COUN A221F Lecture 8 Person Centered Therapy PDF

LECTURE 8: PERSONCENTERED THERAPY COUN A221F Theories and Practice in Counselling and Mental Health Hong Kong Metropolitan University LEARNING OUTCOME ▪ Identify the basic principle and assumption humanistic approach and person-centered therapy. ▪ Recognize the six conditions of person-centered...

LECTURE 8: PERSONCENTERED THERAPY COUN A221F Theories and Practice in Counselling and Mental Health Hong Kong Metropolitan University LEARNING OUTCOME ▪ Identify the basic principle and assumption humanistic approach and person-centered therapy. ▪ Recognize the six conditions of person-centered therapy, including genuineness, positive regard. empathy, and unconditional ▪ Describe the stages of person-centered therapy. ▪ Demonstrate an understanding of the contribution and limitation of person-centered therapy. CARL ROGERS(1902 - 1987) ▪ Founder of Nondirective – Clientcentered / Person-centered Therapy (PCT) ▪ A major spokesperson for humanistic psychology. ▪ Family atmosphere close and warm relationships but also by strict religious standards. ▪ Academic major changed from agriculture to history, then to religion, and finally to clinical psychology. ▪ First to record counselling session. A REACTION AGAINST THE DIRECTIVE AND PSYCHOANALYTIC APPROACHES ▪ The assumption that “the counselor knows best”. ▪ The validity of advice, suggestion, persuasion, teaching, diagnosis, and interpretation. ▪ The belief that clients cannot understand and resolve their own problems without direct help. ▪ The focus on problems over persons. HUMANISTIC WORLDVIEW 1 People are basically good and will actualize in the absence of interference. 2 At their core, humans are trustworthy and positive. 3 Society, rather than restraining negative forces, leads people astray. 4 Society does this by providing conditional positive regard. VIEW OF HUMAN NATURE ▪ Reality is subjective, no one can fully understand experiences of another. ▪ Human beings are inherently good, can change (antideterministic), and living productive, effective lives, also self-directing and accept full responsibility. ▪ Destructive or anti-social is a product of experience in the environment. VIEW OF HUMAN NATURE ▪ If people depart from their basic nature, then they may commit bad or destructive acts. ▪ If a relationship is characterized by acceptance, caring, trust and respect, a person can regain his or her emotional and spiritual equilibrium. ▪ People can understand their defensiveness and move towards actualizing their full potential. VIEW OF HUMAN NATURE ▪ Free Choice: People can choose what they become. ▪ Actualizing tendency: Humans innately gravitate toward self-actualization and strive towards reaching their full potential. ▪ Growth Orientation: People have a tendency toward growth and actualization. ▪ Given the right growth-fostering conditions, individuals strive to move forward and fulfill their creative nature. ▪ All have a need for positive regard, those behaviors that are positively regarded tend to manifest themselves more readily than other behaviors. ▪ People are experts about themselves. As a result, therapy is generally insight-oriented and nondirective. IT IS NOT A THINKING ABOUT SOMETHING, IT IS AN EXPERIENCE OF SOMETHING AT THIS INSTANT, IN THE RELATIONSHIP. HUMANISTIC VIEW OF PERSONALITY DEVELOPMENT ▪ The humanistic approach states that the self is composed of concepts unique to ourselves. The self-concept includes three components: ▪ Self worth ▪ Self-image ▪ Ideal self HUMANISTIC VIEW OF PERSONALITY DEVELOPMENT ▪ Self worth (or self-esteem) – what we think about ourselves. Rogers believed feelings of self-worth developed in early childhood and were formed from the interaction of the child with the mother and father. ▪ Self-image – How we see ourselves. Self-image includes the influence of our body image on inner personality. ▪ Ideal self – This is the person who we would like to be. It consists of our goals and ambitions in life, and is dynamic – i.e., forever changing. CONDITIONS OF WORTH Basic on societal rules, norms. Seek love from important others. Seek love and approval from significant others (parents, teachers, etc.) Love