035 – When a Client Judges You – Psychological Contact – When a Client Cries

In episode 35 of the Counselling Tutor Podcast, Rory Lees-Oakes and Ken Kelly discuss how to deal with clients who show prejudice towards you. ‘Theory with Rory’ explains the ‘hidden condition’ of psychological contact. Last, the presenters talk about what to do when a client cries in the therapy room.

When a Client Judges You (starts at 4.20 mins)

As student counsellors, we learn about equality and diversity, with the aim of being able to show all clients unconditional positive regard (UPR). But what if a client appears to show a prejudice towards us on the grounds of variables that have nothing to do with our counselling ability, e.g. gender, clothing, age or weight? There is no easy answer here, nor any one answer that would be appropriate in every situation, but Ken and Rory offer a number of general tips:

• Remember that this is the client’s ‘stuff’, not yours. If you are sure of this in yourself – i.e. you feel secure and confident as a counsellor – then a client holding a view that you cannot counsel them because you are (for example) ‘too young’ will not feel hurtful to you.
• Try reflecting the view back to the client, as an interesting lens on their process, exploring where their concern is coming from. For example, if it has arisen from a lack of understanding on the part of the client of what counselling is and how it works, you could re-explain this. Or if it stems from something in their past experience, you could support them in looking at it.
• If the remark did feel hurtful to you, take this to your personal-development group and/or your supervisor, so you can explore what it is within yourself that has led to you reacting to it in this way.

Finally, if an organisation seems to be judging you on something that doesn’t relate to your ability as a counsellor, remember that they must abide by the Equality Act 2010.

Psychological Contact (starts at 18.08 mins)

Rory examines the first of the hidden conditions of Carl Rogers. The three core conditions – congruence, UPR and empathy – are relatively well-known, though Rogers never actually used the term ‘core conditions’. But in fact Rogers held that six conditions are necessary and sufficient to bring about constructive personality change. He described these in a paper, ‘The Necessary and Sufficient Conditions of Therapeutic Personality Change’, published by the Journal of Consulting Psychology in the 1950s.

The first of the six conditions is that the counsellor makes psychological contact with the client (i.e., they are ‘on the same page’ psychologically). Rory explores the possible barriers to this, which include:

• the client not understanding where they are and what they have come for – e.g. being under the influence of drugs or alcohol
• the client and counsellor being unable to understand each other’s language
• the client looking not for counselling but for something else, e.g. friendship or expert advice (perhaps medical or legal)
• there being a mismatch in the communication styles of the client and counsellor (for example, if one uses a lot of metaphor but the other finds this difficult)
• the client having a mental-health condition (e.g. schizophrenia or memory loss) that means they do not share the reality of others). Although this may be a barrier, Rogers objected to the pathologising of such conditions (which relies on the medical model) and asserted that person-centred counselling could still be helpful. Even if it is not, other forms of talking therapy may be of value, for example validation therapy for people with dementia.

When a Client Cries (starts at 24.32 mins)

It is natural that clients will sometimes cry in the therapy room, as this is a place where we encourage emotion to be experienced and talked about, but how is the right way for the counsellor to respond? Positive emotions are much more highly valued – and so accepted – in our culture, meaning that it can be difficult to cry in front of others.

Ken and Rory give some tips, based on their counselling experience:

• Do have tissues available in the room, within arm’s reach of the client (as not doing so might make it look as if crying is not welcome there).
• If a client starts to cry, don’t automatically pass them the tissues or even mention that they are there: doing so can interrupt the flow of the client’s process, plus it is the client’s choice whether they wish to use them (some may choose to let the tears stream down).
• When a client cries, you could say: ‘You’re not on your own.’
• If a client apologises for crying, you could say: ‘All of your emotions are welcome here.’
• Don’t say, ‘It’ll be alright’ (trying to rescue the client) or ‘Don’t cry!’ (which is generally more about the issues of the person who says it than about the issues of the person crying).
• Remember that if a client is crying, it probably suggests they feel safe with and trusting of you and the environment. This brings the opportunity to do deep and beneficial work.

Links and Resources

Counselling Study Resource

Counselling Tutor Facebook group

Counselling Tutor website

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036 – Using Counselling Qualifications Overseas and in Other Roles – Congruence – Funding for Counselling Training

In episode 36 of the Counselling Tutor Podcast, Rory Lees-Oakes and Ken Kelly discuss the viability of using counselling qualifications in other countries and in other areas of work. ‘Theory with Rory’ looks at congruence, and then the presenters talk about funding for counselling training.

Using Counselling Qualifications Overseas and in Other Roles (starts at 3.05 mins)

Are counselling qualifications gained in the UK portable to other countries? Rory reports that the set-up in the USA is very different from the UK, with a master’s degree required, as well as passing an exam to gain entrance to the professional body there. Therapists in the USA have much more of a diagnostic role, and need to understand how to claim payment from insurance companies, given that most healthcare (including counselling and psychotherapy) is funded in this way. Ken notes that South Africa too has an insurance-based healthcare system.

In short, each country has its own unique set-up in terms of how therapy works there. The main tip is to contact the professional body for counselling and psychotherapy in the country you are interested in, and ask whether your qualification would be accepted there, and whether any bridging courses or arrangements would be needed. Don’t forget too to check out whether you would need a work permit to be allowed to work there.

Counselling skills are potentially portable not only to other countries but also to other areas of work in the UK, for example nursing and teaching. Rory describes counselling qualifications as ‘CV gold’, given that they demonstrate a range of aptitudes and attitudes:

• interpersonal skills
• understanding of standards and ethics
• self-awareness
• commitment to learning, and to personal and professional development
• mental toughness and perseverance

Have you experience of using your counselling qualification abroad or in another profession? If so, do share your experiences and views on our Facebook group.

Congruence (starts at 12.55 mins)

Rory models congruence by explaining that he usually reads from a script for his theory slot, but this time is not doing: which do you prefer? Rory talks about congruence, one of the six conditions described by Carl Rogers in a paper, ‘The Necessary and Sufficient Conditions of Therapeutic Personality Change’, published by the Journal of Consulting Psychology in the 1950s.

Congruence is all about being genuine and real. After the strong influence of the psychoanalytical approach in the 1940s, in which the therapist specifically avoided connecting with the emotions of the ‘analysand’ (as the client was known), Rogers’ approach represented a sea change.

Rory provides several examples of where he has used congruence in his practice and found this to be effective. He believes that when he is real with a client, this helps build and deepen the therapeutic relationship, enable the client see him as real, and become real themselves.

However, being real can be easier said than done. Rory offers some observations on how to achieve this, based on his own experience:

• Be yourself – in the words of the band Oasis, in their song ‘Supersonic, ‘I need to be myself; I can’t be no-one else.
• Don’t hide behind a professional façade and/or become defensive.
• If you’re wrong, own it – this models the idea that it is OK to make mistakes. The Ethical Framework for the Counselling Professions, published by the British Association for Counselling and Psychotherapy, states (2015, page 10): ‘We will ensure candour by promptly informing our clients of anything important that has gone wrong in our work together, and … offer an apology when this is appropriate.’
• If you don’t know the answer to a question asked by the client, admit it.

Funding for Counselling Training (starts at 28.12 mins)

Counselling and psychotherapy training is expensive. Many UK public-sector colleges offer access to government-supported loan schemes, though these can change from year to year. Currently, Advanced Learning Loans are available to those aged 19 or over who are studying at Level 3 to 6. These tend not to be available in private colleges, but they may well allow you to pay in installments. If you don’t finish the course, you may have to repay the course fees straight away. Also, it is not always possible to transfer to a different college partway through a course.

Before you start a course, it is worth adding up the costs of the various different elements that may be required to complete it, for example:

• course fees
• supervision
• insurance
• membership of professional body
• travel
• personal therapy
• residentials
• time away from paid work

Links and Resources

Counselling Study Resource

Counselling Tutor Facebook group

Counselling Tutor website

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037 – Transference and Countertransference – Unconditional Positive Regard – Your Research Project

In episode 37 of the Counselling Tutor Podcast, Rory Lees-Oakes and Ken Kelly talk about transference in the counselling room. ‘Theory with Rory’ examines unconditional positive regard (UPR). Finally, the presenters talk about doing your research project.

Transference and Countertransference (starts at 3.48 mins)

Transference occurs when you meet someone new, and attribute to them issues, behaviours and fantasies that relate to someone from your past. In other words, you bring the whole history of an old relationship into the new relationship, rather than seeing the new person for who they really are.

What happens when your client experiences transference in the therapy room? It can be hard to spot that this is happening, and can even lead to countertransference – when you react to the way the other person is acting towards you (in other words, you ‘play the part’ of the person in their history).

Of course, it can happen the other way round: you, as therapist, may experience transference towards the client, and the client may respond with countertransference. Either way, ask yourself: ‘Who am I to the client? And who is the client to me?’

