Traditional Intervention Strategies
The counselor looking for a specific list of things to say, actions to take, or diagnoses to make will not find them in this theory. Person-centered theory is much more related to who counselors are rather than what techniques they use. A practitioner's actions are focused around providing the conditions of genuineness, unconditional positive regard, and empathy in the relationship. No book can say how all individuals should be genuine, because each person is different. Likewise, how a practitioner genuinely shows unconditional positive regard or empathy is also dictated to some degree by the type of person he or she is. This section offers suggestions on how to be genuine and some specific behaviors that have consistently been identified with communication of the core conditions.
To be genuine, counselors need to look closely at themselves before deciding how to be or what to do. People cannot be genuine and congruent by thinking, saying, or doing what someone else does. Knowing oneself and being comfortable with that knowledge is critical. This allows actions and words to be congruent with the way one really is while at the same time helping the practitioner match the client's needs. Counselors must be more congruent than their clients, or they are likely to take more from the client than is given. One clear way to deal with these issues is for practitioners to seek quality helpful relationships, including counseling, for themselves and to work as hard on their own continued growth as they ask their clients to work.
Being genuine does not mean sharing every thought or feeling with the client. Such a tactic would simply take the focus off the client and put it on the practitioner, which is not a part of person-centered counseling. What is appropriate is being a helpful, attentive, caring person who is able to demonstrate genuine interest and involvement. We have all experienced an acquaintance saying, "I know how you feel," and we know very well the words coming from this near stranger are nothing more than words. Not only do we reject the words, but also we lose faith in the person's honesty. The same person might have said, "I hardly know you, but if it is anything like my own loss it must hurt a great deal." The second statement communicates genuineness by recognizing the reality of the two different people rather than trying to indicate more understanding than is reasonable to believe. There are as many genuine statements or actions as there are people and situations. The right one matches who the counselor is with the counselor's unique situation with the client at a given time.
The first technique emphasized in person-centered theory is active listening and its reflection of content and feelings. Demonstrating empathy for the client requires highly attentive and interactive listening skills. Counselors must first show that they are paying attention with physical steps such as facing clients, leaning toward them, and making good eye contact. Combining this with the use of facial and body expressions that relate to the client's comments will at least initially put practitioners and clients in physical contact. After putting themselves in the best possible position to listen, practitioners must then hear and see what is communicated by words and action to turn the bits and pieces into a holistic picture.
Acquiring information is only the first part of active listening. Practitioners must then reflect the content and feelings of clients back to them for their listening to have action value. "I hear you saying . . .," "So you are feeling . . .," and "You seem to be feeling . . . because of . . ." are samples of the ways counselors explore with the client how accurate their empathy truly is. Only in this way can they jointly discover understanding and misconceptions at one level and then move on to greater understanding.
It is expected that genuine counselors will not always have a full understanding of the client's world and will make varied degrees of mistakes trying to reflect it. The process of active listening helps both parties clarify the content and feelings of a situation and is a learning process for each participant. Practitioners who can treat their own mistakes and growth during this learning process in a genuine manner as a natural part of life also help clients accept their uncertainties and weaknesses.
Reflection of Content and Feelings
The first steps in the empathy exploration process tend to be the recognition and reflection of the actual words stated and the feelings that are most obvious. As client and counselor get to know each other better, an effective practitioner becomes better able to see behind these surface interactions to identify and convey feelings that clients do not even recognize they are expressing. For example, a client may be distracted or become quieter periodically during the session. Initially, these reactions may appear related to the specific topic at hand. However, over time, the counselor may be able to tie those reactions to a theme that pulls what seemed to be very different discussion topics together in meaningful ways.
Describing to the client what has been recognized can be very valuable even when it is as little as extended listening, observing, and reflecting of the client's world. At its most powerful, reflection can also bring together complex elements of the client's world that draw a much more accurate picture of the client as a whole than the individual elements provide separately. This process is similar to what you would experience in trying to describe your face and then looking in the mirror. The closer and longer you look in the mirror, the more detail you see to describe and the better you can describe the overall look of your face. Counselors who accurately reflect content and feelings act like a mirror by helping clients see what they are expressing so that clients can revise and expand perceptions of themselves based on counselor reflections.
Many of the most powerful interactions are those in which the content and feelings involved relate directly to the immediate situation between the client and the counselor; in other words, they depend on immediacy. The mirror analogy fits here, because immediate feedback is provided, which is much more valuable than if the mirror only showed how a person looked several hours or years earlier. Immediacy provides a here-and-now approach to the relationship in general and to feelings in particular. Those feelings that both client and counselor are currently experiencing are often the most therapeutic ones available. Statements that receive primary emphasis are ones like "Your words express calmness, but your hands are shaking as if you were nervous" and "Your statements make me feel...." On the other hand, statements seen as less therapeutically useful might be, "Why did you feel that way?" or "What did the other person think?"
