What we covered last week

Carl Roger (1959) has claimed that self-concept has three component which includes self-image,
self-esteem, and ideal self.
(1) Self-image is about how one looks. (2) Self-esteem deals with a value that person has on own.
(3) Ideal self means to wish what one wants or assumes to look.
 Person Centered Therapy:
Therapeutic techniques, goals & procedures

Week 7
 Purpose of PCT

 This therapy is to help the

person become self-aware so
that he/she can change their
own behaviour and improve
his/her self-concept.
 It reduces:
(a) anxiety,
(b) tension and
(c) defensiveness by
providing a non-
judgemental environment.
 Main technique of PCT
 PCT begins with the counsellor’s explanation of the roles he and
the client will play in order to work out the patient’s difficulties
together.
 He puts no pressure on the client to follow any prescribed course,
does not criticise nor judge what the patient express his feelings
that were formerly repressed.
 The primary technique is the reflection of feeling which
includes:
 (a) Clarification
 (b) Restatement
 (c) Summarisation

PCT Role play https://www.youtube.com/watch?v=4wTVbzvBH0k

 Clarification in PCT

 Reflection makes things more transparent, more

intelligible to the therapist and client.
 The client can then verbalize his approval,
amendment, or rejection.
 Sometimes, clarification brings out feelings which lies
beneath the conversation level.
 When clarification is used as reflection, this response
can serve as a mirror in which the client can see his
feelings and attitudes being reflected.

 EXAMPLE:
 Client: She is close-minded. No matter what I do or say, she does
not listen to me… She sticks to her own beliefs.
 Therapist: You seem to feel that she does not all understand you.
 Restatement in PCT

 This is a verbatim repetition of what the client

has said.
 As he/she hears their own statement, he/she
receive accurate feedbacks of his/her own
words and this gives them an opportunity to
clarify or reiterate for emphasis..

EXAMPLE:
 Client: Oh! I don’t know. I mean, I read fast enough, but I
can’t understand fully well what I read.
 Therapist: You read fast enough, but you don’t
comprehend enough.
 Summarisation in PCT

 This is a brief review of ideas/feelings expressed by

the client.
 It is a synopsis, a bird’s eye view after a long
monologue.

 EXAMPLE:
 Client: I am tired of talking about my grades. I am sure they
will never get any better.
 Therapist: You want to stop talking about your grades. I
wonder if I can remember some things we’ve talked about
today.
 You told me that your teacher and your and your parents are
not happy about your low grades in Math. You also told me
that you get good grades in Arts, but nobody thinks Arts is
important. Let’s see, what else did we talk about today?
 Therapeutic success depends on:

 A seasoned therapist agree that the

therapeutic success depends not on the
technical training or skills of the therapist, but
primarily on the presence of certain attitudes
in the therapist.
Such attitudes are:
a) Genuineness
b) Empathic understanding
c) Unconditional acceptance or -positive regard
Therapeutic process: Therapeutic Goals
Emphasis is placed on:

Client’s ability to engage their own resources to act in their world with
others

Facilitating a client’s capacity to define and clarify their own goals

Therapeutic alliance = cornerstone of therapeutic outcome

Through promotion of self awareness and self reflection

Client’s are assisted in achieving a greater degree of independence and

integration so that they can better cope with problems as they identify
them.

Clients are assisted in becoming aware of

The facades they develop and adopt through the process of

socialisation.

In a climate of safety in the therapeutic session they come to realise that

there are more authentic ways of being.
 Application to Group Counselling
The person-centred approach emphasises the unique role of the group
counsellor as a facilitator rather than a leader.
The primary function of the facilitator is to:
1. create a safe and healing climate – a place where the group members
can interact in honest and meaningful ways.
2. In this climate, members become more appreciative and trusting of
themselves as they are and are able to move toward self-direction and
empowerment.
3. The facilitator’s way of being can create a productive climate within a
group:
 Facilitators cannot make participants trust the group process.
 Facilitators earn trust by being respectful, caring and even loving.
 Being an effective group facilitator has much to do with one’s ‘way of
being’.
 Instead of leading the members toward specific goals, the group
facilitator assists members in developing attitudes and behaviours of
genuineness, acceptance and empathy.
 This enables the members to interact with each other in therapeutic ways
to find their own sense of direction as a group
 Motivational Interviewing
1. Motivational interviewing is based on humanistic principles, has many
basic similarities with person-centred therapy, and expands the
traditional person-centred approach.
2. MI provides multiple ways to address the impasses clients often
experience during the change process.
3. Both MI and person-centred practitioners believe in the client’s
abilities, strengths, resources and competencies. The underlying
assumption is that clients want to be healthy and desire positive
change
4. Both MI and person-centred therapy are based on the idea that
individuals have the ability to develop an intrinsic motivation to
change.
5. Responsibility for change rests with clients, not with the counsellor,
and therapist and client share a sense of hope and optimism that
change is possible.
 Stages of Change Model
The stages of change model assumes that people progress through a
series of five identifiable stages in the counselling process.

