Person-centred counselling with clients presenting with drug and alcohol issues: an exploration of the client’s view

1. Person-centred counselling with clients presenting with drug and alcohol issues: an exploration of the client’s view Pauline Redgrift MA Client-Centred Psychotherapy, Leeds Metropolitan University May 2009

2. Research Presentation • Rationale • Aims and objectives • Methodology • Literature review • Evidence, analysis and discussion • Recommendations

3. Rationale • Current political climate • financial and clinical efficiency • person-centred therapy viewed as generic • Personal interest • 10 years’ experience with client group • pressures and marginalisation • need for a choice of therapeutic interventions

4. Aims and Objectives • To explore - from the client’s perspective - what had been helpful during the counselling process • What does this tell us – or not - about the client’s perception of the therapeutic relationship • What - if anything – does this tell us about the needs of this client group • What does this show about the suitability – or otherwise - of person-centred therapy for clients presenting with drug or alcohol issues.

5. Methodology • Data • Grounded theory • Limitations

6. Literature review • Conclusions • Equivalent outcomes • Paucity of person-centred research and literature

7. Evidence, Analysis, Discussion • Major findings from this research • What the findings tell us • How they relate to existing research

8. Evidence • Four categories emerged • communication • change • counsellor qualities • structure.

9. Evidence • Communication • having someone to talk to • having someone to listen • freedom • trust and safety.

10. Evidence • Communication – the client’s voice • “Feeling I can talk openly without feeling ashamed” • “Freedom to discuss anything” • “I’ve felt free to talk about personal things, without feeling silly or judged” • “Knowing someone is there, to talk to, especially when something bad has happened is good”.

11. Evidence • Change • changes in awareness • changes in behaviour • changes in self-concept.

12. Evidence • Change – the client’s voice • “Has helped me to respond differently to difficult situations” • “Coming here makes me think clearly, when I go away from here I know I’m OK, I trust myself more”. • “I am in touch with my feelings now, whereas before I didn’t really think they mattered” • “I like who I am becoming”.

13. Evidence • Counsellor qualities • the client’s experience of particular qualities related to the counsellor • e.g. consistent, supporting, encouraging

14. Evidence • Counsellor qualities – the client’s voice • “Helps not to be judged, the counsellor doesn’t change her opinion of me whatever I say” • “Good to have someone impartial to speak to, not judging, just say what you want to say” • “The counsellor being a real person” • “ Kindness - the counsellor calling when I haven’t attended”.

15. Evidence • Structure • the structure of a dedicated physical and emotional space • the structure provided by the routine of attending a weekly session.

16. Evidence • Structure – the client’s voice • “A space once a week especially to talk” • “A time and space to concentrate on what the problems are” • ‘Weekly routine gives structure’ • “The routine of coming is important”.

17. Analysis • Findings and the research questions • Findings and existing person-centred research/literature

18. Analysis • Research findings • perception of the therapeutic relationship • the needs of this client group and the suitability of the therapeutic relationship

19. Analysis • Findings and existing research/literature • Lillie (2002), Moerman and McLeod (2006) • other writers from within the person-centred approach

20. Discussion • Significant Issues • Co-morbidity • Extra-therapeutic variables • What is being measured • Therapeutic personality change

21. Recommendations • More person-centred, evidence-based research is urgently needed, particularly with specific client populations if this approach is not to be further marginalised by disorder-specific therapeutic interventions.

22. Recommendations • A study of clients reporting no change or an increase in their substance use during therapy in order to explore • if clients reported growth (therapeutic change) in other areas • the nature of the changes • the potential influence or not of extra therapeutic variables in supporting those changes.