Chapter 6: Person-Centered Counseling and Psychotherapy Flashcards
Person-Centered Counseling
Known as client-centered or Rogerian Counseling; Developed by Carl Rogers, based on assertion that three core conditions are sufficient to promote client change; focus is on emotional and relational processes that promote change rather than the use of specific techniques to achieve desired outcomes
Humanistic and Existential Counseling Approach
Grounded in phenomenological philosophy which examines a person’s subjective inner reality
Conditions for Person-Centered Counseling
Accurate empathy
Counselor genuineness
Unconditional Positive Regard
Existential Counseling
Grounded in existential philosophy; more neutral assumptions about the human conditions in comparison to the more optimistic humanistic foundations of person-centered counseling
Gestalt Counseling
A more humanistic approach that focuses on helping people to self-actualize or to become more fully themselves
Logical Positivism
Focus on external, objective reality
Phenomenology
Refers to the study of human consciousness: our inner lives, particularly our emotions; focuses on subjective, inner reality that cannot be easily observed and measured; counselor relies heavily on clients’ self reports as to what they are experiencing, combined with a general understanding of how emotions and cognition work; focuses on subjective, internal reality
Humanism
Tend to be more optimistic; based on the premise that all people tend naturally toward positive growth
Role of Humanistic counselor
Remove the blockages to this natural tendency to self-actualize rather than remediate deficiencies
Existentialists
View life not as inherently positive or negtive but as inherently meaningless, or neutral until a person creates meaning
Warmth & Empathy
Hallmark feature of most therapies grounded in phenomenology and humanism
Empathy
Primary vehicle for therapeutic change
Self of Counselor
Used to promote change; the counselor relates to the patient as a whole, real, unedited person; used to provide clients with both a role model and a genuine person with whom to have an authentic human encounter
Maslow’s Herarchy of Needs
Physiological needs: breathing, food, sex, freedom from pain
Safety Needs: shelter, financial security, personal safety, health
Love and belonging: friends, family, community, social connectedness
Esteem: feeling valued by others and self
Self-actualization: realizing one’s full potential; becoming more and more who one is
Maslow’s Self-Actualization
Involves humble acceptance of the positive and negative aspects of being human generally (existential realities) and of one who is individually (subjective reality) coupled with an unstoppable drive to become more fully human, more fully oneself, and more fully alive
Rogerian Counseling
Based on the radical and startling proposition that the necessary and sufficient elements of therapeutic change are counselor congruence or genuineness, accurate empathetic understanding of the client, and unconditional positive regard
Therapeutic Plan
Focuses on helping clients to experience their in-the-moment internal experiences to expose the facades they live behind and the socially imposed shoulds that may be organizing their lives
Unconditional Positive Regard
Attitude that focuses on the client’s basic human worth at a fundamental level; recognizes that human have free will and that they make bad decisions, have irrational fears, and are capable of hurting themselves and others; involves embracing the whole person
Validating Clients’ Feelings
Each person has unique experiences and emotional reactions to a situation that can be validated;
Core Conditions
Two persons are in psychological contact
The first (client) is in a state of incongruence being vulnerable or anxious
The second (therapist) congruent or integrated in the relationship
Therapist experiences Unconditional Positive Regard for the client
Therapist experiences emphatetic understanding of the client’s internal frame of reference and endeavors to communicate this experience to the client
Communication to the client of the therapist’s emphatic understanding and unconditional positive regard is to a minimal degree achieved
Three Conditions that the therapist must create in the counseling relationship
Congruence or genuineness of the counselor
Unconditional positive regard
Accurate Empathy
Counselor Genuineness
Congruence; Refers to the counselor’s outer expressions being congruent with his or her inner experience; being real; being freely and deeply one’s self while able to accurately take in what is experienced and simultaneously remaining aware of one’s internal processing of that experience
Unconditional Positive Regard
Valuing the clients no matter what they say or do; warm acceptance, nonpossessive warmth, prizing, affirmation, respect, support, and caring; founded on the idea that we are all human and we all suffer and therefore have the capacity for good and evil (or destructive behavior); involves a deep sense of compassion for how hard it is to be human, and how easy it is to get off track and make hard decisions
Accurate Empathy
To be able to sense the client’s anger, fear, or confusion as if it were your own, yet without your own anger, fear or confusion getting bound up in it, is the condition we are endeavoring to describe
