Person Centred Therapy - Core Conditions | Simply Psychology
Repairing Alliance Ruptures in Humanistic/ Experiential Psychotherapy. the therapeutic relationship in Counselling Psychology (BPS, ), this sections. The Therapeutic Relationship in Humanistic Therapy. Rogers (69) holds that the therapist's primary effectiveness is through the therapeutic relationship. Humanistic Therapy (or Person Centred): – places great importance on the quality of the relationship between client and counsellor and believe in the.
Freud began writing this work in Vienna in composed of three sections. Providing the Counsellor in the professions treatments and interventions a route to follow. Information on the impact and outcome of Therapeutic Alliance can be found in books, articles and scientific papers. Empathy shown during the course, is an essential part of the healing process. Empathy is not only communicated orally but with an increase in eye contact; posture; tone of voice and listening skills.
They enable the counsellor to press home the elements of the programme that are beneficial to each unique client. It is important for the counsellor to realise to not only think of the therapeutic alliance but also in the ways they show empathy as an influence on treatment results.
There is a danger that if the counsellor launches into their favourite method, without first discussing with the client their concerns and hopes, they will be met with resistance. This resistance can create an outstanding chance that any hope of a successful conclusion being reached is diminished by their own self-importance and lack of understanding.
The failure of many people in a given conversation is to be thinking of what they are going to say next and not actively listening to the other person in the conversation usually the client. This leads to another building block being removed from the desired structure. A counsellor should always actively listen to a client. Live by the rule that you have two ears and one mouth and they should be used in the same ratio! In doing so the counsellor will allow the client to take the session where they want to go.
This may be difficult to achieve and it may well demand some creative thinking during the course on behalf of the Counsellor. But what must be consideredis the goal of the client.
This is more important than the counsellor taking the lead. Barriers to Therapeutic Alliances No matter how skilled a counsellor or how much empathy they display to a client, they will hit barriers, this can lead to frustration.
Barriers can also appear because of the pace the consultation. Every client is different even those who present the same or similar problems. The counsellor needs to be solution focused. But if they go too fast the client, who is problem focused, may think that the problem is being taken away from them. Unlike the counsellor who feels frustrated the client is more likely to throw in the towel and stop the sessions.
The counsellor must never forget that the client is in charge not the other way around. The client has probably stated the goals they want to achieve.
Sometimes what appears small to the counsellor can be massive in the eyes of the client. Positivity Plays a Role There is a temptation in any session to be continually talking about the problems. Expectations and goals can be articulated through strategic questions or comments like, "What might be accomplished in treatment that would help you live better" or "You now face the choice of how to participate in your own substance abuse recovery.
Unless the therapist succeeds in engaging the client during this early phase, the treatment is likely to be less effective. Moreover, the patterns of interaction established during the early phase tend to persist throughout therapy.
The degree of motivation that the client feels after the first session is determined largely by the degree of significance experienced during the initial therapeutic encounter. A negative experience may keep a highly motivated client from coming back, whereas a positive experience may induce a poorly motivated client to recognize the potential for treatment to be helpful. Compatibility of Humanistic And Existential Therapies and Step Programs Humanistic and existential approaches are consistent with many tenets of Step programs.
For example, existential and humanistic therapists would embrace the significance stressed by the "serenity prayer" to accept the things that cannot be changed, the courage to change what can be changed, and the wisdom to know the difference.
However, some would argue against the degree to which Alcoholics Anonymous AA identifies the person's "disease" as a central character trait, or the way in which some might interpret the notion of "powerlessness. Yet, such surrender must result from conscious decisions on an individual's part.
The AA concept of rigorous self-assessment--of accepting one's own personal limitations and continually choosing and rechoosing to act according to certain principles as a way of living life--are compatible with both existential and humanistic principles. Research Orientation The predominant research strategy or methodology in social science is rooted in the natural science or rational-empirical perspective.
Such approaches generally attempt to identify and demonstrate causal relationships by isolating specific variables while controlling for other variables such as personal differences among therapists as well as clients. For example, variations in behavior or outcomes are often quantified, measured, and subjected to statistical procedures in order to isolate the researcher from the data and ensure objectivity. Such strategies are particularly useful for investigating observable phenomena like behavior.
