Person Centered Therapy

Basic Principles of Motivational Interviewing

1.) exerience the clients world through their eyes. Reflective listening. Expressing empathy. If clients are slow to change, they need to remain as they are as having reasons to change 2.)MI used to evoke and expore both discrepencies and ambivalence. USe change talk 3.) Reluctance to change is seen as normal and expected part of therapeutic process. Increase internal motivation to change based on the personal goals and values of clients. 4.)Support self efficacy by encouraging the client to use their own resources to make necessary actions. 5.) clients are showing signs that they are reasy to change and therapist shift their focus toward strengthening and helping implemet a change plan

Contributions of Natalie Rogers:

Cain says " Natalie ROgers expressive arts therapy represents a major innovation in practice in helping open the way for other person centered theapist to expand the variety and range of practice" PCT expressive art therapy may be a solution for stuck in linear or rigid ways people.

Unconditional Positive Regard and Acceptance:

Deep and genuine caring. Caring nonpossessive and not contaminated by judgment of evaluation of the clients feelings or thoughts. " Ill accept you as your are" Acceptance is the recognition of clients rights to have their own feelings and beliefs. NOT approval of behavior. If therapists caring stems from their own need to be liked and appreciated , constructive change is inhibited.

Application to Group Counseling:

Facilitato rather than a leader. 1.) create a safe and healing climate Groups can move forward if the facilitator exhibites a deep sense of trust in the members and refrains from using techniques or exercises. Core conditions apply to the process of a group. Instead of goals, members are encouraged to develop good attitudes like aceptance and empathy. Facilitators should avoid making interpretive comments or group process observations because such comments are apt to make the group self conscious and slow the process down. Group process observations should come from members.

Accurate Empathic Understanding

Main tasks : understand clients experience and feelings sensitively and accurately as they are reveled in the moment by moment interaction. Tries to get the clients subjective experience, meaning here and now and for the client to feel more deeply and intensely and resolve incongruity that exists within them. Empathy is a deep and subjective understanding of the clients with the client. NOT sympathy or feeling sorry. Therapist can relate but not lose their own separateness. Empathy helps clients to 1.) pay attention and value their experience 2.) process their experience both cognitively and bodily 3.) view prior experiences in new ways 4.) increase their confidence in making choices and in pursuing a course of action. Clark describe an integral model of empathy in 3 ways of knowing 1. subjective empathy enables practitioners to experience what it is like to be the client 2.) Interpersonal empathy: pertains to understanding a clients internal frame of reference and conveying a sense of the private meanings to the person 3.)objective empathy relies on knowledge sources outside of a clients frame of reference. Accurate empathy is the cornerstone of person centered approach and implies that the therapist will sense clinets feeling as if they were his or her own without becoming lost in them. Empathy is an active ingredient of change that facilitates clients cognitive processes and emotional self regulation.

Person Centere Expressive Arts Therapy

Natalie rogers expanded on Expressive Arts Therapy allowing creativity to enhance personal growth. Counselors trained in PCT offer clients the opportunity to create movement, visual arts, journal writing, sound, and music to express feelings and gain insight from activities.

Evolution of Person centered methods:

PCT evolutionary process of more than 70 yrs. Not prohibited from suggesting tecniques but how these suggestions are presented is crucial. Tecniques are not attempts at doing anything to a client. The tradiationl PCT Therapist would not tend to suggest a tecnique. What is essential is the therapists presence being immersed in the client as well as in the clients expressed concern. Therapists PRESENCE is essential . PCT continued to evolve and be supported because of its diversity, innovation, and individualization in practice. Immediacy: addressing what is going on between client and therapist if highly valued on this approach. requires considerable diversity in personal style among PCT therapist. Guiding question : " does it fit?"

Role of Assessment:

PCT therapists do not find traditional assessments and diagnosis to be useful because these procedures encourage an external and expert perspective on the client. Rogers believed that beginning therapy with assessment of measures would allow the client to think that the therapist would find them solutions. Today the questions is HOW to involve clients as fully as possible in their assessment and treatment process..

Application of the Philosophy of the Person Centered Approach:

PCT therapy can help people with anxiety disorders, alcoholism, psychosomativ problems, agoraphobia, interpersonal difficulties, depression, cancer and personality disorders. PCT therapy has been shown to be as more goal oriented therapy. Also, research conducted in the 1990's sats that effective therapy is based on the client- therapist relationship in combination with the inner and external resources of the client Staying with the client. NOT GOING AHEAD! An effective therapist must be grounded, centered, genuine, respectful, caring, present, focused an astute listener, patient and accepting.