are given only under certain requirement. Initially externalized, then internalized become part of self. Operating base on “external locus of control”. CONDITIONS OF WORTH A condition of worth arises when the positive regard of a significant other is conditional, when the individual feels that in some respects he is prized and in others not. (Rogers, 1959,p. 209) CONDITIONS OF WORTH ▪ Individuals do not self-actualize in a direction consistent with their actualizing tendency but in a direction consistent with their conditions of worth (Joseph & Linley, 2004). ▪ Psychological disorder and distress develop through the assimilation of worth conditions into an individual’s own identity. VIEW OF DYSFUNCTION ▪ “Good life” is a process not a destination. ▪ Congruent person → Perception of self is consistent with what he experiences ▪ Creative and take risks in life. ▪ Incongruence is the root of psychological or emotional dysfunction. VIEW OF DYSFUNCTION ▪ When incongruence occur , as we prefer to see ourselves in ways that are consistent with our self-image, we may use Defense Mechanism like denial or repression in order to feel less threatened: ▪ Selective of perception ▪ Distort situation ▪ Deny threat to self ▪ A person whose self-concept is incongruent with her or his real feelings and experiences will defend because the truth hurts. PERSON-CENTERED THERAPY Two persons are in psychological contact. The client is experiencing incongruence. The therapist is congruent or integrated in the relationship. The therapist experiences unconditional positive regard or real caring for the client. The therapist experiences empathy for the client’s internal frame of reference and endeavors to communicate this to the client. The communication to the client is, to a minimal degree, achieved. SIX CONDITIONS FOR PERSONALITY CHANGES TO OCCUR THE THERAPIST ▪ Provides a supportive therapeutic environment in which the client is the agent of change and healing. ▪ Serves as a model of a human being struggling toward greater realness. ▪ Can openly express feelings and attitudes that are present in the relationship with the client. ▪ Is invested in developing his or her own life experiences to deepen self- knowledge and move toward self-actualization. NATURE OF THERAPY ▪ Assessment: Do not use any form. ▪ Therapeutic Atmosphere ▪ Counselor is non-expert. ▪ Roles: equals ▪ Provide a climate for self-actualizing. ▪ Client is to be genuine. ▪ Goals: facilitate the client’s journey toward full potential – congruence. CORE CONDITIONS IN PERSON-CENTERED THERAPY HOW TO DEMONSTRATE? LISTENING AND FEEDBACK ▪ Reflect the client’s conflicting wants and needs. ▪ Point out the difference between the fact and the person’s assumption. ▪ Let the client clearly see the gap between the goal and results. ▪ Compare with the congruence and difference of client’s behavior and attitude. ▪ Let the client discern his/her own blind spot in his language expression. HOW TO DEMONSTRATE? LISTENING AND FEEDBACK ▪ Using phrases like “I noticed…”, “I saw…”, “I feel…”,“I observed…” ▪ Do not interpret, just describe ▪ Describe the impact on you: ▪ “I wondered if you were angry with me?” ▪ “You touched your face a lot while you were talking. I wonder whether you were confident about what you were saying.” 1. GENUINENESS ▪ Therapist’s behaviors match his or her words ▪ Being genuine or real ▪ Not hiding self ▪ Willing to risk self ▪ Natural and spontaneous EXAMPLE 當事人: “我來的目的是想得到說明, 其實我已 把全部的資料告訴你了, 但你還是不能給我任 何的幫助或建議” 輔導員: “我知道你的期望及不滿, 我也為事 情沒有進展而相當困擾, 也許我們應該先就 這點來討論一下。” 2. UNCONDITIONAL POSITIVE REGARDS ▪ By allowing clients freedom to discuss themselves. ▪ By demonstrating that you hear and remember specific parts of a client’s story. ▪ By responding with compassion or empathy to client’s emotional pain and intellectual conflicts. ▪ By clearly trying to accept and respect your clients. 2. UNCONDITIONAL POSITIVE REGARDS ▪ Acceptance and genuine caring about the client as a valuable person. ▪ Accepting clients regardless of content and feelings expressed. ▪ Assists clients in recognizing false aspects of self, which were the results of past experiences with conditions of worth. ▪ Therapist need not approve of all client behavior. EXAMPLE 當事人: (一位被控虐兒的媽媽, 被警署輔介到輔導 員) : “你說你想幫我, 你們這些人都是那樣虛偽。