process of becoming, not bound by their past or my past Endeavour College of Natural Health endeavour.edu.au 28
Being with the client Not about doing things, making changes Important factor is the relationship and just being with the client The relationship is one of bilateral learning. The therapist tries to understand/hear and relate to the client. The client tries to understand/hear and be with themselves Reflect spoken feelings, thoughts and behaviours AND try to reflect the unspoken experience, way of being Not just about what s said but also what s unsaid Seeking clarification helps identify blind spots for client and/or therapist Endeavour College of Natural Health endeavour.edu.au 29
Class Activity - Discussion: Empathy o How does one become empathic? o Is empathy Innate? Learned? Part of personality? Limited to certain areas? (excludes pedophilia?) Endeavour College of Natural Health endeavour.edu.au 30
Core Conditions of Therapy Three essential therapist attributes: 1. Congruence genuineness or realness 2.Unconditional positive regard acceptance and caring 3.Accurate empathetic understanding ability to deeply grasp the subjective world of another person Endeavour College of Natural Health endeavour.edu.au 31
Congruence o Realness or Genuineness the client and therapist are both able to be who they are no professional fronts or personal facades: this conveys the message that it is not only permissible but desirable to be oneself transparency with the client no attempt to be superior, hence the client is more likely to reach for their own resources Endeavour College of Natural Health endeavour.edu.au 32
Unconditional Positive Regard o Communicating a deep and genuine caring for the client as a person Unconditional caring not contaminated by evaluation or judgement of the client s feelings, thoughts and behaviour as good or bad Non-possessive caring The greater the degree of caring, prizing, accepting, and valuing of the client in a non-possessive way, the greater the chance the therapy will be successful (Corey 2009, p175). Endeavour College of Natural Health endeavour.edu.au 33
Unconditional Positive Regard (cont) o Shows acceptance and non-judgmental attitude Client is safe to explore negative or more painful feelings more space for client to face him/herself honestly without fear of rejection more possibility for client to come to experience self acceptance therapist is able to recognise values & strengths in client, even when the client holds widely different attitudes from his/hers. Endeavour College of Natural Health endeavour.edu.au 34
Empathy o Ability to track and sense accurately the feelings of the client ability to perceive what it is like in the shoes of the client being able to articulate sensitive understanding of client s experience the experience of being literally heard and understood deeply, in some personally vital sphere, has its own kind of impact whether of relief, of something at last making sense, a feeling or inner connection or somehow being less alone, or of some other easing or enhancing quality (Barrett-Lennard 1993, p 6, as quoted in McLeod 2003, p 173). Endeavour College of Natural Health endeavour.edu.au 35
Applying the Empathic Attitude o Try to experience the world from another s perspective seeing through another s eyes, hearing as they might hear, feeling & experiencing their internal world. o Avoid mixing your thoughts and feeling with those of the client. Counsellor must still remain separate, true to yourself and to your own beliefs. o Clarify and understand vague ideas & problems. When clients are abstract in their language or talk in generalities, ask for an example of the general situation and they will often become more concrete. (e.g. Could you give me a specific example? ) Endeavour College of Natural Health endeavour.edu.au 36
Empathy & Acceptance o Empathy requires acceptance It is easy to feel acceptance toward a child suffering from an emotional hurt from a peer or toward a survivor of spousal abuse. It is not so easy to feel acceptance toward a bully on the playground or the perpetrator of family violence. It is important to remember that you do not have to support or respect the behavior to respect the client. Endeavour College of Natural Health endeavour.edu.au 37
Respect & Warmth How to incorporate them to your practice o Respect for the client can be communicated verbally through a language of respect. You express your opinion well. Good insight. o Respect can be communicated non-verbally using warmth. Posture, gestures, facial expressions Best single predictor of warmth ratings in an interview was smiling. o Empathy, respect, and warmth can restore a sense of belonging to even a very isolated client Endeavour College of Natural Health endeavour.edu.au 38
