Humanistic Approaches Continued – Person-Centered Theory

Introduction
Person-Centered Therapy
The person-centered approach to counseling was developed by Carl Rogers in 1942. This theory focused on the strength and knowledge of clients. Rogers believed that clients would make changes in their lives if a strong relationship was developed with a counselor. Rogers believed that when therapists are nondirective and show great empathy for clients, clients will be empowered to change.
Person-centered counselors believe in the trustworthiness of individuals and in their innate ability to move toward self-actualization. The counselor must provide three basic conditions to support a client’s natural instinct for positive growth:
• Genuine relationship.
• Acceptance and care.
• Accurate understanding of the client’s worldview.
The role of the counselor in person-centered counseling is to promote the conditions for change. Counselors maintain a genuine human relationship in which they provide unconditional positive regard to their clients. This process helps clients understand the impact of their choices and actions.
Reference
Corey, G. (2013). Theory and practice of counseling and psychotherapy (9th ed.). Pacific Grove, CA: Cengage-Brooks/Cole.
Objectives
To successfully complete this learning unit, you will be expected to:
1. Utilize key concepts of person-centered therapy.
2. Evaluate key concepts of person-centered theory.
3. Evaluate the appropriateness of psychotherapeutic approaches for diverse populations.
4. Evaluate evidence-based practice rooted in a main theory of counseling.
5. Evaluate concepts, principles, and assumptions of a major theory of counseling.
6. Critically evaluate the limitations of using the chosen theory or theories.
7. Identify a theory that most resonates with you, establishing your personal theoretical foundation.
8. Incorporate evidence-based theories in a personal philosophy of counseling.
9. Communicate in a manner that is consistent with the expectations of a professional counselor.
Learning Activities Study 1
Studies Readings
Use your Theory and Practice of Counseling and Psychotherapy text and the library to read the following:
• Chapter 7, “Person-Centered Therapy,” pages 172–209.
• Knight’s 2007 article “Showing Clients the Doors: Active Problem-Solving in Person-Centered Psychotherapy” in the Journal of Psychotherapy Integration, volume 17, issue 1, pages 111–124.
• Farber’s 2007 article “On the Enduring and Substantial Influence of Carl Rogers’ Not-Quite Necessary nor Sufficient Conditions” in Psychotherapy: Theory, Research, Practice, Training, volume 44, issue 3, pages 289–294.
Video
Use The Case of Stan DVD that accompanied your Corey text to complete the following:
• Watch the video’s Person-Centered Therapy segment. Watch the introduction to the therapy, simulated counseling session, and the commentary on the approach.
Optional Reading
The following reading is recommended but not required for this unit:
• Mason, M. J. (2009). Rogers redux: Relevance and outcomes of motivational interviewing across behavioral problems. Journal of Counseling and Development, 87(3), 357–362.Discussion 1: 1 page needed with 2 references.
Key Concepts of Person-Centered Therapy
After reviewing the therapists demonstrating person-centered responses in the assigned videos, use the person-centered approach to create a counselor’s response to each of the following statements made by a client. Concentrate on responses that demonstrate empathy, rather than asking questions or offering solutions. Discuss how the counselor’s statement you created uses the theory’s key concepts and how your response aligns with the theory’s overall goal.
• Client comment 1: “I have no idea what to do, and I hope you can tell me.”
• Client comment 2: “My mother thinks I’m making the wrong decision and that makes me so angry. She is always trying to control me.”
• Client comment 3: “I only came along because my wife made me. I just didn’t want to listen to her continuing to nag. Counseling is stupid, and I don’t believe it will help me at all!”
• Client comment 4: “I’m going to school, I have a job, and I’m taking care of two kids and trying to make time for my husband. Most days, I don’t even know where to begin.”
• Client comment 5: “My five-year-old daughter died of cancer after a year-long struggle. I cry all of the time, and I don’t know what to do. My daughter was everything to me, and I’ve lost her.”
Multimedia
Before updating the Theories of Counseling Chart, view the Theories in Action multimedia presentation on Person-Centered Counseling to inform your work.
Theories in Action
Person Centered Counseling
Mr. Tim Seibel’s:
The heart of person-centered counseling rests on three critical personality characteristics that Carl Rogers, the founder of this therapy and philosophy of living, believed were critical: congruence, unconditional positive regard and empathy.
