Person-centred therapy today and

tomorrow:

Vision, challenge and growth

Mick CooperBAPCA 2011

mick.cooper@strath.ac.uk

With thanks to Art Bohart, Maureen O’Hara, Peter Schmid and Katherine McArthur

Aims• To present a personal view of:

–Current challenges–How we can meet (and grow through) the current challenges

• Based on a personal vision of the PCA

Draws from new introduction to The Handbook of Person-Centred Psychotherapy and Counselling (2nd ed., due late 2012)

A personal vision of the person-centred approach: Core values

Contributing to greater social wellbeing and equity

Developing ways of engaging with people that are deeply

respectful and valuing

A personal vision of person-centred therapy: Principles

Clients as resourceful, agentic humans– as worthy of respect as their

therapists

Non-pathologisingResponsive to individual clients: Relational responsiveness over

standardised techniques

THE CHALLENGES

1. The rise of ‘evidence based’ therapies

• Therapeutic practices only valid to the extent that they have been ‘proved’ to work

• Person-centred therapies tend to lack the ‘right’ sort of evidence (i.e., manualised, experimental RCTs for specific psychological ‘disorders’)

1. The rise of ‘evidence based’ therapies

• Ideology of EBTs has become dominant in many countries: e.g., UK (NICE), Germany, USA…

• UK: publicly-funded person-centred services decommissioned/under threat

• Germany: PCA is “gradually and increasingly disappearing from sight”

Direct impact on provision of PCA

2. Dilution of person-centred values practices in haphazard

syncretism

“Everyone ’does’ empathy, UPR,

congruence these days”

“Just the basics”

Moves towards integrative practices -- away from single-orientation specialisms

PCA principles and values lost in bland mish-mash of practices

Attempts from within the PCA field to

integrate, unsystematically, other practices

“Anything goes”

3. Global social, environmental and economic threats

• PCA doesn’t operate in a vacuum

• No world, no PCA!• Is person-centred

therapy achieving its potential if so much of world is not?

GROWTH:

MEETING THE CHALLENGES

1. Consolidating and developing the PCA

evidence-base• Disseminating

the evidence that does exist for PCA therapies

• …Becoming familiar with it ourselves

1. Consolidating and developing the PCA

evidence-base• Developing and enhancing the

evidence-base…• Taking responsibility for

generating evidence (no-one is going to do it for us): MSc, PhD, service evaluation

• Conducting ‘research that counts’…

1. Consolidating and developing the PCA

evidence-base• Randomised controlled trials

(RCTs): e.g., – BACP’s funding of trial of IAPT-

based ‘Counselling for depression’– Katie McArthur’s PhD pilot trial of

school-based humanistic counselling

1. Consolidating and developing the PCA

evidence-baseResearch that counts:

• Systematic reviews of PCA evidence• Case studies• Developing PCA measures• Qualitative studies of helpful factors

in PCA

• Improved PCA practices

2. Articulating, and taking forward, the PCA’s unique

contributions to the “melting pot” of therapeutic

practices

• What is our unique contribution…?

2.1. A humanising commitment

• Keeping to the fore a deep respect for clients

• Reconceptualising psychological distress in non-pathologising terms: e.g., Margaret Warner’s difficult processes

2.2. Understanding clients as active agents of change

• Client as instigator – not subject - of change

• Therapist as catalyst, not cause• Powerful research

support• Links to related

approaches, such asDuncan, Hubble, Miller…

2.3. Non-directivity• The therapeutic importance of

supporting clients to take the lead

2.4. Deep relating• More than a working alliance,

but the healing power of a deep and enduring connectedness

• Relational depth…• Dialogue…

2.5. Wellbeing as self-concordance

• PCA is one of the few orientations to emphasise the therapeutic value of being “true” to ourselves…

• Supporting people to prize their own diversity and uniqueness: whether personality, sexuality, ethnicity, etc.

• Strongly supported by social psychological research: Sheldon, Kasser, Self-determination theory…

2. Articulating, and taking forward, the PCA’s unique

contributions to the “melting pot” of therapeutic

practices, through…• Discussing with

colleagues/Ensuring these contributions aren’t neglected

• Developing new theories/practices

• Research, e.g…..

Findings from contemporary RD research

(e.g., Knox, Wiggins, Murphy, McLeod…)

• Most therapists, and many clients, experience moments of RD in therapy

• Experiences of RD are strikingly similar across individuals: e.g., timelessness, aliveness, immersion, ‘soul-to-soul encounter’

• There tends to be a high level of matching between a therapist’s, and a client’s, experiencing of RD

Findings from contemporary RD research

(e.g., Knox, Wiggins, Murphy, McLeod)

• Both clients and therapists report that the experience of RD is associated with positive outcomes – quantitative evidence (Wiggins, 2011) suggests that it may be a key predictor

• For RD to take place, therapists need to be experienced as genuinely caring and real…

• but clients needs to choose to open themselves up to the therapist

3. Developing person-centred principles as a basis for integrative

practices• Deep respect for clients can be basis

for new integrative practices: – Responsiveness– Openness– Collaboration– Transparency

• E.g., David Cain’s “Collaborative person-centered psychotherapy”

“Pluralistic” approach to therapy

• To try and develop ways of conceptualising, and practising, therapy that…

• Maximise empowerment of clients

• Allows therapists to be open to – and draw on – their knowledge, skills and resources

• Respects the work of other therapists – whatever their orientation

Pluralistic approach: Basic assumptions

1. Lots of different things can be helpful to clients

2. If we want to know what is most likely to help clients, we should explore it with them

Pluralistic approach• Emphasis on

collaborating/meta-communicating with clients over aims and methods of therapy

• Can be both:– “Meta-therapeutic” framework for

conceptualising therapeutic field– Integrative practice

specialistpractice

pluralisticpractice

PCT

4. Taking PCA concepts and practices back into the socio-

political realm• Developing Rogers’ political

work in the fields of:– Peacework– Emancipatory learning– Organisations– Sustainable communities

• Linking to service user organisations (Sanders)

CONCLUSION

Being expansive• Challenges can lead to…• Anxiety…• Defensiveness and shutting

down

• Our biggest contemporary challenge may be to see current challenges as opportunities rather than threats

Growth through adversity

• Current challenges offer us an opportunity to: – Improve our practice and theory– Develop our unique potential– Enhance our contribution to the

therapeutic – and global – community

The challenge of being person-centred in a person-centred way

Experientialfield

Rigid self-Concept as

“Person-centredTherapist”

Flexible

Open-minded

Responsiv

e

CreativeGr

owin

g

Attuned to our corevalue and principles:

Deeply ourselves

Thank you

mick.cooper@strath.ac.uk