不 要以為我來這裡是因為我想你幫我。我在此純粹是 因為那個警員要我來, 不然說要拉我坐牢!” 輔導員: “要你來見我令你很憤怒, 尤當你覺 得我是假裝幫你. 我想如困我像你那樣沒有 其他選擇的時候, 我也會有同樣的感覺。” 3. EMPATHIC UNDERSTANDING ▪ Rogers (1965) was intent on facilitating clients’ access to their inner experience so that they could nurture an in-built capacity to evaluate their experience. ▪ To help clients become aware of their inner subjective experience, to symbolize it, and to reflect on problematic aspects in order to develop new ways of seeing and behaving that would be more self-satisfying. ▪ The sharing of emotional information that is validated and empathically received by another is soothing and calming. 3. EMPATHIC UNDERSTANDING ▪ In this way, person-centered therapy encourages a greater tolerance for ambiguity and a capacity to look at things from different angles, thereby admitting alternative explanations for events. ▪ Increased cognitive complexity increases people’s range of action and responses to events and helps to modulate their emotional responses. 3. EMPATHIC UNDERSTANDING ▪ The ability to deeply grasp the client’s subjective world. ▪ Helper attitudes are more important than knowledge. ▪ The therapist need not experience the situation to develop an understanding of it from the client’s perspective. ▪ Being sensitive from moment to moment with the client’s changing meanings and emotions. EXAMPLE 當事人︰「我快受不了！天天看著我的母親和我的 女朋友在家吵架, 我能做些什麼？…」 輔導員回應:「你覺得左右為難又無助, 因為你不知道如 何做才能改善現在的情況……」 輔導員回應:「你夾在母親與女朋友之間, 既左右為難又 無助, 不知如何是好。」 EXAMPLE 當事人: 「我相信我只係怕陌生, 一旦我認識佢地多一 D, 我就會好好多。」 輔導員: 「你覺得與熟悉的人感覺比較自然和舒服, 同時你會害怕與陌生人接觸, 擔心(別人不知有何 看法 / 會留下不理想的印象)。在此情況下, 我猜你 一方面想擺脫這些陌生人, 但另一方面又想克服這 些憂慮 / 驚謊。」 3. EMPATHIC UNDERSTANDING The more a therapist is aware of her or his own experience, thus congruent, the more she or he can be aware of and open to client experience. VIDEO SHARING ▪ A Conversation with Carl Rogers: The Job of a Therapist ▪ https://www.youtube.com/watch?v=cabN4yE2fZo ▪ Role Play: Person Centered Therapy ▪ https://www.youtube.com/watch?v=4wTVbzvBH0k ▪ Carl Rogers and Gloria - Counselling 1965 Full Session ▪ https://www.youtube.com/watch?v=ee1bU4XuUyg STAGES OF THERAPY ▪ Stage 1: The client comes in for therapy, an important, responsible action to takes in charge of his/her life. ▪ “I don’t know what might want to talk about, but I’m very ready to hear. We have half an hour, and I hope that in that half an hour we can get to know each other as deeply as possible, but we don’t need to strive for anything. I guess that’s my feeling. Do you want to tell me whatever is on your mind?” STAGES OF THERAPY ▪ Stage 2: Define helping relationship with client, which the counselor does not have the answer, but can offer a safe place for explore self and find solution on own problems. ▪ Stage 3: Counselor provide a safe place where clients free to express all feelings. ▪ Stage 4: As client feel the safe, accepted climate, negative feeling will arise, it can be examined and gain insight. STAGES OF THERAPY ▪ Stage 5: After negative feeling has expressed and processed, positive feelings and thought will begin to arise, sometimes a surprise for clients. ▪ Stage 6: Both negative and positive feelings that arise will be accepted and examined, process. ▪ Stage 7: The exploration of all feelings within a safe, acceptance climate leads to an understanding and acceptance of self. ▪ Stage 8: As counselling continues increased insight is achieved and possible course of action are decided. STAGES OF THERAPY ▪ Stage 9: Clients begin to make small but important positive behavioral changes in daily life. ▪ Stage 10: insight is expanded, and self understanding become more complete and more accurate. ▪ Stage 11: increase self-direction in his/her life and become less fearful about making choices that will leads to more productive relationship and effective. ▪ Stage 12: become increasingly autonomy and gradually develop a sense that therapist is no longer need. CHANGES ON THE CLIENT An increase openness to experience A greatly ability to be more objective and to have more realistic perceptions Better psychological adjustment More