Ken and Rory provide some practical tips on how to notice and tackle transference and countertransference:

• Develop your self-awareness so that you are more likely to notice and deal with transference, and to avoid responding with countertransference.
• Look out for the client ‘acting out’ or being very familiar towards you: these may be warning signs that they are experiencing transference towards you.
• Do you feel parental towards your client? If so, this could be a warning sign of transference.
• If you feel transference is taking place, ask your client: ‘Do I remind you of anybody?’
• Take any issues of possible transference to supervision: a good supervisor is always looking out for this.
• Check out more resources on transference and countertransference in Podcast 3, and find out about eroticised transference in Podcast 21.

Unconditional Positive Regard (starts at 17.20 mins)

Counselling students often wonder: ‘How can we look at all our clients with no judgement whatsoever? Is this possible?’ Illustrating his points with real-life examples, Rory talks about our tendency as humans to see only the parts of others we don’t like, and to dismiss or judge them on this basis.

Carl Rogers described the importance of UPR in his paper, ‘The Necessary and Sufficient Conditions of Therapeutic Personality Change’, published by the Journal of Consulting Psychology in the 1950s. In this, he wrote (p. 97):

To the extent that the therapist finds himself [sic] experiencing a warm acceptance of each aspect of the client’s experience as being a part of that client, he [sic] is experiencing unconditional positive regard … It means that there are no conditions of acceptance, no feeling of ‘I like you only if you are thus and so.’ It means a ‘prizing’ of the person … It is at the opposite pole from a selective evaluating attitude – ‘You are bad in these ways, good in those.’

Even Rogers admits that he did not always find it easy to show UPR, citing an example of a session with an army officer in South Africa during the time of apartheid. Rogers said that he struggled to offer UPR in this case, but the officer reported he had felt accepted and that the session had been life-changing.

Rory offers three tips on UPR:

• Don’t just accept the parts of a person that you like. Try instead to see and reflect back all that the person is saying, not auditing or correcting the parts that you don’t like.
• Remember the quote: ‘I disapprove of what you say, but I will defend to the death your right to say it. (It is unclear who said this, some claiming it was Voltaire, others refuting this.) In other words, freedom of speech matters.
• It is not up to us to seek to change the client’s world views; instead, it is our job to help them make sense of their world, and to start the process of self-healing. Counsellors are not agents of social control.

It is really important that we see clients as fellow human beings, who are the results of the paths they have walked. We must somehow separate the sin from the sinner.

Your Research Project (starts at 25.32 mins)

In the UK, counselling training courses at level 4 and above typically include the need to complete a research project. This can feel quite daunting – working out where to get the information you need, how to bring it all together, what to put in and what to leave out, and how to present it to the class without getting overcome by nerves.

Ken and Rory offer their insights into this task, and recommend a book, Rory’s Easy Research. This offers great tips on doing your research project, using the acronym SMARTER: specific, measurable, agreed, realistic, ethical and recorded. This is available through our Counselling Study Resource and as a free download from this podcast (see link below).

Links and Resources

Counselling Study Resource

Counselling Tutor Facebook group

Counselling Tutor website

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038 – Law in Counselling and Psychotherapy – Seven Stages of Process – Endings

In episode 38 of the Counselling Tutor Podcast, Rory Lees-Oakes and Ken Kelly discuss the laws relating to counselling. ‘Theory with Rory’ examines the seven stages of process. Last, the presenters talk about endings in counselling.

Law in Counselling and Psychotherapy (starts at 5.17 mins)

Rory and Ken preface this section of the podcast by explaining that the legislation they are discussing is that relating to the UK, and that they are not qualified lawyers. They recommend Peter Jenkins’ book, Counselling, Psychotherapy and the Law, published by Sage in 2007, as a reference source in this area.

The new Ethical Framework for the Counselling Professions, which was developed by the British Association for Counselling and Psychotherapy and came into effect on 1 July 2016, specifically requires that we ‘give conscientious consideration to the law and any legal requirements concerning our work and take responsibility for how they are implemented’ (p. 9).

Key to counselling practice is the Data Protection Act 1998, which relates to how client information is stored and who can access this (in general, the therapist, the client, coroners and judges). The Data Protection Act applies not just to clients but also to those who make enquiries about services (e.g. people who email a private practitioner, or fill in their web enquiry form). The Information Commissioner’s Office can provide information on all this.

Counselling agencies may require access to notes made by their therapists, and may specify how these should be structured and stored; if so, it is important to cover this when contracting with clients. Other important areas of law for agencies are insurance, and health and safety (including fire regulations). If you are writing an assignment (or part of your external portfolio) about your agency’s legal processes, a good starting point is its policies and procedures.

The main laws that you need to be aware of when contracting with clients about the limits of confidentiality relate to the prevention of terrorism, drug trafficking (the bulk movement of drugs) and money laundering (concealing the origins of money that has been obtained illegally). Additional requirements to break confidentiality (e.g. on the protection of children and vulnerable adults) usually exist in agencies; although these do not apply in private practice, many such counsellors may choose to follow them for ethical reasons.

If you do ever need to break confidentiality, you could go to the relevant authorities (via your agency, if you work in one) or you could report it anonymously through Crimestoppers. If you do the latter, you must record this, so you have proof that you have done so if you are ever challenged on this (e.g. in court).

Seven Stages of Process (starts at 21.44 mins)

Rory believes that the seven stages of process, part of person-centred theory (as originally developed by Carl Rogers) is the ‘most marvelous piece of theory ever written in the lexicon of psychology’! It describes clearly the path by which clients move from a fixed and rigid view of the world to a more fluid position, in which they can ‘live life on life’s terms’, accepting responsibility for how they interact with and influence the world around them.

The seven stages of process are one of the three pillars of the person-centred approach, the other two being the 19 propositions (Rogers’ theory of personality) and the six necessary and sufficient conditions for therapeutic personality change. In his book On Becoming a Person (published in 1961 by Constable), Rogers (p. 131) writes:

Individuals move, I began to see, not from a fixity or homeostasis through change to a new fixity, though such a process is indeed possible. But much the more significant continuum is from fixity to changingness, from rigid structure to flow, from stasis to process.

The seven stages of process provide a valuable common language with which to discuss clients in both supervision and case studies. Rory describes typical features of each stage, and asks: what stage do you think you are at? Why not take your views on this into your personal development group?

For more information on the seven stages of process, watch Rory’s lecture in the Counselling Study Resource and read the chapter dedicated to the application of this theory in Ken’s newly published book, Basic Counselling Skills: A Student Guide.

Endings (starts at 34.52 mins)

Ken and Rory discuss endings in counselling, offering a number of tips:

• Plan for endings where possible, seeing ending as a process not a one-off event.
• Start at the very beginning of the therapeutic relationship by explaining to clients in contracting any limits on the number of sessions available.
• Remind clients each time you meet how many sessions they have left.
• Build in regular reviews of how the client is experiencing counselling.
• If, as the therapist, you need to take a break from counselling (e.g. if you are going on holiday), try to give clients one week’s notice for each month you have been working with them.
• Think about how you would respond if a client seemed to you ready to end but was resisting doing so.
• If you feel sad when ending with a client, and feel you will miss them, take this to supervision and, if the feeling persists, to personal counselling.
• Think about how your own attachment style may impact on your endings with clients.
• Read the chapter on endings in Basic Counselling Skills.

Links and Resources

Counselling Study Resource

Counselling Tutor Facebook group

Counselling Tutor website

Basic Counselling Skills: A Student Guide

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040 – Personal Boundaries – Melanie Klein’s Object Relations Theory – Diversity

In episode 40 of the Counselling Tutor Podcast, Rory Lees-Oakes and Ken Kelly discuss personal boundaries for counsellors. ‘Theory with Rory’ explains object relations theory, as developed by Melanie Klein. Finally, the presenters talk about diversity in the counselling room.

Personal Boundaries (starts at 2.19 mins)

Ken and Rory offer a number of tips on maintaining personal boundaries as a counsellor:

• Our counselling training means that we sometimes can’t help but pick up the emotions and experiences of people we are talking to in social settings. It is important to learn to switch off from counselling, as it would be both unhealthy and unethical to counsel someone in this situation.
• Don’t overshare with people – it can be especially easy to do this on social media, where your sharing will be stored forever. If you feel tempted to do so, try to reflect on your reasons for this (which may relate to transference or to needing therapy yourself to offload issues), and use your journal, personal development group and/or supervision to explore it.
• As counsellors, we may sometimes see clients when we are out with our family/friends. Explain to your family in advance that if someone they don’t know greets you when you are out, you will not be able to tell them how you know them.
• Similarly, don’t ‘out’ colleagues to your family/friends – your fellow counsellor may not wish others to know about their work.

To conclude, Ken reminds us that boundaries are intended to be firm not elastic, and Rory points to Spiderman’s words that ‘with great power comes great responsibility’.

Melanie Klein’s Object Relations Theory (starts at 14.39 mins)

Melanie Klein was an Austrian-British psychoanalyst who worked with Sigmund Freud but ultimately parted ways with him. While Freud believed that we as humans are driven by libido (i.e. an aggressive sexual energy), Klein asserted that we are driven by object relations, especially how we bond with significant caregivers and ourselves. Klein’s theory was therefore related to attachment.

