Phenomenology in Person-Centred Counselling

The philosophy of individual experience

Carl Rogers, the ‘founding father’ of humanistic counselling embraced Phenomenology person centred counselling when moving away from the pessimistic views of human nature put forward by Sigmund Freud. Who believed that the human condition was involved in a constant battle between the Id Ego and Super-ego. Rogers’ Person-Centred theory is based on what he described as The Phenomenal field. Hence perceptions of taste, sound and how we experience the world are as individual as ourselves.

 What is Phenomenology?

It is an approach in Philosophy which concentrates on the study of consciousness and how we experience the world, it focuses on:-

• Individual perception
• Conscious experience
• Developing meanings from our perceptions
• Frame of reference 

A brief description of phenomenological movement will make it clear why Rogers theory and practice has been linked in this way. Developed at the beginning of the 19th Century by German philosophers Edmund Husserl and Martin Heidegger. They believed that reality consisted of objects and events, which they called ‘phenomena’ which represent our conscious perception of reality.

How did it influence Rogers thinking?

Rogers based his theory of personality outlined in his 1951 book Client Centred Therapy on the earlier work of Snygg & Coombs 1949 book Individual Behaviour: A New frame of reference for psychology.

In 1951 Rogers acknowledged the connection between the Person-Centred approach and phenomenology stating, ‘his theory of personality and behaviour was ‘basically phenomenological in character’ (Rogers cited in Douglas, P190). Clearly demonstrating the Phenomenology Person Centred Counselling overlap.

Rogers further expanded on his phenomenological view of personality in his 1961 book On Becoming a Person. He clearly stated his theoretical ideas of personality in this observation;-

“Experience is, for me, the highest authority. The touchstone of validity is my own experience. No other person’s ideas, and none of my own ideas, are as authoritative as my experience. It is to experience that I must return again and again, to discover a closer approximation to truth as it is in the process of becoming in me. Neither the Bible nor the prophets — neither Freud nor research — neither the revelations of God nor man — can take precedence over my own direct experience. 

My experience is not authoritative because it is infallible. It is the basis of authority because it can always be checked in new primary ways. In this way its frequent error or fallibility is always open to correction.” (Rogers Cited in Kirschenbaum P 25)

As we can see from the quote above, Rogers clearly linked Phenomenology Person Centred Counselling together.

How phenomenology links to Person-Centred theory

Rogers developed his psychological ideas which included  ‘The Internal Locus of evaluation’ and ‘Organismic valuing’. In 1953 he published his theory of personality known as the Nineteen Propositions.

The first of the 19 observations make a very clear link to phenomenology and its ideas of how we perceive the world;

1. All individuals (organisms) exist in a continually changing world of experience (phenomenal field) of which they are the center.

In other words, our own experience is our reality, in any given moment of time.

Why is an understanding of phenomenology important?

Because it informs how a person-centred therapist works with clients:-

• View of themselves and others
• Experience of feeling
• Moment by moment experiencing
• Edge of awareness material

It also worth remembering that Person Centred therapy relies on the counsellors ability to be empathic, congruent and non-judgmental, sometimes referred to as the ‘Core Conditions. When used effectively the client feels that someone else can experience how they feel and be validated by the experience. which is how Phenomenology Person Centred Counselling is experienced.

References

Douglas, B. Et al (2016) The Handbook of Counselling Psychology, Fourth edn., London: Sage.

Rogers, C. (1995) Client Centered Therapy , London: Constable & Robinson.

Cooper, M. Et al (2007) The Handbook of Person-Centred Psychotherapy and Counselling, Basingstoke: Palgrave Macmillan.

Kirschenbaum, H. Lands Henderson, V. (1989) The Carl Rogers Reader, New York: Haughton Mifflin.

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Recent Developments in Person-Centred Therapy:

Carl Rogers and Beyond 

Recent developments in person-centred therapy have been cited in a number of books, in particular The Tribes of the Person-Centred Nation. Written by well-known voices in the world of humanistic therapy such as Nick Baker and Mick Cooper, it explores how the work and thinking of Carl Rogers developed since his death in 1987.

Some of the newer developments highlighted in the book are:

• Margaret Warner –Fragile process 
• Dave Mearns and Mick Cooper-Working at relational depth 
• Mick Cooper and John Mcleod-Pluralistic person-centred therapy 

Why are students encouraged to look at recent developments in person-centred therapy?