Stages of Change:

Precontemplation stage: no intention of changing behavior pattern in the future Contemplation: aware of the problem and are considering overcoming it Preparation stage: take action immediately and report some small behavorial changes Action stage: taking steps to modify their behavior to solve their problems. Maintenane stage: people work to consolidate their gains and prevent relapse. NOt all clients go through the stages in a linear fashion. When in precontemplation stage, the role assumed is that of a nurturing parent In contemplation , therapist is a Socratic teacher Preparation: experience coach Maintenance: consultant. When in progress to action or maintenance...

Relationship Between Therapist and Client:

Roger based his hypthesis of the necessary and sufficient conditons for therapeutic personality change on the quality of the relationship. Roger said that significant positive personality change does not occur except in a relationship. Hypothesis is stated as such 1.) 2 persons are psychological contact 2.) the 1st is in a state of incongruence being vulnerable and anxious. 3.) the 2nd being the therapist is congruent ( real or genuine) 4.) the therapist experiences unconditional positive regard for the client 5.) The therapist experiences an empathic understading of the clients internal frame of reference and endeavors to communicate this experience to the client. 6. The communication to the client of the therapists empathic understanding and unconditional positive regard is to a minimal degree achieved. Therapeutic Core Conditions:exists over some period of time, construcitve personality chance will occur. Do not vary to to client type: They are both necessary and sufficient for therapeutic change to occur Rogers perspectve on client therapist is equality; therapist do not use knowledge of a secret or attempt to mistify the therapeutic process. Therapist listens carefully and client will also learn to do the same. Therapist sees value and worth in them, clients will do th esame for themselves. Humanist approach as a way of being or shared journey in which therapist and client can reveal their humannes and participate in a growth experience.Therapist must journey themselves in order to experience their clients to do the same. The quality, depth continuity of their own experienceing becomes the very cornerstone of the competence they bring to professional activity. Therapists broaden their life experiences and are willing to do what it takes to deepen their self knowledge. Rogers admitted that his theory was striking provocative and radical because he maintained that many conditions other therapist commonly regarded as necessary for effective psychotherapy were nonessential Overall the core therapist of congruence, unconditional positive regard and accurate empathic understanding have been embraced by many therapeutic schools as essential. Therapist create to work holistically in creating a sage environment for learning. Strive to listen empathially.

Clients Experience in Therapy

Therapeutic change depends on client's perception both of their own experience in therapy and of the counselors basic attitudes. Counselor is encouraged to create a climate conducive to self exploration. Clients comes to the counselor with a descrepency between their self perception and experience in reality known as state of congruence. One reasons clients seek therapy is a feeling of basic helplessness, powerlessness and an inability to make decisions or effectively direct their own lives. Clients lean on the therapist for guidance but learn that they can be responsible for themselves in the relationship. In short their experience in therapy is like throwing off the sel imposed shackles that had kept them in psychological prison. Person centered therapy is grounded on the assumption that it is clients who heal themselves who create their own self growth and who are active self healers. Therapy provides them a supportive structure within the clients self healing capacities are activitated. Clients most value being understood and accepted which is them seeking a place to explore feelings, thoughts and behaviors etc. They value support for trying out new behaviors.

Congruence or Genuiness:

Therapists are real Inner experience and out expression match and can openly express their feelings, thoughts, reactions, and attitudes that are present in the relationship with the client. Therapist creates the example for struggle for greater realness..Being congruent means that it may be necessary to express feelings like anger, frustration and nnoyance or concern but not impulsively show all. Cain stressed that therapists need to be attuened to the needs of the client and to respond in ways that are in the best interest of the individual. Congruence exists on a continuum from highly congruent to very incongruent.. HUmans cannot be expected to be fully authentic.

MI spirit:

deliberately directive and aimed at reducing client ambivalence about change and increasing intrinsic motivation. Working with the spirit rather than applying strategies of the approach. Use open ended questions, empoying reflective listening, and supporting the clients, responding to resistance noconfrontationally, guiding a discussion of ambivalence and summarizing and linking at the end of session and eliciting and reinforcing change talk. BOTH PCT and MI the cousnelor provides conditions for growth and change by communicating attitudes of accurate empathy and unconditional positive regard

Application to Crisis Intervention:

helps with clients with unwanted pregnancy, an illness, disastrous event, or loss of a loved one. PCT may need to provide more structer in crisis intervention. for example: you may need to hospitaliza a suicidal client.