Class Activity - Role Play Congruence o Task Work in pairs Focus on being congruent Use Basic Listening Skills (open & closed questions, encouraging, paraphrasing, reflection of feeling & summarising) to counsel the client Then reverse the roles where therapist is client & client is now therapist. o Scenario Client is sad because they ve had a falling out with a friend, family member, lover, boss. Endeavour College of Natural Health endeavour.edu.au 39
Person-Centered Therapy Techniques & Procedures NO structured set of techniques for clinical practice. Rather, focus on the way (how) these suggestions are presented. What is essential for the client s progress is the therapist s presence: Being with clients & entering imaginatively into their world of perceptions & feelings. Importance of Immediacy: Addressing what is going on between the client and the therapist. No leading and probing questions. No interpretations of the client s behaviour. No intent to assess, diagnose, create a treatment plan, employ treatment techniques on, direct, advise, or take responsibility for the client. Endeavour College of Natural Health endeavour.edu.au 40
A SESSION in Person-Centered Therapy Video Carl Rogers and Gloria Counselling Conclusions about PCT PT 5 Suggested: from 1.45min 7.33 min https://www.youtube.com/watch?v=l19nxmvbs8e Endeavour College of Natural Health endeavour.edu.au 41
Class Activity - Role Play Empathy, Respect & Warmth o o o Task Work in pairs, therapist & client. Each person plays role of therapist twice. 1. Therapist to show respect, but no warmth. 2. Therapist to show both respect & warmth. Reverse roles (therapist client, client therapist). Scenario The client is stressed & sad as they have developed diabetes. Client, a single young woman, is devastated over her unwanted pregnancy. Reflection To what extent, if any, did the lack of warmth negate the positive message? Endeavour College of Natural Health endeavour.edu.au 42
PCT - Contributions Rogers was a pioneer in shifting the focus from an emphasis on technique & reliance on therapist authority to that of the importance of the therapeutic relationship. Attention on self-growth and health Importance of a person s subjective view of reality Rogerian counselling skills are considered a foundation of on which other skills can be added. Applicable to clients from diverse backgrounds. Emphasis on research within the counselling field The vital role of Empathy in facilitating change in the client Endeavour College of Natural Health endeavour.edu.au 43
PCT - Limitations and Criticisms Lack of direction or structure. No specific techniques, making the treatment difficult to standardize for research and difficult to test Individuals from collectivistic cultures may perceive the focus on autonomy & personal growth as selfish Excessively optimistic about human nature (difficult to actually find people who have self-actualised) Tendency for practitioners to be very supportive without being challenging It may be difficult to truly allow client s to decide on their own therapeutic goals & follow their own direction, particularly when they make choices you may not agree with. Endeavour College of Natural Health endeavour.edu.au 44
Revision Questions What is client-centered practice and why is it important? How might Roger's conditions of growth apply to my work as a natural health practitioner? Is personality a fixed concept according to PCT? What are Roger s core conditions of therapy? How would you ensure a positive therapeutic bond with the client? Why is congruence important in therapy? What does it mean to be a congruent therapist? Endeavour College of Natural Health endeavour.edu.au 45
References Bohart, A.C. (2005). Person-Centered Psychotherapy and Related Experiential Approaches. In A. S. Gurman & S.B. Messer, eds., Essential Psychotherapies. New York: Guilford Press Corey, G. (2015). Theory and practice of counselling and psychotherapy (10 st ed.). Australia: Cengage Learning. Huitt, W. (2007). Maslow's hierarchy of needs. Educational Psychology Interactive. Valdosta, GA: Valdosta State University. Rogers, C. (1961) On Becoming a Person: A therapist s view of psychotherapy (1 st ed.). Boston: Houghton Mifflin. Rogers, C. (1980). A way of being (1 st ed.). Boston: Houghton Mifflin. Endeavour College of Natural Health endeavour.edu.au 46