Introduction to Children C. Rogers developed his client-driven approach

Introduction

The aim of this
literature review is to examine and to present a comprehensive analysis of
Person Centred Therapy (PCT) and Choice Theory/Reality Therapy (CT/RT). The aim of this systematic overview is to demonstrate the
different dimensions of each approach described in the literature, compare the
similarities and the differences of each model, and establish the strengths and
limitations as they apply in a multicultural setting. This essay will introduce the main concepts of CT/RT and PCT and analyse these
methodologies through the Ways Paradigm developed by Sharon E. Cheston
(Cheston, 2000). The Ways Paradigm catalogues the significant differences
between counselling approaches by comparing and organizing their application around
three principles: as a way of being in the
interpersonal dynamic, their theoretical way of understanding of psychopathology and mental functioning, and their
techniques in a way of intervening in the
counselling relationship.

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Carl
Rogers and Person Centred Therapy

PCT was humanistic
and emerged in the 1950’s as an alternative to psychoanalysis and behaviourism.
J. McLeod (2013) says, that the birth of PCT is usually attributed to a talk
given by C. Rogers in 1940 on “new concepts in psychotherapy” at the University
of Minnesota. The Person Centred
Approach is the foundational philosophy of many Irish counsellors because it is
congruent with traditional and conservative Irish values (Chamberlain, 1983).

 

C. Roger’s Biography

C. Rogers grow up
in conservative family, his parents tried to keep their children free from
society’s corrupt influences;

His family moved
to the farm; here he developed serious working knowledge of scientific methods.
From the age of 13 Carl had viewed himself as a scientist;

  He studied agriculture, history, religion and
finally psychology. His trip to China helped broaden his religious and social
philosophy;

In Teachers
College he pursued a doctorate in Clinical Psychology;

At the Rochester
Society for Prevention of Cruelty to Children C. Rogers developed his
client-driven approach and emphasis on
the non-judgmental therapeutic relationship. Here he wrote his first book, “the
Clinical Treatment of the Problem Child” (Thorne, 2006);

A full-
professorship at Ohio State University; he began to articulate his own views on
counselling and published the second book “Counselling and Psychotherapy: Newer
Concepts in Practice”, in which he introduced his non-directive method;

C. Rogers moved to
Chicago University, where developed and ran the internationally renowned
Counselling Centre. In 1961 with the publication
of his book “Becoming a Person” his theories gained public influence (Kirshenbaum,
2004). 

 

The
Main Concepts of PCT

Rogers (1961) believed that
people are inherently good and
creative, but the environment makes changes in each personality.

The
Way of Being

The
therapist has to be real, congruent and present
himself in a genuine way: to be aware of
his own feelings, recognise them and express himself in his words and
behaviours. The attitude of therapist rather his techniques or theories
facilitate personality change and growth (Rogers, 1961). According to Corey
(2013) therapist is a catalyst for client’s change, his role is to stay without
a role and focuses on immediate client’s
experience. Rogers (1961, p.34)
underlines “only as I see them as you see them, and accept them and you, that
you feel really free to explore…your inner and often buried experience.” Another
aspect of the process is to accurately and empathically understand the client’s
experiences and feelings. The empathy is one of the core conditions in PCT. There are no judgments placed upon the
client, the therapy is applied through a therapist’s unconditional positive
regard for the client. It means- valuing the core
of the person and trusting the ability to self- actualize given the right
conditions (McLeod,
2013).

The Way of Understanding

McLeod (2013) says that client in PCT is viewed as incongruent and
acting to fulfill his need to self-actualization.
Rogers (1961) called a self-actualised
person as fully functioning, creative, opened to experience and trusting
feelings. It is the individual who fulfilled his or her potential and achieved
the highest level of human beingness. The central point in PCT is self-concept
which is shaped by conditions of worth: each individual is not at the centre of
his valuing system, he needs the judgment
of others. The experiencing self, in reality, differs from the ideal
self-perception. All individuals respond to the world through their frame of
reference, but they tend to move away from a real self. Rogers (1961) observed
that clients tend to express the fear of exposing real self, because of parents
or society expectations, they tend to please others. The client becomes not
fully functioning person; he blocks actualising tendency through low
self-esteem and defence mechanism.

