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3 Core Conditions for Therapeutic Change

3 Core Conditions for Therapeutic Change

The person-centered counseling approach was established in the 1940’s by humanistic psychologist, Carl Rogers. The goal of a person-centered therapy is to create the necessary conditions for clients to engage in meaningful self-exploration of their feelings, beliefs, behavior, and worldview, and to assist clients in their growth process, enabling them to cope with current and future problems.

A major concept of this approach is that people are generally trustworthy, resourceful, capable of self-understanding and self-direction, able to make constructive changes, and able to live effective and productive lives. Another key concept is that the attitudes and characteristics of the therapist, and the quality of the client-therapist relationship are prime determinants of the outcome of the therapeutic process.

Rogers maintains that therapists must have three attributes to create a growth-promoting climate in which individuals can move forward and become capable of becoming their true self: (1) congruence (genuineness or realness), (2) unconditional positive regard (acceptance and caring), and (3) accurate empathic understanding (an ability to deeply grasp the subjective world of another person).

1. CONGRUENCE (GENUINENESS)
Congruence refers to the therapist being real, authentic, and genuine with their clients. It’s called congruence because their inner experience and outward expression match. In being authentic, the therapist shows they are trustworthy, which helps in building a good therapeutic relationship with the client. It also serves as a model for clients, encouraging them to be their true selves, expressing their thoughts and feelings, without any sort of false front.

2. UNCONDITIONAL POSITIVE REGARD and ACCEPTANCE
Unconditional positive regard means the therapist genuinely cares for their clients and does not evaluate or judge their thoughts, feelings, or behaviors as good or bad. Each client is accepted and valued for who they are, as they are, without stipulation. Clients need not fear judgment or rejection from the therapist.

3. ACCURATE EMPATHIC UNDERSTANDING
Accurate empathic understanding means that the therapist understands their client’s experience and feelings in an accurate and compassionate way. The therapist recognizes that each client’s experience is subjective and therefore strives to see things from the client’s unique perspective. An important part of accurate empathic understanding is for the therapist to convey that they “get it” by reflecting the client’s experience back to them. This encourages clients to become more reflective with themselves, which allows for greater understanding of themselves.

If you’ve ever had an experience where you felt like someone just really got you…they completely understood where you were coming from, or could truly relate to the way you felt – that’s accurate empathic understanding.

Rogers asserts that empathy helps clients (1) pay attention and value their experiencing; (2) see earlier experiences in new ways; (3) modify their perceptions of themselves, others, and the world; and (4) increase their confidence in making choices and pursuing a course of action. Jeanne Watson (2002) states that 60 years of research has consistently demonstrated that empathy is the most powerful determinant of client progress in therapy. She puts it this way:

“Therapists need to be able to be responsively attuned to their clients and to understand them emotionally as well as cognitively. When empathy is operating on all three levels – interpersonal, cognitive, and affective – it is one of the most powerful tools therapists have at their disposal.”

 

References:
1. Watson, J. C. (2002). Re-visioning empathy. In D. J. Cain (Ed.), Humanistic psychotherapies: Handbook of research and practice (pp. 445-471). American Psychological Association, Washington, DC.
2. Corey, Gerald. Theory and Practice of Counseling and Psychotherapy. Belmont. Thomas Learning, Inc. 2005.

6 Principles for Meaningful Living

6 Principles for Meaningful Living

The Happiness Trap: How to Stop Struggling and Start Living [A guide to ACT: the mindfulness-based program for reducing stress, overcoming fear, and creating a rich and meaningful life] by Russ Harris

Acceptance and Commitment Therapy is based upon six core principles that work together to help a person develop a mind-set known as “psychological flexibility.” Psychological flexibility is the ability to adapt to a situation with awareness, openness, and focus, and to take effective action, guided by your values. For short, psychological flexibility can be thought of as Mindfulness + Values + Action.

  1. DEFUSION is creating distance and separating from unhelpful thoughts. It entails recognizing that most of our thoughts are neither true nor false; rather, most of our thoughts are actually opinions, judgments, beliefs, and morals and related plans, goals, wishes, and values. The idea is not to determine whether a thought is true or false, but whether it is helpful. One way to create distance from an unhelpful thought is to simply insert the following phrase in front of the thought: “I’m having the thought that…” or “I notice I’m having the thought that…” DEFUSION recognizes that thoughts may or may not be true; therefore, we mustn’t automatically believe them. It also recognizes that thoughts may or may not be important; therefore, we only pay attention if they’re helpful.