People who are congruent are real, genuine, or transparent with others. Their feelings, thoughts and behaviors are in sync. However, it is important to note the therapists who are congruent do not necessarily express moment-to-moment feelings with clients as sometimes, such feelings can rapidly change and often deepen over time. However, it is important for the therapist to express feelings toward his or her client, even negative ones, if such feelings are persistent. Otherwise, the relationship would be marred by falseness or incongruity.
Unconditional positive regard is the ability to provide the client with a sense of acceptance regardless of what feelings or experiences are expressed by the client. Such acceptance allows the client to feel safe within the relationship and to delve deeper into him or herself. Person-centered counselors believe that individuals are born with the need to be loved and when significant others such as parents do not provide unconditional positive regard, children end up living as they believe others would want them to be, as opposed to being who they really are.
The last quality, empathic understanding has been one of the most widely used tools of the counseling relationship regardless of theoretical orientation, and has been shown to be a critical factor in positive therapeutic outcomes. Empathy can be demonstrated in many ways including accurately reflecting the client’s meaning and affect using a metaphor, analogy or visual image, or simply nodding one’s head or gently touching the client during the client’s deepest moments of pain. A therapist, who shows empathy is with the client, hears the client, understands the client fully and is able to communicate such understanding to the client. Let’s join Dr. Ed Neukrug as he tries to embody the characteristics of congruence, unconditional positive regard, and empathy with Jose who is discussing some concerns he has about his mother and younger brother.
Dr. Ed Neukrug:
Hi Jose, thanks for coming in today. I know you have some things you want to talk about, so where would you like to start?
Jose:
Well actually, I am very concerned about my brother back home in Puerto Rico. I think that the environment in which I grew up in is getting the best of him. So one of my plans is to actually finish my – go back to school, get a PhD, and hopefully move to Florida, be able to bring him with me, also my mom. So I am kind of concerned about him getting in any trouble more than he already is.
Dr. Ed Neukrug:
(Empathy: Reflecting Affect and Content) so you are concerned about your brother obviously and with your mom also.
Jose:
Correct.
Dr. Ed Neukrug:
And you are hoping to move to Florida as quickly as possible so you could help them out.
Jose:
Right. My mom have done a lot for all the family for so many years. I think it is time for her to relax and I think if my plans go – if I have them worked out, I will be able to provide that for her.
Dr. Ed Neukrug:
So you want to get back to your mom.
Jose:
Correct.
Dr. Ed Neukrug:
Because she has given to you so much over the years.
Jose:
Correct. I would not be here if it was not for her. And back in Puerto Rico, the things are really getting difficult all the time.
Dr. Ed Neukrug:
(Advanced Empathy: Adding “Urgency”) It feels like things are getting worse there. I guess I am hearing in some ways the urgency that you are feeling.
Jose:
Correct. That is one of my main concerns, is the urgency of getting them out and for me to be able to accomplish what I want to do in the time that I wanted to or need to.
Dr. Ed Neukrug:
So the urgency of both helping your brother and your mother and getting to Florida. It seems like if you got to Florida that would be easier to do with them there.
Jose:
Correct, yes. Basically, Florida here in the United States is the most similar environment to Puerto Rico. Not just that, I went recently to our 25th high school reunion and I find out that a lot of my schoolmates live in Florida. So actually, even I have never been in Florida. I know more friends and family that live there. They are actually people that I know here. I have been here for six years.
Dr. Ed Neukrug:
(Advanced Empathy: Adding “More Connected”) Right. So you feel more connected to people in Florida even though you have never lived there.
Jose:
Yes.
Dr. Ed Neukrug:
And it feels also more like an environment that feels more similar to where you grew up.
Jose:
Correct. This time it was kind of – that I went back to Puerto Ricowas kind of shocking because for the first time, I realized that I would not be back. It is not a real option at this time because of the whole financial situation back in Puerto Rico. So it was a hard reality to accept.
Dr. Ed Neukrug:
(Empathy: Reflecting Affect and Content) OK, so it kind of hit you when you are back last time that you are not going to move back there.
Jose:
Correct.
Dr. Ed Neukrug:
And I guess up to this point in time – up to that point in time, you are thinking that that might be something that you would do.
Jose:
Correct, that is home. So I realized that not going back home is not a real option. It really shocked me.
Dr. Ed Neukrug:
(Advanced Empathy – Adding: “Taking that feeling of home out…”) Yes. I would guess that taking that feeling of home out of your life must be hard.
Jose:
Correct, and the little that I have achieved at this point, the success that I have to this point, I do not think it is complete without having the opportunity to help my mom, get my mom out of there and my little brother.
