WEEK 3 Section 3: Theoretical Orientations Towards Change: The Humanistic Schools 1 Section overview The aim of this section, just as the previous and following two sections, is to give students the opportunity to consider how different schools advocate that change happens. The goal remains not to sell particular ideologies but to continue to wrestle with Kottler’s (2001, p. x) questions about how and why change takes place and which conditions will most likely lead to lasting change. In this section, the Humanistic Schools will be considered. Cain (2002, p. 3) states that the origin of humanistic psychotherapies might be dated back to December 11, 1940 when Carl Rogers gave a speech entitled “Newer Concepts in Psychotherapy” at the University of Minnesota in which he was critical of many of the psychotherapy methods used at that time such as advice giving, suggestion, persuasion, exhortation and interpretation. The speech resulted in a furore of excitement, praise, criticism and confusion. Cain (2002, p. 47) points out that in the years since then, “a number of major humanistic therapies have been developed whose contribution to the field of psychotherapy has been pervasive and profound”. It is, therefore, beyond the scope of this section to consider in depth all the humanistic approaches that have evolved. Yet, the intention is to provide a somewhat representative picture of humanistic approaches and to both emphasise the most commonly shared characteristics and to note the substantive variations (Cain, 2002, p. 4). Gehart (2010, p. 136) chose Carl Roger’s client-centred therapy, Fritz Perl’s gestalt therapy, Virginia Satir’s communication approach, Carl Whitaker’s symbolic-experiential therapy and Sue Johnson’s emotionally focused therapy as representative of humanistic schools. This section will consider two of these approaches as well as existential therapy. First, the person-centred approach of Carl Rogers has been selected because of Rogers’s “profound and pervasive influence on the major schools of humanistic psychotherapy and on the field of psychotherapy in general” (Cain, 2002, p. 4). This will be followed by existential therapy, and specifically the work of Irvin Yalom, and then the emotionally focused therapy ideas of Susan Johnson. In order to further appreciate change occurring in a variety of contexts, Yalom’s approach to group therapy and Johnson’s approach to couple therapy will be considered and videos of their work will be required watching. Finally, the case of Stan will be revisited to summarize Corey’s (2009) ideas on working with Stan from person-centred and existential perspectives. Learning outcomes On completion of this section, students will be able to: • describe how person-centred, existential and emotionally focused therapies theorize change • describe the techniques these schools use to bring about change • explain humanistic ideas in regard to therapy and the change process • consider the similarities as well as the differences in humanistic approaches • discuss the advantages of group therapy in regard to change particularly the views of Carl Rogers and Irvin Yalom • consider the advantages of phenomenological approaches and the advantages of working in the here-and-now with an emphasis on process rather than content • define and analyse more clearly their own beliefs around the change process and what they think facilitates change 2 Section requirements Activities There are four self-directed activities in this section. Textbook The textbook for this unit is: Duncan, B. L., Miller, S. D., Wampold, B. E. & Hubble, M. A. (2010). The heart and soul of change: Delivering what works in therapy (2nd ed.). Washington, DC: American Psychological Association. There is no chapter reading for this section. Readings There are four readings for this section: 1. Cain, D. J. (2002). Defining characteristics, history, and evolution of humanistic psychotherapies. In D. J. Cain, & J. Seeman (Eds.), Humanistic psychotherapies: Handbook of research and practice (pp. 3-53). Washington, DC: American Psychological Association. 2. Van Deurzen, E. (2007). The change process in therapy. In W. Dryden (Ed.), Dryden’s handbook of individual therapy (pp. 214-215). Los Angeles: SAGE Publications. 3. Corey, G. (2013). Person-centred therapy applied to the case of Stan. In Theory and practice of counseling and psychotherapy (9th ed. pp. 196-197). Belmont, CA: Thomson Brooks/Cole. 4. Corey, G. (2013). Existential therapy applied to the case of Stan. In Theory and practice of counseling and psychotherapy (9th ed. pp. 162-163). Belmont, CA: Thomson Brooks/Cole. Self-assessment Please complete the self-assessment questions at the end of this section to test your understanding and knowledge against the objectives stated in this section. 