Therapeutic Relationship Essay Example

Therapeutic Relationship Paper Person centred counselling originated and was evolved on the ideas of American psychologist Carl Rogers. The influences on Carl Rogers and he’s conceptualisation of Person centred counselling are numerous, from his early family life living on a farm, his interest and involvement in theology and his formative professional career. One incident which appears to have had a particular impact on Carl Rogers was when working in his first job as a psychologist, at Rochester New York, for an organisation for the prevention of cruelty to children, whilst working with a parent (Kirshenbaum H, et al. 1989). At this stage in his career Carl Rogers, being trained in or influenced by the tradition of psychoanalysis, was essentially working in a diagnostic and interpretative way, helping a child or parent gain insight or an intellectual understanding of their own behaviour and what was unconsciously driving or motivating it (Thorne B 2002) . He formalised that the problem with the child stemmed from the Mother’s rejection of the child in his early years. But despite a number of sessions was unable to help the Mother gain this insight. He concluded that it wasn’t working and finally gave up. The Mother was leaving when she asked Carl Rogers if he takes adults for counselling. He began working with the mother, where she subsequently expressed her despair of unhappiness and feelings of failure, which was more emotive and authentic in expression, than the previously intellectual and matter of fact account given previously of her history and current life. Carl Rogers said that ‘real therapy’ began at this moment and concluded in a successful outcome (Kirshenbaum H, et al. 1990). We will write a custom essay sample on Therapeutic Relationship specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on Therapeutic Relationship specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on Therapeutic Relationship specifically for you FOR ONLY $16.38 $13.9/page Hire Writer This is Carl Roger’s view and what he learned from this experience: â€Å"This incident was one of a number which helped me to experience the fact- only fully realized later- that is the client who knows what hurts, what directions to go, what problems are crucial, what experiences have been deeply buried. It began to occur to me that unless I had a need to demonstrate my own cleverness and learning, I would do better to rely upon the client for the direction of movement in the process†. (Kirshenbaum H, et al. 1990 p13). This statement is arguably the beginnings of what, in many ways would later define and becomes a way of working within person centred therapy – that is a therapy that allows the client to be whom the client is, without any active direction from the therapist. Carl Rogers through clinical experience, research and development later defined his model of therapy. He based it upon the principles of a person as having at it’s a core an instinctive tendency towards growth, to fulfilling their potential as a person in what he termed ‘self actualisation’ (Mearns D, et al.1988). Carl Rogers believed that every living organism has a desire to increase, widen and broaden. Essentially, a fundamental urge to improve upon itself and that although, in the case of human beings, this urge may be buried or hidden by multiple psychological structures and conflicts, he strongly believed in the existence of this actualisation tendency in all of us and that given the correct conditions, it could be freed and realised in all of us (Rogers C 1961- becoming a person). Personally, I have recognised a need to develop and grow within myself for sometime and this has again been highlighted to me during this term. The more I become aware of my insecurities and pre judgements, the greater the desire to become bigger than them only becomes more apparent to me. Through my clinical experience working with adults with mental health problems, I have certainly recognised a desire in many, to become bigger or more than their issues, although, I am not certain if that was a desire to escape from their often intolerable suffering, or a fundamental need to self actualise†¦ at the very least, I would suggest self actualisation is an entirely relative supposition and will differ from person to person, dependent upon their own experiences, circumstances and perhaps even expectations. These correct conditions which are required within person centred therapy in order that the client can achieve self actualisation and personality change were outlined by Carl Rogers and he believed that if this 6 conditions were met, it would facilitate change within the client: Two persons are in psychological contact- both client and counsellor are present physically and psychologically. The client is in a state of incongruence, (which will be discussed in more detail) the communication of the counsellor’s empathetic understanding and unconditional positive regard is met at a minimal level. The last condition mentioned involves 3 other conditions, which are essential attitudes and qualities necessary for the counsellor to posses for successful therapy; empathic understanding, unconditional positive regard and congruence. (Rogers C, 1957). Before looking at the latter 3 in more detail, it is important to understand Carl Rogers’s view of the person and perhaps what is ultimately bringing the client to therapy. Carl Rogers believed that there is incongruence between the self that is the actualisation part, that has a desire to grow, is open to experiencing in the moment and ultimately psychological well being and the actual experience of the