The Way of Intervening

   Rogers (1961, p.33) believed that if he
provides “a certain type of relationship, the other person will discover within
himself or herself the capacity to use that relationship for growth and change,
and personal development will occur.” As being non-directive
the counselling relationship is based on equality of client-therapist
relationship and the core conditions of empathy, congruence and unconditional
positive regard (Corey, 2013). The
communication of them to the client is to a minimal degree achieved (Rogers,
1956). By clients being valued, they can learn
to accept and reconnect with their true selves, take responsibility for
themselves, and to move toward
acceptance of experience of others. This is the way to unblock the actualising
tendency, become more free, autonomous and become a person. There are no techniques in particular for this form of
therapy; the greatest importance is that the therapist remains engaged deeply
with the client.

 

William Glasser and Choice
Theory/Reality Therapy

CT was created by
W. Glasser in the 1950’s. He rejected the Freudian model because of observation
of psychoanalytically trained therapists, which seemed not implementing
Freudian principles, but tended to hold people responsible for their behaviour
(G. Corey, 2013). CT/RT came into
Ireland in 1985, when the Institute of Guidance Counsellors began inviting W.
Glasser to teach it. This initiative was highly successful; the
Institute for Reality Therapy was founded in September 1987 (Lennon, 2006).

 

William
Glasser Biography

W. Glasser was
born in 1925 in Ohio. He was married to Naomi for 47 years, who was involved
with William Glasser Institute very much;

Initially a
chemical engineer he turned to clinical psychology and in 1961 he became a
board-certified psychiatrist. He was influenced by G.L. Harington, psychiatrist
and mentor. On this time W. Glasser began to put together ideas of RT; 

He learned about
control theory from W. Powers in 1980’s, and spent ten years to develop theory,
which he named Choice Theory (Corey, 2013);

W. Glasser has gone on to apply CT to schooling, as a
methodology for the development of “Quality Schools” (Glasser, 1998). He was
the president and founder of the William Glasser Institute designed to teach
people choice theory;

Robert E.
Wubbolding – one of W. Glasser’s colleagues and followers made some good
suggestions for CT. He expanded the CT and practice of RT with WDEP system
(want; do; evaluate; plan differently) (Corey, 2013).

 

The
Main Concepts of CT/RT

Control Theory,
which was renamed to Choice Theory, was developed by W. Glasser as a
theoretical framework for understanding the person, underlying the
interventions of Reality Therapy (Glasser, 1998). According to Glasser (1998,
p.3) “we choose everything we do, including the misery we feel”.

The
Way of Being

CT is the
theoretical basis for RT, which is considered as a mentoring process in which
therapist is a teacher, he demonstrates his knowledge and skills. Sometimes
therapist might gently but firmly confront client (Corey, 2013). The reality
therapist provides a supportive, non-judgmental, challenging environment, using
warmth, humour and counselling micro skills (Glasser, 1998). He listens and
accepts the client, stays congruent and shows concern and respect for the client,
to make him believe that he is on the client’s side. The role of reality
therapist to create a safe environment,
where the client is engaged in
self-evaluation process (Wubbolding, 2011).

The
Way of Understanding

Glasser (1998) emphasizes, that most
client’s problem is the present unsatisfied relationship with at least one
significant person in their life. He believed, that all people behave to
satisfy five genetic needs: survival,
love and belonging, power, freedom and fun. Every behaviour is total, which
made from four inseparable components: thinking, acting, feeling and
physiology. People choose to use the external
control to make them feel better (to satisfy unmet needs). But “external
control harms everyone, both the controllers and controlled…he loses any chance
of happiness” (Glasser, 1998, p. 7). According to Corey (2013, p. 307) “all what we do feels good. We store information
inside our minds and build a file of wants, called our quality world”. The main components of this world are people and
connections with them. Every individual has his own unique quality world,
strives to make connections with people from their quality world, and behaves
to get his needs met and feel better. There is a gap between perceived and
desired worlds.