3 Introduction Greenberg, Korman and Paivio (2002, p. 522) say that “during decades of neglect of emotion in mainstream psychotherapy research and practice, humanistic psychotherapies have kept the light burning on the importance of feelings and have continued to develop emotionally focused interventions to bring about clinical change”. However, they stress that though feelings are certainly a feature of humanistic therapy, it is an unwanted oversimplification to characterise humanistic therapies as “proposing that getting in touch with one’s feelings is the core element of psychological health and change” (Greenberg et al., 2002, p. 499). Cain (2002) offers 12 defining characteristics of humanistic psychotherapies. These are: View of the Person, Values, the Actualizing Tendency, Relational Emphasis, Phenomenology, Empathy, The Self, Emotion, Meaning, Holism, Anxiety and Freedom-Choice-Responsibility. The first reading for this section explains these characteristics. Reading Please read Cain, D. J. (2002). Defining characteristics, history, and evolution of humanistic psychotherapies. In D. J. Cain, & J. Seeman (Eds.), Humanistic psychotherapies: Handbook of research and practice (pp. 3-53). Washington, DC: American Psychological Association. Please keep these defining characteristics in mind as you reflect upon Person-Centred, Existential and Emotionally Focused therapies in this section. Do these therapies fit these characteristics in your opinion? Gehart (2010, pp. 135) states that modernist therapists emphasise objective truth and see reality as objective and observable; that modernist schools espouse a therapeutic relationship which is hierarchical and where the therapist takes the position of expert, able to teach and guide “patients” in better ways of being and interacting. On the other hand, she points out that humanistic approaches accept subjective truth which is individually accessible. The therapist is an empathetic other who creates a context that supports a natural self-actualization process for the “client”. This is possibly too general a statement as in terms of self-actualisation, the existential therapist, Emmy van Deurzen (2002, pp. 50-51), points out that whilst the person-centred practitioner would simply seek to encourage the client in the exploration of their potential, and believe that human beings are basically positive creatures who develop constructively and in the right direction under the right conditions, existential therapists are less certain of human goodness. According to Van Deurzen (2002, p. 51), the existential position is that people may evolve in any direction, and the consideration of both good and bad is fundamental to make it possible to exercise one’s choice in the matter. Van Deurzen and Kenward (2005, p. 38), however, suggest that both person-centred and existential therapy “share a commitment to being-with the client rather than solving their problems”. As stated by Walsh and McElwain (2002, p. 255), “existential psychotherapists tend to take people’s private, inner experience of themselves more seriously than many other therapists”. As this section continues, the differences between how change and its facilitation is viewed by diverse humanistic therapies will become clearer, as will the intersections. But firstly, as this section moves to a consideration of person-centred counselling, the division between modernist and humanistic approaches becomes very evident in a Carl Rogers’ video which you are asked to watch now. 4 Person-Centred Counselling Activity 3.1: Self-directed Please watch Rogers, N., & Rogers, C. (2012). Carl Rogers on person-centred therapy. Mill Valley, Calif: Psychotherapy.net. 1:11:09. In this video, Rogers also speaks about his approach to education but these thoughts are invaluable and pertinent when considering the differences between modernist and humanistic approaches in facilitating change in counselling. Rogers slams educationalists for adopting a “mug and jug approach”, questioning what value there can be in simply pouring knowledge from a “jug” to a “mug” without inspiring curiosity. Likewise, he reflects that a student needs to be empowered rather than the power remaining in the teacher’s hands. Please take time to reflect upon these statements in terms of your own counselling practice. Rogers also offers his views on group therapy. He says that as a group facilitator, it is not possible to understand individuals as deeply as when working with them individually. However, from his perspective, what transpires in groups is that a situation arises in which there is not one but several facilitators. Therefore, when a person reveals himself or herself to the group, apart from the fact that group members can sometimes be even more sensitive to expressed feelings than professional facilitators, the acknowledgement and support is not just from one person but from several. What occurs is a type of social support that does not exist in individual work. Rogers does not set much importance on the selection of group members. He feels that a group has wisdom and can handle the diversity of its members. Furthermore, he observes that the time limits on a group tend to bring closure; that individuals seem to recognize, probably unconsciously, that there is only so much time, that they can only do so much and they can’t do any more. Most therapists are made aware from early in their counselling training that person-centred counselling does not rely on techniques or on doing things to clients and that Carl Rogers believed that “it is the quality of the interpersonal encounter with the client which is the most significant element in determining effectiveness (Rogers, 1962, p. 416, as cited in Nelson-Jones, 1995, p. 44). From their earliest days of counselling, counsellors have drummed into them, usually without question that Rogers believed there are 6 necessary, and sufficient, conditions for therapeutic personality change which are that: 1. Two people need to be in psychological contact. 