STAGES DESCRIPTION
1. Pre-contemplation stage • There is no intention of changing a
behaviour pattern in the near future.
2. Contemplation stage • people are aware of a problem and are
considering overcoming it, but they have
not yet made a commitment to take
action to bring about the change
3. Preparation stage • individuals intend to take action
immediately and report some
• small behavioural changes.
4. Action stage • individuals are taking steps to modify their
behaviour to solve their problems.
5. Maintenance stage • People work to consolidate their gains and
prevent a relapse.

People do not pass neatly through these five stages in linear fashion, and a
client’s readiness can go “up-and-down” throughout the change process
Therapeutic process: Therapist’s Role and Function
The therapeutic relationship is key to the PCT approach.

Therapist’s role is rooted in their ways of being and attitudes, rather than their
knowledge, theories and techniques.

Therapists use themselves as an instrument of change, by encountering clients

on a person to person level.

Central assumption: the therapist’s attitude and their belief in the inner resources
of the client (rather than their knowledge, theories or techniques) facilitate the
therapeutic climate for growth and thus personality change in clients.

 Therapist thus uses themselves as an instrument of change through a genuine

human-to-human exchange.

Therapist must be willing to be real (congruent, accepting and empathic)

in the here and now relationship with clients.

Thus, allowing clients the freedom to explore areas of their life and
experience (including feelings, beliefs, behaviour and world view) that
were either denied to awareness or distorted.

Here, freedom refers to the loosening of defences and rigid perceptions -

thus affording a shift to a higher level of personal functioning.
 Client’s Experience in Therapy
Client comes to counsellor in a state of "incongruence":
 Discrepancy that exists between their self perception and their experience in
reality.

 The discrepancy between how a client sees themselves (self concept) and how
they would like to view themselves (ideal self concept) generates anxiety and
personal vulnerability - and thus a state of discomfort with his/her present state of
psychological adjustment.

 This may prompt the client to explore possibilities for change.

Clients are provided with an opportunity to explore a wide range

of beliefs, feelings and experienced
 They can express their fears, anxiety guilt, shame etc - feelings that they have
deemed too negative to accept and incorporate into their self structure.

As the client feels more understood and accepted they become less defensive
and more open to their experience which facilitates a tendency to distort less, an
opportunity to discover hidden aspects of self and thus the capacity to move to a
greater acceptance and integration of conflicting and confusing feelings.
 Client’s Experience in Therapy cont.

The therapy relationship provides a supportive structure within

which the client’s self healing capacities are activated.
The therapeutic climate is thought to facilitate the following
(psychological maturity and increased self-actualisation):
Development of more realistic, accurate views of self and other
Greater understanding and acceptance of self and others
Appreciation for self as one is - greater flexibility and creativity
Less concerned about meeting others’ expectations - greater
authenticity and autonomy (i.e., less about deferring to
perceived expectations of others) in behaviour.
More in contact with what they are: (a) experiencing at the
present moment, (b) less bound by the past, (c) less determined,
(d) free to make decisions and (e) increasingly trusting in
themselves to manage their own lives
The Necessary and Sufficient Conditions for
Therapeutic Personality Change
Carl Rogers: “If I can provide a certain type of relationship, the other person will
discover within himself or herself the capacity to use that relationship for growth
and change, and personal development will occur”

Rogers asserts that there are SIX therapeutic core conditions that have to exist
over a period of time in order for constructive personality change to occur:

1. Two persons are in psychological contact

2. The first person, the client, is in a state of incongruence (vulnerable or

anxious)

3. The second person, the therapist, is congruent (real or genuine) in the

relationship and this is perceived by the client

4. The therapist experiences unconditional positive regard for the client

5. The therapist experiences an empathic understanding of the client’s internal

frame of reference and endeavours to communicate this experience to the
client

6. The communication to the client of the therapist’s empathic understanding

and unconditional positive regard is to a minimal degree achieved.
The Quality of the Therapeutic
Relationship
Emphasis is on equality in the client-therapist relationship

 The extent to which this equality is present = extent to

which change can take place

 Both therapist and client reveal their humanness and

participate in a growth experience

 Therapist is a relational guide who is usually more

psychologically experienced in this role than the client
(i.e., therapist is invested in broadening their own life
experiences and are willing to do what it takes to
deepen their self-knowledge).
 Three Therapist Attributes –
Essential to Creating a Growth Promoting
Climate
Attribute 1: Congruence/Genuineness
Therapist is real, genuine, integrated and authentic in
the therapy hour.
Without a false front: internal experience and outer
expressions of that experience match and can
openly express feelings, thoughts, reactions and
attitudes that are present in the relationship with the
client.
Communicated carefully and with considered
judgement on the therapist’s part.
Attribute 1: Congruence/Genuineness cont.