Dr. Ed Neukrug:
(Empathy: Reflecting Affect and Content) so you are not going to feel complete unless you move to Florida and help your mom and your brother who has been having some real issues.
Jose:
Correct, especially things getting worse every time. And actually, today is – it is going to be the burial of a friend of mine – a very, very good friend of mine that we grew up together and once again, it is the environment around that is so bad. So bad that I get to set them up and do not even get to see out of that environment.
Dr. Ed Neukrug:
(Subtractive Empathy: No affect, Misstatement about Funeral) so you are going to a funeral of a friend of yours.
Jose:
I would not be able to but today, he is buried back in my hometown. My mom called me and she told me, “Listen, I want to tell you something,” and she told me. So that kind of reminds me of the real sense of urgency to actually do what I want to do and get them out of there as soon as I can.
Dr. Ed Neukrug:
(Advanced Empathy: “Urgency and Death of a Friend”) Somehow, the death of this friend of yours is making it more present for you or more urgent for you to do something to help your mom and your brother.
Jose:
Correct, this really worries me. And I talk to my mom every Sunday and I ask her how my brother is doing. He is still running around and if I do no help him, I do not think anybody will because he has been living with my mom for several years and he is just stuck. He is just living there. He is not making any progress. So, he just kind of – at the mercy of what is around him, basically.
Dr. Ed Neukrug:
(Empathy: Reflecting Affect and Content) and you are feeling like it is a life or death situation for him.
Jose:
It may come to that. It is likely with his lifestyle. He is one of the healthiest one. He is younger than I am and when he stands next to me, he looks older. And it really worries me.
Dr. Ed Neukrug:
(Advanced Empathy. Metaphor: Drained Life Out of Him) so his lifestyle has really kind of in a way drained the life out of him. And again, I hear your love for them and I hear your concern about them. And I hear the urgency again of you feeling like you need to do something.
Jose:
Correct, yes. I have to do something. I am the older. So we were out with a single-family home. But we are, we owe it our mom. I mean she is doing the best she can but she still worry a lot about him. So, he is worrying her out even at this stage.
Dr. Ed Neukrug:
(Advanced Empathy. Adding: “Sense of Responsibility”) and being the older, you feel some responsibility for both taking care of your younger brother and for helping out your mom.
Jose:
Correct, yes. And he is a very hard worker, he is really a hard worker. I know that if I am able to get him out of there, mingle with me here, he will adapt and he will have that choice of just walking next to the bar or something like that. That is what he thinks. There is a bar or a liquor store every 10 feet there, so yes.
Dr. Ed Neukrug:
(Advanced Empathy: Highlighting Choices) I think one of the things I am hearing also is kind of the tug, maybe the internal tug that you are feeling between things that you need to finish up here and also your need to take care of them, and move to Florida. That must be a real struggle for you.
Jose:
It is. I feel that in order for me to be able to be more effective in helping them, I think I must start something that I really want to do. Go for the PhD, but I think that if I were to accomplish that, I would be more in the position to help them out. But that would take me a few years, so that is my concern, how to try to balance that.
Dr. Ed Neukrug:
You can do both of those things?
Jose:
Correct.
Dr. Ed Neukrug:
So if you get the PhD, you are in a better position to help them. But on the other hand, if you get the PhD, you are waiting and you do not want to wait too long.
Jose:
Right.
Dr. Ed Neukrug:
(Empathy: Reflecting Affect and Content) Well it sounds like – I guess what I am hearing is again, you are concerned about your family, your desire and your wanting to help your family, and you want to do it in the best way possible. And that you have a lot of important choices to make for yourself. And that they are pretty difficult choices because people’s lives are at stake.
Jose:
Correct. Yes. Basically, it is weighing for those decisions is really – I am hoping that I am making the right ones. Yes. Every day I guess the assessment of my decision is saying, “Am I doing the right thing?”
Dr. Ed Neukrug:
(Self-Disclosure/Genuineness) I guess I am sitting here thinking boy, I wish I could make those decisions for you and tell what would be the right one and to make but at the same time I am thinking only you have that in a sense of what is going to be right for you and your family.
Jose:
I agree. I think I am the one that should arrive to that decision. I think I am in the position in which I can – not just balance that decision but also I know the details of the situation and I grew up there, so I know how it is there.
Dr. Ed Neukrug:
(Self-Disclosure/Genuineness) At the same time, I hope that maybe I can be helpful to you in helping you look at some of the feelings you have inside that will help you to direct you to do the right decision for you. So maybe that is something that we can do here and talk about.