2. The client is in a state of incongruence and is vulnerable or anxious. 3. The counsellor is congruent or integrated in the relationship. 4. The counsellor experiences unconditional positive regard for the client. 5. An empathic understanding of the client’s internal frame of reference and endeavours to communicate this to the client. 6. The counsellor is minimally successful in communicating empathic understanding and unconditional positive regard to the client (Nelson-Jones, 1995, p. 44). However, what most counsellors seem less certain of is why Rogers believed these to be the necessary conditions for change. Simply stated, Rogers thought that a person has two inherent qualities. One is the self-actualising tendency and the other, an organismic valuing process. The self-actualising tendency is “a directional process of striving towards realisation, fulfilment, autonomy, self-determination, and perfection” (Corey, 2009, p. 169). As stated by Ivey, D’Andrea, Ivey and Simek-Morgan (2007, p. 260), at the heart of Roger’s worldview is the belief that “people are positive, forward moving, basically good, and ultimately self-actualising” and that ultimately self-actualisation can be described as reaching one’s fullest humanity (Ivey et al., 2007, p.260). Helping the actualising tendency along is the organismic valuing process. Nelson-Jones (1995, p. 29) describes it as being responsible for “the continuous weighing of experience and the placing of values on that experience in terms of its ability to satisfy the actualising tendency”. With the actualising tendency and organismic valuing process, people are primed to maintain and develop their potential. However, an unhelpful environment will thwart such development (Van Deurzen & Kenward, 2005, p. 37). According to McLeod (2003, p. 640, Rogers believed that when love or acceptance by parents of children was conditional and withdrawn when they behaved contrarily, a child learned to define themselves according to parental values. Rogers used the phrase “conditions of worth” to describe the way in which the child’s self-concept was shaped by parental values (McLeod, 2003, p. 640), rather than being based upon their own organismic valuing process (Nelson-Jones, 1995, p. 32). Nelson-Jones (1995, p. 32) also points out that conditions of worth are also prevalent because as Rogers stated, “individuals are culturally conditioned, rewarded, reinforced, for behaviours that are in fact perversions of the natural directions of the unitary actualising tendency” (Rogers, 1977, p. 247 as cited in Nelson-Jones, 1995, p. 32). In other words, people develop a second valuing process. The first valuing process is the organismic valuing process which truly reflects the actualising tendency. The second valuing process is based on the “internalisation or ‘introjection’ of others’ evaluations, which does not truly reflect the actualising tendency but serves to impede it” (Nelson-Jones, 1995, p. 32). Rather than having an internal locus of evaluation, people begin to over rely on external evaluations. As stated by Nelson-Jones (1995, p. 36) When experiences are accurately symbolised and included in the self-concept, there is a state of congruence between self-concept and experience, or stated another way, between the self-concept and the organismic self. When, however, experience is denied and distorted, there exists a state of incongruence, between self-concept and experience. This state of incongruence may exist where experiences are positive as well as where they are negative. McLeod (2003, p. 164) says that “incongruence results from gaps and distortions in the self-concept caused by exposure to conditions of worth” and that incongruence is the term used to describe the whole range of issues that clients bring to counselling. This gives meaning to Nelson-Jones’s (1995, p. 29) comment that all psychological difficulties are caused by blockages to the actualising tendency and that it is the task of counselling to release this fundamentally good motivating drive. Therefore, person-centred counsellors need to provide the attitudinal conditions that are the antidote to the emotional deprivations experienced by their clients (p. 44). Congruence, empathy and unconditional positive regard allow the client to once again become more self-aware, to increase their self-acceptance and self-esteem, to shift their locus-of-evaluation from external standards and beliefs to their own internal locus-of-evaluation, and to be less reliant on, and vulnerable to, external conditions of worth (Nelson-Jones, 1995, p.p. 48-49). The three counsellor attitudinal