Person Centred Practice or Counselling (PCP)
Although the fundaments of classical person-centred therapy are considered by most therapeutic modalities as basic requirements for good therapy, increasing understanding of the complexity of the human condition supported by research, has demonstrated that there is a greater need for diversity through integration of other experiential modalities for the treatment of ‘incongruence’
With the evolution of classical client-centred to the more current person centred approach there has been a re-conceptualisation of the relational aspect of Rogers original theory. There is now room for a more directive involvement by the therapist as with Cognitive Behaviour Therapy.
With a more integrated model of PCP there are advantages for both the client and the therapist. Although exploring the self within a supportive therapist can be helpful, it is important that what is experience in the therapeutic setting can be generalised into the clients external environment. The research shows (depending on the issue) that including cognitive restructuring, this may require, exposure exercises, simple problem solving strategies or additional communication skills.
An additional advantage within the more current paradigm of PCP, and based on the philosophical unpinning the ethical mandate to provide help in the best way possible, and not to just observe the phenomenon of suffering, and appear to be doing the ‘right thing’. Based on this philosophical perspective it would be unethical for a therapist to with hold information.
The following is an over view of traditional Rogerian Person Centred (non-directive) Counselling
The person-centred approach to counselling belongs to the Humanistic School of Therapy and was conceived by the American psychologist Carl Rogers
During the 1950s when Behaviourism, Psychoanalysis and the medical model were considered the only options, Rogers presented a form of therapy that concentrated on how the clients experienced themselves, shifting away from the diagnostic expert role of the therapist, who traditionally labelled the patient with a set of symptoms and directed them as to what they should do. The position the therapist maintained was one of an equal partner during the client’s therapeutic journey holding the belief that the client is the expert about his own destiny.
This new humanistic approach was based on a client-centred interpersonal relationship with the therapist that was crucial to the therapeutic outcome. The therapeutic relationship was demonstrated by a set of core conditions namely Congruence (Genuineness), Unconditional Positive Regard and Empathy; these core conditions manifest by the therapist, formed the basis for the relationship, with the therapist playing the part of a facilitator, providing a supportive environment for change. Under no circumstances would the therapist play a directive role, so in contrast to previous therapies or more current therapeutic modalities, the responsibility for decision making was the clients and not taken on by the counsellor. In its purest form PCP strongly discourages the use of techniques or strategies, primarily because it is in conflict with the underlying philosophical and basic aims of Roger’s therapeutic approach.
This absence of techniques highlights the importance and focus on the therapeutic relationship for change and not on what the therapist may say or do as with a directive approach.
What may be mistaken for a strategy or technique is the therapists use of active listening, indications of acceptance and understanding, reflections and inquiry, all of which are inline with the core condition that Rogers prescribed as essential for PCP
Core Conditions:
There are three core principles to which the therapist must adhere.
- Congruence / Genuineness with the client.
- Unconditional positive regard.
- Empathetic understanding toward the client.
Congruence / Genuineness: Rogers stated that for the therapeutic relationship to develop as a template for change the therapist must be genuinely interested in the client, and able to present as a ‘real person’ within the client- therapist relationship, with an understanding of their own psychology, and a high level of self acceptance and congruence.
Unconditional Positive Regard
For an individual to self-actualise and continue to grow throughout their lives Rogers believed they needed to be of value to themselves. Rogers also believed that clients could learn to do this by working with a therapist who demonstrates unconditional positive regard toward the client in a genuinely caring way. This requires that the therapist maintain a genuine non- judgmental attitude and acceptance of the client no matter how they may present. PCP requires the acceptance of the client as a whole person even if their behaviour or actions are distasteful for the therapist.
Empathy
To truly empathise with another about their life position and circumstance in the “here and now”, is possibly the most difficult of the three principles to demonstrate. The client-centred therapist strives to develop genuine accurate empathy through the therapeutic relationship by frequently inquiring, reflecting and communicating understanding of the client’s experience. In the words of (Rogers, 1975), accurate empathic understanding is as follows:
“If I am truly open to the way life is experienced by another person…if I can take his or her world into mine, then I risk seeing life in his or her way…and of being changed myself, and we all resist change. Since we all resist change, we tend to view the other person’s world only in our terms, not in his or hers. Then we analyse and evaluate it. We do not understand their world. But, when the therapist does understand how it truly feels to be in another person’s world, without wanting or trying to analyse or judge it, then the therapist and the client can truly blossom and grow in that climate” (Rogers, 1975).
Roger’s theory of Change (Process of Therapy)
Stages of Change:
During the process of self-actualisation Carl Rogers observed what he determined to be seven stages of change on a continuum of increasing growth. At one end, the client may be defensive, resistant and cut off from
their feelings, in contrast to the other end of the continuum, where the client has a far greater awareness, acceptance and understanding of their inner world. Each one of these seven stages could be perceived as stuck points for the client on which to ponder and explore with increasing depth, and as stepping stones for the following stages of change. Rogers theorised that clients moved through the therapeutic process by integrating the experience
of each stage, and only when they felt understood and genuinely accepted within the therapeutic relationship could they then move toward the next stage.
To facilitate the stages of growth and change Rogers theorised that there are six conditions needed to be present within the therapeutic process.
Conditions for Change
1: Two persons are in psychological contact,
2: The first person (the client) is in a state of incongruence,
3: The therapist is congruent or integrated into the relationship,
4: The therapist is experiencing unconditional positive regard for the client,
5: The therapist is experiencing an empathetic understanding of the client’s internal frame of reference, and endeavours to communicate this to the client,
6: The client perceives the unconditional positive regard and empathetic understanding of the therapist (Rogers,1959).
Rogers proposed a concept of change that differed from the more common approaches to therapy, which tended to promote the idea that change is ‘not’ the result of learning.
Rogers Person-Centred Psychotherapy (PCP) presented a therapy based on a paradigm of growth through actualisation. Rogers believed that the human organism does not change solely by learning but becomes different through actualisation, or grows to be different, whether learning takes place or not.
To understand the concept of growth and change through actualisation the practitioner needs to differentiate between Rogers proposition of ‘actualising tendency’ and ‘self-actualisation’. PCP theory states that the orgasmic nature of human beings naturally motivates them to continually strive and positively strengthen themselves in what ever they engage; this is termed the actualising tendency.
In contrast to the actualising tendency of the organism, self-actualisation refers to the development of a specific aspect of a person. This aspect is based on the concept of ‘self’, both actual and idealised, which PCP states is strongly influenced by environmental conditions during development.
Rogers postulated that if a person (the self) learns to believe they are only of worth when fulfilling certain conditions a ‘self- actualising’ conundrum is experienced. The PCP theory suggests that the self may try to actualise in a direction that puts the two ‘actualising’ concepts in to conflict, resulting in incongruence for the orgasmic human being as a whole, this manifests in anxiety, depression or general discontent. With the principles of PCP the therapist’s role is to then help the client work through their incongruence and resolve the ‘actualising conundrum’, and find the pathway to self-actualisation.