Klein looked at how very young children initially view the world, and begin to regulate themselves, in response to their experiences of relationships. If a baby’s needs are consistently not met, their experience of connecting with others can become split or fragmented. Klein characterised this split using the concept of ‘good breast, bad breast’, describing the two parts of the maternal object.

The youngster can take this split within themselves, and it can even contribute to the development of borderline personality disorder (in which the person has not been able to fully integrate the various parts of self). This theory has contributed to the move from foster care being institution-based to foster children being placed with families.

Rory provides more information on object relations theory and how it applies to counselling practice in his free download, ‘Five Observations on Object Relations’.

Diversity (starts at 22.58 mins)

In the UK, the Equality Act 2010 requires equal treatment of all in employment access and in private and public services, regardless of the nine protected characteristics of age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion or belief, sex, and sexual orientation. It is important to think about how you adhere to this in your counselling practice.

However, understanding diversity and accepting difference in others is about more than just meeting legal requirements. Each of us experiences the world in a unique way, and it is vital for counsellors to avoid making assumptions and generalisations about others based on their own individual experiences. Our own ‘truths’ may come from the media, what our family has told us, our own experiences, and our experiencing of others.

Rory recommends that to gain an insight into how women might experience the world, male therapists should read The Beauty Myth by Naomi Wolf and The Second Sex by Simone de Beauvoir.

Links and Resources

Counselling Study Resource

Counselling Tutor Facebook group

Counselling Tutor website

Basic Counselling Skills: A Student Guide

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041 – Writing Case Studies – Carl Rogers’ 19 Propositions – Counselling Skills

In episode 41 of the Counselling Tutor Podcast, Rory Lees-Oakes and Ken Kelly describe how to write a case study. ‘Theory with Rory’ looks at how best to apply the 19 propositions when writing case studies and assignments. Last, the presenters talk about diversity in the counselling room.

Writing Case Studies (starts at 3.26 mins)

Ken and Rory offer a number of tips on writing case studies as a student:

• Always check the criteria set by your awarding body before you start writing.
• Open the case study with a ‘pen portrait’ of the client – e.g. age, gender and presenting issue.
• Continue by describing the client’s counselling journey, from start to finish.
• Depending on the criteria you are working to, there are various themes you can develop – for example, ethics, the theory of your modality, and your self-awareness during the work.
• It is always good to reflect on your own learning from your sessions with the client, and how you might approach things differently in future.

Carl Rogers’ 19 Propositions (starts at 13.51 mins)

The 19 propositions were developed by Carl Rogers, the founder of person-centred therapy. They describe his theory of personality, expressed in terms of how a human being perceives the world (i.e. phenomenology). This part of person-centred theory is often seen as particularly hard to ‘decode’. Rory has done so previously in Counselling Tutor Podcasts 13 and 14. One key tip he offers when reading Rogers’ original wording is to swap the word ‘organism’ for ‘person’.

Rory offers three insights into how you can make maximum use of the 19 propositions when writing case studies and assignments. For example, you can use this theory to:

• evidence how clients engage with their incongruent selves
• describe how, in making sense of their reality, clients can transcend it (as the philosopher Edmund Husserl believed that once indivuduals understand their reality, they can then transcend it)
• explain how clients engage with their truth and what changes they make as a consequence of that.

Key to all these is to use client statements from counselling interactions to illustrate your points.

For more information, you can download Rory’s handout, ‘Three Positions in Phenomenology: The 19 Propositions’.

Counselling Skills (starts at 19.40 mins)

In counselling training, it is harder to demonstrate our use of skills than our understanding of theory (which can be written about in assignments). Because our work with clients is subject to confidentiality, we must showcase our grasp of skills through simulated sessions with peers. This can feel rather artificial, with a pressure to somehow slot in every skill in order to meet the criteria.

Ken’s new book, Basic Counselling Skills: A Student Guide is a great resource for skills development at all qualification levels. Uniquely, this includes links to online audio recordings of skills demonstrations. The effect of each skill is explored. As shown in research by Catherine Goldsmith at the University of Manchester, which led to the dodo bird conjecture, the key to effective therapy is primarily the relationship between the patient and therapist. Good counselling skills are key to building this relationship.

Rogers used to audio record client sessions and listen back to these for learning. Recording is really useful for student counsellors; Ken strongly recommends doing so as much as possible (with client consent). Voice recorders can be purchased inexpensively these days.

Links and Resources

Counselling Study Resource

Counselling Tutor Facebook group

Counselling Tutor website

Basic Counselling Skills: A Student Guide

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044 – Getting into the Client’s Frame of Reference – Existential Counselling – Does the Seventh Stage of Process Exist?

In episode 44 of the Counselling Tutor Podcast, Rory Lees-Oakes and Ken Kelly offer tips on how to get into the client’s frame of reference. ‘Theory with Rory’ looks at existential counselling, as developed by Rollo May and Viktor Frankl. Finally, the presenters discuss the seven stages of process.

In addition, Ken describes his new book – now available in hard copy – Basic Counselling Skills: A Student Guide.

Getting into the Client’s Frame of Reference (starts at 4.54 mins)

Are there any questions or skills we can use to help get into the client’s frame of reference faster?

Ken’s view is that questions are not especially useful unless used to clarify our understanding of what the client is bringing. Skills that are particularly valuable in entering the client’s frame of reference are:

• Attending: Rory describes how listening attentively and non-judgementally often helps clients to resolve their own issues. So many people in daily life instead provide advice or dismissal: it is really refreshing and novel for a client to experience counselling-type listening.
• Silence: although this can be uncomfortable for new therapists, it is a very valuable (yet often underrated) skill in allowing clients the space to process their feelings, and in avoiding reverting to our own frame of reference.
• Empathy: as this core condition (which is not so much a skill as a personal quality or way of being) is all about trying to see the client’s world as they do (putting ourselves in their shoes, though remembering to ‘keep our socks on’), this is key to getting into the client’s frame of reference.
• Reflection: although this may seem a very simple skill, reflecting back what the client is bringing provides the ideal opportunity for them to confirm or refute our understanding.

Rory and Ken provide the following tips:

• Remember that it takes practice – and reflection on your own development – to learn how to get into and stay in your client’s frame of reference.
• Make the most of supervision and dialogue with other therapists to help you develop your ability.
• Use your personal-development group at college to practise really listening to your peers, getting into their frames of reference.
• Read biographies as a way of ‘listening’ to another person describe their world; while doing so, reflect on your own feelings and reactions to the material.

Existential Counselling (starts at 16.17 mins)

Existential therapists believe that the world and human life have no meaning unless we as humans give one – that is, it is up to us to find the meaning in our own lives. Thus, this modality aims to help us draw meaning from our own experiences, and to make sense of a world that can feel random, unpredictable, cruel and unfair.

The modality links to other forms of therapy, particularly the person-centred approach, as Carl Rogers read a lot of work by the Danish philosopher Søren Kierkegaard, who is considered the grandfather of existential philosophy.

Key contributors to existential therapy are:

• Viktor Frankl, an Austrian neurologist and psychiatrist who wrote Man’s Search for Meaning, about his experiences in a concentration camp, noticing that those who were motivated by a meaning to life survived longer than those who lacked purpose. Frankl developed logotherapy.
• Rollo May, a US psychologist, wrote about the struggle between security and dependence, and between the delights and pains of growth (in other words, our need to move away from fixed positions to less comfortable ones in order to be able to grow).
• James Bugental, a US psychotherapist who saw counselling as a journey into the client’s subjective world; this has clear parallels with the person-centred approach.
• Irvin Yalom, a US psychiatrist who has written a number of popular books on psychotherapy, e.g. Love’s Executioner and Staring at the Sun.

You can download Rory’s handout, ‘An Overview of Existential Counselling’.

Does the Seventh Stage of Process Exist? (starts at 23.23 mins)

Ken and Rory discuss whether the seventh stage of process really exists – that is, whether there are people who have reached this. Attaining this level of development does seem a really difficult task.

It should be remembered that Rogers’ theory of the seven stages of process was based on ‘interviews’ (as he termed sessions) with clients. As most people finish counselling once they are at level 5, it would have been unusual for him to encounter clients at level 6 or 7.

Some examples of people at stage 7 might be Mahatma Gandhi and Nelson Mandela. Perhaps someone who really was at the seventh stage of process wouldn’t claim they were, instead saying: ‘I have much to learn’!

Links and Resources

Counselling Study Resource

Counselling Tutor Facebook group

Counselling Tutor website

Basic Counselling Skills: A Student Guide

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045 – Dialogue in Therapy – Development of the Person-Centred Approach – Choosing a Supervisor

In episode 45 of the Counselling Tutor Podcast, Rory Lees-Oakes and Ken Kelly talk about how to avoid asking, ‘How does that make you feel?’ ‘Theory with Rory’ looks at three key phases in the development of person-centred counselling. Last, the presenters offer tips on finding a suitable counselling supervisor.

Dialogue in Therapy (starts at 3.50 mins)

‘How does that make you feel?’ has become a rather laughable question, often used to parody counsellors on TV etc. But since counselling is all about feelings, how do we avoid asking this stereotypical question?