conditions, in fact, “allow clients to become more effective counsellors and growth enhancers for themselves”. On the other hand, counsellors who lack these attitudinal conditions may, in fact, “increase their clients’ incongruence, negative self-regard and lack of empathy to themselves and others” (p. 49). Nelson Jones (1995, p. 49), ends his chapter on person-centred counselling therapy with what he describes as “a beautiful saying of Lao-Tse that resonated very deeply with Rogers and summarises the crux of his counselling approach” It is as though he/she listened And such listening as his/hers enfolds us in a silence In which at last we begin to hear What we are meant to be 5 Existential therapy Walsh and McElwain (2002, p. 253) ask the question, “What is existential psychotherapy, and in what sense is it one of the humanistic psychotherapies?”, and they immediately reflect that, “There is no simple answer to either query … indeed the posing of, and reflecting on, questions of meaning makes a course of psychotherapy existential [and] faith in client’s abilities to discern their own answers makes existential therapy a humanistic endeavour” (p. 253). Walsh and McElwain (2002, pp. 254-255) go on to severely criticise those who apply scientific methods to the study of human beings as though they were objects They stress that existentialists consider that objects in the world are not free, and that scientific methods are totally inadequate to the understanding of the complexities of human experience. Existentialists, they say, uphold the uniqueness and irreducibility of human experience and totally respect human subjectivity. It is the aim of existential psychotherapists “to clarify, reflect upon and understand life as each person in practice experiences it in order to overcome particular problems or dilemmas” (Van Deurzen & Kenward, 2005, p. 71). As people are considered unique, a counsellor must be flexible towards their clients and in their therapeutic style (Van Deurzen, 2007, p. 209). Existentialists also believe that “Minds, psyches, and subjectivities are inseparable from the worlds (i.e., the meaningful contexts) in which they exist”. Human beings always find themselves in relationship with others and it is these relational experiences that provide the material on which subjective meaning is built. People cannot be seen separately from the contexts and histories from whence they come (Walsh & McElwain, 2002, p. 255) and self and object are inseparable (Van Deurzen & Kenward, 2005, p. 194). Therefore, in the light of the inescapable nature of human existence, say Walsh and McElwain (2002, p. 258), “it should come as no surprise that many existential therapists regard the quality of the therapeutic relationship as of paramount importance”. The meeting between the client and the therapist is called an encounter, which indicates an openness of self by the therapist and is distinct from the common division between therapist and client as observer and observed, or subject and object. Instead, it is an active and wholehearted participation with another person as a human being … It is in this way that real dialogue is created, encountering the whole of someone else’s being with the whole of one’s own (Van Deurzen & Kenward, 2005, p. 64). Unlike person-centred therapy which cites a lack of psychological congruence as the central issue, Van Deurzen and Kenward (2005, p. 254) suggest that existential therapy believes that a person lives their life in relationship to the difficult factors of existence. Freedom is one such issue. All human beings are considered as being free; free to make choices in a particular situation, though freedom is not about total autonomy. There are always both given and chosen aspects of any particular moment but people cannot avoid “the continual process of making choices that determine who they are and who they will be” (Walsh & McElwain, 2002, p. 255). Existential therapists help the client towards authenticity, and openness to Being (Van Deurzen & Kenward, 2005, p. 71). Authenticity is similar to the Rogerian concept of genuineness but is not limited to a fixed idea of a “real self”. It is about being open to the world, to others and to one’s experiences. It is about honesty and about confronting the givens of existence for the purpose of living in conscious harmony with them (Walsh and McElwain, 2002, p. 257). To existentialists, anxiety is a healthy and natural reaction to life (Van Deurzen & Kenward, 2005, p. 71). It is the unavoidable product of being confronted by the “givens of existence”, by death, freedom and responsibility, by isolation and meaningless (Walsh and McElwain, 2002, p. 257). Likewise, when one is unable to face the existential givens, the existential guilt that arises is expected and both existential anxiety and existential guilt are regarded as valuable in that they mobilize concern and motivate a person to pursue change. In regard to change and the change process, not all existential philosophers have, or have had the same view. For example, Heidegger argued that human existence was in a constant process of change. Sartre’s