Person-Centered Approaches for Counselors

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Jeffrey H. D. Cornelius-White

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    Series Preface

    “Theories for Counselors” provides practical applications of major theories from a common factors, multicultural perspective. What does that mean? Let’s break it down.

    The authors in the “Theories for Counselors” series are highly experienced counselors with extensive knowledge and expertise concerning the theory that they present. They present each theory from an applied perspective, asking themselves, “How is this concept useful in actual clinical practice?” It may surprise you to know this, but Freud’s work can be (and is) applied day in and day out in modern counseling. (If this surprises you, it could indicate that you have not been taught Freud well.) He believed that the relationship between the client and clinician was of utmost importance; he believed that his patients needed to feel comfortable speaking their mind; he believed that clinicians needed to listen with attentiveness and tact. Freud’s legacy, as is shown in the first book of this series, Psychoanalytic Approaches for Counselors, has been revised and revisited, but its therapeutic usefulness remains, and for each theory that is presented, therapeutic utility is utmost on the minds of the authors as they present material to their readers.

    Each book begins by addressing the two most vital themes common to any counseling theory: the client and the therapeutic relationship. Why have we picked the client and the therapeutic relationship as the two most important themes? The reason is called the common factors hypothesis, and this is where research comes in. The common factor hypothesis is the result of decades of research that has compared various schools of counseling and psychotherapy. Contrary to prior belief, it has been convincingly demonstrated that research in general finds no significant difference in how effective the various therapies are. These findings, predicted by Rosenzweig (1936) nearly 80 years ago, began to be empirically demonstrated in the mid-1970s (Luborsky, Singer, & Luborsky, 1975; Smith & Glass, 1977). Research confirming the relative equivalence of bona fide therapies has accumulated since that time (e.g., Ahn & Wampold, 2001; Lambert, 1992; Lambert & Barley, 2001; Lambert & Ogles, 2004; Wampold et al., 1997).

    What does this mean? It means that instead of therapeutic improvement being due to specific ingredients prescribed by different theoretical schools of counseling and psychotherapy, positive therapeutic change can be attributed to factors that are common to all bona fide therapies. Additionally, these factors can be broken down into four categories: client variables (40% of change), relationship variables (30%), hope and expectancy (15%), and theory or technique (15%) (Duncan, 2002; Lambert, 1992) (see Figure 1).

    Figure 1 Common Factors

    Source: Lambert, M. J. (1992). Psychotherapy outcome research: Implications for integrative and eclectic therapists. In J. C. Norcross & M. R. Goldfried (Eds.), Handbook of psychotherapy and behavior change (4th ed., pp. 143–189). New York, NY: John Wiley.

    As we see, the client and the relationship accounts for the vast majority of therapeutic change, and as such, should be centrally located in the presentation of any counseling theory.

    Interestingly, the history of counseling begins right where research predicts: in an intense relationship between one person who wants help and another person wanting to help. Sigmund Freud, who inaugurated themes that continue to organize the counseling profession, described and redescribed the origins of psychoanalysis. Two major components in his descriptions were the famous first patient of psychoanalysis, Bertha Pappenheim (referred to in case studies as “Anna O.”), and the relationship she had with her doctor, Josef Breuer, Freud’s friend and colleague at the time. Though Freud revised his opinions on many things about that famous case (as he did about almost everything), what remained constant was the fact that he saw something of primary importance in that case—the “talking cure” that occurs between a patient/client and doctor/counselor.

    Thus the origins of counseling display a deep consonance with the latest in empirical research, and it is this consonance that is the underlying theme behind the series “Theories for Counselors.” Starting with Freud and moving through past and contemporary counseling theories and theorists, the focus remains on the client and the therapeutic relationship, and how this relationship fosters and enhances the client’s natural resilience and hope for change. The theory’s techniques and the theory itself are important only inasmuch as they provide a common roadmap—a way for both client and counselor to think about where a client has been and where he or she wants to go.

    Just as it is important to know that Freud remains useful for contemporary counselors, so it is important to know that Freud began his work against a backdrop of rising racial hatred in Austria and Western Europe, and that while he successfully fled to England in 1938, his sisters perished in the Nazi concentration camps during the Holocaust (Gay, 2006). Thus the counseling enterprise began at a time of extreme racial hatred, which is a sobering and important fact to reflect on; from the inception of counseling in Western Europe and throughout its development worldwide, multicultural awareness and respect for diversity are no mere add-ons but are integral components for the practice of counseling. In addition, another important group membership—gender—has assumed greater and greater importance in the counseling field; its central importance imbued the case of Bertha Pappenheim, which has been deemed the founding one for psychoanalysis and hence for all that followed.

    Counselors must practice from a culturally aware place rather than one that would seek to downplay the impact of race, gender, and other important group affiliations on our clients’ lives. Sue, Arredondo, and McDavis (1992) provided a conceptual framework for organizing the types of competencies needed by a culturally skilled counselor, saying that he or she becomes aware of his or her own assumptions, actively attempts to understand differing worldviews, and actively develops culturally sensitive intervention strategies and skills. Sue (2001) expanded his conceptual framework into a multidimensional model of cultural competence; this model was primarily focused on racial and ethnic minority groups, though he did also recognize that it might be applicable for other groups including those of “gender, sexual orientation, and ability/disability” (p. 816). Such topics are now recognized as rightfully fitting within the context of multicultural counseling (Conyers, 2002; Pope, 2002; Richardson & Jacob, 2002). In addition, Smith and Richards (2002) point out the obligation that counselors have to address issues of religion and spirituality as multicultural issues.