Ken points out that in fact ‘How does that make you feel?’ distances us from the client, as it suggests we have no idea what emotions they might be experiencing. Listening to a client’s story, noticing their body language, using our intuition, and listening out for words that indicate underlying emotion can always enable us to have a go at saying what we think they might be feeling: they can then confirm this, or correct us.

Rory talks about the importance of getting the language right when we do this – using words that fit with the client’s own understanding and use of language. It’s important not to assume that everyone has the same breadth of vocabulary for emotions, and it may be hard for clients to find the right word to explain what they are feeling. As therapists, we can work on expanding our ‘feelings vocabulary’ by writing a regular journal in which we can work on finding just the right words to describe our experiences.

Development of the Person-Centred Approach (starts at 15.03 mins)

Since its beginning in the 1950s, person-centred counselling has developed considerably, and continues to do so today. There are many different branches of person-centred therapy, as described in The Tribes of the Person-Centred Nation (edited by Pete Sanders, PCCS books, 2012). However, all would agree on the key tenets of Carl Rogers’ approach:

• the six necessary and sufficient conditions for therapeutic personality change
• the seven stages of process (though some therapists believe these to be less linear than Rogers suggested)
• phenomenology
• the 19 propositions

Because Rogers did not prescribe any particular template, there are as many different styles of person-centred therapy as there are therapists themselves: we are all different, and it is important in this modality to be ourselves.

Rory describes three key stages in the development of person-centred counselling  over its first 30–40 years:

• The first phase (1940–1950), when Carl Rogers first introduced his ideas, could be termed ‘non-directive psychotherapy’. This represented a big challenge to the two types of therapy that prevailed at that time, psychoanalysis and behaviourism, which were used to telling clients how they were and what they should do. In contrast, non-directive psychotherapists listened to and sought to understand the client’s experience.
• In the second phase (1950–1957), ‘reflective psychotherapy’ (so-called as the therapist reflected the client’s feelings – the focus was on avoiding threat in the therapeutic relationship, by being congruent and real. This represented another step away from psychoanalysis and behaviourism.
• The third phase (1957–1970) is known as ‘experiential psychotherapy’; it involved therapists becoming even more congruent in terms of expressing to clients how they were experiencing them. This can be a really useful form of feedback for clients on their process. This evolved into focusing, as developed by Eugene Gendlin, one of Rogers’ students.

Rory has prepared a handout on this topic, which you can download free of charge.

Choosing a Supervisor (starts at 24.45 mins)

Ken and Rory provide tips on what to think about when choosing a counselling supervisor:

• Check that the supervisor has sound knowledge and experience of your modality.
• Choose carefully, as it’s not easy to change part-way through training (as you may need them to write both a 50-hour and 100-hour report).
• Ask which professional body’s standards they work to: it may be useful to choose a supervisor who belongs to the same one as you.
• If you will be working with a specific client group (e.g. bereavement), try to find a counsellor with an interest and experience in this field.
• Ask how the supervisor will support you if you are ever feeling ‘less than’ – it is normal to have crises of confidence, and it’s important to have a supervisor who can support you at such times.
• Visit three to four supervisors before deciding which one to go with.
• When meeting possible supervisors, don’t get put off by transference. If you don’t like someone, try to work out why before making a final decision.
• Make sure you can feel safe, in a threat-free environment. It is the stuff you are most ashamed of that is the most important to bring to supervision!
• If your placement agency wants you to use a supervisor there, ask yourself whether you feel happy with this. Might you want an external supervisor too? If so, how would it work in practice using both?

Robert Shohet is a key figure in the development of supervision theory, having developed – with Peter Hawkins – the seven-eyed model.

Links and Resources

Counselling Study Resource

Counselling Tutor Facebook group

Counselling Tutor website

Basic Counselling Skills: A Student Guide

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047 – Rise of Person-Centred Counselling in Europe – Endings in Counselling – Achievements of Counselling Tutor

In episode 47 of the Counselling Tutor Podcast—the finale of Season 2—Rory Lees-Oakes and Ken Kelly discuss how person-centred counselling first came to Europe. ‘Theory with Rory’ looks at endings in counselling. Finally, the presenters review the achievements of Counselling Tutor over the last 12 months.

Rise of Person-Centred Counselling in Europe (starts at 2.56 mins)

How did person-centred therapy (which began in the USA) come to Europe and become such a strong modality here?

At the end of the Second World War, Europe was in a parlous state after all the bombings, etc. In psychotherapy, the dominant modality here was psychoanalysis, Freud having moved to London.

When the war ended, the US factories turned to producing consumer goods and the American economy boomed, fostering a culture of optimism in which alternative approaches flourished. It was in this environment that humanistic ideas became the ‘third force in psychology’ (as Abraham Maslow put it), and Carl Rogers’ ideas on counselling began to take shape.

The three core conditions—empathy, congruence and unconditional positive regard—appealed to the UK public sector, and our education and health services were built on these. Interestingly, India is now adopting the same values in developing its own public services.

As a country becomes more developed, mental health issues and services grow in relevance, as before that practical needs (e.g., for food and shelter) tend to take priority, as Maslow’s hierarchy of needs illustrates. As a country develops, social isolation tends also to increase. The basic tenets of person-centred counselling—providing try caring and deep listening—are of huge value in this situation.

Endings in Counselling (starts at 14.14 mins)

Endings are by nature difficult. In counselling, they may be planned or unplanned – coming about, for example, as a result of the client experiencing health problems, family changes or commitments, new work patterns or even simply not ‘clicking’ with the therapist.

It’s really important to get the ending right in counselling. An abrupt ending can leave the therapist feeling deskilled and confused. Without a proper ending, the client can be left feeling vulnerable, discounted, confused and unable to re-engage with therapy in future. Badly handled endings are also a major cause of complaints to professional bodies in counselling and psychotherapy.

Rory offers a number of good-practice tips on endings in counselling:

• Always plan ahead for the ending of therapy. If you are working in a service where there is a limited number of sessions, make sure that you explain this to the client during contracting. If there is no such limit (e.g. if you’re working in private practice), it is still useful to talk in the first session about the client’s expectations of therapy, to introduce the idea that you don’t assume therapy will go on and on. This helps to avoid the client becoming dependent on the counsellor.
• Remind the client each week of which number session you are on, and make it clear when the last session is, so that they are not taken by surprise by this.
• Always explore with clients how they feel about endings. It can be useful too to share how you feel about ending, including pointing out the differences you observe in them between the first and last sessions.
• If you struggle with endings, take this to supervision and/or personal counselling, exploring the endings you have experienced in your own life.
• If ending with one particular client seems harder for you than usual, ask yourself whether transference could be taking place, evoking memories of a past ending that you found difficult.

You can download a free handout by Rory on endings in counselling.

Achievements of Counselling Tutor (starts at 21.55 mins)

Ken and Rory review the incredible success of Counselling Tutor over the last 12 months. The service has proved enormously popular, with its Facebook group (where you can discuss issues with other students of counselling and psychotherapy), free resources on the Counselling Tutor website, and paid-for support available through the Counselling Study Resource (of which we have retained 86% of the original members, illustrating their satisfaction with the service).

Another big achievement this year has been the launch of Ken’s book, Basic Counselling Skills: A Student Guide, hundreds of copies of which have already been sold.

We look forward with excitement to the next academic year, starting in September 2017!

Links and Resources

Counselling Study Resource

Counselling Tutor Facebook group

Counselling Tutor website

Basic Counselling Skills: A Student Guide

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Introduction

In counselling training courses, you will have to record your skills in order for these to be evaluated. While this might sound a really daunting prospect, getting into good habits on recording skills can really help your development as a counsellor. Carl Rogers himself was strongly in favour of recording sessions, and was one of the first counsellors to do so. He wrote:

I cannot exaggerate the excitement of our learnings as we clustered about the machine which enabled us to listen to ourselves, playing over and over some puzzling point at which the interview clearly went wrong, or those moments in which the client moved significantly forward. (I still regard this as the one best way of learning to improving oneself as a therapist.)

– From ‘Empathic: An Unappreciated Way of Being’, The Counseling Psychologist, 1975, Vol. 5, No. 2-10

In this article, I present three steps to help you record your skills confidently, and to write your skills assignment successfully.

Step 1: Start Recording and Listening to Your Skills from Today

Get the equipment right.

My first advice here is to obtain your own recording equipment. This will enable you to fully understand how it works, to feel comfortable using it, and to trust in its quality (e.g. to record the nuances in the session, such as silences and breathing). These benefits will in turn help you to not to get distracted by the presence of a recording device, or by worrying whether it’s working properly – so supporting the building of the therapeutic relationship and empathy.

Many people buy dictaphones, but these aren’t the best type of device for this purpose: they are intended more for dictation by one person than for dialogue between two people. I would recommend a proper recording device, which you can spot by the microphone that sticks up at the top. You can often find good secondhand ones for reasonable prices on auction websites (e.g. eBay) – just search for ‘handheld pro audio recorder’. So long as it works, you’re all set!

Reap the rewards.