view was that people are constituted by their actions and therefore, need to take responsibility for re-inventing themselves but Kierkegaard did not believe that people could change fundamentally. Whilst he thought that personality change was improbable, he accepted that a person could significantly change their views on how to live their life (Van Deurzen & Kenward, 2005, p. 34). In regard to practice, Walsh and McElwain (2002, p. 256) argue that if existential practitioners see people as dynamic rather than as determined and predictable mechanisms, they ought therefore to assume that people are capable of change, i.e. that if the essence of being human is not to have an essence, then radical change is possible at any time. Van Deurzen and Kenward (2005, p. 17) agree that however one avoids it, “one is in constant flux, never still, always becoming” and that to maintain one’s personality, a person has to continuously choose it, commit to it and then choose it again and again. It is Van Deurzen’s belief that if human beings have freedom and choice to change themselves (Van Deurzen & Kenward, 2005, p. 34), then the existential therapist must resist the temptation to try to change the client and allow the therapy to be the opportunity for the client to take stock of their lives and ways of being in the world (Van Deurzen, 2007, p. 209). Reading Please read Van Deurzen, E. (2007). The change process in therapy. In W. Dryden (Ed.), Dryden’s handbook of individual therapy (pp. 214-215). Los Angeles: SAGE Publications. In this reading Van Deurzen (2007) summarises the change process in existential therapy from her perspective. Activity 3.2: Self-directed Please watch at least the first part (there are 2) of Leszcz, M. & Yalom, Y. (2011). Group therapy: A live demonstration. Mill Valley, CA: Psychotherapy.net. The full video (Part 1) runs for 1.50 minutes in total. If time is limited, please go to the chapter entitled Group One, which runs for 50 minutes and shows the group in progress. The introduction and discussion chapters of this video are very good as well. Yalom and Leszcz (2005, p. 31) say that A freely interactive group, with few structural restrictions, will, in time develop into a social microcosm of the participant members ... There is no need for them to describe or give a detailed history of their pathology: they will sooner or later enact it before the other group member’s eyes … as a result, group therapy with its emphasis on feedback, is particularly effective treatment for individuals with character pathology. After observing the video, what is your view of this comment? How difficult, would you find it to work constantly in the here-and-now as a group therapist? Please give some time to ponder upon the questions Yalom asks in the introduction to this video: Imagine a demon coming to you one night, whispering into your ear that this life, as you have lived it, will return to you exactly again and again and again throughout all eternity, and that every event that happened will once again return to you. What would you feel? Would you curse me, as a demon, or would you perhaps bless me for bringing you the gladdest news in your life? The issue is, are you living your life in such a way that you would want this exact same life to be repeated again and again and again, throughout all eternity? Or, would you gnash your teeth and curse the demon? You never want to go through this life again. If that's the case, then why? And then we get into the concept, in therapy, of regrets. What are you doing in your life that's causing regrets? Then we can be much more therapeutic by flashing forward: what can we do so that one year from now, two years from now, you won't have accumulated even more regrets? 6 Emotionally focused therapy Whilst this section will focus on emotionally focused work with couples, Johnson (2004, p. 3) states that the application of Emotionally Focused Therapy (EFT) is widening and that it is “now used to address more and more ‘individual’ symptomatology, such as depression, anxiety disorders, and chronic illness”. EFT is actually a synthesis of both humanistic experiential and systemic approaches (Johnson, 2004). It, therefore, provides a bridge between this section on humanistic schools and the following one which will deal with how change is perceived and facilitated by systemic schools. In a nutshell, systemic schools focus their attention on patterns of behaviour rather than on the intrapsychic and individual pathology. Rather than lineal explanations for symptomatic behaviour, systemic schools focus upon “reciprocity, recursion, and shared responsibility” i.e. reciprocal causality and circularity (Becvar & Becvar, 2013, p. 9). The word “experiential” also needs some explanation. As explained by Goldenberg and Goldenberg (2008, p. 206) experiential models are an outgrowth of the phenomenological techniques used by such approaches as Gestalt, psychodrama, Rogerian person-centred counselling, and the encounter movement. Johnson (2004, p. 14) says that EFT is experiential because it focuses upon “the process of how people actively process and construct their