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Theory of Counselling
Person-Centered
Michael Dadson
Counselling Psychology
Clinical Comprehensive Exam
⦿ I) Key Elements of the Theoretical Perspective:
• A) View of Human nature:
• B) View of Personality:
⦿ II) Theoretical Perspective’s Process of
Counselling:
• A) The Person of the Therapist:
• B) The Therapeutic Relationship:
• C) Mechanisms of change:
• D) Goals of Therapy:
• E) Interventions and techniques:
• F) Assessment and Criteria of Effectiveness:
⦿ III) Research Support and Rationale for Use:
Michael Dadson Person-Centered
I) Key Elements of the
Theoretical Perspective:
⦿A) View of Human nature: Tageson, 1982
• Basic trust in the person’s growth tendency.
• Basic trust in the pull to fulfill one’s potential.
• Basic optimism in the person’s capacity to
overcome life’s restricting experiences.
Michael Dadson Person-Centered
I) Key Elements of the
Theoretical Perspective:
⦿B) View of Personality:
• The human personality is in constant moving process.
Nuttin (1962)
• This process leads to: self-actualization, self
transcendence, self-awareness. This becoming is the
moral gift of the self.
• This process transforms a human being into a
genuinely caring person who will safeguard the best
interests of humanity in general (Tageson, 1982)
Michael Dadson Person-Centered
II) Theoretical Perspective’s
Process of Counselling:
⦿ A) The Person of the Therapist:
⦿ The therapist is a process expert who can facilitate
the development of the human psyche. Like a
farmer, the therapist sets the conditions that
cultivate the growth of the human mind.
⦿ The therapist seeks to increase the client's
awareness of his or her current feelings,
perceptions, and physical state.
⦿ The therapist views clients as being experts in
their own experience (Angus, & Kagan, 2007).
Michael Dadson Person-Centered
II) Theoretical Perspective’s
Process of Counselling:
⦿B) The Therapeutic Relationship:
• Being understood and accepted by a genuine,
engaged and empathic listener, in the therapeutic
relationship, enables clients to disclose their most
important and emotionally salient personal
experiences to the therapist (Angus & Hardtke,
2006).
Michael Dadson Person-Centered
II) Theoretical Perspective’s
Process of Counselling:
⦿B) The Therapeutic Relationship:
• Once externalized as a story, clients are then able
to “stand back” from and actively reflect on their
inner world of emotions, intentions, motives,
goals, expectations, and beliefs.
• This process provides the conditions necessary to
create moments where the client is able to sense
and see themselves.
Michael Dadson Person-Centered
II) Theoretical Perspective’s
Process of Counselling:
⦿B) The Therapeutic Relationship:
• The relationship itself, combined with the proper
conditions, engages the client in a process that
results in the hopeful expectancy for change and a
heightened capacity to take action (Angus &
Hardtke, 2006).
Michael Dadson Person-Centered
II) Theoretical Perspective’s
Process of Counselling:
⦿C) Mechanisms of change:
⦿The therapist, the therapeutic
relationship and the facilitating
conditions stimulate the actualizing
tendency that pulls the client towards
goals that she sets.
Michael Dadson Person-Centered
II) Theoretical Perspective’s
Process of Counselling:
⦿C)Mechanisms of change:
⦿The human actualizing tendency is
the inherent propensity of persons to
develop and form more differentiated
and integrated personal life structures
(Bohart, 2005).
Michael Dadson Person-Centered
II) Theoretical Perspective’s
Process of Counselling:
⦿C) Mechanisms of change:
⦿It is this self-righting preference that is
the primary force of change in
psychotherapy; the human growth
tendency facilitated within the
therapeutic relationship and activated
by the conditions of change (Bohart,
2005).
Michael Dadson Person-Centered
⦿D) Goals of Therapy:
⦿congruence,
⦿self-awareness,
⦿self-determination
⦿self-transcendence (Tageson, 1982).
⦿“The fully functioning person”
II) Theoretical Perspective’s
Process of Counselling:
Michael Dadson Person-Centered
⦿ D) Goals of Therapy:
⦿ “The fully functioning person” as illustrated by the six modes of
experiencing.
⦿Rogers differentiated six process stages of
being and experiencing as a person. In the
following figures illustrate his
understanding of personality, its
relationship to the actualizing tendency,
and how these intersect with conditions of
change.
II) Theoretical Perspective’s
Process of Counselling:
Michael Dadson Person-Centered
⦿The Person as Process: six process
modes of being and experiencing as a
person.
• 1. Change in relationship to feelings.
• 1 2 3 4 5 6 7
⦿ The necessary conditions stimulating the actualizing tendency
Feelings are sensed,
differentiated, and
expressed in the living
moment.
Person does not
recognize feelings.
⦿The Person in Process: six process
modes of being and experiencing as a
person.
• 2. Change in manner of experiencing.
• 1 2 3 4 5 6 7
• The necessary conditions stimulate the actualizing tendency
Remoteness from
experiencing and
its meaning.
Living, trusting and
using experience as
a way to encounter
life now with
meaning.
⦿The Person as Process: six process
modes of being and experiencing as a
person.
• 3. Change in personal constructs.
●How one construes their experiences.
• 1 2 3 4 5 6 7
• The necessary conditions stimulate the actualizing tendency
Construction of
experiences as rigid,
unchanging facts.