Thought Defusion PICTURE for blog post

  1. ACCEPTANCE (EXPANSION) literally means “taking what is offered.” It is fully opening yourself to your present reality – acknowledging what is, right here and now, and letting go of the struggle with life as it is in this moment. This philosophy is encapsulated in Russ Harris’s “Serenity Challenge” (his version of the Serenity Prayer): Develop the courage to solve those problems that can be solved, the serenity to accept those problems that can’t be solved, and the wisdom to know the difference.

In practicing EXPANSION, the aim is to observe your emotions, not think about them. The four steps of EXPANSION are (1) Observe, (2) Breathe, (3) Create Space, and (4) Allow.

  • Observe the sensations in your body (i.e. a lump in your throat or a knot in your stomach) and focus your attention on that sensation with curiosity.
  • Breathe into and around the sensation with a few deep, slow breaths co provide a center of calm within you, like an anchor in the midst of a storm to hold you steady.
  • Create Space with your breath flowing in and around the feeling, giving it plenty of room to move around.
  • Allow the sensation to be there (even if you don’t like it or want it); simply let it be. Acknowledge any urges to fight with the feeling or push it away, and bring your attention back to the sensation.

Expansion PICTURE for blog post

  1. CONTACT WITH THE PRESENT MOMENT (CONNECTION) means being fully aware of you’re here-and-now experience, fully in touch with what is happening at this moment. The goal is to pull yourself out of the past or the future and bring yourself back to the present – right here, right now.

Why practice Connection?

  • so you can appreciate the richness and fullness of life
  • because the only moment we have is NOW
  • so that you can take effective, mindful, value-driven action (which requires being aware of what’s happening, how you’re reacting, and how you wish to respond).

CONNECTION happens through the OBSERVING SELF; it involves bringing full attention to what is happening here and now without getting distracted or influenced by the thinking self.

  1. THE OBSERVING SELF (as opposed to the THINKING SELF) is a viewpoint from which you can observe thoughts and feelings. It’s essentially pure awareness; without the observing self, you would have no capacity for self-awareness. Your thoughts, feelings, and sensations change continuously; sometimes they’re pleasant, sometimes painful, helpful, happy, calm, angry, etc. The observing self can’t be judged as good or bad, right or wrong, because all it does is observe, nor does it judge or criticize you (because judgments are thoughts, which come from the THINKING SELF); it simply sees things as they are. You can think of the observing self as being like the sky, while thoughts and feelings are like the weather – constantly changing.
  1. VALUES are (1) Our heart’s deepest desires: how we want to be, what we want to stand for, and how we want to relate to the world around us, and (2) Leading principles that can guide us and motivate us as we move through life.

To identify what your values are, here are some questions to ask yourself:

  • Deep down inside, what is important to you?
  • What do you want your life to be about?
  • What sort of person do you want to be?
  • What sort of relationships do you want to build?
  • If you weren’t struggling with your feelings, or avoiding your fears, what would you channel your time and energy into doing?

Values are not the same thing as goals; a value is a direction we desire to keep moving in, and ongoing process that never reaches an end, while a goal is a desired outcome that can be achieved or completed. For example, getting married is a goal, whereas being a loving and caring partner is a value. One can think about their values in relation to different domains of life, such as Family, Marriage/Intimate Relationships, Friendships, Employment, Education/Personal Development, Recreation/Fun/Leisure, Spirituality, Community Life, Environment/Nature, and Health.

Values PICTURE for blog post

  1. COMMITTED ACTION entails setting meaningful goals for your identified values. Use the following steps to create a Committed Action Plan for yourself:
    • Summarize Your Values for each domain. For example, “In the domain of Family, I value being honest, respectful, authentic, and supportive.”
    • Set an Immediate Goal – something that can be accomplished right away. For example: “During my lunch break, I’ll call my husband and encourage him because I know he’s having a stressful day.”
    • Set Short-Term Goals: ask yourself what small things you can do over the next few days and weeks that are consistent with your identified values.
    • Set Medium-Range Goals: think of larger challenges you can set for the next few weeks and months that are consistent with valued living.
    • Set Long-Term Goals: decide upon major challenges you can set for the next few years that will continue to take you in your valued direction. A good question to ask yourself is, “Where do I want to be five years from now?”