In most healthcare systems, the term ‘evidence-based practice’ is used to describe therapeutic interventions, research indicates will be successful.

This provides:

• Reassurance to the public that the therapy has a chance of succeeding.
• Counselling students know they are being taught updated information.
• Clear evidence that research is an important element in developing psychological interventions in any modality of therapy.

It also gives a clear message that we must not dismiss new ideas or ways of working when evidence clearly points us in the direction of change or new approaches.

How did Carl Rogers view new developments in therapy?

He was very clear about developing research into all therapies including his own. He states:

“The first challenge I wish to mention is not particularly new but is definitely unmet. It is this: Does our profession dare to develop a new conception of science which is so necessary if we are to have a true psychological science? Or will we continue as a pseudoscience? ” (P358)

Below, Professor Mick Cooper discusses Existentially informed person-centered therapy, another new development based on the work of Carl Rogers.

References

Kirschenbaum, H. Lands Henderson, V (1989) The Carl Rogers Reader, New York: Haughton Mifflin.

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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

The post 047 – Rise of Person-Centred Counselling in Europe – Endings in Counselling – Achievements of Counselling Tutor appeared first on Counselling Tutor.

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!

The post Three-Step Blueprint to Passing Your Skills Evaluation First Time appeared first on Counselling Tutor.

057 – Explicit versus Implicit – Existentialism – Science behind Person-Centred Counselling

In episode 57 of the Counselling Tutor Podcast, Ken and Rory talk about the difference between ‘explicit’ and ‘implicit’. ‘Theory with Rory’ discusses existentialism. Last, the presenters explain the science behind person-centred counselling.

Explicit versus Implicit (starts at 1.21 mins)

The awarding body CPCAB asks students to differentiate between ‘implicit’ and ‘explicit’ in the world of counselling.

Rory explains that these terms relate to the difference between using counselling skills (e.g. for support workers, nurses, police officers and hairdressers, who may do level 2/3 training in counselling skills to facilitate their main work) and actual counselling. Using counselling skills involves using active listening to support other work, but not looking to go deeper or to dig into any emotions (which would be unethical given the context and likely time constraints).

While using counselling skills focuses on the content brought by clients or service users, actual counselling looks at their process – ‘the music behind the words’. For example, a counsellor might comment on mismatches between the client’s words and body language, so identifying possible incongruence.

Existentialism (starts at 8.46)

Philosophers from long ago – such as Plato and Socrates – believed that essence precedes existence: in other words, they thought that humans were put in the world with a specific purpose. As time went on, religion took on this role of seeking to explain the purpose of life. However, following the Second World War, intellectual thinking shifted as a result of the horrors of the concentration camps and Holocaust.

In particular, Jean-Paul Sartre turned the original argument on its head, asserting that existence preceded essence: we arrive in the world with no set purpose and must make our own. Humans are thus free – and we are responsible for ourselves. Existentialists believe that it is this need to find our own meaning that causes anxiety.

Counsellors and psychotherapists work with clients’ attempts to find meaning in their experiences, for example in loss and in other difficult times. Carl Rogers, in his work developing person-centred counselling, was influenced by theist existentialist Søren Kierkegaard and his teleological ideas. Existentialism has also informed transactional analysis, in the form of existential life positions.

Science behind Person-Centred Counselling (starts at 16.10 mins)

What is the science behind person-centred counselling? How can the use of counselling skills and the six necessary and sufficient conditions help people?

Ken and Rory explain the basics of person-centred theory, developed by Carl Rogers following many ‘interviews’ (as he called them) between his students and clients. While there is a substantial body of person-centred theory, it is more metaphysical than some other branches of psychotherapy (e.g. cognitive-behavioural and psychodynamic modalities). It is not an exact science, and is more about being than about doing.

Trusting the process is key. This can be difficult in the early stages of your placement as a student counsellor, but doing so really can bring amazing results, as Ken and Rory recount from their own experience.

Links and Resources

Counselling Study Resource

Counselling Tutor Handouts Vault

Counselling Tutor Facebook group

Counselling Tutor website

Basic Counselling Skills: A Student Guide

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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?

Download your Ethical Problem-Solving Matrix

Click here to download your Ethical Problem-Solving Matrix

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.

Download your Ethical Problem-Solving Matrix

Click here to download your Ethical Problem-Solving Matrix

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

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?

Download your Ethical Problem-Solving Matrix

Click here to download your Ethical Problem-Solving Matrix

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.