Experience itself is only a
tentative construction and
ongoing experiences guide
formation and adaptability
to new circumstances.
⦿The Person as Process: six process
modes of being and experiencing as a
person.
• 4. Change in communication of self.
• 1 2 3 4 5 6 7
The necessary conditions stimulate the actualizing tendency
Inhibiting,
inappropriate self-
consciousness.
Accurately identify and
express the complexity of
their feelings in the
moment.
⦿The Person as Process: six process
modes of being and experiencing as a
person.
• 5. Change in relationship to problems.
• 1 2 3 4 5 6 7
The necessary conditions stimulate the actualizing tendency
Do not recognize
personal problems but
perceive them as
outside themselves.
Acceptance of personal
responsibility and a
willingness to understand
and confront them in
relationships.
⦿The Person as Process: six process
modes of being and experiencing as a
person.
• 6. Change in interpersonal relationships.
• 1 2 3 4 5 6 7
The necessary conditions stimulate the actualizing tendency
Fear and avoidance of
close personal contact
with others.
Capable of sharing deepest
inner reactions, positive or
negative in ongoing
relationships.
⦿The Person as Process:
⦿According to Rogers, becoming autonomous is
a major goal of human development. The fully
functioning person has an internal locus of
control and operates on the basis of personally
chosen values rather than by rigidly conforming
to the dictates of society.
⦿Person as “a self in context”
• Bohart (2003) and O’Hara (1992) Argue for a self
that is interdependent and interconnected. Thus
the individual achieves integration with other
group members and with the collective mind.
Individuals do not lose their identity to the group
but integrate the I with the We.
II) Theoretical Perspective’s
Process of Counselling:
⚫ E) Interventions and techniques:
⦿ The therapist is a process expert who can facilitate the
development of the human psyche. The therapist is like a
farmer who sets the conditions that cultivate the human mind
with:
⦿ The three conditions of change (Rogers, 1957):
⦿ 1) Unconditional Positive Regard
⦿ 2) Genuineness or Congruence
⦿ 3) Empathy.
Michael Dadson Person-Centered
⦿1. Unconditional Positive Regard. The
quality of likening, respecting, or prizing
directed at the client as a whole person.
⦿The conditions of change.
⦿2. Genuineness or Congruence (being
aligned and connected with one’s self).
Congruence is attending inwardly to one’s
experience and working to sort out its
meanings. It is being inwardly in tune by
sorting out the degree to which my
reactions are mine and what they mean.
⦿Incongruence is the cause of what some
would call pathology.
⦿The conditions of change.
⦿3. Empathy. The ability to perceive
the internal frame of reference of
another with accuracy, the persons
emotional components and meanings
“as if” you were that person.
Empathy continued
⦿Greenberg, Watson, Elliott, & Bohart, (2001)
define empathy as the therapist's sensitive
ability and willingness to understand the
client's thoughts, feelings, and struggles from
the client's point of view… It is this ability to
see completely through the client's eyes, to
adopt his frame of reference…It means
entering the private perceptual world of the
other and being sensitive, moment by
moment, to the changing felt meanings which
flow in this other person... It means sensing
meanings of which he or she is scarcely
aware.
II) Theoretical Perspective’s
Process of Counselling:
⚫E) Interventions and techniques:
integration.
⚫ Other techniques can be integrated into
person-centered approaches, but only if they
further the central process of being with the
client in a real, empathic relationship. The
heart of the person-centered approach is the
therapist’s “reflective stance” towards the
client (Bohart, 2005, p.122).
Michael Dadson Person-Centered
II) Theoretical Perspective’s
Process of Counselling:
⚫E) Interventions and techniques:
⦿Allen, Fonagy and Bateman (2008), have
constructed a powerful treatment technique
called “mentalizing” which they propose as a
robust and powerful reflective process.
Mentalizing based treatments integrate and
assimilate well with person-centered focus on
the reflective process of the therapeutic
relationship.
Michael Dadson Person-Centered
II) Theoretical Perspective’s
Process of Counselling:
⚫E) Interventions and techniques:
⚫Mentalizing is a reflective process that
involves imaginatively perceiving and
interpreting behaviour of oneself and
others as conjoined with intentional mental
states (Allen, Fonagy, & Bateman, 2008). It
is to hold mind in mind and reflect on the
mental states in self and others.
Michael Dadson Person-Centered
II) Theoretical Perspective’s
Process of Counselling:
⚫E) Interventions and techniques:
⚫Mental states include: Ordinary states
like emotions, thoughts, motives, desires,
needs, beliefs, fantasies, and dreams.
Pathological processes such as panic
attacks, dissociative states,
hallucinations, and delusions (Allen,
Fonagy, & Bateman, 2008).
Michael Dadson Person-Centered
⦿ Stages of Mentalizing Development Allen, (2008) p. 145
⦿
⦿ Mentalizing Proper
⦿ Symbolic, imaginative and interpretive thinking about self and other;
representational/autobiographical agency.
⦿ Empathy and Realistic Attunement
⦿ Psychological mindedness; mentalized affectivity; thinking while
feeling
⦿ Reflective and Flexible Thinking
⦿ Affect regulation; attentional control; thinking about thinking and
feeling.
⦿ Awareness of Reacting
⦿ Identifying the emotion: attentional focus; “pushing the pause button”
⦿ Acting and Reacting:
⦿ Rigid and stereotypical thinking: high emotional arousal. Information
about reality is experienced as reality. The experience becomes the
self (Psychic equivalent).
