Aim is not to solve problems but to assist clients in their growth process so clients can better cope<\/strong><\/li>\n<\/ul>\n <\/p>\n
Growth promoting climate<\/p>\n
\u2212 Three therapist attributes create a growth-promoting climate in which individuals can move forward and become what they are capable of becoming o Congruence: <\/em><\/strong>genuine or realness o Unconditional positive regard: <\/em><\/strong>acceptance and caring<\/p>\n\n- Accurate empathetic understanding: <\/em><\/strong>the ability to deeply grasp the subjective world of another person. Effective empathy is grounded in authentic caring for the client.<\/strong><\/li>\n
- Presence: <\/em><\/strong>just being with someone<\/li>\n<\/ul>\n
<\/h3>\nTherapeutic process<\/h3>\n
Therapeutic relationship <\/em><\/p>\n\n- Rogers based his hypothesis of the necessary and sufficient conditions for therapeutic personality change <\/em>on the quality of the relationship.<\/strong><\/li>\n
- He hypothesized further that significant positive personality change does not occur except in a relationship. <\/em><\/li>\n
- Therapeutic core conditions: <\/em>\n
\n- Six conditions that are necessary and sufficient for personality changes to occur:\n
\n- Two persons are in psychological contact<\/strong><\/li>\n
- The first, the client, is experiencing incongruence<\/strong>\u00e0\u00e0 being anxious or vulnerable<\/strong><\/li>\n
- The second person, the therapist, iscongruent <\/strong>or integrated and fully present in the relationship.<\/li>\n
- The therapist experiences unconditional positive regard<\/strong> or real caring<\/strong> for the client<\/li>\n
- The therapist experiences empathy<\/strong> for the client\u2019s internal frame of reference and endeavours to communicate this to the client.<\/li>\n
- The communication to client-unconditional positive regard, and empathic understanding- <\/strong>is to some degree.<\/li>\n<\/ol>\n<\/li>\n
- Rogers hypothesized that no other conditions were necessary.<\/li>\n
- If the therapeutic core conditions <\/strong>exist over some period of time, constructive personality change will occur.<\/li>\n
- The client \u2013therapist relationship is characterized byequality<\/strong>.<\/strong><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n
\u00a0<\/em><\/p>\nThe client\u2019s experience <\/em><\/p>\n\n- If the counsellor creates a climate conducive to self-exploration, clients have the opportunity to explore the full range of their experience.<\/li>\n
- Clients come to the counsellor in a state of incongruence<\/em>\u00e0\u00e0 a discrepancy exists between self-perception and their experience in reality.<\/em><\/li>\n
- Individuals in therapy come to appreciate themselves more as they are, and their behaviours shows more flexibility and creativity.<\/strong><\/li>\n
- They move in the direction of being more in contact with what they are experiencing at the present moment, less bound by the past, freer to make decisions.<\/li>\n<\/ul>\n
\u00a0<\/em><\/p>\nTherapeutic goals <\/em><\/p>\n\n- Aims towards the client achieving a greater degree of independence and integration.<\/strong> – Its focus is on the person, not the presenting problem.<\/li>\n
- Rogers believed that the goal of therapy is to assist clients in their growth process so clients can better cope with problems as they identify them.<\/li>\n
- The underlying aim is to provide a climate conducive to helping the individual strive toward self-actualization.<\/strong><\/li>\n
- The therapist does not choose specific goals for the client<\/li>\n
- Clients in a relationship with a therapist have the capacity to define and clarify their own goals.<\/li>\n<\/ul>\n
\u00a0<\/em><\/p>\nTherapist function\/role <\/em><\/p>\n\u2212 The role of PCT therapists is rooted in their ways of being and attitudes<\/strong>\u00e0\u00e0 not techniques<\/p>\n\u2212 Research on PCT indicates that the attitude of therapists rather than knowledge, theories or techniques, facilitate personality change.<\/p>\n
\u2212 Therapists use themselves as an instrument of change. <\/em><\/p>\n\u2212 Person-centred theory holds that the therapist\u2019s function is to be present and <\/strong>accessible to clients and to focus on their immediate experience<\/strong><\/p>\n\u2212 By being congruent, accepting and empathic, <\/em>the therapist is a catalyst for change.<\/strong><\/p>\n\u2212 Therapist qualities: \u00a0<\/em><\/p>\n\n- Therapist focuses on the quality of the therapeutic relationship o Does not find traditional assessment and diagnosis useful<\/li>\n
- Provides a supportive therapeutic environment in which the client is the agent of change and healing<\/li>\n
- Serves as a model of a human being struggling toward greater realness and an instrument of change for the client<\/li>\n
- They are genuine, integrated, and authentic, without a false front.<\/strong><\/li>\n
- They can openly express feelings and attitudes that are present in the relationship with the client<\/li>\n
- They are invested in developing his or her own life experiences to deepen selfknowledge and move toward self-actualization<\/li>\n<\/ul>\n
\u2212 When these therapist attitudes are present, clients then have the necessary freedom to explore areas of their life that were distorted or denied to awareness \u00a0<\/em><\/p>\n\u00a0<\/em><\/p>\nThe actualizing tendency<\/p>\n
\n- Directional process of striving towards realization, fulfilment, autonomy, selfdetermination and perfection<\/strong><\/li>\n
- Humans gravitate towards self-actualizing<\/li>\n<\/ul>\n
<\/p>\n
Well functioning person<\/p>\n
\n- Well-functioning person is becoming self-actualized<\/strong><\/li>\n
- They are open to experience<\/strong> and unafraid of own feelings<\/strong><\/li>\n