congruence, increased selfregard Move from external to internal locus of control More acceptance of others Better in problem solving Accurate perception of others FULLY FUNCTIONING PERSON (ROGERS, 1961) ▪ The good life is a process of movement (not a state of being) in a direction (not a destination) which the total human organism selects. A person becoming more fully functioning involves: ▪ An increasing openness to experience ▪ Increasingly existential living (i.e., to live fully in each moment) ▪ An increasing trust in one’s organism (i.e., as a means of arriving at the most satisfying behavior in each existential situation) ▪ An increasing experience and acceptance of one’s feelings. CONTRIBUTION OF PERSON-CENTERED THERAPY ▪ Applicable to a wide variety of helping situations and setting, group counselling, family counselling, classroom learning, education, business coaching etc. ▪ Remove the helping process from the exclusive control of highly trained professionals. ▪ Make psychotherapy understandable and usable to all people. LIMITATIONS OF PERSON-CENTERED THERAPY ▪ Too Individualistic and optimistic view of human nature people. ▪ Counselor sometimes have trouble in allowing clients to decide their own goals. ▪ It may be adequate for “healthy” client, but what about the severely distributed clients or less than normal intelligence? ▪ Does not focus on the use of specific techniques, making this treatment difficult to standardize. ▪ Beginning therapists may find it difficult to provide both support and challenges to clients. CULTURAL CONSIDERATIONS ▪ Some clients may prefer a more directive, structured treatment. ▪ Individuals accustomed to indirect communication may not be comfortable with direct expression of empathy or creativity. ▪ Individuals from collectivistic cultures may disagree with the emphasis on internal locus of control. ▪ Too much individualism, emotional expression, nondirective, and self-disclosure. REFERENCE: EMPIRICAL SUPPORT FOR PERSON-CENTERED THEORY ▪ Research has demonstrated that people experiencing more well- being when pursuing goals for autonomous reasons (Sheldon, Ryan, Deci, & Kasser, 2004). ▪ Research has demonstrated that individuals who select more intrinsically motivated goals put more continued effort into them, thus enabling their attainment (Patterson & Joseph, 2007). ▪ Judge, Bono, Erez, and Locke (2005) demonstrated that people with positive self-regard are more likely to have intrinsically motivated goals and have greater life satisfaction and happiness. REFERENCE: EMPIRICAL SUPPORT FOR PERSON-CENTERED THEORY ▪ Participants low in control and high in autonomy were less likely to make self-enhancing attributions with successful and defensive attributions after failure. These individuals perceive less threat to self-esteem, and invite opportunities for growth, (Knee & Zuckerman, 1996). ▪ Kasser and Ryan (1996) demonstrated that intrinsic aspirations for self-acceptance, affiliation, and community feeling were associated with greater well-being, self-actualization, less distress, with the opposite associations for extrinsic aspirations such as a drive for financial success. REFERENCE: EMPIRICAL SUPPORT FOR PERSON-CENTERED THEORY ▪ Wood et al. (2008) has demonstrated authenticity to be positively associated with psychological well-being, life satisfaction, and self-esteem. ▪ Research suggests that well-being is associated with character strengths (Park, Peterson, & Seligman, 2004) including enthusiasm, hope, love, and curiosity. ▪ Authentic living involves expressing emotions and behaving in a way consistent with one’s awareness—that is, being true to oneself and living in accordance with one’s values and beliefs (Wood et al., 2008). REFERENCE: EMPIRICAL SUPPORT FOR PERSON-CENTERED THEORY ▪ Perceived spirituality has been found to positively influence life satisfaction (Zullig, Ward, & Horn, 2006), and daily spiritual experiences have been found to be associated with positive affect and life satisfaction (Van Dyke, Glenwick, Cecero, & Kim, 2009). ▪ Post-traumatic growth corresponds with character strengths related to fully functioning person, including more meaningful interpersonal