Jose:
Certainly. I guess talking about how do I feel about it in having feedback or a sense of direction; whether I am going the right way would be very helpful.
Dr. Ed Neukrug:
I want to thank you so much for sharing.
Dr. Garrett McAuliffe:
Well Ed, there was a gentleness about this session that may characterize person-centered counseling. Maybe that is a springboard for us to understand. What were you trying to do with Jose and what do you think happened as a result of the session?
Dr. Ed Neukrug:
Right. Those are some good questions. I think most of what I am trying to do is hear Jose clearly. So I need to be kind of a vessel to take in what he is saying to me about his thoughts and his feelings. So I want to hear him clearly, maybe you can hear him at deeper levels of his own experience and reflect it back to him. Sometimes people are not in touch with some of their own feelings. It is kind of slightly out of their awareness and if I can hear some of their feelings and give it back to them, then I am providing them some deeper levels of awareness about self. That is why I am striving all the time to just be hearing them clearly and letting him know that I am understanding him.
Dr. Garrett McAuliffe:
And what can that do for a client – going to deeper levels of understanding – how does that help them solve their problems?
Dr. Ed Neukrug:
I think in terms of the person-centered approach, which again is humanistically based, we are talking about a person getting in touch with their inner selves in a clear way and that a lot of times I think we have ways of not being in touch with ourselves. And so, if I can hear them and tell them my sense of what they are going through, I can help them hear themselves better and help them make clearer choices for themselves in their lives. In case of Jose, he is struggling with some very difficult issues around his family – his mother and his brother in particular. And what types of choices he was going to make in trying to balance that with some of his own life issues.
Dr. Garrett McAuliffe:
What I hear is helping people be congruent in their choices so that the inner matches the outer, and so that maybe Jose will be doing and be more clear and confident that what he is doing is what he wants to do. Merely by hearing himself speak and you – and you mentioned as a vessel for his speaking about himself.
Dr. Ed Neukrug:
Right. Exactly.
Dr. Garrett McAuliffe:
So you attempt to be congruent as a person in this approach to help the client become congruent with – again the parts of themselves that are maybe mixed up or in conflict – then what you do is model some congruence when you are working with that person and attempt to help them as you say go deeper somewhere from their more superficial defenses I guess we would call them.
Dr. Ed Neukrug:
And I think there are a couple of times at least in this short session which I heard some deeper feelings that I tried to reflect back to him. I also – when you talk about congruency – I think about the importance of the therapist being together within him or herself which speaks to how important it is for all therapists who have been through their own therapy or therapeutic type of experiences, so they do hear the client clearly.
Dr. Garrett McAuliffe:
And you know, that brings up the issue of the counselor as authority. In some ways, being authority does not mean a person is in congruentbut it also tells me that you are not playing a role, some kind of official kind of capacity, that there is something about you as another human being in the room with the other person. That seems important to this approach.
Dr. Ed Neukrug:
Right. I certainly do not see it as my role to tell the client what to do. I view people as being self-determining and being able to make their own choices if they are in touch with themselves. And so, that is what I see as my purpose is being, to help be in touch with themselves so they can make good choices for themselves. I really liked what he said about clarity and choice and he felt like if we would become more clear within ourselves, then the choices become clearer.
Dr. Garrett McAuliffe:
OK. Does that mean – I guess it seems like that means you go with the flow as a counselor in the session? Rather than going against the flow which some counseling approaches more or less interrupt the person’s thinking. There is something about this approach that seems like it is going with the grain, going with the flow. On the other hand, are you adding anything to the person’s experience?
Dr. Ed Neukrug:
Excellent question. I have two thoughts on that. One is that I am going with the flow and I think throughout that session, you saw Jose saying “correct” to me. I was in line with him. I was hearing him correctly. He was telling me that. I am hearing that from him, and so I can keep going with it.
The other piece is do I add anything to it. Well, first the research on emphatic responding shows that if you just go with flow, that is going to be helpful for clients. But I do think you have opportunities for adding, and how do you add? You hear the client’s deeper feelings and you reflect it back to them, maybe feelings that they are not saying to themselves. I think I used the word “urgency” with Jose, and he was using that word with me when I reflected that back. And so you hear deeper levels of feelings and give it back to them. That is one way.
Other ways of adding to a session might be using metaphors or using analogies to help people view the situation in different ways. But you are using those metaphors and analogies based on what they have given you, not based on some type of preset model as a Freudian might do. And so there are multiple ways besides just kind of the traditional reflective listening or active listening ways of telling a client that you hear them in deep ways.