Traditional approaches to understanding human experience and meaning, however, have been criticized as an insufficient means to understanding the lived reality of human experience. Von Eckartsberg noted, "Science aims for an ideal world of dependent and independent variables in their causal interconnectedness quite abstracted and removed from personal experience of the everyday life-world" Von Eckartsberg,p. Similarly, Blewett argued, "The importance of human experience relative to behavior is beyond question for experience extends beyond behavior just as feeling extends beyond the concepts of language" Blewett,p.
Thus, traditional methodological approaches seem ill-suited for understanding the meaning of human experience and the process by which self-understanding manifests itself in the context of a therapeutic relationship. A humanistic science or qualitative approach, which has its roots in phenomenology, is claimed to be more appropriate for the complexities and nuances of understanding human experience Giorgi, The personal and unique construction of meaning, the importance of such subtleties as "the relationship" and the "fit" in therapy, and shifts in internal states of consciousness can be quantified and measured only in the broadest of terms.
A more subtle science is required to describe humans and the therapeutic process. Rather than prediction, control, and replication of results, a humanistic science approach emphasizes understanding and description. Instead of statistical analysis of quantifiable data, it emphasizes narrative descriptions of experience. Qualitative understanding values uniqueness and diversity--the "little stories" Lyotard, --as much as generalizability or grander explanations.
Generally, this approach assumes that objectivity, such as is presumed in rational empirical methods, is illusory. For the qualitative researcher and the therapist, the goals are the same: Intersubjective dialog provides a means of comparing subjective experiences in order to find commonality and divergence as well as to avoid researcher bias.
Because humanistic and existential therapies emphasize psychological process and the therapeutic relationship, alternative research strategies may be required in order to understand the necessary and sufficient conditions for therapeutic change.
Person Centered Therapy
For example, Carl Rogers "presented a challenge to psychology to design new models of scientific investigation capable of dealing with the inner, subjective experience of the person" Corey,p.
Some 50 years ago, he pioneered the use of verbatim transcripts of counseling sessions and employed audio and video taping of sessions long before such procedures became standard practice in research and supervision. The Humanistic Approach to Therapy Humanistic psychology, often referred to as the "third force" besides behaviorism and psychoanalysis, is concerned with human potential and the individual's unique personal experience. Humanistic psychologists generally do not deny the importance of many principles of behaviorism and psychoanalysis.
They value the awareness of antecedents to behavior as well as the importance of childhood experiences and unconscious psychological processes. Humanistic psychologists would argue, however, that humans are more than the collection of behaviors or objects of unconscious forces. Therefore, humanistic psychology often is described as holistic in the sense that it tends to be inclusive and accepting of various theoretical traditions and therapeutic practices. The emphasis for many humanistic therapists is the primacy of establishing a therapeutic relationship that is collaborative, accepting, authentic, and honors the unique world in which the client lives.
The humanistic approach is also holistic in that it assumes an interrelatedness between the client's psychological, biological, social, and spiritual dimensions. Humanistic psychology assumes that people have an innate capacity toward self-understanding and psychological health. Some of the key proponents of this approach include Abraham Maslow, who popularized the concept of "self-actualization," Carl Rogers, who formulated person-centered therapy, and Fritz Perls, whose Gestalt therapy focused on the wholeness of an individual's experience at any given moment.
Some of the essential characteristics of humanistic therapy are Empathic understanding of the client's frame of reference and subjective experience Respect for the client's cultural values and freedom to exercise choice Exploration of problems through an authentic and collaborative approach to helping the client develop insight, courage, and responsibility Exploration of goals and expectations, including articulation of what the client wants to accomplish and hopes to gain from treatment Clarification of the helping role by defining the therapist's role but respecting the self determination of the client Assessment and enhancement of client motivation both collaboratively and authentically Negotiation of a contract by formally or informally asking, "Where do we go from here?