relationships, a greater appreciation of life, enhanced confidence, and spiritual development (Joseph & Butler, 2010). IN-CLASS EXERCISE (1) ▪ The three core conditions of person-centered counseling include all the following except: ▪ caring ▪ empathy ▪ genuineness ▪ unconditional positive regard IN-CLASS EXERCISE (2) ▪ Which of the following statements best describes the term unconditional positive regard? ▪ The tendency of an individual to move towards self-actualization ▪ Accurate understanding of the client’s inner world ▪ A sense of acceptance ▪ Reflection of feelings IN-CLASS EXERCISE (3) ▪ When a child is called "stupid" for making mistakes on homework, Carl Rogers would say that: ▪ authenticity will develop ▪ conditions of worth will develop ▪ congruence will develop ▪ the grandiose self will be fostered IN-CLASS EXERCISE (4) ▪ Which statement correctly describes Carl Rogers position on diagnosis in therapy? ▪ Assigning clients to diagnostic categories facilitates the empathic responding of the counselor. ▪ Diagnosis is not helpful in person-centered therapy. ▪ Drawing from a wide range of assessment instruments gives the therapist more information about the client, thus increasing the opportunity for therapist congruence. ▪ Understanding the psychological development of the client is important in therapy. REFERENCES ▪ Archer, J., & McCarthy, C. J. (2007). Theories of Counseling and Psychotherapy: Contemporary Applications. Upper Saddle River, NJ: Merrill Prentice Hall. ▪ Corey , G (2008). Theory and Practice of Counseling and Psychotherapy, Thomson Learning ▪ Joseph, S., & Linley, P. A. (2004). Positive therapy: A positive psychological theory of therapeutic practice. In P. A. Linley & S. Joseph (Eds.), Positive psychology in practice (pp. 354-368). Hoboken, NJ: John Wiley. ▪ Judge, T. A., Bono, J. E., Erez, A., & Locke, E. A. (2005). Core self-evaluations and job and life satisfaction: The role of self-concordance and goal attainment. Journal of Applied Psychology, 90, 257-268. ▪ Kasser, T., & Ryan, R. M. (1996). Further examining the American dream: Differential correlates of intrinsic and extrinsic goals. Personality and Social Psychology Bulletin, 22, 280-287. ▪ Knee, C. R., & Zuckerman, M. (1996). Causality orientations and the disappearance of the self-serving bias. Journal of Research in Personality, 30, 76-87. ▪ Mcleod, J. (2003) An Introduction to Counselling. (3rd ed.). Open University Press. ▪ Patterson, T. G., & Joseph, S. (2007). Person-centered personality theory: Support from self-determination theory and positive psychology. Journal of Humanistic Psychology, 47, 117-139. REFERENCES ▪ Raymond, J. C., & Danny, W. (2005). Current Psychotherapies. (7th ed.). Thomson Brooks / Cole. ▪ Rogers, C. R. (1959). A theory of therapy, personality, and interpersonal relationships as developed in the client- centered framework. In S. Koch (Ed.), Psychology: A study of a science: Vol. 3: Formulations of the person and the social context (pp. 184-256). New York,NY: McGraw-Hill. ▪ Rogers, C. R. (1961). On becoming a person: A therapist’s view of psychotherapy. London,England:Constable. ▪ Rogers, C. R. (1965). Client-centered therapy: Its current practice,implications, and theory. Boston:Houghton Mifflin. ▪ Sheldon, K. M., Ryan, R. M., Deci, E. L., & Kasser, T. (2004). The independent effects of goal contents and motives on well- being: It’s both what you pursue and why you pursue it. Personality and Social Psychology Bulletin, 30, 475-486. ▪ Van Dyke, C. J., Glenwick, D. S., Cecero, J. J., & Kim, S.-K. (2009). The relationship of religious coping and spirituality to adjustment and psychological distress in urban early adolescents.Mental Health, Religion & Culture,12, 369-383. ▪ Wood, A. M., Linley, P. A., Maltby, J., Baliousis, M., & Joseph, S. (2008). The authentic personality: A theoretical and empirical conceptualization and development of the Authenticity Scale.Journal of Counseling Psychology,55, 385-399. ▪ Zullig, K. J., Ward, R. M., & Horn, T. (2006). The association between perceived spirituality, religiosity, and life satisfaction: The mediating role of self-rated health.Social Indicators Research,79, 255-274.