Michael Dadson Person-Centered
Comparing and Contrasting
Mentalizing and Empathy
⦿1) Empathy focuses attention reflecting on
another person. Mentalizing focuses
attention reflecting on another person and
one’s self.
Michael Dadson Person-Centered
Comparing and Contrasting
Mentalizing and Empathy
⦿2) Empathy focuses attention reflecting on
emotions. Mentalizing focuses attention on
a range of experiences: emotions,
thoughts, motives, desires, needs, beliefs,
fantasies, and dreams.
Michael Dadson Person-Centered
Comparing and Contrasting
Mentalizing and Empathy
⦿3) Empathy focus attention the here and
now experience of feeling. Mentalizing
focus attention on here and now
experiences, past experiences and
anticipated future experiences of self and
others.
Michael Dadson Person-Centered
Mentalizing and Empathy
⦿Mentalizing techniques are well suited to
be comfortably assimilated into person-
centered perspectives because the
mentalizing construct complements and
expands the notion of empathy and the
reflective therapeutic relationship.
Michael Dadson Person-Centered
III) Research Support and
Rationale for Use:
⦿Research strongly supports the therapist
qualities, the therapeutic relationship and
facultative conditions as common and
central factors that produce change
(Stricker, & Gold, 2005; Lambert & Barley,
2001).
Michael Dadson Person-Centered
III) Research Support and
Rationale for Use:
⦿Norcross (2001) suggests that if we asked
a neutral scientific panel, from outside the
field, to review the corpus of
psychotherapy research and determine
what is the most powerful phenomenon we
should be studying, practicing, and
teaching ,the therapeutic relationship
would be the obvious, and empirically
validated answer.
Michael Dadson Person-Centered
III) Research Support and
Rationale for Use:
⚫ There is strong empirical evidence that a
strong therapeutic alliance is essential for
effective psychotherapy. (Orlinsky, Grawe, &
Parks, 1994)
⚫ Relationship factors like empathy,
genuineness and unconditional positive regard
have been identified as the specific
contributions that facilitate the development of
a therapeutic alliance and productive
outcomes in psychotherapy.
Michael Dadson Person-Centered
III) Research Support and
Rationale for Use:
⚫ Research has shown that the therapist’s
empathic, reflective engagement contributes
towards the development of a secure,
relational bond. This bond is a key
precondition for the subsequent identification
of shared goals and introduction of tasks that
taken together constitute a strong therapeutic
alliance (Angus & Kagan, 2007).
Michael Dadson Person-Centered
III) Research Support and
Rationale for Use:
⦿The person-centered experiential
approach and interventions are research
based, empirically supported, and
effective. They are therapeutically useful
for all populations who are able to tolerate
an open-ended, process-orientated
relationship.
Michael Dadson Person-Centered
Michael Dadson Person-Centered
Michael Dadson Person-Centered
⦿Empathy is a complex interactive process
that is created within the therapeutic
relationship.
⦿Barrett-Lennard (1981) conceptualizes
empathy as a process in which
• 1. The client recounts the experience
• 2. The therapist first attends to and receives the
experience, then resonates to it, and finally
expresses this awareness to the client.
• 3 The client receives this awareness and
evaluates the therapist's understanding.
⦿Empathy is a process in which the person
of the therapist resonates emotionally with
a person’s experience. The therapist is
able to sense what it is like to be the client
in their situation and can communicates
this to the client. Barrett-Lennard's (1981).
⦿How researchers operationalize empathy.
⦿The clearest operational definition of
empathy is Barrett- Lennard's (1981)
delineation of the three different
components and perspectives of empathy:
⦿1. The therapist's experience ("empathic
resonance").
⦿2. The observers' view ("expressed
empathy").
⦿3. The client's experience ("received
empathy").
⦿How researchers operationalize empathy.
⦿Who is the best person to access what
happened in session?
●Supervisor
●Therapist
●Client
⦿Greenberg, et al., (2001) conducted a
meta-analysis of the relation of empathy
to psychotherapy outcome. The resulting
sample consisted of 47 studies,
encompassing 190 separate tests of the
empathy-outcome association and a total
of 3,026 clients. Study dates ranged from
1961 to 2000. Overall, empathy accounts
for as much and probably more outcome
variance than does specific intervention
(compare to Wampold's [2001] estimate of
1 to 8% for interventions).
⦿(Angus & Kagan, 2007) noted
⦿Rogers’ (1975) definition of therapeutic
empathy, as both therapist empathic
attunement skills (inside the therapist)
and empathic communication skills (to
the client) are both viewed as essential for
sustained empathic engagement and the
development of a secure, relational bonds
in psychotherapy
⦿How is empathy effective?
⦿Therapist empathic attunement skills
facilitate the following client outcomes (In
Angus & Kagan 2007):
⦿Empathic Attunement Skills
⦿1. Create a safe and trusted relational bond:
• a) That enables clients to disclose, emotionally
significant personal stories to the therapist (Angus,
Lewin, Bouffard, & Rotondi-Trevisan, 2004).
• b) Where the absence of rejection and censure assists
the identification of core relational (Luborsky & Crits-
Christoph, 1990), and emotion themes (Greenberg,
2002).
• c) That provides a context that facilitates the
formulation of case conceptualizations and the
articulation of shared therapeutic goals.