Motivational Interviewing

humanistic, client centered, psychosocial, directive counseling approach developed by William R Miller and Stephen Rollnick in the early 1980s Effective as a relatively brief intervention defined as a directive, client centered counseling style for eliciting behavior change by helping clients explore and resolve ambivalence. Based on humanistic principles and expands the traditional PCT therapy Initially designed for brief intervention for drinking problems but expanded to substance abuse, gambling, eating disorders, anxiety disorders, depression, suicidality, chronic disease management and health behavior change practices. Stresses client self-responsibility and promotes an invitational style for working cooperatively with clients to generate alternative solutions to behavorial problems. MI therapist see clients as allies playing a major role in present and future success.. believe in clients abilities, strengths, resources and competence. Underlying assumption is that clients want to be healthy and desire positive change

Strengths from a diversity perspective:

impact on the field of human relations with diverse cultural groups. ( Europe( several) South America and Japan 1.) significant impact on practice of counseling as well as education, cross cultural communication and reduction of racial and political tensions. 1980s Rogers elaborated on a theory of reducing tension among antagonistic groups that he began developing in 1948 2.) 1970s Rogers and associates began conducting workshops promoting cross cultural communication. Led large workshops in many parts of the world in the 1980s. Australis, Japan, SA, Mecivo and UK have been receptive to PCT. Before his death, Rogers conducted intensive workshops with professionals in the former Soviet Union. Reached more than 30 countries and translated into 12 languages. Underlying philosophy is on the importance of hearin the deeper messages of a client. Make no initial assumptions about individuals. Appropriate for multidiverse because counselor does not take the role of expert . MI culturally sensitive.

Shortcomings

more structure needed at times. culturall sensitive people may be put off if counselor does not provide structure. difficult to translate the core therapeutic conditions into actual practice in certain cultures. Values internal locus: some cultures ( collectivist) more motivated by societal expectations and not by personal preference.

Early Emphasis on Reflection of Feelings:

roger changed from a nondirectice stances to emphasizing the therapists relationships with the client. Many followers of Rogers simply imitated his reflective style and client centered therapy has been identified primarily with the tecnique of reflection despite Roger's contention that the therapists relational attitudes and fundamental ways of being with the client help the heart of change in the process.. ROgers and others have said it is a simple restatement of what the client just said.

Therapists Function and Roles

rooted in being and attitudes, not in techniques designed to get the client to do something. Therapists use themselves as an instrument of change. It is the therapists attitude and belief in the inner resources of the client that creates the therapeutic climate for growth. Person to person way. Thorne says that professionalism is aimed at protecting the therapists from overinvolvement with clients which results in underinvolvement with them. Therapist is to be present and accessible to clients and to focus on their immediate experience. Therapist must be real with client. By being congruent, accepting and empathic the therapist is a catalyst for change. Moment to moment experiental basis and enters their world. Clients are able to loosen their defenses and rigid perception and move to a higher level of personal functioning if they receive caring, respect, acceptance, and support.

Principles of Expressive Arts therapy

uses artistic forms toward the end of grown, healing and self-discovery 1.) all people have ability to be creative 2.) creative process is transformative and healing. ( include Medication, movement, art, music and journal writing) 3.) personal growth and high states of consciousness are achieved through self awareness, self understanding and insight 4.) self awareness, understanding and insight are achieved by delving into our feelings of grief, anger, pain, fear, joy and ecstasy 5.) our feelings and emotions are an energy source that can be channeled into arts 6.) expressive arts lead us into the unconscious, thereby enabling us to express unknown faces of ourselves and bring to light new information and awareness 7.) one art form stimulated and nurtures the other, bringing us to an inner core or essence that is our life energy 8. a connection exists between our life force- our inner core, or soul and the essence of living 9.) as we journey inward to discour our esence or wholeness we discover our relatedness to the outer world and the inner and out become one. Various art modes interrelate in what NAtalie Rogers calls " creative connection" When we move, it affects how we write or paint. When we write or paint it affects how we feel and think. Her approach based on PCT theory of individual and group processes.