experience in interactions with their environment, in the present”. New emotional experiences are fostered and heightened in the here-and-now of the therapy session where each person’s behaviour is seen “in the context of, and as a response to, the other’s behaviour” (p. 15). The reason that EFT chooses to marry humanistic experiential and systemic approaches is that “it views marital distress as being maintained by the manner in which people organise and process their emotional experience, and the patterns of interaction they engage in, which takes on a life of their own and become self-reinforcing” (Johnson, 2004, p. 41)”. From a humanistic experiential perspective, an EFT therapist focuses on process – not on content or facts but the process in the present. The therapist is a process consultant and sees the clients as being the experts of their experience. The EFT therapist also focuses on a safe and collaborative therapeutic alliance where emotion and emotional experience is given prime place (Johnson, 2004, pp. 41- 44). The therapist attempts to assist clients to “reprocess and expand their experiences” (p. 41) in a context of empathy and validation. As Johnson (2004, p. 15) states, “the safety provided by the therapist’s acceptance and authenticity allows each client’s innate self-healing tendencies to flourish”. On the other hand, from a systemic perspective, the EFT practitioner focuses upon interactional patterns and helps the clients to understand that each partner is in some sense creating the responses of the other (p. 15); that they are in an interactional dance (p. 9) which often takes the shape of “I withdraw because you nag, and you nag because I withdraw.” (p. 16). In this approach, clients are seen to be “stuck” rather than deficient or sick, “constrained by the interactional patterns or rules of the relationship” (p. 50) and the therapist’s task is to change the negative and rigid interactional cycle that the couple is engaging in (p. 48). Johnson (2004, p. 52) states that, “Change does not occur primarily through insight, through some kind of catharsis, or through negotiation. It occurs through new emotional experience and new interactional events”. In EFT, the change process is delineated into three stages and nine steps (Greenberg & Johnson, 1988; Johnson, 2004). The following table is from Johnson (2004, pp. 17-18) and it is presented to clarify the stages that Susan Johnson refers to in the video you are required to view. Stage 1. The De-escalation of Negative Cycles of Interaction Step 1 Creating an alliance and delineating conflict issues in the core attachment struggle. Step 2 Identifying the negative interactional cycle where these issues are expressed. Step 3 Accessing the unacknowledged emotions underlying interactional positions. Step 4 Reframing the problem in terms of the negative cycle, underlying emotions, and attachment needs. The cycle is framed as the common enemy and the source of the partner’s emotional deprivation and distress. Stage 2. Changing Interactional Positions Step 5 Promoting identification with disowned attachment emotions, needs, and aspects of self and integrating these into relationship interactions. Step 6 Promoting acceptance of the partner’s experience and new interactional responses. Step 7 Facilitating the expression of needs and wants and creating emotional engagement and bonding events that redefine the attachment between partners. Stage 3. Consolidation and Integration Step 8 Facilitating the emergence of new solutions to old relationship problems. Step 9 Consolidating new positions and new cycles of attachment behaviours. Activity 3.3: Self-directed Please watch Johnson, S (2011). Emotionally focused therapy in action. Mill Valley, California: Psychotherapy.net. This video has two parts. In the first, Susan Johnson acts as a consultant to a therapist, Joshua, who is working with a couple Rhea and Matt. In addition to offering insight into change and the EFT process, this video is also useful to consider “change” in the counsellor as a result of the supervision process. Please pause and consider what you observed in this part of the video. What did you like about the process? What, if anything, did you feel less comfortable about? Susan Johnson says that “relentless empathy corrodes aggression”. What is your view on this and do you believe that this was demonstrated, particularly by her in the second part of the video? How do you feel about her use of touch? Is this something that you feel is appropriate to do? What do you think and feel about her often used statement “I want to slow you down”? In the second part, Johnson counsels the couple using EFT techniques and at the end of the session demonstrates the use of a reflecting team whom she confers with before coming back and offering the clients their thoughts. This is very much a process developed by systemic therapists and will be discussed in the following section. Once again, as so often occurs with couple work, domestic violence is implicated. Susan Johnson in her writings (Johnson, 2004; Greenberg & Johnson, 1988) makes it very clear that EFT is not appropriate for working with couples when domestic violence is an issue. In this situation where the purpose was to demonstrate EFT techniques to practitioners, Susan Johnson continues with the therapy session but notes that Joshua, the therapist, is to pick up on this revelation when he works with this couple again. He will need to assess the level and nature of abusive behaviour in their relationship to consider the best way to ensure safety in the counselling context. As stated by Jenkins (2007, p. 232) “it can be problematic not to address issues of safety, the nature and effects of violence and abuse, and the prevention of future violence and abuse in couples”. It can even be dangerous and irresponsible to continue with conjoint therapy (Bograd, 1984). 