Download your Ethical Problem-Solving Matrix

Click here to download your Ethical Problem-Solving Matrix

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

The post 012 – Self-Actualisation – Solving Ethical Problems – Seven Stages Of Process in Practice 2 – Difference between Counselling and Psychotherapy appeared first on Counselling Tutor.

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 GDPR or the General Data Protection Regulations 2018)
• 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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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).

Download your Frame of Reference handout - It’s 100% FREE

Click here to download your Frame of Reference (Developing Empathy) handout

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.

Download your Frame of Reference handout - It’s 100% FREE

Click here to download your Frame of Reference (Developing Empathy) handout

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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The philosophy of individual experience

Carl Rogers, the 'founding father' of humanistic counselling embraced Phenomenology person centred counselling when moving away from the pessimistic views of human nature put forward by Sigmund Freud. Who believed that the human condition was involved in a constant battle between the Id Ego and Super-ego. Rogers' Person-Centred theory is based on what he described as The Phenomenal field. Hence perceptions of taste, sound and how we experience the world are as individual as ourselves.

Free Download - Experience phenomenology yourself using this worksheet

Click here to get your Phenomenology Worksheet now!

What is Phenomenology?

It is an approach in philosophy which concentrates on the study of consciousness and how we experience the world, it focuses on:

• Individual perception
• Conscious experience
• Developing meanings from our perceptions
• Frame of reference

A brief description of phenomenological movement will make it clear why Rogers theory and practice has been linked in this way. Developed at the beginning of the 19th Century by German philosophers Edmund Husserl and Martin Heidegger. They believed that reality consisted of objects and events, which they called 'phenomena' which represent our conscious perception of reality.

How did it influence Rogers' thinking?

Rogers based his theory of personality outlined in his 1951 book Client Centred Therapy on the earlier work of Snygg & Coombs 1949 book Individual Behaviour: A New frame of reference for psychology.

In 1951 Rogers acknowledged the connection between the Person-Centred approach and phenomenology stating, 'his theory of personality and behaviour was 'basically phenomenological in character' (Rogers cited in Douglas, P190). Clearly demonstrating the Phenomenology Person Centred Counselling overlap.

Rogers further expanded on his phenomenological view of personality in his 1961 book On Becoming a Person. He clearly stated his theoretical ideas of personality in this observation;-

"Experience is, for me, the highest authority. The touchstone of validity is my own experience. No other person's ideas, and none of my own ideas, are as authoritative as my experience. It is to experience that I must return again and again, to discover a closer approximation to truth as it is in the process of becoming in me. Neither the Bible nor the prophets -- neither Freud nor research -- neither the revelations of God nor man -- can take precedence over my own direct experience. 

My experience is not authoritative because it is infallible. It is the basis of authority because it can always be checked in new primary ways. In this way its frequent error or fallibility is always open to correction." (Rogers Cited in Kirschenbaum P 25)

As we can see from the quote above, Rogers clearly linked Phenomenology Person Centred Counselling together.

How phenomenology links to Person-Centred theory

Rogers developed his psychological ideas which included  'The Internal Locus of evaluation' and 'Organismic valuing'. In 1953 he published his theory of personality known as the Nineteen Propositions.

The first of the 19 observations make a very clear link to phenomenology and its ideas of how we perceive the world:

1. All individuals (organisms) exist in a continually changing world of experience (phenomenal field) of which they are the center.

In other words, our own experience is our reality, in any given moment of time.

Free Download - Experience phenomenology yourself using this worksheet

Click here to get your Phenomenology Worksheet now!

Why is an understanding of phenomenology important?

Because it informs how a person-centred therapist works with clients:-

• View of themselves and others
• Experience of feeling
• Moment by moment experiencing
• Edge of awareness material

It also worth remembering that Person Centred therapy relies on the counsellors ability to be empathic, congruent and non-judgmental, sometimes referred to as the Core Conditions. When used effectively the client feels that someone else can experience how they feel and be validated by the experience. which is how Phenomenology Person Centred Counselling is experienced.

References

Douglas, B. Et al (2016) The Handbook of Counselling Psychology, Fourth edn., London: Sage.

Rogers, C. (1995) Client Centered Therapy , London: Constable & Robinson.

Cooper, M. Et al (2007) The Handbook of Person-Centred Psychotherapy and Counselling, Basingstoke: Palgrave Macmillan.

Kirschenbaum, H. Lands Henderson, V. (1989) The Carl Rogers Reader, New York: Haughton Mifflin.

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