Michael Dadson - What is my theory of Counselling Psychology Person-centered presentation copy

1. Theory of Counselling Person-Centered Michael Dadson Counselling Psychology Clinical Comprehensive Exam April 23, 2009

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. II) Theoretical Perspective’s Process of Counselling: • D) Goals of Therapy: • congruence, • self-awareness, • self-determination • self-transcendence (Tageson, 1982). • “The fully functioning person” Michael Dadson Person-Centered

13. II) Theoretical Perspective’s Process of Counselling: • 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. 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 Experience itself is only a tentative construction and ongoing experiences guide formation and adaptability to new circumstances. Construction of experiences as rigid, unchanging facts.

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 Accurately identify and express the complexity of their feelings in the moment. Inhibiting, inappropriate self-consciousness.

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 Acceptance of personal responsibility and a willingness to understand and confront them in relationships. Do not recognize personal problems but perceive them as outside themselves.

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 Capable of sharing deepest inner reactions, positive or negative in ongoing relationships. Fear and avoidance of close personal contact with others.

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

41. Michael Dadson Person-Centered

42. Michael Dadson Person-Centered

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 attunementskills facilitate the following client outcomes (In Angus & Kagan 2007):