7 Stan – A case study As before, this section ends with a consideration of the case of Stan. Activity 3.4: Self-directed Consider how you might approach the case of Stan from a person-centred approach. In your learning journal, jot down your thoughts on what you think is important for the facilitation of change from a person-centred approach. What might you do to help Stan improve his sense of well-being and to make changes to his life? When you have done that, do the same thing for Stan taking an existential approach. Once you have reflected on Stan from these two schools of thought, please read Corey’s (2013, pp. 196-197; pp. 162-163) outline of person-centred and existential approaches to the case of Stan. Reading Please read 1. Corey, G. (2013). Person-centred therapy applied to the case of Stan. In Theory and practice of counseling and psychotherapy (9th ed. pp. 196-197). Belmont, CA: Thomson Brooks/Cole. 2. Corey, G. (2013). Existential therapy applied to the case of Stan. In Theory and practice of counseling and psychotherapy (9th ed. pp. 162-163). Belmont, CA: Thomson Brooks/Cole. Corey (2009) includes some useful questions for you to consider if you were to continue as Stan’s therapist to bring about change. 8 Conclusion and Self-assessment Conclusion This section has concentrated on humanistic approaches to change. It has shown that there are marked differences between humanistic schools of thought and the modernist schools that were considered in section two. However, there are also similarities. As McLeod and Wheeler (1996, p. 8) state, the following are some of the main ways in which the two approaches converge: • They are exploratory and their goal is to help people • They operate mainly through dialogue and conversation • The counsellor-client relationship is considered the vehicle for promoting learning and understanding so that, though in a very different way, the notion of a therapeutic alliance can be applied to both • Both require their counsellors to have undertaken a significant amount of work on self • Both incorporate practitioners with different shades of opinion under the same banner. In this section, for example, person-centred counsellors and existential practitioners view human nature differently. Person-centred therapists view human beings as inherently good, whereas existential therapists believe that people have the inherent capability for both good and evil within them. It is the choices they make that define them (Boyd, 2013). Emotionally focused therapy as another example, is far more structured than is person-centred counselling. It also concentrates on attachment theory rather than on the idea of a self- actualizing tendency i.e. on developing positive bonding interactions rather than on an individual’s potential. The differences between the two schools, humanist and modernist are neatly summarised in the following table from McLeod and Wheeler (1996, p. 9). Differences between person-centred and psychodynamic counselling Person-centred Psychodynamic Conscious processes Unconscious processes Dream work not emphasized Use of dreams Therapist congruence (may include self-disclosure) Therapist opaque stance (no self-disclosure) Shows warmth Professional distance Focus on experiencing feelings Focus on the underlying anxiety Expression of feelings Understanding feelings Focus on past, present or future Linking past and present Sees people as fundamentally good Sees people as destabilized by bad/hostile/self-destructive instincts Allows clients to make their own interpretations Makes interpretations for clients Allows client to determine what they talk about: the client is right May see reluctance to engage with a topic as resistance Accepts the clients where they are Looks for what is hidden Does not make an initial assessment: mutual negotiation Assessment an essential part of the work The past sometimes irrelevant History-taking essential Some flexibility with time boundaries Time boundaries fixed Theory genderless [feminists might argue with this] Theory gender-orientated Adaptable to cultural diversity Less flexible to cultural diversity Promotes personal growth Promotes self-understanding Limited theoretical literature [The emphasis on evidence based practice in recent times might have changed this point] Vast theoretical literature Self-assessment Did you achieve the objectives for this section? To test your knowledge, write brief answers to the following questions: 1. Describe how person-centred, existential and emotionally focused therapies theorize change and describe the change process that they advocate for facilitating it? 2. What defines these three approaches, and others, as humanistic? 