self. He believed this effect was caused by ‘conditions of worth’, by external expectations, such as by parents and teachers, i. e. if you behave in a certain way that pleases me, that perhaps doesn’t evoke anxieties in me, you are a good boy- there are certain ‘conditions’ attached to being in this relationship- the child tries to internalise these conditions in order to maintain the relationship (Mearns D 1994- developing PC). Consequently, people deny or distort the experiences to their selves, which differ to how we are supposed or are conditioned to be. Therefore, Carl Rogers believed that we begin to believe in what we are not and refute who we really are (Mearns D 1994). The person has a fixed and inflexible view, or self concept (Rogers C 1980). It’s almost as if the person is driven in implementing or adopting certain behaviours in order to be accepted or loved and denying, or at the cost of their true self and feelings. This is the state of incongruence Rogers was referring as apart of the necessary conditions. Carl Rogers recognised, through his development of this approach, that distinctive and essential qualities are necessary within the therapist, for successful therapy and to facilitate character change. The emphasis being on the therapist’s attitude towards the client, as opposed to any technical skills or interventions, in comparison to many other modalities. As already mentioned, the key attitudes or qualities being empathy, congruence and unconditional positive regard (Rogers C 1980). Empathy can be considered as having an ability to perceive and understand in the other person their feelings, experiences and their meaning to that person. To understand the internal world of that person, to be fully aware of the feelings they are experiencing, their anger or sadness for example, as if they are your own, but being aware that they are the clients, in order that your own feelings do not become the focus or blur the clients own experiencing (Rogers C, 1957). To absolutely see from the clients view, the feelings they may have from their position or personal experiencing, but recognising them as separate from your own. I recall a moment during this term, when in skills practise, being in the ‘client role’, when I received empathy. I was speaking about a personal situation, which I was aware on some level had meaning to me, but wasn’t fully aware of, or experiencing the feelings relating to this meaning. My perception later was that the person listened so intently, was so with me in trying to make sense of my situation, that they really did know and fully understand how it must feel for me. It was almost if I had no choice in allowing my feelings to be present, to come to my awareness and I was left with a sense of loss, feelings of loss, that I wasn’t aware of and made tremendous sense to my circumstances and why I had some anxiety and confusion in relation to this particular issue. This highlights for me how powerful empathy can be, as well as actively listening to and showing an interest sufficient in trying to understand the client, but also how it has the potential to provoke in the client in becoming aware of hidden feelings or realisations. Unconditional positive regard (UPR) is another important aspect and described as having total acceptance of the client, without conditions, whoever and whatever the client is, or how they may behave. An acceptance of not what they may or could be, but as they are now, regardless of what desired qualities the counsellor may wish for. It means total respect and valuing the person, without judgement. It also involves a sense of genuine care and wanting the best for them, including warmth for the person (Rogers C 1961). David Mearns talks about the often confusion in trainees, when understanding UPR, with a statement such as, ‘how is it possible to like all my clients’? He makes a distinction that liking is generally selective, as we perceive a similarity in values and complementary needs and UPR and liking are two very different concepts (Mearns D 1994). Unconditional positive regard is completely about valuing the person, without conditions, with all the facets of the person, their struggles, protective layers, confusion and perhaps inconsistencies. This unconditional stance is a contradiction to the conditions of worth spoken of earlier and is a vital component of person centred counselling (Kulewicz S, 1989). If a client is holding a believe that they will only be accepted, depending on the condition of others, essentially they do not see themselves as being wholly acceptable. The stance and communication of UPR can break this believe and the client is able to be in a relationship, with the counsellor accepting them without conditions (Rogers C 1961). If the counsellor is consistently valuing the client, the client perhaps has no reason for the protective layers and can be more open to their own inner experiences. Also, I wonder if the counsellor is almost giving permission and communicating a message to the client that it is ok to accept who they truly are. Another essential attitude for the counsellor, recognised by Rogers is congruence. This is the counsellor being who they are, no facade or ‘professional’ barrier. The counsellor is open and genuine in the relationship, allowing all feelings and thoughts to be in his awareness and available to him (Rogers C 1961). It’s being present with yourself and owning your feelings, not necessarily expressing what you are experiencing at the time to the client, but also not denying it. How congruence is conveyed is ultimately depended upon the counsellor themselves and when appropriate. It is about allowing a trust