Through authenticity the therapist models the struggle

towards greater realness (which may include sharing a
range of feeling including anger, frustration, liking, concern,
annoyance) - self disclosure is always appropriate, well
timed and must have constructive therapeutic intent.

Therapy will be inhibited if the therapist feels one way

about a client but acts in a different way. Thus, it is essential
that the therapist always hold the client’s emerging needs
in mind and respond in ways that are in the best interests of
the individual. This ensures sound therapeutic decision-
making.
 Three Therapist Attributes –
Essential to Creating a Growth Promoting
Climate

Attribute 2: Unconditional Positive Regard and Acceptance

Deep genuine care for the client as a person: I value you and
you are free to have your feelings and experiences
Best achieved through empathic identification with the client
Caring is not possessive nor judgmental of the client’s feelings,
behaviours and thoughts as good or bad
Warmly value and accept clients without placing conditions on
acceptance: “I accept you as you are”
Attribute 2: Unconditional Positive
Regard and Acceptance cont.

The greater the degree of caring, prizing,

accepting and valuing of the client in a non-
possessive way, the greater the chance that
therapy will be successful.

Not possible to feel this at all times: but is essential

that one’s caring is not informed by the therapist’s
need to be liked and appreciated.

Also essential that one be respectful of difference.

 Three Therapist Attributes –
Essential to Creating a Growth Promoting Climate

Attribute 3: Accurate Empathic Understanding:

Central task - understand client’s experiences and feelings sensitively
and accurately as they are revealed in the moment-to-moment
interaction of the therapeutic relationship.
Deep and subjective understanding of the client with the client.
Able to share the clients subjective world view by drawing from their
own experiences that may be similar to the client’s feelings. Yet, the
therapist maintains their separateness. Thus about the capacity to
grasp the client’s private world as the client sees and feels it - without
losing the separateness of their own identity (allows constructive
change to occur).
This is thus the capacity to feel the client’s feelings as if they were
one’s own without becoming lost in the feelings. Way for the therapist
to hear the meanings expressed by their client’s - the meanings that
are often at the edge of their awareness. Primary way of determining
whether the client experiences the therapist’s empathy is to secure
feedback from them.
 Attribute 3: Accurate Empathic Understanding cont.

Emotionally focused empathy allows clients to:

i) pay attention to and value their experiencing;
ii) process their experience both cognitively and bodily, and
iii) view prior experiences in new ways and
iv) increase their confidence in making choices and in pursuing a
course of action.
Model of empathy incorporates three ways of knowing
for the therapist:
i) subjective empathy - i.e., experiencing what it is like to
be the client;
ii) interpersonal empathy - understanding a client’s internal
frame of reference and conveying a sense of the private
meanings to the person, and
iii) objective empathy - knowledge sources outside of a
client’s frame of reference
 Applicability to the South African Context
Strengths:
The emphasis on the core conditions makes this approach a useful one when
attempting to work with and understand diverse worldview.
The underlying philosophy of PCT is based on the importance of hearing the
deeper messages of the client from a place of (a) curiosity, (b) openness and
(c) acceptance.
Empathy, being present and respecting the values of clients are essential
attitudes and skills when counselling culturally diverse clients.
Although PCT is aware of diversity factors, it does not make initial assumptions
about individuals - which means that therapy is geared towards meeting the
client where they are as opposed to attempting to impose a particular model
or world view on the client’s phenomenological experience of self and other.
This approach is considered ideally suited to clients of diverse identities and
subject positions: counsellor does not assume the role of expert who will
impose a “right way of being” on the client. Instead, the therapist is viewed as
a fellow explorer who attempts to understand the client’s phenomenological
world in an interested, accepting and open way and checks with the client to
confirm that the therapist’s perceptions are accurate.
Applicability to the South African Context
Limitations:
Many clients who present at community health clinics or
who are involved in outpatient treatment want more
structure than this approach provides.

Some clients are seeking professional help to: (a) deal with
crises, (b) to improve emotional problems or (c) to learn
coping skills on how to deal with everyday problems.

Such clients may be expecting the counsellor to provide

guidance or give advice and may be put off by this
unstructured approach.

Difficult to translate the core therapeutic conditions into

actual practice in certain cultures.

Communication of these core conditions must be consistent

with the client’s cultural framework.
 For Week 8

1) Do homework exercise.

2) Try to participate on the discussion forum to assist you with the

application of lecture content.

3) Prepare well for the upcoming Test 2 (test 2 will cover ONLY

conceptual and application questions).

4) Read on Rational Emotive Behavioural Therapy (REBT) Chapter 10

Watch movie clip:

https://www.youtube.com/watch?v=1U6GwAWQvDU
In Summary: Person Centered Therapy:
Therapeutic techniques, goals & procedures