Dr. Garrett McAuliffe:
So what I am hearing is the classic notion and very difficult notion of empathy. In other words, it is no simple achievement to be empathic with another and you can be empathic in a more simple, interchangeable way. But you can also do it in a way in which you add a person’s understanding but you do not put in anything new to the client’s experience.
Dr. Ed Neukrug:
Exactly, right. In fact, Carl Rogers later in his life wrote an article about reflective listening. He said that in that article that he never actually used that reflective listening. Other people used that. What he said was show the client that you understand him or her and you can do that in multiple ways, as we just mentioned.
Dr. Garrett McAuliffe:
And one method that people give a name to is reflective responding and that is actually, it is an act of – it is a commitment you make which comes out as maybe a skill, we can call it – but it is in a frame of mind that you are in to be empathic.
Dr. Ed Neukrug:
Right, and that is one way. And again there are these other ways also.
Dr. Garrett McAuliffe:
I want to add one piece that seems important. At the end of the session, Jose said I would like to get some feedback and a sense of direction, and I thought to myself he might wind up with a sense of direction but I do not think it is going to come from you giving him feedback or giving him a sense of direction. Can you just say something about that?
Dr. Ed Neukrug:
Yes, he is asking me a very direct question and I do not want to avoid the question by just giving a reflective response. That would be kind of silly. I want to be real with him and I genuinely feel like I cannot give him a sense of direction but I also genuinely feel that I can help him find his own sense of direction. And that is basically what I said to him.
Dr. Garrett McAuliffe:
He will be giving himself a feedback in the process of you helping him discover his sense of direction.
Dr. Ed Neukrug:
Exactly.
Dr. Garrett McAuliffe:
Well, thank you. That really illuminates what we just saw in that session.
Dr. Ed Neukrug:
I appreciate you going over this with me.
Dr. Garrett McAuliffe:
You are welcome.
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Humanistic Approaches Continued – Person-Centered Theory

Humanistic Approaches Continued – Person-Centered Theory

ANSWER


Introduction
Person-Centered Therapy
The person-centered approach to counseling was developed by Carl Rogers in 1942. This theory focused on the strength and knowledge of clients. Rogers believed that clients would make changes in their lives if a strong relationship was developed with a counselor. Rogers believed that when therapists are nondirective and show great empathy for clients, clients will be empowered to change.
Person-centered counselors believe in the trustworthiness of individuals and in their innate ability to move toward self-actualization. The counselor must provide three basic conditions to support a client’s natural instinct for positive growth:
• Genuine relationship.
• Acceptance and care.
• Accurate understanding of the client’s worldview.
The role of the counselor in person-centered counseling is to promote the conditions for change. Counselors maintain a genuine human relationship in which they provide unconditional positive regard to their clients. This process helps clients understand the impact of their choices and actions.
Reference
Corey, G. (2013). Theory and practice of counseling and psychotherapy (9th ed.). Pacific Grove, CA: Cengage-Brooks/Cole.
Objectives
To successfully complete this learning unit, you will be expected to:
1. Utilize key concepts of person-centered therapy.
2. Evaluate key concepts of person-centered theory.
3. Evaluate the appropriateness of psychotherapeutic approaches for diverse populations.
4. Evaluate evidence-based practice rooted in a main theory of counseling.
5. Evaluate concepts, principles, and assumptions of a major theory of counseling.
6. Critically evaluate the limitations of using the chosen theory or theories.
7. Identify a theory that most resonates with you, establishing your personal theoretical foundation.
8. Incorporate evidence-based theories in a personal philosophy of counseling.
9. Communicate in a manner that is consistent with the expectations of a professional counselor.
Learning Activities Study 1
Studies Readings
Use your Theory and Practice of Counseling and Psychotherapy text and the library to read the following:
• Chapter 7, “Person-Centered Therapy,” pages 172–209.
• Knight’s 2007 article “Showing Clients the Doors: Active Problem-Solving in Person-Centered Psychotherapy” in the Journal of Psychotherapy Integration, volume 17, issue 1, pages 111–124.
• Farber’s 2007 article “On the Enduring and Substantial Influence of Carl Rogers’ Not-Quite Necessary nor Sufficient Conditions” in Psychotherapy: Theory, Research, Practice, Training, volume 44, issue 3, pages 289–294.
Video
Use The Case of Stan DVD that accompanied your Corey text to complete the following:
• Watch the video’s Person-Centered Therapy segment. Watch the introduction to the therapy, simulated counseling session, and the commentary on the approach.