Measuring Empathy
Level 1: No Empathy Level 2: Some empathy communicated Level 3: Basic Empathy Level 4: Deepened Empathy Level 5: Significantly deepened empathy
Empathy Scale Description
Level 1: Reflection focuses on content or intellectual part of the client message
Level 2: Some empathy expressed but some aspects of emotional experience ignored or missed
Level 3: Reflects client emotion back at the same level that client expressed it
Level 4: Reflects back client emotion at a slightly deeper level than the client expressed, providing an enhanced understanding to further the client’s exploration of internal process
Level 5: Counselor significantly expands and deepens the reflection, identifying subtle emotions that may not have been clearly expressed
Person-Centered Counseling
Process-oriented approach; the counselor’s attention is on how things happen (process) rather than what happens (content), the focus is on persons (their inner processes)
Seven Stages of the Change Process from entering counseling to self-actualization
First Stage: Personality seems fixed, personal problems are not acknowledged, there is a remoteness of experiencing, and there is little desire to change; not likely to voluntarily enter counseling
Second Stage: Once person feels “received” he begins to loosen up and is more open to seeing problems which are viewed as external to the self, with little sense of personal responsibility
Third Stage: If clients continue to feel accepted, and understood by the counselor, they become better able to express past feelings and personal meanings
Fourth Stage: If clients continue to feel safe with the counselor, they begin to become more open to reconsidering their constructs about self and others and are increasingly able to verbalize deep emotions.
Fifth Stage: As clients continue to explore themselves in the safety of the counseling relationship, they are increasingly
Sixth Stage: The person is not able to experience difficult emotions as they arise in the present moment with acceptance rather than fear, denial or struggle
Seventh Stage: No longer necessary for the client to be received by the counselor to self-actualize. although it is still helpful because the client has learned how to sustain the process of self-actualization without outside help; generally occurs outside of the counseling relationship
Dimensions for the Seven Stages of Roger’s Change Process
Experience and communication of self Recognition of feeling Expression of feelings Present moment experiencing Personal constructs Complexity and contradiction Perception of problems; responsibility for situation
Experience and Communication of Self
As people become more self-actualized, how they experience themselves changes, the sense of self evolves from a static entity to one where the self is more of a process that is constantly unfolding and changing; person discovers that the self is constantly in flux and unfolding
Recognition of Feelings
Counselors look for whether clieents can identify a range of emotions when they discuss the concerns they bring to counseling; can they identify feelings of anger, hurt, joy, or fear? The more self-actualized a person is, the greater the range of emotion and the greater his or her ability to own that emotion as one he or she feels without shame, fear, or embarrassment
Expression of Emotion
In the process of self-actualization, people become better able and more comfortable with expressing their full range of emotions;
Present Moment Experiencing
Refers to the ability to mindfully experience emotions in the present moment; through the counseling process, clients become increasingly able to feel their feelings in the present moment and be aware of this experience, experiencing and witnessing their experience at the same time
Personal constructs and Facades
Personal Constructs - facades we use to tell us who we are, how we should behave, and what we are worth; we need to experience ourselves more as an unfolding process than a static entity; experience ourselves as a complex being having a series of unfolding life experiences that involve a fluid and adapting sense of self
Complexity and Contradictions
Ability to engage the complexities and contradiction that characterize our internal lives and life more generally; the more complex the topic, the more likely a person has contradictory thought and emotions; both loving and resenting a significant other, both liking and hating one’s career, etc.; the greater a person’s ability to accept these inherent contradictions in oneself, others, and life, the more resourcel one will be in managing life stressors
Perception of Problems and Responsibility
Problems will be increasingly described with an emphasis on how one is contributing and/or perpetuating the situation; the more self-actualized a person becomes, the greater the awareness that life is a two-way street; how we interact with another contributes to how they respond to us; clients need to describe problems in terms of being agents of their own lives, taking responsibility in creating the problem situation and are quick to assume full responsibility for resolving the problem no matter their source.