There are several key benefits of recording your skills sessions:

• You can listen back to them yourself and learn from this.
• You can ask peers for feedback.
• You can encourage peers to record their own sessions, and then you can learn from each other.

Don’t forget to make a contract even in simulated sessions.

What to listen for

When you listen back, try not to get distracted by the material that the client is bringing; while this is clearly important to the session, it’s not your priority for this exercise. Instead, ask yourself:

• How did I respond to the material?
• Can I name the skill?
• What effect did the skill have on the client?
• What could I have done differently?

You could use the Carkhuff and Truax empathy scale to rate yourself.

Step 2: Define Your Skills

Your awarding body will be seeking evidence that you know what the skills are, are aware where to use them, and understand the effect of each skill on the client. I really recommend taking some time to write yourself a skills master-list. For each skill (reflection, paraphrasing, silence, open questions etc.), write down a definition, what it does, and how it affects the client.

Step 3: Apply This to Your Assignment

Once you are comfortable with your recording equipment, you will be able to make your recording in a relaxed and confident way. Then, listen back to it and note down the timecode (shown on the recorder) every time you hear yourself using a skill. You can then use your skills master-list to name the skill and relate it to the client’s material.

Once you have completed this preparation, you are ready to write your assignment, again with the help of your skills master-list. For each use of skills that you have recorded, write down the short quote that shows the transaction between your client and yourself. State what skill you used in this quote, provide its definition, describe what it did, and reflect on how it affected the client and the therapeutic relationship.

This is a clear and simple way to present your evidence, so ticking all the boxes for the awarding body: it’s a winning formula!

I hope that this three-step blueprint helps you to link your skills to practice, and to write a skills assignment that helps you pass your evaluation with flying colours!

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Shame in psychotherapy is one of the most powerful emotions clients can experience, and perhaps the most contradictory and difficult to work with as a therapist.

One of the most powerful reflections on shame was quoted by AdamAppleton a writer of personal development books who had suffered an abusive childhood;

“Share whatever it is you're ashamed about. You may think you can hide your shame by not talking about it, but in reality, it's your shame that's hiding you”.

Many clients come to therapy feeling shame which has been ‘pre-programmed’ from other people such as lovers, parents, teachers or abusers.Shame is like an internal voice which criticises, judges and repeats what may have been said to you by others such as you are ugly , stupid , bad , or ‘if it wasn’t for you ’.

The reason shame can be hard to work with is that it is surrounded by a set of very able ‘bodyguards’ such as anger, fear, embarrassment, denial and love.

All of which provide a very effective mechanism to deny the client access to their real self and as importantly their ability to self heal.

Shame can take many forms, physically a person may not make eye contact with you, or avoid you gaze. blushing, being defensive, anger, denials as well as affecting the individual’s ability to think or see the world rationally are all the products of feeling this strong and self esteem corroding emotion.

Exaggeration or a desire to overly please can trace their roots back  to a shamed psyche, which impacts on our ability to form intimate relationships or know our self worth. 

As a therapist I have become a lot more aware of how shame can manifest itself in the therapy room,a few years ago I was working with a *client whose father had regularly hit her since she was a child, now a woman in her middle age she looked stunned when I reflected back to her that he had been abusive.

She said that she had been a ‘difficult child’ if she had behaved better this would not have happened before adding “how else do you discipline your children?” 

It took 10 more sessions before she reflected that her father’s abuse had a massive impact on her life, I reflected that she had used the ‘A’ word, for the first time and we both acknowledged that she was being herself, no longer the ‘shamed’ child thinking she deserved to be hit. 

The psychologist Carl Rogers, wrote a lot about the non judgmental attitude of the therapist and how it helped defeat ‘Conditions of worth and Introjected values’ others attitudes which we take on as our own and use to emotionally beat ourselves up.

Rogers who as a child was brought up on a farm and by all accounts was shamed on a regular basis , reflected in his later years that a therapist must provide “the  soil of a different kind ‘  which is experienced by the client as a non judgmental approach by the therapist .

In his elegant theory Rogers hypothesises that along with empathy and a genuine approach by the therapist, being non Judgmental, provides the emotional nutrition for the client to grow and flourish.

When this is experienced by the client, in my experience the ‘bodyguards of shame’ fade in to the shadows of the past, and shame itself slips out of the back door , leaving only the client and their newly acquired self worth behind.

It’s lovely to see……….but you have to dodge the bodyguards !

* Some details have been changed to protect the identitiy of the client 

// ]]>

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Carl Rogers and Gloria

Carl Rogers and Gloria, there cannot be many counsellors or students of counselling that have not watched the film ‘Three approaches to Psychotherapy’ and wondered who Gloria was and what was the story behind the film?

‘Three approaches to psychotherapy’., filmed in 1964 was Everett Shostrom’s second attempt at filming the world of counselling and psychotherapy, the first, made 3 years earlier featured an actor ‘playing’ the role of the client , he considered her performance to be ‘inauthentic’, consequently the film never got a wider screening.

Three Approaches, showed a real client ‘Gloria being’ interviewed in turn by Carl Rogers, Albert Ellis and Fritz Perls ‘,the idea was to produce an academic firm used for the training of Psychotherapists, however it slipped out of academia and ended up being played in cinemas across America.

The story of how Gloria became involved in the project is as an intriguing as the film itself, In the book Living with ‘The Gloria Films’ ,written by Gloria’s daughter – Pamela J Burry, (referred to in the film as Pammy ),she states that both Gloria and herself were individually in therapy with Everett and Miram Shostrom, acquaintances of Fritz Perls.

The film itself was ground breaking, showing Gloria talking about having sexual relationships with men, and how she would explain this to her young daughter ‘Pammy’, the material by contemporary standards is fairly,tame, however in the historical context of 1960’s American society it was quite shocking, Gloria’s courage in talking openly and being filmed should not be underestimated.

Asked after filming which therapist she preferred, she stated that if she was at the beginning of therapy she would have chosen Rogers, but in her current position preferred Perls whom had dominated her in the interview, however later on her opinion changed.

.A year or so later Gloria contacted Carl Rogers and asked to attended the annual psychology convention hosted by the Western Behavioural Sciences institute, La Jolla ,California. Rogers agreed but warned Gloria that the publicity around the film may be unsettling for her, she attended anyway. As part of the event the film was screened to an audience, according to contemporary accounts at the end Gloria stood up in front of over 100 delegates angrily stating “ Why did I do all those things that he asked me to do! Why did I let him do that to me! ” referring to her session with Perls.

The next day Rogers describes meeting Gloria for lunch with his wife Helen, he goes on –

“The second aspect of the weekend which I wish to report is the luncheon she shared with me and my wife. I had wanted to learn how life was going for her and I invited her to take lunch with us. She and Helen formed a very quick contact (Helen’s interest in people was like a magnet) and we had a lively and enjoyable luncheon. As we were about to leave, she said she had a question she wanted to ask. Would we object if, in her thinking, she regarded us as her parents in spirit? We both understood her to mean that she wished to see us as parents she would have liked to have had. We each replied that we would be pleased and honored to have that status in her life. Her warm feelings for us were reciprocated.” (Levant, Ronald F. and Shlien, John M.,)

So who was Gloria?, Gloria Szymanski was born in October 1933 to a polish family that had recently emigrated to America. In 1953 she Married Bill Burry a Korean war veteran , however the marriage did not last and in 1958 she found herself with daughter Pammy going West literally to build a new life in California .

After the film Gloria’s life took her in many directions, she married again in 1968 separating in 1978, the same year later she published an academic paper entitled’ Comments on the art of psychotherapy’ ,she trained and practised as a nurse, had in interest in eastern philosophies, and by all accounts lived a varied and full life, although not always happy.

Gloria died of leukaemia in September 1979 at home in Carmel California, she was 46 years old, her passing, as her life seemed to have a profound effect Carl Rogers , who later wrote :

“In the ensuing years she wrote me about many things in her life, but I do not feel free to reveal the content. I will only say that there were very good times, and there were tragic times, especially of family illness, and she showed sensitivity, wisdom, and courage in meeting the different aspects of her experience. I felt enriched by knowing the open way in which she met difficult issues. I was often touched by her letters. I believe that those who view (or read*) the interview will gain more from it by knowing a small part of my later interaction with Gloria. I am awed by the fact that this fifteen-year association grew out of the quality of the relationship we formed in one thirty-minute period in which we truly met as persons. It is good to know that even one half-hour can make a difference in a life.“ (Levant, Ronald F. and Shlien, John M.,)

Perhaps the legacy of what is now known as the ‘Gloria Film’,shows the therapies in historic context providing inspiration not a template or instruction book of how to practice.

Have you seen the film?
What are your thoughts, how did it influence your learning?

Please leave a comment  below 

Reference list Burrell Pamela J ., Living with the ‘Gloria Films’ . Ross on Wye PCCS Books .2008 Levant, Ronald F. and Shlien, John M., Client-Centered Therapy and the Person-Centered Approach: New Directions in Theory, Research, and Practice. New York, Praeger Publishers, 1984, pp. 423-425

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The revelations published in the Wall St Journal that Facebook in 2012 had manipulated information on the news feeds of 689,000 users home pages, in an attempt to make people feel more positive or negative through a process called ’emotional contagion’ has set the psychological world talking – mainly about research ethics.