⦿Empathic Attunement Skills
⦿2. Help clients create meaning of their
inner world.
⦿Empathy engages clients in active, self-
reflection facilitating the expression and
symbolization of primary adaptive
emotions (Greenberg, 2002), core beliefs
(Goldfried, 2003) leading to the
construction of new, more coherent, and
empowering personal meanings (Angus,
Levitt, & Hardtke, 1999).
⦿Empathic Attunement Skills
⦿3. Engenders agency and self-mastery
⦿Empathic attunement helps sustain
client’s active self-reflection in the therapy
and engenders a heightened sense of
personal agency and self-mastery
(Bandura, 2006), (Frank, 1961).
⦿Empathic Attunement Skills
⦿4. Impacts client expectancies for change
and leads to enhanced motivation for
engagement in therapy tasks and goals
(Westra, 2004).
⦿Empathic Attunement Skills
⦿5. Increase therapist attunement to
fluctuations in the depth and affective tone
of the therapeutic bond and so attunement
functions as an early warning system for
the detection and repair of alliance
ruptures (Safran & Muran, 2000).
⦿How is empathy effective?
⦿Empathic communication of therapist’s
understanding and validation facilitates
the following client outcomes (In Angus &
Kagan 2007):
⦿Empathic communication
⦿1. Assists the client to disclose deeply
personal and painful experiences to the
therapist, and feel accept and understood.
This may be the basis of a new, corrective
interpersonal experience (Castonguay,
2005; Pachankis & Goldfried, 2007) for
the client.
⦿Empathic communication
⦿2. Is experienced as relieving and
soothing by clients and enhances their
capacity for emotional self-regulation
(Elliott, Watson, Goldman, & Greenberg,
2004).
⦿Empathic communication
⦿ 3. Accounts for—new outcome stories—
helps bring saliency and meaning to
experiences (Hardtke & Angus, 2004;
Kagan, 2007) and may facilitate the
emergence of insight (Angus & Hardtke,
2006; Castonguay & Hill, 2006) and new,
more positive views of self/self-identity
(Goldfried, 2003; Kagan, 2007).
⦿Directions for new research
⦿Empathy may be conveyed using a variety
of therapist response modes, such as
interpreting, evoking, reflecting, probing,
questioning and speculating (Greenburg &
Elliott (1997).
⦿Directions for new research
⦿Empathic communication as a highly
selective as well as a highly reflective
process. This means the therapist is
selectively reflecting particular feelings at
particular times.
⦿Directions for new research
⦿Empathy involves selectively responding
both to what is most alive in the client's
experience and to primary adaptive
emotional responses.
⦿Effective empathy requires picking up the
ongoing, growing edge of the client's
experience, the aspect that is
developmentally moving the client forward to
a greater sense of competence and mastery.
(Greenberg, & Goldman, 1988)
⦿Directions for new research
⦿When entering the client's frame of
reference, the therapist must not respond
to just any expression of emotion but to
those emotions that provide “biologically
adaptive information.”
⦿Unconditional Positive Regard
⦿To the extent that the therapist finds himself
experiencing a warm acceptance of each aspect
of the client’s experience as being a part of that
client, he is experiencing unconditional positive
regard. …It means there are no conditions of
acceptance…it means a “prizing” of the
person… it means a caring for the client as a
separate person.
(Rogers,1957, p.101)
⦿Unconditional Positive Regard-Research
⦿ Therapists ability to provide positive regard seems to be
associated with therapeutic success—when the patients
perspective on outcome is taken.
⦿ Virtually all significant findings bear:
⦿ - modest effect sizes only, suggesting that UPR is a
significant but not exhaustive part of the process
outcome equation.
⦿ - UPR may be sufficient by itself to effect change. There
is no reason to withhold positive regard; It is the
patient’s perspective of therapist’s positive regard that is
usually associated with good outcome.
⦿ (Farber and Lane, 2002)
⦿Unconditional Positive Regard-Research
⦿ Therapists vary in the extent to which they are able to convey
positive regard to their patient (some therapists better than others at
providing it)
⦿ Client’s vary in the extent to which they need or benefit from
therapists positive regard
⦿ The level of positive regard a therapist generally functions at is
influenced by characteristics of his or her patients as well as the
current state of therapy.
⦿ Therapists, whether they are skilled at providing positive regard to
patients, need to self-monitor their ability and adjust as a function of
the needs of particular clients and particular clinical situations. Also,
there may be ruptures in alliances not only due to a therapist’s
technical errors but also the therapist’s occasional inability to
demonstrate minimally facilitative levels of positive regard.
⦿ (Farber and Lane, 2002, p. 192)
⦿Unconditional Positive Regard
⦿Future studies:
• the question of specificity: for what clients,
presenting with what types of problems, is the
provision of therapist regard most important, and
for which is this variable of minor importance.
• interaction between modes of therapy and
positive regard. Eg. More potent interaction, in
terms of outcome, between psychodynamic
therapy and positive regard than there is between
CBT and positive regard.
⦿Unconditional Positive Regard
⦿Farber and Lane (2002, p.192):
⦿“Despite the current zeitgeist emphasizing more
technical (technique-oriented, manually driven)
therapeutic interventions, it is difficult to envision the
future or psychotherapy without imagining therapists
who are deeply caring, compassionate, supportive, and
affirming of their patients. The research indicating a
positive, albeit modest association between therapist
positive regard for patients and outcome is testament to
the importance of a therapist’s humanity and also
testament to the importance of relational factors in the
outcome of psychotherapy.”

