Person-centred therapy
today and tomorrow:
Vision, challenge and growth
Mick Cooper
BAPCA 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 PersonCentred Psychotherapy
and Counselling (2nd
ed., due late 2012)
A personal vision of the personcentred 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 personcentred therapy: Principles
Clients as resourceful, agentic humans
– as worthy of respect as their therapists
Non-pathologising
Responsive 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…
Direct
impact on
provision of
PCA
• UK: publicly-funded person-centred
services decommissioned/under threat
• Germany: PCA is “gradually and
increasingly disappearing from sight”
2. Dilution of person-centred values
practices in haphazard syncretism
Moves towards integrative practices -- away
from single-orientation specialisms
“Everyone ’does’
empathy, UPR,
congruence these
days”
“Just the basics”
Attempts from within
the PCA field to
integrate,
unsystematically, other
practices
“Anything goes”
PCA principles and values lost in bland mishmash of practices
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-base
Research 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 as
Duncan, 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/metacommunicating with clients over
aims and methods of therapy
• Can be both:
– “Meta-therapeutic” framework for
conceptualising therapeutic field
– Integrative practice
pluralistic
practice
specialist
practice
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
Growing
The challenge of being personcentred in a person-centred way
Creative
Rigid selfExperiential Concept as
field “Person-centred
Therapist”
Attuned to our core
value and principles:
Deeply ourselves
Thank you
mick.cooper@strath.ac.uk