- Trust own cognitive and emotional functioning<\/strong>\u00e0\u00e0 less dependent on others<\/li>\n
- Internal source of evaluation<\/li>\n
- Willingness to continue growing<\/li>\n
- Enjoys life spontaneously\u00e0\u00e0 able to live in the present<\/strong><\/li>\n<\/ul>\n
<\/p>\n
Incongruence<\/p>\n
\n- Experience does not match self-concept\/perception <\/strong>– 3 solutions to incongruence: \u00a0<\/strong>\n
\n- Change (get rid of) the experience to make it consistent with self-concept \u00e0\u00e0 often use of defence mechanism (most common<\/em>)<\/li>\n
- Alter self concept positively <\/strong>to include the new experience<\/li>\n
- Alter self conceptnegatively<\/strong> to include the new experience e.g. \u2018I must be crazy because I have these feelings\u2019<\/li>\n<\/ul>\n<\/li>\n
- Defence mechanisms\u00e0\u00e0 get rid of the incongruence.<\/li>\n<\/ul>\n
<\/p>\n
Techniques<\/p>\n
\n- Reflective listening and paraphrasing<\/u> <\/em>o Paraphrasing is when the clinician restates the content of the client\u2019s previous statement\n
\n- Uses words that are similar but fewer<\/li>\n
- The purpose is to communicate to the client that you understand what he or she is saying.<\/strong><\/li>\n
- It helps the clinician to reduce the client\u2019s clutter<\/li>\n
- It helps the client realize that the counsellor understands what they are saying, clarify their remakes and focus on what is important.<\/li>\n<\/ul>\n<\/li>\n
- Refection of feelings<\/u><\/em> o Often people use the big emotions incorrectly<\/strong> and make their real feelings.\n
\n- A therapist needs to listen careful and watch if non-verbal behaviours, tone of voice and context of situation match.<\/strong><\/li>\n
- Reflection of feelings is when counsellor tries to perceive the emotional state of the client and then expresses the client\u2019s feelings back to them in a tentative manner. oIt helps the clinician: <\/em><\/li>\n
- \u00a7 Check whether or not they accurately understand<\/u> what the client is feeling<\/li>\n
- \u00a7 Tests hypotheses<\/u><\/li>\n
- \u00a7 Brings out problem areas<\/u> without the client being pushed o It helps the client: <\/em><\/li>\n
- \u00a7 Realize that the counsellor understands what they feel<\/u><\/li>\n
- \u00a7 Increase awareness<\/u> of their feelings<\/li>\n
- \u00a7 Learn that feelings and behaviours are connected<\/u>.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n
\u00a0<\/em><\/p>\nMotivational interviewing<\/p>\n
\n- Developed by William Miller and Stephen Rollnick in the early 1980s.<\/li>\n
- Shown to be effective as a relatively brief intervention<\/strong><\/li>\n
- MI is a <\/em>directive<\/em><\/strong> client centred counselling style for eliciting behaviour change by helping clients to explore and resolve ambivalence. <\/em><\/li>\n
- It is based on humanistic principles <\/strong>\u00e0\u00e0 has some similarities with PCT<\/strong> – Initially design as a brief intervention for problem drinking.<\/li>\n
- MI stresses client self-responsibility<\/li>\n
- MI therapist avoids assuming a confrontational stance, reframes resistance as a healthy response, expresses empathy and listens reflectively.<\/li>\n
- They view clients as allies <\/strong><\/li>\n
- Both MI and PCT believe in the client\u2019s abilities, strengths, resources and competencies. <\/strong><\/li>\n
- The underlying assumption is that clients want to be healthy and desire positive change<\/u><\/li>\n
- Five basic principles of motivational interviewing o Therapists practicing MI strive to experience the world from the client\u2019s perspective without judgment\u00e0\u00e0 expressing empathy, reflective listening.<\/strong>\n
\n- MI is designed to evoke and explore both discrepancies and ambivalence.<\/strong><\/li>\n
- Reluctance to change is viewed as a normal and expected part of the therapeutic process\u00e0\u00e0 central is to increase internal motivation to change based on the client\u2019s personal goals\/values.<\/strong><\/li>\n
- Practitioners support clients\u2019 self-efficacy, mainly by encouraging them to use their own resources to take necessary actions that can lead to success in changing. o When clients show signs of readiness to change through decreased resistance to change and increased talk about change, <\/em>a critical phase of MI begins<\/em>\u00e0\u00e0therapist shift their focus toward strengthening client\u2019s commitments to change and helping them implement a change plan.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n
<\/p>\n
Stages of Change model<\/h3>\n– \u00a0\u00a0 Assumes that people progress through five identifiable stages in the counselling process<\/h4>\n\n- Precontemplation stage<\/em>\u00e0\u00e0 no intention of changing behaviour in the near future. Therapist assumes the role of a nurturing parent.<\/strong><\/li>\n
- Contemplation stage<\/em>\u00e0\u00e0 people are aware of a problem and are considering overcoming it, but they have not yet made a commitment to take action. Therapists function as a Socratic teacher who encourages them to achieve their own insights.<\/strong><\/li>\n
- Preparation stage<\/em>\u00e0\u00e0 individuals intend to take action immediately and report some small behavioural changes. Therapists take the stance of an experienced coach.<\/strong><\/li>\n
- Action stage<\/em>\u00e0\u00e0 individuals are taking steps to modify their behaviour to solve their problems. In action and maintenance stage, the therapist\u2019s function in the role of a consultant.<\/strong><\/li>\n
- Maintenance stage<\/em>\u00e0\u00e0 people work to consolidate their gains and prevent relapse. – \u00a0\u00a0 A client\u2019s readiness can fluctuate throughout the change process.<\/li>\n<\/ol>\n