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Michael Dadson - What is my theory of counselling psychology person centered?

  • 1. Theory of Counselling Person-Centered Michael Dadson Counselling Psychology Clinical Comprehensive Exam
  • 2. ⦿ I) Key Elements of the Theoretical Perspective: • A) View of Human nature: • B) View of Personality: ⦿ II) Theoretical Perspective’s Process of Counselling: • A) The Person of the Therapist: • B) The Therapeutic Relationship: • C) Mechanisms of change: • D) Goals of Therapy: • E) Interventions and techniques: • F) Assessment and Criteria of Effectiveness: ⦿ III) Research Support and Rationale for Use: Michael Dadson Person-Centered
  • 3. I) Key Elements of the Theoretical Perspective: ⦿A) View of Human nature: Tageson, 1982 • Basic trust in the person’s growth tendency. • Basic trust in the pull to fulfill one’s potential. • Basic optimism in the person’s capacity to overcome life’s restricting experiences. Michael Dadson Person-Centered
  • 4. I) Key Elements of the Theoretical Perspective: ⦿B) View of Personality: • The human personality is in constant moving process. Nuttin (1962) • This process leads to: self-actualization, self transcendence, self-awareness. This becoming is the moral gift of the self. • This process transforms a human being into a genuinely caring person who will safeguard the best interests of humanity in general (Tageson, 1982) Michael Dadson Person-Centered
  • 5. II) Theoretical Perspective’s Process of Counselling: ⦿ A) The Person of the Therapist: ⦿ The therapist is a process expert who can facilitate the development of the human psyche. Like a farmer, the therapist sets the conditions that cultivate the growth of the human mind. ⦿ The therapist seeks to increase the client's awareness of his or her current feelings, perceptions, and physical state. ⦿ The therapist views clients as being experts in their own experience (Angus, & Kagan, 2007). Michael Dadson Person-Centered
  • 6. II) Theoretical Perspective’s Process of Counselling: ⦿B) The Therapeutic Relationship: • Being understood and accepted by a genuine, engaged and empathic listener, in the therapeutic relationship, enables clients to disclose their most important and emotionally salient personal experiences to the therapist (Angus & Hardtke, 2006). Michael Dadson Person-Centered
  • 7. II) Theoretical Perspective’s Process of Counselling: ⦿B) The Therapeutic Relationship: • Once externalized as a story, clients are then able to “stand back” from and actively reflect on their inner world of emotions, intentions, motives, goals, expectations, and beliefs. • This process provides the conditions necessary to create moments where the client is able to sense and see themselves. Michael Dadson Person-Centered
  • 8. II) Theoretical Perspective’s Process of Counselling: ⦿B) The Therapeutic Relationship: • The relationship itself, combined with the proper conditions, engages the client in a process that results in the hopeful expectancy for change and a heightened capacity to take action (Angus & Hardtke, 2006). Michael Dadson Person-Centered
  • 9. II) Theoretical Perspective’s Process of Counselling: ⦿C) Mechanisms of change: ⦿The therapist, the therapeutic relationship and the facilitating conditions stimulate the actualizing tendency that pulls the client towards goals that she sets. Michael Dadson Person-Centered
  • 10. II) Theoretical Perspective’s Process of Counselling: ⦿C)Mechanisms of change: ⦿The human actualizing tendency is the inherent propensity of persons to develop and form more differentiated and integrated personal life structures (Bohart, 2005). Michael Dadson Person-Centered
  • 11. II) Theoretical Perspective’s Process of Counselling: ⦿C) Mechanisms of change: ⦿It is this self-righting preference that is the primary force of change in psychotherapy; the human growth tendency facilitated within the therapeutic relationship and activated by the conditions of change (Bohart, 2005). Michael Dadson Person-Centered
  • 12. ⦿D) Goals of Therapy: ⦿congruence, ⦿self-awareness, ⦿self-determination ⦿self-transcendence (Tageson, 1982). ⦿“The fully functioning person” II) Theoretical Perspective’s Process of Counselling: Michael Dadson Person-Centered
  • 13. ⦿ D) Goals of Therapy: ⦿ “The fully functioning person” as illustrated by the six modes of experiencing. ⦿Rogers differentiated six process stages of being and experiencing as a person. In the following figures illustrate his understanding of personality, its relationship to the actualizing tendency, and how these intersect with conditions of change. II) Theoretical Perspective’s Process of Counselling: Michael Dadson Person-Centered
  • 14. ⦿The Person as Process: six process modes of being and experiencing as a person. • 1. Change in relationship to feelings. • 1 2 3 4 5 6 7 ⦿ The necessary conditions stimulating the actualizing tendency Feelings are sensed, differentiated, and expressed in the living moment. Person does not recognize feelings.
  • 15. ⦿The Person in Process: six process modes of being and experiencing as a person. • 2. Change in manner of experiencing. • 1 2 3 4 5 6 7 • The necessary conditions stimulate the actualizing tendency Remoteness from experiencing and its meaning. Living, trusting and using experience as a way to encounter life now with meaning.
  • 16. ⦿The Person as Process: six process modes of being and experiencing as a person. • 3. Change in personal constructs. ●How one construes their experiences. • 1 2 3 4 5 6 7 • The necessary conditions stimulate the actualizing tendency Construction of experiences as rigid, unchanging facts. Experience itself is only a tentative construction and ongoing experiences guide formation and adaptability to new circumstances.