3. How do they differ from each other? 4. How do they differ from modernist schools? 5. What are some of the advantages of group therapy for facilitating change as indicated by Carl Rogers and Irvin Yalom? 6. In terms of your own practice, what have you personally gained from this section on humanistic practice, and specifically the exploration of person-centred, existential and emotionally focused therapies? 9 References Becvar, D. S., & Becvar, R.J. (2013). Family therapy: A systemic integration (8th ed.). Boston, M.A.:Pearson. Bograd, M. (1984). Family systems approaches to wife battering: A feminist critique. American Journal of Orthopsychiatry, 54(4), 558-568. Boyd, N. (2013). Existential vs humanistic theories: Comparing two major theories in psychotherapy. Retrieved from: http://education-portal.com/academy/lesson/existential-vs-humanistic-theories-comparing-two-major-theories-in-psychotherapy.html. Cain, D. J. (2002). Defining characteristics, history, and evolution of humanistic psychotherapies. In D. J. Cain, & J. Seeman (Eds.), Humanistic psychotherapies: Handbook of research and practice. Washington, DC: American Psychological Association. Retrieved from: http://web.b.ebscohost.com.elibrary.acap.edu.au/ehost/results?sid=3c650f1b-bd61-4ff0-bf41-7f96f862ffe3%40sessionmgr115&vid=4&hid=107&bquery=AN+2001-18223-001&bdata=JmRiPXB6aCZ0eXBlPTEmc2l0ZT1laG9zdC1saXZl Corey, G. (2013). Theories and practice of counseling and psychotherapy (9th ed.). Belmont, CA: Thomson Higher Education. Gehart, D. (2010). Mastering competencies in family therapy: A practical approach to theories and clinical case documentation. California: Brooks/Cole. Goldenberg, H., & Goldenberg, I. (2008). Family therapy: An overview (7th ed.). Belmont, California: Brooks/Cole. Greenberg, L.S., & Johnson, S. M. (1988). Emotionally focused therapy for couples. New York: The Guildford Press. Greenberg, L.S., Korman, L. M., & Paivio, S. C. (2002). Emotion in humanistic psychotherapy. In In D.J. Cain and J. Seeman (Eds.), Humanistic psychotherapies: Handbook of research and practice. Washington, DC: American Psychological Association. Retrieved from: http://web.b.ebscohost.com.elibrary.acap.edu.au/ehost/results?sid=3c650f1b-bd61-4ff0-bf41-7f96f862ffe3%40sessionmgr115&vid=4&hid=107&bquery=AN+2001-18223-001&bdata=JmRiPXB6aCZ0eXBlPTEmc2l0ZT1laG9zdC1saXZl. Ivey, A.E., D’Andrea, M., Ivey, M.B., & Simek-Morgan, L. (2007). Theories of counseling and psychotherapy. Boston: Pearson. Johnson, S. M. (2004). Practice of emotionally focused couple therapy: Creating connection. New York: Brunner-Routledge. Johnson, S. (2011). Emotionally focused therapy in action. Mill Valley, California: Psychotherapy.net. Retrieved from: http://www.psychotherapy.net.elibrary.acap.edu.au/stream/acap/video?vid=178 Jenkins, A. (2007). Becoming respectful: Approaches to relationship counselling in situations of domestic violence and abuse. In E. Shaw, & J. Crawley, (Eds.), Couple therapy in Australia: Issues emerging from practice. Melbourne, Australia: PsychOz Publications. Kottler, J. A. (2001). Making changes last. Philadelphia: Brunner/Mazel. Leszcz, M., & Yalom, Y. (2011). Group therapy: A live demonstration. Mill Valley, CA: Psychotherapy.net. Retrieved from: http://www.psychotherapy.net.elibrary.acap.edu.au/stream/acap/video?vid=170. McLeod, J. (2003). An introduction to counselling. Buckingham, Philadelphia: Open University Press. McLeod, J., & Wheeler, S. (1996). Person-centred and psychodynamic counselling: A dialogue. In S. Palmer, S. Dainow & P. Milner (Eds.), Counselling: The BAC counselling reader. London, England: Sage Publications. Nelson-Jones, R. (1995). Counselling and personality: Theory and practice. St Leonards, Australia: Allen & Unwin. Rogers, N., & Rogers, C. (2012). Carl Rogers on person-centred therapy. Mill Valley, Calif: Psychotherapy.net. Retrieved from: http://www.psychotherapy.net.elibrary.acap.edu.au/stream/acap/video?vid=204 Van Deurzen, E. (2002). Existential counselling & psychotherapy in practice. London: Sage Publications. Van Deurzen, E., & Kenward, R. (2005). Dictionary of existential psychotherapy and counselling. London: Sage Publications. Van Deurzen, E. (2007). Existential therapy. In W. Dryden, (Ed.), Dryden’s handbook of individual therapy. London: Sage Publications. Walsh, R. A., & McElwain (2002). Existential psychotherapies. In In D. J. Cain, & J. Seeman (Eds.), Humanistic psychotherapies: Handbook of research and practice. Washington, DC: American Psychological Association. Retrieved from: http://web.b.ebscohost.com.elibrary.acap.edu.au/ehost/results?sid=3c650f1b-bd61-4ff0-bf41-7f96f862ffe3%40sessionmgr115&vid=4&hid=107&bquery=AN+2001-18223-001&bdata=JmRiPXB6aCZ0eXBlPTEmc2l0ZT1laG9zdC1saXZl. Yalom, I. D., & Leszcz, M. (2005). The theory and practice of group therapy (5th ed.). New York: Basic Books.