    D’Andrea and Daniels (2001) provided a multicultural framework for working with clients that is RESPECTFUL and inclusive of Religion and spirituality, Economic class, Sexual identity, Psychological development, Ethnic/racial identity, Chronology, Trauma, Family, Unique physical abilities and disabilities, and Language and location of residence. Similarly, Hays (2008) outlined a model that emphasized nine cultural influences in relation to specific minority groups that counselors should be ADDRESSING: Age, Developmental and other Disabilities, Religion, Ethnicity/race, Social status, Sexual orientation, Indigenous heritage, and Gender. These models help counselors deliver diversity competent services and pay attention to all the potential resources that a client brings to the counseling encounter. Ultimately, respect for diversity and celebration of all aspects of culture and group membership should lead to a more nuanced understanding of the client and the sometimes-hidden strengths that he or she possesses. Better knowing a client enhances the richly relational counseling encounter that began with Freud’s work.

    Once again, this is consonant with the common factors approach. The common factors approach can be applied to, and makes sense of, any counseling theory, beginning with Freud and psychoanalysis. According to this approach, all bona fide counseling theories do the same thing, though they describe it using differing terminology. One analogy is traveling to a particular destination, say New York City. There is no one right way to get there—it depends on where you are starting from, whether you want to fly, drive, or take the train, and whether you want to get there by a direct route or take a scenic one. Each unique route is analogous to a different counseling theory. The destination is the same—in a travel scenario, getting to New York City, and in a counseling scenario, achieving positive treatment outcome.

    In their book, The Heroic Client, Duncan and Miller (2000) put it this way—they seek to “(1) enhance those factors across theories that account for successful outcome; (2) encourage the client’s unique integration of different theories; and (3) selectively apply diverse ideas and techniques as they are seen as relevant by the client” (p. 146). Miller has talked about the need for clinicians to know different theories because they serve as language resources to connect with the client. In this view, theory is a way to connect with clients; if one language that I’m using—for instance, solution focus therapy—doesn’t appear to be the language that the client is speaking, then I should use other theoretical languages that might allow me to communicate better with my client. The test of theory is in how well it accords with each individual client’s culturally influenced worldview and how useful it proves to be in the context of the therapeutic encounter.

    “Theories for Counselors” will help you consider theories from the perspective of the client and what makes sense to her or him. It will show that theory and technique are good inasmuch as they aid clients in understanding their present situation and what they need to do to improve it. Finally, the series will help you situate the work of counseling within a sociocultural framework that takes into account client uniqueness, universality, and important group affiliations to enhance and activate client resources.

    Finally, I direct the reader to the companion website for this book and series, http://study.sagepub.com/theoriesforcounselors. There you will find extended discussions of topics that are mentioned briefly in the text, topics that are not addressed in the text but that might be useful to know when studying for comprehensive or licensing exams, definitions of terms, and supplemental exercises and activities. In general, if a topic is not covered or is covered in detail in the printed text, please search the website, as it will in all likelihood be discussed there.

    Acknowledgments

    I acknowledge the help of Michelle Ciesielski and Chris Carver who helped hold my voice, both in this book and in general during a difficult time. I also acknowledge the many clients, students, colleagues, mentors, family, and friends who together honed my ability to learn, research, integrate, and practice the person-centered approach. I am forever in your debt.

    This work is dedicated to four generations of women who have inspired

    me to be who I am by being who they are: Nana, Mom, and the two

    AJs. I am grateful for the time I have had with them and the

    permanent etch these relationships have had on my heart.

    Avery Jane, you are awesome. I have never experienced

    such a frequent sense of amazement in the

    world as I have with you.

    It is also dedicated to four

    generations of men who have inspired

    me to endure with surprising grace despite untold

    suffering: Grandpa Chuck and Slim, Dad, Herbie and

    Chebby, and Evan. Evan Riley, you will never know

    how much I love you. Your humor and resilience shine brilliantly.

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    About the Author

    Jeffrey H. D. Cornelius-White, PsyD, LPC, is Professor and Counseling Programs Coordinator in the Department of Counseling, Leadership and Special Education at Missouri State University in Springfield, and Adjunct Assistant Professor and doctoral faculty for the Cooperative EdD Program in Educational Leadership and Policy Analysis at the University of Missouri– Columbia. He served as Chair of the Board of the World Association for Person-Centered and Experiential Psychotherapy and Counseling, Coeditor of The Person-Centered Journal, Content Editor of the Journal of Border Educational Research, and has edited and authored several other books, including Learner-Centered Instruction with SAGE (2010). His 100 publications have been mostly concerned with person-centered and social justice issues in education, psychology, and counseling. Jef is the father of two children, Avery and Evan. He enjoys biking, swimming, reading, and playing with his kids.


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