The
Way of Intervening

The supportive
relationship or therapeutic alliance is the foundation
for effective outcomes. The therapist teaches CT: supports and helps to explore
client’s quality world. The client perceives therapist as a skilled and
knowledgeable. The supportive way of learning allows the client to believe, that he is no longer alone,
the change is possible; he has a choice and can control and change only his own
behaviour and thoughts, which leads to life changes. (Corey, 2013). CT is an
internal control psychology. Change occurs when the client is able to use the internal
control to change his own acting and thinking to satisfy his needs that can
only be met through relationships with happy sociable people (Glasser, 1998).
Wubbolding suggests the WDEP procedure (want; do; evaluate; plan differently)
which involves therapist guiding a client through an evaluation of the clients wants and needs (Corey, 2013). The therapist does not listen to the client’s feeling or past. The
primary emphasis is on behaviour and choice in the present because of the acting impacts the feeling, thinking
and physiology.

 

Comparative Analysis of PCT and CT/RT

 

Similarities
of PCT and CT/RT

When comparing and
contrasting these two major approaches the following similarities occur between
the PCT and CT/RT. They both have a positive view of human nature and believe
in an innate human capacity and strength toward growth and change in their
life. Every individual is able to determine their own futures and set the goals
to keep their lives more fulfilled and happier. PCT and CT/RT approaches
acknowledge that the only client has a
control over their own lives and behaviours. Both approaches deal with the conscious
mind, the present moment and focus on current problems and issues the client
may have. They both attempt to improve well-being by means of a collaborative
therapeutic relationship that enables and facilitates healthy coping mechanisms
in clients who are experiencing psychological discomfort and disharmony in
their lives. The trustable and non-judgmental therapeutic relationship is the
core condition to make client engaged in psychological contact and to ensure
effective outcomes in both approaches. In highlighting the similarities in
practical rationale between the PCT and CT/RT approaches therapist utilises the
core conditions of empathy, congruence and unconditional positive regard but in
RT it is used to establish the working alliance. Finally, both approaches
rejected the Freudian principles, that we are victims of our unconsciousness,
that we are wild, selfish and destructive (Kirshenbaum, 2007).      

 

Differences
between PCT and CT/RT

In comparison, the
differences in the main characteristics of the client: CT/RT emphasis lays on
client’s encouragement to become very skilled at evaluation, planning,
reframing and alteration; PCT- the client is more emotionally connected, more
opened and self-actualised. Even though therapist in both approaches uses the
same core conditions, but his behaviour is radically different. PCT therapist
is a non-directive facilitator: “his role
is rooted in his way of being and attitudes, not in techniques” (Corey, 2013,
p.165).  Reality therapist is mentor:
teaches his client choice theory, he is directive and encourages the client to be active in self-evaluation, might
gently but firmly confront the client, uses strategic interventions, suggests
or gives advice in specific planning, even tries the role play (Corey, 2013).
Time is important in RT, as Glasser (1998) says 10 sessions usually enough; and
PCT is hypothetically long termed counselling. From Roger’s (1961) point of
view PCT focus on the client, and from Glasser’s (1998) point of view RT focus
on at least one unsatisfied client’s relationship with the significant person in his quality world. When comparing
the differences in the process of change: in PCT change occurs when the client
learns to perceive their world from a new perspective and gains the ability to
self-actualise; in RT behavioural change occurs by bringing thoughts into
awareness and changing them and behaviour.

 

Strengths
and Limitations of Each Model in a Multicultural Context

Strengths. The
great strength of both approaches, that they both value a person for his uniqueness and individuality.
They both value and accept the differences in worldview between themselves and
clients. The strength of both models lay in the solid nature of the client-therapist relationship, where is a client in the centre of the strategy. Clients
feel empowered as the responsibility is on them to make decisions (Seligman,
2006).  PCT and CT/RT demonstrate core
conditions in the therapeutic
relationship, which are universal qualities; they are understandable and
acceptable in all cultures (Corey, 2013). All people have internal needs, all
of them make choices (Wubbolding,2011), and
their journeys are unique (Cain, 2010). The therapist in both models
demonstrates non-judgmental listening and acceptance of client perception, so
client can express himself more fully
when he is listened and not judged (Seligman, 2006). Overall, both therapies are optimistic therapies that focus on the client’s ability to make changes
in his or her life and that clients strive for self-actualisation or satisfy
their needs. This is why these approaches can be
applied in groups or individually, in a therapeutic setting or in medical
recovery. Both type therapies can be modified depending on cultural context.
Wubbolding (2011) makes the assumption, that RT can be used artfully and might
be applied in different ways with a variety
of clients. Therapists, who practising PCT, work in diverse ways, they have the
freedom to use a variety of responses and methods to assist their clients. It is
essential for each therapist to adapt the therapeutic style to accommodate the
uniqueness of each client (Cain, 2010). 