  • 17. ⦿The Person as Process: six process modes of being and experiencing as a person. • 4. Change in communication of self. • 1 2 3 4 5 6 7 The necessary conditions stimulate the actualizing tendency Inhibiting, inappropriate self- consciousness. Accurately identify and express the complexity of their feelings in the moment.
  • 18. ⦿The Person as Process: six process modes of being and experiencing as a person. • 5. Change in relationship to problems. • 1 2 3 4 5 6 7 The necessary conditions stimulate the actualizing tendency Do not recognize personal problems but perceive them as outside themselves. Acceptance of personal responsibility and a willingness to understand and confront them in relationships.
  • 19. ⦿The Person as Process: six process modes of being and experiencing as a person. • 6. Change in interpersonal relationships. • 1 2 3 4 5 6 7 The necessary conditions stimulate the actualizing tendency Fear and avoidance of close personal contact with others. Capable of sharing deepest inner reactions, positive or negative in ongoing relationships.
  • 20. ⦿The Person as Process: ⦿According to Rogers, becoming autonomous is a major goal of human development. The fully functioning person has an internal locus of control and operates on the basis of personally chosen values rather than by rigidly conforming to the dictates of society.
  • 21. ⦿Person as “a self in context” • Bohart (2003) and O’Hara (1992) Argue for a self that is interdependent and interconnected. Thus the individual achieves integration with other group members and with the collective mind. Individuals do not lose their identity to the group but integrate the I with the We.
  • 22. II) Theoretical Perspective’s Process of Counselling: ⚫ E) Interventions and techniques: ⦿ The therapist is a process expert who can facilitate the development of the human psyche. The therapist is like a farmer who sets the conditions that cultivate the human mind with: ⦿ The three conditions of change (Rogers, 1957): ⦿ 1) Unconditional Positive Regard ⦿ 2) Genuineness or Congruence ⦿ 3) Empathy. Michael Dadson Person-Centered
  • 23. ⦿1. Unconditional Positive Regard. The quality of likening, respecting, or prizing directed at the client as a whole person.
  • 24. ⦿The conditions of change. ⦿2. Genuineness or Congruence (being aligned and connected with one’s self). Congruence is attending inwardly to one’s experience and working to sort out its meanings. It is being inwardly in tune by sorting out the degree to which my reactions are mine and what they mean. ⦿Incongruence is the cause of what some would call pathology.
  • 25. ⦿The conditions of change. ⦿3. Empathy. The ability to perceive the internal frame of reference of another with accuracy, the persons emotional components and meanings “as if” you were that person.
  • 26. Empathy continued ⦿Greenberg, Watson, Elliott, & Bohart, (2001) define empathy as the therapist's sensitive ability and willingness to understand the client's thoughts, feelings, and struggles from the client's point of view… It is this ability to see completely through the client's eyes, to adopt his frame of reference…It means entering the private perceptual world of the other and being sensitive, moment by moment, to the changing felt meanings which flow in this other person... It means sensing meanings of which he or she is scarcely aware.
  • 27. II) Theoretical Perspective’s Process of Counselling: ⚫E) Interventions and techniques: integration. ⚫ Other techniques can be integrated into person-centered approaches, but only if they further the central process of being with the client in a real, empathic relationship. The heart of the person-centered approach is the therapist’s “reflective stance” towards the client (Bohart, 2005, p.122). Michael Dadson Person-Centered
  • 28. II) Theoretical Perspective’s Process of Counselling: ⚫E) Interventions and techniques: ⦿Allen, Fonagy and Bateman (2008), have constructed a powerful treatment technique called “mentalizing” which they propose as a robust and powerful reflective process. Mentalizing based treatments integrate and assimilate well with person-centered focus on the reflective process of the therapeutic relationship. Michael Dadson Person-Centered
  • 29. II) Theoretical Perspective’s Process of Counselling: ⚫E) Interventions and techniques: ⚫Mentalizing is a reflective process that involves imaginatively perceiving and interpreting behaviour of oneself and others as conjoined with intentional mental states (Allen, Fonagy, & Bateman, 2008). It is to hold mind in mind and reflect on the mental states in self and others. Michael Dadson Person-Centered
  • 30. II) Theoretical Perspective’s Process of Counselling: ⚫E) Interventions and techniques: ⚫Mental states include: Ordinary states like emotions, thoughts, motives, desires, needs, beliefs, fantasies, and dreams. Pathological processes such as panic attacks, dissociative states, hallucinations, and delusions (Allen, Fonagy, & Bateman, 2008). Michael Dadson Person-Centered
  • 31. ⦿ Stages of Mentalizing Development Allen, (2008) p. 145 ⦿ ⦿ Mentalizing Proper ⦿ Symbolic, imaginative and interpretive thinking about self and other; representational/autobiographical agency. ⦿ Empathy and Realistic Attunement ⦿ Psychological mindedness; mentalized affectivity; thinking while feeling ⦿ Reflective and Flexible Thinking ⦿ Affect regulation; attentional control; thinking about thinking and feeling. ⦿ Awareness of Reacting ⦿ Identifying the emotion: attentional focus; “pushing the pause button” ⦿ Acting and Reacting: ⦿ Rigid and stereotypical thinking: high emotional arousal. Information about reality is experienced as reality. The experience becomes the self (Psychic equivalent). Michael Dadson Person-Centered