A major reason for person-centered theory's emphasis on the here and now is that reactions between client and counselor can be verified, checked, and explored immediately by both participants. Statements or feelings from the past make use of only the client's perspective, thus giving the practitioner a reduced opportunity to be a vibrant part of the client's experience.
Truly genuine relationships let clients see relevant parts of counselors' phenomenological worlds as well as their own. Appropriate self-disclosure allows clients to compare their views of the world with the view of another individual whom they have come to trust and value as a significant human being. Under nonthreatening circumstances, these highly personalized comparisons give clients the chance to review and revise their views based on information they might otherwise not have had available or that has been too threatening to accept.
Personalized Counselor Actions
The greatest misconception among new practitioners is that simplistic listening and reflecting is all the person-centered counselor does. This rigid reaction to his concept of an evolving and personalized theory was a major frustration to Rogers throughout his professional life. After one demonstration counseling session, a workshop participant confronted Rogers, "I noticed that you asked questions of the client. But just last night a lecturer told us that we must never do that." Rogers responded, "Well I'm in the fortunate position of not having to be a Rogerian" (Farber, Brink, & Raskin, 1996, p. 11). Rogers used his own thoughts and personality in many creative ways, just as all quality person-centered counselors do. These are the aspects of therapy that appear as metaphor, humor, confrontation, and at times even interpretation or directiveness (Bowen, 1996).
Many counselors now use Rogers's relationship development model as the foundation on which to build other cognitive, behavioral, or emotional approaches (Hill, 2009; See & Kamnetz, 2004). True person-centered approaches will have a consistent foundation, but the full range of the relationship must build on the unique aspects of the counselor, the client, and their personalized relationship. While Rogers did not write about this in any exact fashion, he has been identified as generally supportive of this model, including being quoted as saying, "If a therapist has the attitudes we have come to request as essential, probably he or she can use a variety of techniques" (Wilkins, 2003, p. 92).
It is important to note the kind of techniques that will not be used as true parts of person- centered counseling. One key example is the specific diagnosis and detailed treatment planning that have become a major focus of the mental health field today. Increasingly, insurance companies and government agencies require clear-cut statements of the client's so-called illness, its severity, and the estimated length of time it will take to be corrected. Because person-centered counselors do not view clients in an ill versus well context, they can have a great deal of trouble working with these issues. Person-centered theory is much better suited to helping people progress than it is for getting them over some designated level of a diagnosable condition. Person-centered practitioners who find themselves in situations in which they need to design extensive diagnosis and treatment models must give close attention to how and what degree they can integrate these relatively divergent processes.
One way that person-centered counselors have approached the assessment model is to deal with it as a joint task of the client and counselor to determine their ability to work successfully together (Wilkins, 2003). Rather than viewing assessment as something the counselor does to the client, it is viewed as counselor and client exploration of how they will work together and toward what goals. Counselors using this model see it as part of the counselors' congruence by being clear on how their roles and responsibilities will influence the relationship and potential success of counseling. This process is seen by those using it as similar to reaching agreement on many other ethical and practical conditions for their working relationship. The key to this approach is the joint interaction of counselor and client wherein clients continue directing the counseling with recognition of how joint responsibilities with the counselor influence their work together.
Many new counselors identify with a person-centered approach because it fits what they want to do and what has helped them grow in other positive relationships. However, when they attempt to use this approach, they often get caught up in many non-person- centered techniques, mostly for their own comfort. For example, there is little need for extensive questioning in the person-centered approach, because the task is to follow and interact with the client rather than to continually direct them toward issues to be explored. New practitioners are likely to begin seeking extensive information in clients' pasts rather than talking about current perceptions and interactions. The questions also tend to lead counselors into overanalyzing client comments and reactions to develop elaborate rationales for why clients do what they do. These reactions may come in part from the fact that student trainees have completed many years of education in which such tactics are highly effective methods for succeeding in academia. Now they are faced with doubts about their ability to use the new skills with real clients who can be hurt. This lack of confidence and experience often causes them to fall back on the questioning and directing tactics of the traditional academic community rather than the responding and following tactics of the person-centered approach. Just as clients need time and proper conditions to gain trust in their organism, it also takes time for new person-centered counselors to trust in their developing organisms.