to be formed with the client, without pretences, where the counsellor is being human and willing to be seen (Thorne B 2002). If the counsellor is willing to acknowledge his feelings, strengths, perhaps their mistakes or weakness, it can not only allow for a more open and flowing relationship, but again I see this as perhaps giving permission to the client to embrace themselves, their strengths and weaknesses. How this differs from a helping relationship, are mainly the quality of contact and the nature of the differences in relationship. What if our client seeks help from a non person centred counsellor, perhaps a professionally respected person, a Doctor, teacher, perhaps even a work place manager, or colleague. They will listen, perhaps are sympathetic, are likely to offer advice and some direction the person may take in order to resolve their problem. But there is no ongoing process, no consistency of a relationship, with all the qualities discussed, empathy, UPR and congruence. The person centred therapist offers a safe and non judgemental relationship, with the client being valued for who they are, where they can grow in understanding of themselves, gain insight and become psychological stronger and independent. A helping relationship, although perhaps useful and supportive, will not facilitate change and allow a person to grow. In conclusion, person centred therapy is about an effective relationship, or aspires to be one, in which a person through experiencing a positive connection with another person, namely the therapist, receives deep empathy, understanding and genuine care. This enables a person to question or challenge their self concepts, to begin to experience buried or hidden feelings and gain a deeper understanding of themselves, with more acceptances and the autonomy to live without fear of their own feelings and perhaps their truer selves. It is without any difficulty from me to admire the sheer humanity of what Carl Rogers achieved with person centred therapy, the whole ethos of accepting and allowing the person to grow through such a positive and caring relationship. It appears to me that this is an incredibly challenging model of therapy, for both client and therapist. For the client the person centred therapist may appear safe and accepting, even inoffensive or unchallenging to his protective mechanisms or fixed self concepts, but that is perhaps the greatest challenge to the client, who may want answers or ways of dealing with their issues, perhaps unbearable anxiety and will perhaps look to the therapist for solutions and will find the person centred therapist completely and deeply sharing their distress, but essentially leaving it with client to be able to tolerate and accept for themselves, with of course as discussed, with the intention for the client to grow, understand the meaning behind their distress and ultimately in becoming psychologically independent. I would imagine, at least initially or in the short term, it must be difficult for the client, who is still searching and looking outside of himself, for the apparent safety and false ‘conditions’ that will make it all well again. For the therapist, the challenge is potentially numerous, but what I recognise is the trust he must have in the process of person centred therapy, in maintaining all the attitudes as discussed and consistently so. I can see that taking great strength and discipline, when he could perhaps temptingly turn to direction and advice giving. I am also left wondering if the strengths within PC therapy are also its weaknesses. The quality of therapy can only be as effective as the quality of therapist, or the limitations of the therapist. This could be said of other therapies, but for example, the CBT therapist has a direction and structure to fall back on. The challenge to the PC therapist is to be constantly growing and developing, as there is such a dependence upon who they are in the relationship. References: Kirshenbaum, H. and Henderson, V. L. (1989) The Carl Rogers reader Bury St. Edmunds: St Edmundsbury Press Limited. Kulewicz, S. F. (1989) The twelve core functions of a Counselor (5th Edn). Marlborough, CT: Counselor Publications. Mearns, D. and Thorne, B. (1988) Person-centred counselling in Action (3rd Edn). London: Sage Publications Ltd. Mearns, D. (1994) Developing Person Centred counselling (2nd Edn). London: Sage Publications Ltd. Rogers, C. R. (1957) The Necessary and Sufficient Conditions of Therapeutic Personality Change Journal of Consulting and Clinical Psychology Vol. 60, No. 6, 827-832. Rogers, C. R. (1961) On Becoming a Person London: Constable Robinson Ltd. Rogers, C. R. (1980) A way of Being Boston: Houghton and Mifflin Company. Rogers, C. R. (1980) Client Centred psychotherapy In: Kaplan, H. I. et al, ceds, Comprehensive text book of Psychiatry (3rd Edn). Baltimore: Williams Wilkins Co. Thorne, B. Dryden, W. (2002) Person Centred Counselling in W. Dryden Handbook of Individual Therapy (4th Edn). London: Sage. pp. 131-157. Therapeutic relationship Essay Example Therapeutic relationship Essay Lago (2003: p54) states that Being misunderstood begets anger, frustration even hatred. By contrast, to be understood evokes trust, gratitude, exploration, love and aspiration. The use of language is absolutely central to the communication process and however much good intent there is, on both sides of a conversation, if misunderstandings persist then the potential for therapy is substantially diminished if not stopped altogether. Therefore as well as a means of communication language can form a boundary between two people, this is especially true in the therapeutic relationship. This does not