Peak Experience and Flow
Self-actualized self is fluid and flowing; peak experience is described as a flow state, an experience in which a person feels fully present, in sync, and immersed in a challenging activity for which one has sufficient skill
Flow Experiences - associated with activities that are associated with activities that require effort and practice; frequency and quality of flow experiences need to be evaluated in assessing the client’s level of functioning
Self-Actualization
Refers to fulfilling one’s potential and living an authentic, meaningful life; humans naturally tend to provide the correct environment that fosters this growth; counselor’s primary job is to prove the correct environment that fosters this growth; highest order in his heirarchy of human needs, coming only after more basic physiological, safety, social, and self-esteem meds are being met
Characteristics of Self-Actualization
Openness to present moment experiencing of emotions
Trust in self
Internal locus of evaluation and control
Living without roles, facades, shoulds, or social expectation
Being a complex, dynamic, and unfolding process (rather than a static entity)
Openness to experience
Acceptance of others
Process Issues
Person’s internal processes; identify areas of growth and turn these into middle phase goals; increase living by conscious choice rather than a list of should; reduce attempts to please others in a way that are detrimental to personal needs
Goals Related to Specific Areas of Functioning
Emotional Expression & Here and Now Experiencing - Increase ability to identify emotions in present moment
Victimization and experience of Problems - Increase sense of responsibility for own problems and their resolution
Agency - Increase sense of agency and proactive behavior in work life
Facades and Masks - Reduce use of facades in personal relationships to increae experience of intimacy
Peak Experience and Flow - Increase frequency of peak experience and flow in work life
Perfectionism and Unrealistic Expectations - Increase ability to set realistic expectations for self and other to increase acceptance
Trust Self - Increase ability to trust the evolving and changing nature of the self
Interventions
Self of the Counselor and the Core Conditions Focused Listening or Attending Summarizing Clarifying Reflecting Feelings Process Questions Carkhuff's Core Conditions Concreteness and Specificity Self-Disclosure Confrontation Immediacy Focusing
Self of the Counselor and the Core Conditions
Counselor as a quality presence that helps clients to transform and become more comfortable with experiencing their authentic selves; the counselor’s way of being in the world
Focusing Listening or Attending
Counselor listens for a risk and nuanced description of her internal emotional experience and selects these descriptions to comment on or ask about
Summarizing
When counselors paraphrase back the essence of what a client just said, it helps clients to hear what they said in a different way; it hits home harder than when they said it themselves; need to be well-timed, about emerging insights, in the client’s language; a summarization from a counselor is helpful in crytallizing insight
Clarifying
Clarifying questions involve querying clients to provide more detail or explanation about what theya re talking about; address factual issues; Questions which focus on the client’s emotional process, help client more clearly articulate and conceptualize their internal processes and are essential in promoting self-actualization
Reflecting Feelings
REfers to identifying feelings that the client just described or that seem to underlie what the client just said; listen for client’s emotional experience; highlight and amplify clients’ awareness of their emotions, reactions, and feelings so that they can consciously experience them; useful in early stages of actualization;
Process Questions
Refer to questions or comments that direct clients’ focus toward their inner process rather than content; used to help clients focus on the inner experience, emotions, and subjective reality
Process Questions Examples
Can youd escribe what was going on inside of you when you heard the news?
When you heard the door shut, what is going on inside for you?
As you are telling me the story now, what types of feelings are coming up?
Are these the same or different from what you experienced when things were happening?
Robert Carkhuff
Extended Rogers’s research by stdying observable and measurable behaviors that facilitated change in counseling
Carkhuff’s Core Condition
Empaty Authenticity and genuineness Respect Concreteness and specificity Self-disclosure Confrontation Immediacy
Concreteness and Specificity
Demonstrated with concepts and statements that help clients to clarify what is vaguely expressed; help clients increase their inner awareness by asking questions that help them to be more concrete and specific about their subjective experiences
Self Disclosure
Involves sharing relevant personal experience for the sole purpose of helping the client achieve their goals
Confrontation
Counselor’s effort to address discrepancies in verbalizations, perceptions, and/or body language; point out discrepancies; congruence of body language with what the client is saying
Immediacy
Refers to the condition whereby counselor and client are able to discuss the client’s immediate emotional state which can be related to an outside topic, insession behavior, counselor-client relationship
Focusing
Help clients more quickly access their emotions; technique involves directing clients to identify preverbalized experience which may be in the body or otherwise brought into awareness; clients are encouraged to carry it forward by bringing close attention to it, describing the experience with words, and then moving into action