  • 32. Comparing and Contrasting Mentalizing and Empathy ⦿1) Empathy focuses attention reflecting on another person. Mentalizing focuses attention reflecting on another person and one’s self. Michael Dadson Person-Centered
  • 33. Comparing and Contrasting Mentalizing and Empathy ⦿2) Empathy focuses attention reflecting on emotions. Mentalizing focuses attention on a range of experiences: emotions, thoughts, motives, desires, needs, beliefs, fantasies, and dreams. Michael Dadson Person-Centered
  • 34. Comparing and Contrasting Mentalizing and Empathy ⦿3) Empathy focus attention the here and now experience of feeling. Mentalizing focus attention on here and now experiences, past experiences and anticipated future experiences of self and others. Michael Dadson Person-Centered
  • 35. Mentalizing and Empathy ⦿Mentalizing techniques are well suited to be comfortably assimilated into person- centered perspectives because the mentalizing construct complements and expands the notion of empathy and the reflective therapeutic relationship. Michael Dadson Person-Centered
  • 36. III) Research Support and Rationale for Use: ⦿Research strongly supports the therapist qualities, the therapeutic relationship and facultative conditions as common and central factors that produce change (Stricker, & Gold, 2005; Lambert & Barley, 2001). Michael Dadson Person-Centered
  • 37. III) Research Support and Rationale for Use: ⦿Norcross (2001) suggests that if we asked a neutral scientific panel, from outside the field, to review the corpus of psychotherapy research and determine what is the most powerful phenomenon we should be studying, practicing, and teaching ,the therapeutic relationship would be the obvious, and empirically validated answer. Michael Dadson Person-Centered
  • 38. III) Research Support and Rationale for Use: ⚫ There is strong empirical evidence that a strong therapeutic alliance is essential for effective psychotherapy. (Orlinsky, Grawe, & Parks, 1994) ⚫ Relationship factors like empathy, genuineness and unconditional positive regard have been identified as the specific contributions that facilitate the development of a therapeutic alliance and productive outcomes in psychotherapy. Michael Dadson Person-Centered
  • 39. III) Research Support and Rationale for Use: ⚫ Research has shown that the therapist’s empathic, reflective engagement contributes towards the development of a secure, relational bond. This bond is a key precondition for the subsequent identification of shared goals and introduction of tasks that taken together constitute a strong therapeutic alliance (Angus & Kagan, 2007). Michael Dadson Person-Centered
  • 40. III) Research Support and Rationale for Use: ⦿The person-centered experiential approach and interventions are research based, empirically supported, and effective. They are therapeutically useful for all populations who are able to tolerate an open-ended, process-orientated relationship. Michael Dadson Person-Centered
  • 43.
  • 44. ⦿Empathy is a complex interactive process that is created within the therapeutic relationship. ⦿Barrett-Lennard (1981) conceptualizes empathy as a process in which • 1. The client recounts the experience • 2. The therapist first attends to and receives the experience, then resonates to it, and finally expresses this awareness to the client. • 3 The client receives this awareness and evaluates the therapist's understanding.
  • 45. ⦿Empathy is a process in which the person of the therapist resonates emotionally with a person’s experience. The therapist is able to sense what it is like to be the client in their situation and can communicates this to the client. Barrett-Lennard's (1981).
  • 46. ⦿How researchers operationalize empathy. ⦿The clearest operational definition of empathy is Barrett- Lennard's (1981) delineation of the three different components and perspectives of empathy: ⦿1. The therapist's experience ("empathic resonance"). ⦿2. The observers' view ("expressed empathy"). ⦿3. The client's experience ("received empathy").
  • 47. ⦿How researchers operationalize empathy. ⦿Who is the best person to access what happened in session? ●Supervisor ●Therapist ●Client
  • 48. ⦿Greenberg, et al., (2001) conducted a meta-analysis of the relation of empathy to psychotherapy outcome. The resulting sample consisted of 47 studies, encompassing 190 separate tests of the empathy-outcome association and a total of 3,026 clients. Study dates ranged from 1961 to 2000. Overall, empathy accounts for as much and probably more outcome variance than does specific intervention (compare to Wampold's [2001] estimate of 1 to 8% for interventions).
  • 49. ⦿(Angus & Kagan, 2007) noted ⦿Rogers’ (1975) definition of therapeutic empathy, as both therapist empathic attunement skills (inside the therapist) and empathic communication skills (to the client) are both viewed as essential for sustained empathic engagement and the development of a secure, relational bonds in psychotherapy
  • 50. ⦿How is empathy effective? ⦿Therapist empathic attunement skills facilitate the following client outcomes (In Angus & Kagan 2007):
  • 51. ⦿Empathic Attunement Skills ⦿1. Create a safe and trusted relational bond: • a) That enables clients to disclose, emotionally significant personal stories to the therapist (Angus, Lewin, Bouffard, & Rotondi-Trevisan, 2004). • b) Where the absence of rejection and censure assists the identification of core relational (Luborsky & Crits- Christoph, 1990), and emotion themes (Greenberg, 2002). • c) That provides a context that facilitates the formulation of case conceptualizations and the articulation of shared therapeutic goals.