only occur when the client and counsellor speak different first languages but also when they use the same language. Accents and usage of language vary throughout the U. K. ; this can lead to misunderstandings between the counsellor and the client. In certain parts of the country and with certain ages, swearing is readily accepted and used everyday. However, in other places and with other ages swearing is frowned upon. Language can also be a powerful weapon of oppression. If a client feels insecure, and the counsellor uses long and strange language, the client could feel intimidated and withdraw from the relationship. Therefore, language can be both freeing and constraining. Enabling because it allows us to express our feelings and opinions and communicate with others. Constraining because we cannot communicate with those who do not speak our language, it only allows the use of certain words for certain feelings. For example, the Eskimos have many different words for snow and sleet whereas in the U.  K. we have just those two. We will write a custom essay sample on Therapeutic relationship specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on Therapeutic relationship specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on Therapeutic relationship specifically for you FOR ONLY $16.38 $13.9/page Hire Writer Therefore, if a counsellor has a client with a different first language it could be that the English equivalent does not really mean the same thing in their language. DIFFERING BELIEF SYSTEMS Belief systems are made up from many different parts of a persons psyche and can range from belief in religion to the belief in self. A persons outlook of religion will alter the way that they view the world. For example, I do not believe in any god and so when things happen I say that is life. However, in certain religions whichever god is being worshipped can be blamed or praised for the occurrence. In the counselling setting, the clients belief systems will affect the relationship. The client may believe for example that it is wrong to talk about certain issues and so if the issues are not talked about openly the relationship will falter, as congruence and honesty are a main component in the person centred approach. The counselling relationship is there in many cases to change the clients beliefs about their own self-image. For example, a client may believe that they are useless or worthless; this negative self-image will, hopefully, be changed throughout the counselling process so that the client lives a more fulfilled life. McLeod ( 2003: p484) states that there has been lively interest in the idea that all effective counsellors possess similar belief systems or ways of making sense of the world. The assumption is that counsellors are able to help people because they see the clients problems in a particular way. It could be then that as counsellors not only do we have our own beliefs but also we have certain commonalities that make us good at what we do. It is important to remember that there are two people in the therapeutic relationship and that they are both as important as each other. FAMILY PATTERNS All families no matter the size have patterns and positions. The family is affected not just by the size but the ages of its members and their genders. Adler looked more deeply into family patterns and found that those with different positions took on different roles and characteristics. Adler believed that a persons birth position and gender would influence their development and personality. For example, only children may be quite self-centred and unable to consider the needs of others unless reminded; middle children tend to feel squeezed out or sometimes held in, as they have neither the privileges of the eldest nor rights of a youngest. In addition, there is the difference in how we encourage our children according to their gender. For example, boys are encouraged to get dirty and go exploring and play a bit rough and big boys dont cry, whereas girls are encouraged to play with dolls and play nicely and to be clean and tidy. If a counsellor understands these issues, it may be easier for him to help the client. The relationship could be affected if the counsellor reminds the client of a member of their family that they did not get along with etc. this is also true of the counsellor. By understanding these issues, the counsellor could have more insight into the client and how the clients self-concept was formed. FAMILY LIFE EXPERIENCES The life experiences of the whole family will affect how a person develops and their outlook on life. For example if a client moved house as a child and found the experience unsettling and uncomfortable the client could later on develop problems dealing with loss and change. If the move was pleasant and the client settled into their new house, it is more likely that they will cope with change in a better way. All families have shared life experiences but each member of the family will remember different aspects of the event and be affected by it in different ways. For example a family my go on a holiday. The parents want to visit all the local sights and there is a lot of driving involved. The parents enjoy the driving because they like the countryside however, the kids cannot stand it because they are trapped in a car and prefer cities to the countryside. So even though all the family went to the same places and had the same experiences they all perceived the holiday in different ways. These events influence in later life and will affect all the relationships we have. Obviously, the relationship is one of the most important aspects in the P. C. approach to counselling.