Limitations. One
of the limitations of both theories is
that might be difficult to translate the core therapeutic conditions into
actual practice in certain cultures. According to Corey (2013, p.181) some
clients “may not be comfortable with direct expressions of empathy or
self-disclosure on the therapist part.” The same problem might happen in RT,
where clients are invited by the therapist
to name their wishes: some clients might be “very reluctant to directly
verbally express what they need” (Corey, 2013, p.322). In RT the allegation that all behaviour is chosen
might be problematic because self-directed
behaviour occurs within a background of social learning, conditioning and
available chances that delimit choice. Also by placing the responsibility and
possibility for change in the hands of the client, Choice Theory can be
understood from a social constructivist perspective as an empowering ideology (Jefferson,
Harkins, 2011). It seems cultural norms and values are eliminated at some stage. PCT extols the internal locus of
evaluation; this might be a huge problem in collectivist cultures, where
societal expectations highly influence individual (Corey, 2013). Both approaches consider client’s self-interest
as the most valuable point in therapy, which might be inappropriate for
individual who values the family’s or society’s interests over his or her own
individual values. RT’s avoidance of past trauma might be the limitation for
some clients who have loss of loved ones or child abuse in their past.
According to Corey (2013), RT therapist’s
might be too directive and PCT therapist might be too passive for some clients
in certain cultures.

 

Evaluation

In conclusion,
each model has its own strengths and weaknesses, and individuals may find one
approach more appropriate than another, depending on their own personal
preference or on the severity and depth of their presenting problem. Time
factors and costs would also need to be taken into consideration.

 Both
approaches highlight the client’s innate capacity and strength toward growth and change in their life. A lot of research is done especially for
PCT approach, but all this research focus on therapy with motivated clients. In
the centre of each theory is communicative, intellectual and high motivated
client. Both approaches emphasize the importance of the trustable and non-judgmental relationship. One of the therapeutic relationship conditions by Rogers is
psychological contact: but how to make the contact with the unmotivated person; what happens if the client is unmotivated or finds very hard
express themselves; what if they have a communication
problem or don’t trust in people at all. There is a huge part of our population
which might never benefit any kind of therapy: prisoners, teenagers (forced to
therapy by their parents), socially rejected people or in general very angry
and not trusting individuals. Corey (2013) says that RT can be effectively used
with reluctant clients. He assumes that a lot of clients come to counselling
with a huge part of scepticism. It is
difficult and it is a huge challenge for the therapist
to make a relationship with this type of clients. Some therapists might never
have enough patience or do not want to invest the time and effort to establish
a relationship (Patterson, 1990). Therapist’s ability is flexible in their theoretical knowledge and application of
methods, his willingness to make a contact with the person are crucial in any counselling process. A therapist can learn and relearn a lot of
different theories, but each client is unique,
and the encounter should be unique as well. The main focus lays on the
client’s need and therapist’s job is to adopt the style which works best for
the client.

The therapeutic
relationship is two-way street and involvement of both participants is
necessary. But mostly this depends on patience, willingness, and creativity of
therapist. If he is able to make the certain type of therapeutic contact for
certain client, the change occurs.

 

Conclusion

Both
approaches offer a humane alternative and provide a positive, hopeful
engagement in which therapeutic change can occur. Both methodologies highlight
the importance of safe and trustable
therapeutic relationship delivered to the client by the therapist through the core conditions where the client is in the centre of therapy. While they disagree in their
conception of the person and their methodologies for intervention: in PCT
therapist is a facilitator, who leads the
client through his experiences exploration to the self-actualization; in CT/RT
therapist teaches the client CT and invites him to explore his needs and wishes
through self-evaluation and his quality world. Clients
may find one approach more appropriate than another, depending on their own personal
preference. Each model has its own limitations and strengths. Both therapies
can be modified depending on cultural context and can be applied in groups or
individually in any therapeutic or medical recovery. The plan-making of RT could offer a
useful addition to the skill set of PCT, especially with clients whose time in
therapy must be brief. The exploration of past experiences in PCT might be very
useful for RT clients, especially who have experienced bereavement or relevant
trauma in their past.

Word Count 3210
 

 

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