  • 52. ⦿Empathic Attunement Skills ⦿2. Help clients create meaning of their inner world. ⦿Empathy engages clients in active, self- reflection facilitating the expression and symbolization of primary adaptive emotions (Greenberg, 2002), core beliefs (Goldfried, 2003) leading to the construction of new, more coherent, and empowering personal meanings (Angus, Levitt, & Hardtke, 1999).
  • 53. ⦿Empathic Attunement Skills ⦿3. Engenders agency and self-mastery ⦿Empathic attunement helps sustain client’s active self-reflection in the therapy and engenders a heightened sense of personal agency and self-mastery (Bandura, 2006), (Frank, 1961).
  • 54. ⦿Empathic Attunement Skills ⦿4. Impacts client expectancies for change and leads to enhanced motivation for engagement in therapy tasks and goals (Westra, 2004).
  • 55. ⦿Empathic Attunement Skills ⦿5. Increase therapist attunement to fluctuations in the depth and affective tone of the therapeutic bond and so attunement functions as an early warning system for the detection and repair of alliance ruptures (Safran & Muran, 2000).
  • 56. ⦿How is empathy effective? ⦿Empathic communication of therapist’s understanding and validation facilitates the following client outcomes (In Angus & Kagan 2007):
  • 57. ⦿Empathic communication ⦿1. Assists the client to disclose deeply personal and painful experiences to the therapist, and feel accept and understood. This may be the basis of a new, corrective interpersonal experience (Castonguay, 2005; Pachankis & Goldfried, 2007) for the client.
  • 58. ⦿Empathic communication ⦿2. Is experienced as relieving and soothing by clients and enhances their capacity for emotional self-regulation (Elliott, Watson, Goldman, & Greenberg, 2004).
  • 59. ⦿Empathic communication ⦿ 3. Accounts for—new outcome stories— helps bring saliency and meaning to experiences (Hardtke & Angus, 2004; Kagan, 2007) and may facilitate the emergence of insight (Angus & Hardtke, 2006; Castonguay & Hill, 2006) and new, more positive views of self/self-identity (Goldfried, 2003; Kagan, 2007).
  • 60. ⦿Directions for new research ⦿Empathy may be conveyed using a variety of therapist response modes, such as interpreting, evoking, reflecting, probing, questioning and speculating (Greenburg & Elliott (1997).
  • 61. ⦿Directions for new research ⦿Empathic communication as a highly selective as well as a highly reflective process. This means the therapist is selectively reflecting particular feelings at particular times.
  • 62. ⦿Directions for new research ⦿Empathy involves selectively responding both to what is most alive in the client's experience and to primary adaptive emotional responses. ⦿Effective empathy requires picking up the ongoing, growing edge of the client's experience, the aspect that is developmentally moving the client forward to a greater sense of competence and mastery. (Greenberg, & Goldman, 1988)
  • 63. ⦿Directions for new research ⦿When entering the client's frame of reference, the therapist must not respond to just any expression of emotion but to those emotions that provide “biologically adaptive information.”
  • 64. ⦿Unconditional Positive Regard ⦿To the extent that the therapist finds himself experiencing a warm acceptance of each aspect of the client’s experience as being a part of that client, he is experiencing unconditional positive regard. …It means there are no conditions of acceptance…it means a “prizing” of the person… it means a caring for the client as a separate person. (Rogers,1957, p.101)
  • 65. ⦿Unconditional Positive Regard-Research ⦿ Therapists ability to provide positive regard seems to be associated with therapeutic success—when the patients perspective on outcome is taken. ⦿ Virtually all significant findings bear: ⦿ - modest effect sizes only, suggesting that UPR is a significant but not exhaustive part of the process outcome equation. ⦿ - UPR may be sufficient by itself to effect change. There is no reason to withhold positive regard; It is the patient’s perspective of therapist’s positive regard that is usually associated with good outcome. ⦿ (Farber and Lane, 2002)
  • 66. ⦿Unconditional Positive Regard-Research ⦿ Therapists vary in the extent to which they are able to convey positive regard to their patient (some therapists better than others at providing it) ⦿ Client’s vary in the extent to which they need or benefit from therapists positive regard ⦿ The level of positive regard a therapist generally functions at is influenced by characteristics of his or her patients as well as the current state of therapy. ⦿ Therapists, whether they are skilled at providing positive regard to patients, need to self-monitor their ability and adjust as a function of the needs of particular clients and particular clinical situations. Also, there may be ruptures in alliances not only due to a therapist’s technical errors but also the therapist’s occasional inability to demonstrate minimally facilitative levels of positive regard. ⦿ (Farber and Lane, 2002, p. 192)
  • 67. ⦿Unconditional Positive Regard ⦿Future studies: • the question of specificity: for what clients, presenting with what types of problems, is the provision of therapist regard most important, and for which is this variable of minor importance. • interaction between modes of therapy and positive regard. Eg. More potent interaction, in terms of outcome, between psychodynamic therapy and positive regard than there is between CBT and positive regard.
  • 68. ⦿Unconditional Positive Regard ⦿Farber and Lane (2002, p.192): ⦿“Despite the current zeitgeist emphasizing more technical (technique-oriented, manually driven) therapeutic interventions, it is difficult to envision the future or psychotherapy without imagining therapists who are deeply caring, compassionate, supportive, and affirming of their patients. The research indicating a positive, albeit modest association between therapist positive regard for patients and outcome is testament to the importance of a therapist’s humanity and also testament to the importance of relational factors in the outcome of psychotherapy.”