In an open letter to the Guardian Newspaper on the 1st of July 2014 Professor Kate Bullen (Chair,ethics committee),and Professor John Oates (Chair, research ethics reference group) British Psychological Society stated Facebook’s ‘experiment’  ;

‘Infringed the autonomy and dignity of individuals by interfering with the personal decision-making as to the posts that people wished to make to their chosen groups and, most importantly, by failing to gain valid informed consent from the participants……

..The intervention was socially irresponsible, in that it clandestinely meddled in people’s social lives with consequences that are very likely to have had significant negative effects on individuals and groups. ‘

The term ’emotional contagion’ could be described as mass empathy, the tendency for humans to be able to identify with another’s suffering or happiness on a mass scale, for example someone sharing a picture of a cute puppy on Facebook which is shared 1000’s of times, those who use social media have all experienced this phenomenon to one degree or another.

Not to put to finer point on it, Facebook were trying to manipulate the emotions of 689,000 people, some may use the term ‘brain washing’.

The history of psychology is awash with unethical experiments, for example ;-

The story of Little Albert (1920)

John Watson the father of behaviourist psychology, wanted to test his theory that fear was a conditioned or an inbuilt response.

To do this he used a nine month old child called Albert, the child was given laboratory white rat to play with, at this point the child showed no fear of the animal.

Watson then stood behind Albert and every time the child picked up the Rat, he would hit a metal bar with a hammer, which startled the child.

Eventually the child associated the rat with fear and would cry every time the rat came near, the unfortunate after effects of this experiment soon became clear, Albert showed fear of anything that was white and fluffy, a reaction that Watson could not reverse.

Watson however, went on to leave psychology and join the advertising firm J Walter Thompson……

MKUltra (1953)

MK Ultra was the code came of the CIA’s mind control program during the 1950’s – 60’s, which recruited an army of psychologists to it’s research programs including our very own Carl Ransom Rogers.

Yes, uncle Carl worked on a project for the CIA code named sub-project 74 when he was a Wisconsin University, the research was carried out according to Colin A. Ross in his book The C.I.A. Doctors: Human Rights Violations by American Psychiatrists on ‘Schizophrenic patients and ‘Normals’!

Although little information is available on what actual research Carl Rogers undertook, we do know that MKUltra was a wide ranging research project concerning itself with behavioural control of humans amongst the many projects undertaken in this research , were experiments with the drug LSD , use of electro stimulation on the brain and Hypnosis.

One theme which connects all the above research to the Facebook debacle is the lack of informed consent amongst research participants and quite dubious reasons for undertaking research in the first place.

However one question still unanswered is why Facebook undertook the research in the first place , for whom and why ?

One possible clue might be the Cornell University connection, I found a press release on their website distancing themselves from the Facebook Research while confirming that;

: ‘Jeffrey Hancock and Jamie Guillory, a Cornell doctoral student at the time (now at University of California San Francisco) analyzed results from previously conducted research by Facebook into emotional contagion among its users. Professor Hancock and Dr. Guillory did not participate in data collection and did not have access to user data.

Their work was limited to initial discussions, analyzing the research results and working with colleagues from Facebook to prepare the peer-reviewed paper “Experimental Evidence of Massive-Scale Emotional Contagion through Social Networks,” published online June 2 in Proceedings of the National Academy of Science-Social Science’

Incidentally Cornell is one of  many University’s contributing  to the America Military’s Minerva project who describe their activities as follows.

‘Seek to define and develop foundational knowledge about sources of present and future conflict with an eye toward better understanding of the political trajectories of key regions of the world’

In other words find out what we think and do …

If you are are a student interested in undertaking research as part of you course studies and look out for my new course guide ‘Rory’s Easy Research’ available as a paid download in  September 2014.

Click here to download Tim Bonds excellent guide on conducting ethical research

Why not comment on your research experiences ? we would love to hear your ideas ?

References

Not Credited. (2014). Facebook’s ‘experiment’ was socially irresponsible. Available: http://www.theguardian.com/technology/2014/jul/01/facebook-socially-irresponsible. Last accessed 25th July 2014 .

Colin A. Ross (2006). The C.I.A. Doctors: Human Rights Violations by American Psychiatrists. Texas: Manitou Communications. 14. Public Relations department . (2014).

 Media statement on Cornell University’s role in Facebook ‘emotional contagion’ research. Available: http://mediarelations.cornell.edu/2014/06/30/media-statement-on-cornell-universitys-role-in-facebook-emotional-contagion-research/. Last accessed 25th of July 2014. Various . (2014). 

University-Led Research. Available: http://minerva.dtic.mil/funded.html. Last accessed 25th July 2014.

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Ask anyone who has studied counselling, what psychologist Carl Rogers is best known for, 9 times out of 10 the reply will be “ The Core Conditions”, which is interesting if we consider that Rogers never used the term.

What Rogers did promote was the ‘ Six Necessary and Sufficient Conditions’ of which three are, Empathy ,Congruence and Unconditional Positive Regard.

So why have these conditions become separated and popularised , while the other three conditions have become ‘lost’ or ‘hidden’ ?

The answer may lie in how counselling theory is taught, and popular misinterpretations of Rogers work, which has contributed to a dilution of the theory.

Also, when Rogers work was brought to the UK in the late 1970’s ,some practitioners, theorists and trainers ‘reinterpreted’ the model for a UK audience, hence the term ‘Core Conditions’ slipped in to the lexicon of language used in the British Person Centred movement.

So what are these lost conditions ?, Are they important ? Can we practice without fully understanding them?

Like with any theory, if we are not equipped with all the information, and an understanding of it’s importance, our understanding and application of it becomes compromised , perhaps arguably unethical.

So if Rogers did not use the term ‘Core Conditions’ what did he state was the formula for a therapeutic relationship to be of any benefit to clients ?

One reference can be found in the ‘Journal of Consulting Psychology’ 1957 ,in a paper written by Rogers entitled :

‘The Necessary and Sufficient Conditions of Therapeutic Personality Change‘

In it he described the Six Conditions as:

1. Two persons are in psychological contact.

2. The first, whom we shall term the client, is in a state of incongruence, being vulnerable or anxious.

3. The second person, whom we shall term the therapist, is congruent or integrated in the relationship.

4. The therapist experiences unconditional positive regard for the client.

5. The therapist experiences an empathic understanding of the client’s internal frame of reference and endeavours to communicate this experience to the client.

6. The communication to the client of the therapist’s empathic understanding and unconditional positive regard is to a minimal degree achieved.

He goes on to state :

“No other conditions are necessary. If these six conditions exist, and continue over a period of time, this is sufficient. The process of constructive personality change will follow. “

If we remove conditions 3, Congruence, 4, Unconditional positive regard, and 5 , Empathy.

Which could be described as the ‘Clients conditions,’ those that ensure the client is heard and valued in the therapeutic relationship.

We are left with three others which could be deemed as the therapists conditions, and most importantly, those which ask the therapist to assess if Person Centred Therapy would be useful or ethically applicable for a client.

Lets look at the ‘hidden’ or ‘lost, conditions to find out why ;

1. Two persons are in psychological contact.

Is your client able to understand what they are embarking on , can they give informed consent ?

Barriers to this could be severe mental health issues such as active psychosis , severe learning difficulties or attending under the influence of prescribed medication or mental incapacity due to the use of drugs or alcohol.

If psychological contact cannot be made , then there is an ethical issue around autonomy , the ability for the client to make an informed choice in contracting with the therapist.

2. The first, whom we shall term the client, is in a state of incongruence, being vulnerable or anxious.

Does the client have issues to deal with , can they identify what they would like to look at in therapy?

Sometimes clients, come to therapy for other reasons such as “making friends” or issues which therapy cannot help with such as debt or legal advice.

It could be that a client is not ready for change, blaming others for their misfortune or not taking responsibility for their actions, Rogers himself said the PCT was a growth model.

6. The communication to the client of the therapist’s empathic understanding and unconditional positive regard is to a minimal degree achieved.

This last condition boils down to trust, if for some reason the client does or will not trust you, then it is very unlikely that they will feel safe enough to discuss what is really on their worried mind.

This condition is perhaps the toughest one to work with as it asks two things , the first is to give enough time for the client to build that trust ,the second is to be congruent enough in the relationship to explore with the client if you feel they are reluctant to fully engage with you.

Finally, it is incumbent on us as therapists to have a functional understanding of the therapy we practice, if we don’t ,are we really offering the best possible service to our clients?

Reference

Carl Rogers. (1957).The Necessary and Sufficient Conditions of Therapeutic Personality Change .Available: http://www.shoreline.edu/dchris/psych236/Documents/Rogers.pdf. Last accessed 10th of May 2015.

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The news of Natalie Rogers death, shocked and saddened the world of counselling and psychotherapy in equal measure.

Natalie Rogers was born in 1928 to Carl Rogers and Helen Elliot, and went on to become, like her father an influential voice in the world of counselling and psychotherapy.