For example, emphasizing the choice of seeking help as a sign of courage can occur immediately; placing responsibility and wisdom with the client may follow. Respect, empathy, and authenticity must remain throughout the therapeutic relationship. Placing wisdom with the client may be useful in later stages of treatment, but a client who is currently using or recently stopped within the last 30 days may not be able to make reasonable judgments about his well-being or future. Each therapy type discussed below is distinguished from the others by how it would respond to the case study presented in Figure This case study will be referred to throughout this chapter.
It will provide an example to which each type of humanistic or existential therapy will be applied. Sandra is a year-old African-American woman who has abused more Client-Centered Therapy Carl Rogers' client-centered therapy assumes that the client holds the keys to recovery but notes that the therapist must offer a relationship in which the client can openly discover and test his own reality, with genuine understanding and acceptance from the therapist.
The Therapeutic Relationship - Part II
Therapists must create three conditions that help clients change: Unconditional positive regard A warm, positive, and accepting attitude that includes no evaluation or moral judgment Accurate empathy, whereby the therapist conveys an accurate understanding of the client's world through skilled, active listening According to Carson, the client-centered therapist believes that Each individual exists in a private world of experience in which the individual is the center.
The most basic striving of an individual is toward the maintenance, enhancement, and actualization of the self. An individual reacts to situations in terms of the way he perceives them, in ways consistent with his self-concept and view of the world.
An individual's inner tendencies are toward health and wholeness; under normal conditions, a person behaves in rational and constructive ways and chooses pathways toward personal growth and self-actualization Carson, A client-centered therapist focuses on the client's self-actualizing core and the positive forces of the client i.
The client should also understand the unconditional nature of the therapist's acceptance. This type of therapy aims not to interpret the client's unconscious motivation or conflicts but to reflect what the client feels, to overcome resistance through consistent acceptance, and to help replace negative attitudes with positive ones. Rogers' techniques are particularly useful for the therapist who is trying to address a substance-abusing client's denial and motivate her for further treatment.
Response to the case study A client-centered therapist would engage in reflective listening, accepting the client and her past, and clarifying her current situation and feelings. As Sandra developed trust in the therapist, he would begin to emphasize her positive characteristics and her potential to make meaningful choices to become the person she wants to and can become.
Another goal of therapy would be to help her develop sufficient insight so that she can make choices that reflect more closely the values and principles to which she aspires. For example, she may want to tell her husband about her symptoms and try to strengthen her marriage.
If Sandra began to feel guilt about her past as a prostitute, the therapist would demonstrate appreciation of her struggle to accept that aspect of herself, highlighting the fact that she did eventually choose to leave it.
He may note that she did the best she could at that time and underscore her current commitment to choose a better life. Sandra would be supported and accepted, not criticized. She would be encouraged to express her fear of death and the effect this fear has on her. This might be the first time in her life that someone has been unconditionally accepting of her or focused on her strengths rather than her failings. She apparently has the ability to solve problems, which is reflected by her return to therapy and her insight about needing help.
By being understood and accepted, her self-esteem and sense of hope would increase and her shame would decrease. She would feel supported in making critical choices in her life and more confident to resume her recovery.
Narrative Therapy Narrative therapy emerges from social constructivism, which assumes that events in life are inherently ambiguous, and the ways in which people construct meaning are largely influenced by family, culture, and society. Narrative therapy assumes that people's lives, including their relationships, are shaped by language and the knowledge and meaning contained in the stories they hear and tell about their lives.
Recent approaches to understanding psychological growth have emphasized using storytelling and mythology to enhance self-awareness see Campbell, ; Feinstein and Krippner, ; Middelkoop, Parker and Horton argue that "Studies in a variety of disciplines have suggested that all cognition is inherently metaphorical" and note "the vital role that symbolism plays in perception" Parker and Horton,p.
The authors offer the "perspective that the universe is made up of stories rather than atoms" and suggest, "Myth and ritual are vehicles through which the value-impregnated beliefs and ideas that we live by, and for, are preserved and transmitted" p. From this perspective, narratives reveal a deeper truth about the meanings of our experience than a factual account of the events themselves.
