It’s been a few months since I’ve created enough time to write a blog. A feeling of there being so much to do and not always enough time to do it is something I can relate to my psychotherapy work and also in everyday life. The pressure to complete therapy in as short a time as possible has long been around. However, perhaps more apparent in my work training therapists is the related pressure, and to some extent confusion over, the use of techniques that facilitate change. This is going to be the first of a short series of blogs on the use of technique in Person-Centred Therapy.
Can I use techniques and still be Person-Centred? This is the one question that creates probably as much, if not more, discussion in the counselling training groups that I teach. This is interesting because within some approaches to psychotherapy this question is not an issue. Some approaches are largely a collection of techniques. A good example of this is cognitive behaviour therapy (CBT). To some extent in CBT the client is being trained to become their own therapist; through the application of techniques the therapist teaches the client how to think and behave differently and learn the techniques to then apply for themselves. The use of technique here is the core of the approach.
In Person-Centred Therapy (PCT) the trainee therapist is learning a way of being. Training helps to develop self awareness and the goal is to develop the congruence between direct and symbolised experience. Additionally, for self acceptance or, unconditional positive self regard, as some may know it are also critical for the developing trainee therapist. So what’s the difference here between the CBT and PCT approach when it comes to the issue of techniques? Well, I think the answer can be related directly to the goals for the their training. In CBT training the goal is to teach the therapist techniques to support the development of functional thoughts and behaviours in their clients. It is about doing to the other person. In PCT the goal is for the trainee therapist to develop congruence and self acceptance to support a particular way of being in relationship with the client.
As a Person-Centred therapist I place an emphasis on experiencing unconditional positive regard and empathic understanding for the client. Anything that gets in the way of this needs to be confronted by me in my supervision. As a therapist I make empathic reflections based on experience of the client’s frame of reference, that is, how the client feels or thinks. Typically, as the therapist I don’t have a view, or at least do not impose my view, on how the client ‘ought to be’. So if as the therapist I am going to use a technique, I’d have to be clear as to the purpose and intention behind the decision to use it.
One way to consider the use of techniques in PCT is that they are present as a response to a request directly from the client. The client might ask the therapist to provide help and assistance with an issue they may be struggling. An example of this might be to request help in relaxing or calming themselves when anxiety feels as though it is overwhelming. Over the years clients have reported to me how they’ve found that in helping them to breathe more steadily, they regain a sense of control over their immediate experiencing, and their thoughts or feelings about being in the world return to being more acceptable to them. Responding to direct requests from client to help them through a relaxation technique does not detract from being a Person-Centred therapist. The response is consistent with and supports their self determination.
Another example of how techniques might present in PCT is through supporting the experiencing and communication of the therapeutic conditions in relationship with the client. From my own practice an example I can think of might be as a response to the client expressing a difficulty in processing an emotion related to a past experience. Sometimes I’ve found that after a trauma or a relationship that has ended clients have the need to process some of their responses to this. They may say ‘if only I could say to them what I really felt’ and I may say to them ‘so if they were here now what is it you’d really want to say to them’. The client may chose to either follow that by expressing their feeling or they may not; there’s no pressure to follow the invitation as it is typically a spontaneous and unconditional response on my part to sensing their attempt to express/process their feeling. I try not to over analyse such spontaneous responses from me to the client. I think this can lead to paralysing myself in the relationship and is partly what trainees are doing when they consider the question of techniques.
I’m pretty sure there are probably many more ways that techniques can be presented in PCT. I’m also pretty sure that other Person-Centred therapists might disagree with what I’ve said above. Either way these are just a few thoughts on addressing the question that seems to come more frequently than others from trainees in many Person-Centred therapy training groups.