In 1960 she enrolled Brandeis University’s graduate psychology program, training initially under mentorship of Abraham Maslow. In 1973 she completed her MA and started her first role as a psychologist at the University Counselling Centre in Honolulu, Hawaii.

Best known for her pioneering development of Person Centred expressive arts therapy, describe by her father Carl Rogers as “ploughing new ground”, Natalie Rogers was commemorated in 1998 with a Lifetime Achievement Award presented by the International Expressive Arts Therapy Association.

A prolific author, Natalie Rogers wrote extensively on feminist issues, written in 2006 ‘Seeing the soul of the “Other”: Bringing Israeli and Palestinian women together for a peaceful future’ is a first-hand account of the experience her work with women from a troubled area of the middle east, using dialogue and expressive arts to form a mutual understanding.

Natalie Rogers died peacefully in her home on Oct. 17, 2015 at 87 years of age.

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012 – Self-Actualisation – Solving Ethical Problems – Seven Stages Of Process in Practice 2 – Difference between Counselling and Psychotherapy

In episode 12 of the Counselling Tutor Podcast, Rory Lees-Oakes and Ken Kelly look at Maslow’s hierarchy of needs. Rory presents an approach to solving ethical problems, while Ken continues his application of Carl Rogers’ seven stages of process to counselling practice. Finally, ‘Ask Ken and Rory’ asks: what are the differences, if any, between counselling and psychotherapy?

Self-Actualisation

This is a growth model, based on the idea that we need the basics of existence in place before we can think about the next level. Abraham Maslow’s hierarchy of needs has five levels, each possible to achieve only once the previous one is in place:

• physiological needs
• safety needs
• love and belonging needs
• esteem needs
• self-actualisation.

Self-actualisation represents a person being (in Rogers’ terminology) fully functioning and fluid. It is natural that people move between levels; for example, in a natural disaster, people who had self-actualised would again prioritise their physiological needs.

Solving Ethical Problems

Tim Bond is the main author of the new Ethical Framework for the Counselling Professions, produced by the British Association for Counselling and Psychotherapy (BACP). In the ‘Ethics’ section, paragraph 7 (p. 3) reads: ‘A decision or course of action does not necessarily become unethical merely because it is controversial or because other practitioners would have reached different conclusions in similar circumstances. A practitioner’s obligation is to consider all the relevant circumstances with as much care as possible and to be appropriately accountable for decisions made.’

Defensible decision-making is paramount for any practitioner, and being able to account for our decisions appropriately means following a systematic process. If you face an ethical dilemma, you should consult your supervisor, and could call your professional body (e.g. BACP). But it is vital too to have our own tool, for times when these options may be unavailable; Rory uses Bond’s six-step matrix:

1. Produce a short description of the problem or dilemma – Rory recommends writing this down by hand if possible.
2. Ask yourself: whose dilemma is it (the client’s, the counsellor’s or both)? If the problem is purely the client’s, then you may not need to proceed further.
3. Consider all available ethical principles and guidelines (your professional body’s framework, and your agency’s policies/procedures), as well as the law.
4. Identify all courses of action, even those that sound implausible.
5. Select the best course of action and test it against three ideas: universality (would others in the same position do the same thing?); publicity (would it stand up to public scrutiny?); and justice (is it doing the right thing?).
6. Evaluate the outcome (would you do the same thing again?).

This matrix encourages the counsellor to consider and respond to various aspects of the ethical dilemma, and so enables them to account appropriately for the decision. It can highlight issues that may lead the counsellor to make a different decision from that they originally expected. It can also help the counsellor to reflect on difficult decisions made, so providing learning for dealing with future ethical dilemmas.

Seven Stages of Process in Practice 2

Continuing from last week’s podcast, Ken looks at how people at stages 4 to 7 are likely to present to us in counselling:

• Stage 4: Like stage 3, this is a common stage to enter therapy, and the client is willing and is actively seeking involvement in the therapeutic relationship. However, the counsellor may find the client lacks trust in them; the counsellor also needs to take care not to collude with a client’s use of humour to distance themselves from the full impact of here-and-now feelings.
• Stage 5: This is a very productive stage in therapy, as the client can express present emotions and begin to rely on their own decision-making abilities. The counsellor is likely to see the client taking action in their life.
• Stage 6: Once at this stage, the client is unlikely to regress. They may choose not to continue with therapy, now being able to treat themselves with self-care and love.
• Stage 7: It is very unlikely that you will ever have a client at this stage in your therapy room; they are likely to find their own growth within their own lives, without counselling.

Difference between Counselling and Psychotherapy

Some therapists claim differences between these two terms, affecting views on relative pay rates and status – rather like the Two Ronnies’ sketch, ‘I know my place’! However, the BACP does not distinguish between them. Some modalities prefer one term over the other (e.g. person-centred therapy tends to call its practitioners ‘counsellors’, and transactional analysis ‘psychotherapists’).

Key to any therapy success, whatever the modality, is the client–practitioner relationship. It is good to have a pluralistic approach to therapy, as different approaches suit different clients and presenting issues. Rory refers to the dodo-bird verdict.

Links and Resources

Counselling Tutor Facebook group

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022 – Client Notes and Confidentiality – Actualising Tendency – Offering a Free First Meeting – Research in Practice

In episode 22 of the Counselling Tutor Podcast, Rory Lees-Oakes and Ken Kelly talk about client confidentiality and its many grey areas. ‘Theory with Rory’ looks at the actualising tendency, and ‘Person-Centred Business’ considers offering a free initial meeting in private practice. The presenters conclude the podcast by discussing the importance of research in practice.

Client Notes and Confidentiality

Counselling notes can be accessed by:

• the client themselves (under the Data Protection Act 1998)
• the coroner (if the client has died)
• the police (if the client gives you their written permission, or otherwise by court order)

It may be unclear exactly whether the term ‘notes’ refers simply to the clinical notes (where the factual themes are recorded briefly in writing) or also to the counsellor’s process notes (which by nature may include conjecture).

Counsellors working in the NHS should be aware that if a client dies, the executor of their will or a relative can request the health records to be released.

Podcast 11 looked in detail at note-taking. Particular issues to bear in mind in terms of client confidentiality – and so to cover in contracting – are:

• what the limits of confidentiality are
• who can access which notes
• for how long notes are retained
• agency policies on disclosure, and on sharing notes with other bodies where there is inter-agency working

The Actualising Tendency

The concept of the actualising tendency is commonly associated with Abraham Maslow and Carl Rogers, but in fact it was first introduced by Kurt Goldstein, a German neurologist and psychiatrist, in 1934 in a book entitled The Organism. However, the idea did not gain traction until 1943, when Maslow’s paper ‘A Theory of Human Motivation’ was published in Psychological Review. This formed the basis of the model that would later become known as ‘Maslow’s hierarchy of needs’.

Many people assume that all humanistic psychologists think the same, but in fact there were differences between Goldstein’s, Maslow’s and Rogers’ views of the actualising tendency. Goldstein first put forward the concept as a theory of motivation, whereas Maslow related it to the human desire to be the best that you can be. Maslow also asserted that certain conditions needed to be fulfilled – that is, meeting physiological, safety, relationship and esteem needs ­– in order to self-actualise. Maslow believed that only 1% of people reach self-actualisation.

In 1959, Rogers outlined his own ideas on the actualising tendency in a book chapter, ‘A Theory of Therapy, Personality and Interpersonal Relationships’. While he shared Maslow’s values relating to the intrinsic goodness of human nature, and the innate capacity of individuals for personal growth, he disagreed that the actualising tendency was self-driven and automatic. Instead, Rogers argued that people need the right emotional environment in order to grow emotionally; in particular, we must receive empathy, genuineness and acceptance.

Rogers wrote about this too in his final book, A Way of Being, in 1980, seven years before his death. He illustrates this with the story of potato plants kept in unfavourable conditions, which nonetheless demonstrated a tendency to try their best to grow. Rory provides a quotation relating to this, available in the handout that you can get below. Just like potato plants, we humans have an innate drive to be the very best we can be, given the circumstances in which we find ourselves.

Offering a Free First Meeting

Following a potential client’s initial enquiry, counsellors in private practice may wish to offer an initial session free of charge. Ken discusses the benefits to both parties of doing this, and the issues that you need to bear in mind in order to act ethically and respectfully in this situation. Ken has found that over 90% of people who come for a free first meeting do continue to paid counselling.

Research in Practice

Rory likens research to a wedge of cheese, with the thick end being the substantial research that takes place in the higher-education environment, and the thin end representing the continuing professional development that we must all commit to doing. The Ethical Framework for the Counselling Professions (British Association for Counselling and Psychotherapy, 2016, p. 13) states: ‘We value research and systematic inquiry by practitioners as enhancing our professional knowledge and providing an evidence-base for practice in ways that benefit our clients.’ In the UK, all qualified counsellors have completed a research project as part of their training. It is vital that we research any unfamiliar issues relating to our clients, e.g. through reading and the internet.