Optional Reading
The following reading is recommended but not required for this unit:
• Mason, M. J. (2009). Rogers redux: Relevance and outcomes of motivational interviewing across behavioral problems. Journal of Counseling and Development, 87(3), 357–362.Discussion 1: 1 page needed with 2 references.
Key Concepts of Person-Centered Therapy
After reviewing the therapists demonstrating person-centered responses in the assigned videos, use the person-centered approach to create a counselor’s response to each of the following statements made by a client. Concentrate on responses that demonstrate empathy, rather than asking questions or offering solutions. Discuss how the counselor’s statement you created uses the theory’s key concepts and how your response aligns with the theory’s overall goal.
• Client comment 1: “I have no idea what to do, and I hope you can tell me.”
• Client comment 2: “My mother thinks I’m making the wrong decision and that makes me so angry. She is always trying to control me.”
• Client comment 3: “I only came along because my wife made me. I just didn’t want to listen to her continuing to nag. Counseling is stupid, and I don’t believe it will help me at all!”
• Client comment 4: “I’m going to school, I have a job, and I’m taking care of two kids and trying to make time for my husband. Most days, I don’t even know where to begin.”
• Client comment 5: “My five-year-old daughter died of cancer after a year-long struggle. I cry all of the time, and I don’t know what to do. My daughter was everything to me, and I’ve lost her.”
Multimedia
Before updating the Theories of Counseling Chart, view the Theories in Action multimedia presentation on Person-Centered Counseling to inform your work.
Theories in Action
Person Centered Counseling
Mr. Tim Seibel’s:
The heart of person-centered counseling rests on three critical personality characteristics that Carl Rogers, the founder of this therapy and philosophy of living, believed were critical: congruence, unconditional positive regard and empathy.
People who are congruent are real, genuine, or transparent with others. Their feelings, thoughts and behaviors are in sync. However, it is important to note the therapists who are congruent do not necessarily express moment-to-moment feelings with clients as sometimes, such feelings can rapidly change and often deepen over time. However, it is important for the therapist to express feelings toward his or her client, even negative ones, if such feelings are persistent. Otherwise, the relationship would be marred by falseness or incongruity.
Unconditional positive regard is the ability to provide the client with a sense of acceptance regardless of what feelings or experiences are expressed by the client. Such acceptance allows the client to feel safe within the relationship and to delve deeper into him or herself. Person-centered counselors believe that individuals are born with the need to be loved and when significant others such as parents do not provide unconditional positive regard, children end up living as they believe others would want them to be, as opposed to being who they really are.
The last quality, empathic understanding has been one of the most widely used tools of the counseling relationship regardless of theoretical orientation, and has been shown to be a critical factor in positive therapeutic outcomes. Empathy can be demonstrated in many ways including accurately reflecting the client’s meaning and affect using a metaphor, analogy or visual image, or simply nodding one’s head or gently touching the client during the client’s deepest moments of pain. A therapist, who shows empathy is with the client, hears the client, understands the client fully and is able to communicate such understanding to the client. Let’s join Dr. Ed Neukrug as he tries to embody the characteristics of congruence, unconditional positive regard, and empathy with Jose who is discussing some concerns he has about his mother and younger brother.
Dr. Ed Neukrug:
Hi Jose, thanks for coming in today. I know you have some things you want to talk about, so where would you like to start?
Jose:
Well actually, I am very concerned about my brother back home in Puerto Rico. I think that the environment in which I grew up in is getting the best of him. So one of my plans is to actually finish my – go back to school, get a PhD, and hopefully move to Florida, be able to bring him with me, also my mom. So I am kind of concerned about him getting in any trouble more than he already is.
Dr. Ed Neukrug:
(Empathy: Reflecting Affect and Content) so you are concerned about your brother obviously and with your mom also.
Jose:
Correct.
Dr. Ed Neukrug:
And you are hoping to move to Florida as quickly as possible so you could help them out.
Jose:
Right. My mom have done a lot for all the family for so many years. I think it is time for her to relax and I think if my plans go – if I have them worked out, I will be able to provide that for her.
Dr. Ed Neukrug:
So you want to get back to your mom.
Jose:
Correct.
Dr. Ed Neukrug:
Because she has given to you so much over the years.
Jose:
Correct. I would not be here if it was not for her. And back in Puerto Rico, the things are really getting difficult all the time.
Dr. Ed Neukrug:
(Advanced Empathy: Adding “Urgency”) It feels like things are getting worse there. I guess I am hearing in some ways the urgency that you are feeling.