As Feinstein and Krippner note, "Personal mythologies give meaning to the past, understanding to the present, and direction to the future" Feinstein and Krippner,p. When people tell and retell their life stories with the help of a therapistthe stories evolve into increasingly meaningful and healing constructions.
As narrative therapists listen to the stories clients tell, they assist them by identifying alternative ways of understanding events in their lives. Thus, they help clients to assume authorship of their lives in order to rewrite their stories by breaking patterns and developing new solutions.
Narrative therapy helps clients resolve their problems by Helping them become aware of how events in their lives have assumed significance Allowing them to distance themselves from impoverishing stories by giving new meaning to their past Helping them to see the problem of substance abuse as a separate, influential entity rather than an inseparable part of who they are note the discrepancy between this and the AA member's statement, "My name is Jane, and I am an alcoholic" Collaboratively identifying exceptions to self-defeating patterns Encouraging them to challenge destructive cultural influences they have internalized Challenging clients to rewrite their own lives according to alternative and preferred scripts Narrative therapy can be a powerful approach for engaging clients in describing their lives and providing them with opportunities to gain insight into their life stories and to change those "scripts" they find lacking.
Kohut felt that one of the benefits of the therapeutic relationship was for the therapist to provide the mirror for the client. This was to be done with empathy and understanding, showing the client that his difficulties and way of being were both understandable and understood. Such a freely empathizing therapist gives the client a sense of being listened to, being deeply understood, and being accepted while providing an opportunity to learn the ancient roots of their difficulties and building new self structures to compensate for the old deficits Kahn, The above therapists and their theories all point to the premise that it is the relationship that is the most beneficial aspect of the therapy.
Awareness of the subtleties and changes in the relationship provides the therapist with perhaps his most therapeutic tool of all. However, there are some who would disagree with the full importance of the working alliance. Practitioners using cognitive and behavioural approaches tend to see the therapeutic alliance as simply a means to an end. They feel that it is wrong to overstress the relationship since it obscures the ultimate goal of helping a client manage a problem better.
They do accept that such a goal cannot be achieved if the relationship is poor, but feel that an over-emphasized relationship can be a distraction from the real work to be done Egan, Albert Ellis proposes that recently there has been a one-sided emphasis on relationship as the crucial element in therapy.
He states that while a good therapeutic relationship is usually important to help people feel better, good theory and technique are actually more important to help them get better. However, Barbara Berzon listed eight features of helping which reflect the characteristics of helping most valued by those who have been helped.
The basic features of effective helping relationships can be summarized as follows; when there is increased awareness and self understanding on the part of the client, in particular, about the ways others see them; when they realize how similar they are to others, contradicting their original reason perhaps for seeking therapy, that is, feeling out of touch with others; the extent to which the client feels understood, accepted and reacted to genuinely by the therapist; being made aware how others perceive them; being encouraged to self-disclose, to be assertive and to be immediate in their reactions; feeling a sense of open communication even when the counsellor is being confrontative; when the client senses the warmth and genuineness of the counsellor being himself and not simply functioning in the role of a helper; when the client feels he can divulge his inner thoughts and feelings in a safe and neutral environment.
These eight characteristics of a counselling relationship that clients believe have benefited them therapeutically all have their source in the working alliance and stem from the high level of energy and commitment that the therapist brings to the relationship.
Although I have yet to work with clients, I do find I can agree with the above list simply from my own experience as a client in a counselling situation. In particular, the warmth and openness of communication that my counsellor has brought to our relationship has encouraged me in an area of great difficulty — that of self-disclosure and owning my feelings.
In conclusion, however, we can say that the relationship is the therapy since the therapist provides the client with a secure base from which to explore himself and his relationships. The client needs to see the manner in which he is perceiving and using the therapeutic relationship which helps him understand how he handles himself in relationships with others. Such understandings encourage the client to cognitively link past relationship experiences with current behaviours and emotions while realizing how his current perceptions of interaction with others can influence the conduct of present close relationships.
This in turn can help him build new mental models so that he can come to handle himself more competently within relationships.