Links and Resources

The Organism by Kurt Goldstein (first published in German in 1934, and now published as an English translation by MIT Press, 2000)

A Way of Being by Carl Rogers (Houghton Mifflin, 1980, with a new edition published in 1996)

Counselling Tutor Facebook group

Counselling Tutor website

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To Lead An Honorable Life

An invitation to Person Centred Counselling  

John M Shlien, a contemporary and former student of Carl Rogers. A former lecturer at Harvard University,he remained one of the most influential voices in the world of person-centered counselling until his death in 2002 .

Students who read this book will discover some of Shlien’s radical thinking . For example, a countertheory of transference in which he explained-

‘Transference’ is  a fiction , invented and maintained by therapists to protect themselves from their own behaviour ‘

John Shlien was also one of the few therapists to state his personal ideals . Described by him as a ‘Declaration of Principles;

• All theory is autobiographical.
• No theory is universal. If it claims to be, it exaggerates and has a totalitarian tendency, because the client is unique, has the right to fail as well as succeed and this is the main factor in success.
• In the history of ideas , everything is personal.
• The main human problem is: how to live an honorable life .
• My objectives are clarity and cleanliness.
• Do what you want . Call it what it is.
• Everyone knows everything.This is not a theory of knowledge , it is you, I, we, know every about ourselves . There may be defenses , denials ,l cover-ups secrets ,faults and overloads in memory , but we know …We are the ultimate source.

The last principle makes reference to a key idea in person-centered therapy . In other words, it is the client who knows what hurts .

What else will I learn ?

The chapter on Phenomenology and Personality offers a challenge to behavioural thinkers such as Skinner and Pavlov. By emphasising the importance of both free will and lived experience as a direction in personality formation.

Another chapter A Client-Centred Approach to Schizophrenia. Discusses that although Carl Rogers once believed that PCT was not a suitable therapy for psychosis. Shlien, argues  that the term Psychosis covers a wide spectrum of presentations some of which are treatable with PCT.

In conclusion, this collection of papers, research, and observations from John M Shlien , lovingly edited by Pete Sanders. Provides both an important historical record  and a refreshing insight in a widely practiced and still evolving therapy .

Suggested reference for the book .

Shlien, J M. et al (2003) To Lead An Honorable Life, Ross-on-Wye: PCCS Books.

Where can I get my copy?

To Lead An Honorable Life  published by PCCS Books and is available from their website.

Find out more about the Swivl Robot Here 

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025 – Introjected Values – Gerard Egan – Building a Website 2 – Gender in Counselling

In episode 25 of the Counselling Tutor Podcast, Rory Lees-Oakes and Ken Kelly discuss introjected values. ‘Theory with Rory’ looks at Gerard Egan’s model of counselling, and ‘Person-Centred Business’ suggests what pages and content you will need on your website. Finally, the presenters discuss gender in counselling.

Introjected Values

Ken and Rory discuss the difference between introjected values and conditions of worth, illustrating each with real-life examples. The concept of introjects comes from Carl Rogers’ person-centred theory; Rogers believed that introjects get in the way of people being their true (organismic) selves, causing them to adopt others’ values as their own truths. Challenging the introject of how women ‘should’ look (as implied by, say, magazine covers), Rory recommends The Beauty Myth by Naomi Wolf. A common condition of worth, meanwhile, is: ‘Big boys don’t cry.’

Gerard Egan

Currently Professor Emeritus of Psychology and Organisation Development at the Loyola University of Chicago, Gerard Egan wrote The Skilled Helper – one of the most widely read books on counselling and communication skills – in 1975.

Egan’s integrative model draws from the work of Carl Rogers and Robert Carkhuff (co-creator with Charles Truax of the Empathy Scale, available as a free download in Counselling Tutor Podcast episode 8). Egan developed a non-coercive way of helping people reach their own goals, based on three questions/stages:

1. What is going on (i.e. the current scenario)? This stage subdivides into the story, blind spots and leverage.
2. What do I want instead (i.e. the preferred scenario)? Here, the helper and client look at possibilities, the change agenda and commitment.
3. How might I get to what I want (i.e. action strategies)? The process concludes by examining possible strategies, identifying the best fit and making a plan.

Rory identifies the counselling skills that are needed at each stage. For example, in stage 1, the counsellor needs to use silence to listen to the story; reflection and paraphrasing to identify blind spots; and focusing to create leverage. Questioning is important at stage 2, which includes supporting clients to create objectives that are SMART: specific, measurable, achievable, realistic and time-bound.

Egan believed strongly that first impressions are lasting impressions, and so that establishing a sound therapeutic relationship from the start was vital to success. Key to ensuring that the client developed this trust in the counsellor was the concept of SOLER: sitting squarely, open posture, leaning forward and looking interested, eye contact, and relaxing.

Egan’s model is quite directive, and so in some ways fits better with cognitive behavioural therapy, transactional analysis and motivational interviewing (a technique used by health professionals) than with the person-centred approach. Nonetheless, there are many connections and common features with Rogers’ work. Rory asserts that much person-centred counselling training these days has integrative elements. Indeed, Egan’s model – though not as widely recognized as some other psychologists’ work – could be said to form the basis of much modern counselling.

Building a Website 2

Following on from last week’s podcast on whether to design your own website or commission a professional to do so, Ken explores the pages and content you need. You will be able to use much of the material already discussed in ‘Person-Centred Business’ – for example, the elevator pitch (in which you define your offer), explained in podcast 21, is ideal to use at the start of your home page. The home page is the ‘front door’ of your website: do include a recent photo of yourself, and try to put yourself in the shoes of visitors (who may be feeling very vulnerable).

In addition to the home page, Ken recommends including:

• an ‘About’ page – describing how your skills and experience enable you to help clients
• contact details – how they can get hold of you (including different methods, and considering issues of confidentiality)
• fee information – for transparency
• other useful information – on your style, philosophy, what counselling is, where it takes place, challenging the idea that those who come to counselling are weak etc.

Gender in Counselling

Traditionally, our culture thinks of gender as binary – i.e. you are either male or female. But there is a move towards seeing gender as based on phenomenology (subjective experience) rather than taxonomy (categorisation).

As a counsellor, it is important not to make assumptions about what gender means to a client, but to see this from the client’s own frame of reference. The ‘person of tomorrow’ (to use a phrase of Carl Rogers’) may be free to choose where they fit on the gender continuum, rather than having this prescribed for them.

Links and Resources

The Beauty Myth by Naomi Wolf (published by Vintage, 1991)

The Skilled Helper by Gerard Egan (first published in 1975; 10th revised edition published by Brooks/Cole in 2013)

Counselling Study Resource

Counselling Tutor Facebook group

Counselling Tutor website

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How to develop empathic understanding

Counselling-frame of reference

Counselling-frame of reference was first used by Carl Rogers, the founder of person-centred therapy, in 1959. He believed:-

“The state of empathy, or being empathic, is to perceive the internal frame of reference of another with accuracy and with the emotional components and meanings which pertain thereto as if one were the person” (Carl Rogers 1980 P140).

He felt that being understood is key for a person to feel secure enough to speak about their difficulties.

How do you enter a client’s frame of reference?

By listening carefully to what the client is saying and trying to see their perceptual world, as they see it. This can be achieved by doing the following things:-

• Be aware that everybody has a unique view of their world and how it impacts on them.
• Don’t impose your views or Judgments (this may shut the client down)
• Use questions only to clarify your understanding.
• Be patient, clients may need to build up trust before sharing intimate details of their life.
• Be genuine and real in the relationship. Don’t hide behind a professional facade.
• Be warm and accepting toward your client.

The danger of the counsellor’s frame of reference

A skilled counsellor will be carful to make sure that his or her own frame of reference is not introjected into the counselling relationship.
This requires a high level of self awareness on the part of the counsellor so as to be able to put their own opinions and feelings aside and be fully integrated in what the client is bringing.

What skills does the counsellor use?

Entering to a counselling-frame of reference requires you to use a mixture of skills at an appropriate time, for example:-

• The skill of attending is used at the beginning of the session, to enable clients to feel accepted.
• Silence is also important as it allows the client to share their story.
• Reflecting emotions and paraphrasing. Helps the client hear that you are understanding them.

What about the Core Conditions?

To enter a client’s frame of reference, a counsellor needs to possess and demonstrate the following personal qualities. sometimes referred to as the Core Conditions 

• Empathy, the ability not only hear but feel the clients emotions.
• Congruence, the client needs to see that you are a real person genuinely interested in them.
• Unconditional Positive Regard, the ability of the therapist to listen without judgement.

How is therapeutic change achieved?

Person-Centred Theory, believes that psychological disturbance is caused by conditions of worth and introjected values. For example, a client who has been told throughout their lives that they are stupid and worthless.

The counsellor acts as a ‘companion’ to the client. By entering their frame of reference and seeing the world as they do. The theory states that slowly the client starts to build self-acceptance and internal trusting, this is sometimes referred to as organismic valuing. 

The client’s self-defeating cycle is broken. Now free of others judgments they can trust their own instincts and live life on their own terms.

References

Rogers, C. A Way of Being, 1980 edn., New York: Houghton Mifflin .P140

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