Jose:
Correct. That is one of my main concerns, is the urgency of getting them out and for me to be able to accomplish what I want to do in the time that I wanted to or need to.
Dr. Ed Neukrug:
So the urgency of both helping your brother and your mother and getting to Florida. It seems like if you got to Florida that would be easier to do with them there.
Jose:
Correct, yes. Basically, Florida here in the United States is the most similar environment to Puerto Rico. Not just that, I went recently to our 25th high school reunion and I find out that a lot of my schoolmates live in Florida. So actually, even I have never been in Florida. I know more friends and family that live there. They are actually people that I know here. I have been here for six years.
Dr. Ed Neukrug:
(Advanced Empathy: Adding “More Connected”) Right. So you feel more connected to people in Florida even though you have never lived there.
Jose:
Yes.
Dr. Ed Neukrug:
And it feels also more like an environment that feels more similar to where you grew up.
Jose:
Correct. This time it was kind of – that I went back to Puerto Ricowas kind of shocking because for the first time, I realized that I would not be back. It is not a real option at this time because of the whole financial situation back in Puerto Rico. So it was a hard reality to accept.
Dr. Ed Neukrug:
(Empathy: Reflecting Affect and Content) OK, so it kind of hit you when you are back last time that you are not going to move back there.
Jose:
Correct.
Dr. Ed Neukrug:
And I guess up to this point in time – up to that point in time, you are thinking that that might be something that you would do.
Jose:
Correct, that is home. So I realized that not going back home is not a real option. It really shocked me.
Dr. Ed Neukrug:
(Advanced Empathy – Adding: “Taking that feeling of home out…”) Yes. I would guess that taking that feeling of home out of your life must be hard.
Jose:
Correct, and the little that I have achieved at this point, the success that I have to this point, I do not think it is complete without having the opportunity to help my mom, get my mom out of there and my little brother.
Dr. Ed Neukrug:
(Empathy: Reflecting Affect and Content) so you are not going to feel complete unless you move to Florida and help your mom and your brother who has been having some real issues.
Jose:
Correct, especially things getting worse every time. And actually, today is – it is going to be the burial of a friend of mine – a very, very good friend of mine that we grew up together and once again, it is the environment around that is so bad. So bad that I get to set them up and do not even get to see out of that environment.
Dr. Ed Neukrug:
(Subtractive Empathy: No affect, Misstatement about Funeral) so you are going to a funeral of a friend of yours.
Jose:
I would not be able to but today, he is buried back in my hometown. My mom called me and she told me, “Listen, I want to tell you something,” and she told me. So that kind of reminds me of the real sense of urgency to actually do what I want to do and get them out of there as soon as I can.
Dr. Ed Neukrug:
(Advanced Empathy: “Urgency and Death of a Friend”) Somehow, the death of this friend of yours is making it more present for you or more urgent for you to do something to help your mom and your brother.
Jose:
Correct, this really worries me. And I talk to my mom every Sunday and I ask her how my brother is doing. He is still running around and if I do no help him, I do not think anybody will because he has been living with my mom for several years and he is just stuck. He is just living there. He is not making any progress. So, he just kind of – at the mercy of what is around him, basically.
Dr. Ed Neukrug:
(Empathy: Reflecting Affect and Content) and you are feeling like it is a life or death situation for him.
Jose:
It may come to that. It is likely with his lifestyle. He is one of the healthiest one. He is younger than I am and when he stands next to me, he looks older. And it really worries me.
Dr. Ed Neukrug:
(Advanced Empathy. Metaphor: Drained Life Out of Him) so his lifestyle has really kind of in a way drained the life out of him. And again, I hear your love for them and I hear your concern about them. And I hear the urgency again of you feeling like you need to do something.
Jose:
Correct, yes. I have to do something. I am the older. So we were out with a single-family home. But we are, we owe it our mom. I mean she is doing the best she can but she still worry a lot about him. So, he is worrying her out even at this stage.
Dr. Ed Neukrug:
(Advanced Empathy. Adding: “Sense of Responsibility”) and being the older, you feel some responsibility for both taking care of your younger brother and for helping out your mom.
Jose:
Correct, yes. And he is a very hard worker, he is really a hard worker. I know that if I am able to get him out of there, mingle with me here, he will adapt and he will have that choice of just walking next to the bar or something like that. That is what he thinks. There is a bar or a liquor store every 10 feet there, so yes.
Dr. Ed Neukrug:
(Advanced Empathy: Highlighting Choices) I think one of the things I am hearing also is kind of the tug, maybe the internal tug that you are feeling between things that you need to finish up here and also your need to take care of them, and move to Florida. That must be a real struggle for you.
Jose:
It is. I feel that in order for me to be able to be more effective in helping them, I think I must start something that I really want to do. Go for the PhD, but I think that if I were to accomplish that, I would be more in the position to help them out. But that would take me a few years, so that is my concern, how to try to balance that.
Dr. Ed Neukrug:
You can do both of those things?
Jose:
Correct.
Dr. Ed Neukrug:
So if you get the PhD, you are in a better position to help them. But on the other hand, if you get the PhD, you are waiting and you do not want to wait too long.
Jose:
Right.
Dr. Ed Neukrug:
(Empathy: Reflecting Affect and Content) Well it sounds like – I guess what I am hearing is again, you are concerned about your family, your desire and your wanting to help your family, and you want to do it in the best way possible. And that you have a lot of important choices to make for yourself. And that they are pretty difficult choices because people’s lives are at stake.
Jose:
Correct. Yes. Basically, it is weighing for those decisions is really – I am hoping that I am making the right ones. Yes. Every day I guess the assessment of my decision is saying, “Am I doing the right thing?”
Dr. Ed Neukrug:
(Self-Disclosure/Genuineness) I guess I am sitting here thinking boy, I wish I could make those decisions for you and tell what would be the right one and to make but at the same time I am thinking only you have that in a sense of what is going to be right for you and your family.
Jose:
I agree. I think I am the one that should arrive to that decision. I think I am in the position in which I can – not just balance that decision but also I know the details of the situation and I grew up there, so I know how it is there.
Dr. Ed Neukrug:
(Self-Disclosure/Genuineness) At the same time, I hope that maybe I can be helpful to you in helping you look at some of the feelings you have inside that will help you to direct you to do the right decision for you. So maybe that is something that we can do here and talk about.
Jose:
Certainly. I guess talking about how do I feel about it in having feedback or a sense of direction; whether I am going the right way would be very helpful.
Dr. Ed Neukrug:
I want to thank you so much for sharing.
Dr. Garrett McAuliffe:
Well Ed, there was a gentleness about this session that may characterize person-centered counseling. Maybe that is a springboard for us to understand. What were you trying to do with Jose and what do you think happened as a result of the session?
Dr. Ed Neukrug:
Right. Those are some good questions. I think most of what I am trying to do is hear Jose clearly. So I need to be kind of a vessel to take in what he is saying to me about his thoughts and his feelings. So I want to hear him clearly, maybe you can hear him at deeper levels of his own experience and reflect it back to him. Sometimes people are not in touch with some of their own feelings. It is kind of slightly out of their awareness and if I can hear some of their feelings and give it back to them, then I am providing them some deeper levels of awareness about self. That is why I am striving all the time to just be hearing them clearly and letting him know that I am understanding him.
Dr. Garrett McAuliffe:
And what can that do for a client – going to deeper levels of understanding – how does that help them solve their problems?
Dr. Ed Neukrug:
I think in terms of the person-centered approach, which again is humanistically based, we are talking about a person getting in touch with their inner selves in a clear way and that a lot of times I think we have ways of not being in touch with ourselves. And so, if I can hear them and tell them my sense of what they are going through, I can help them hear themselves better and help them make clearer choices for themselves in their lives. In case of Jose, he is struggling with some very difficult issues around his family – his mother and his brother in particular. And what types of choices he was going to make in trying to balance that with some of his own life issues.
Dr. Garrett McAuliffe:
What I hear is helping people be congruent in their choices so that the inner matches the outer, and so that maybe Jose will be doing and be more clear and confident that what he is doing is what he wants to do. Merely by hearing himself speak and you – and you mentioned as a vessel for his speaking about himself.
Dr. Ed Neukrug:
Right. Exactly.
Dr. Garrett McAuliffe:
So you attempt to be congruent as a person in this approach to help the client become congruent with – again the parts of themselves that are maybe mixed up or in conflict – then what you do is model some congruence when you are working with that person and attempt to help them as you say go deeper somewhere from their more superficial defenses I guess we would call them.
Dr. Ed Neukrug:
And I think there are a couple of times at least in this short session which I heard some deeper feelings that I tried to reflect back to him. I also – when you talk about congruency – I think about the importance of the therapist being together within him or herself which speaks to how important it is for all therapists who have been through their own therapy or therapeutic type of experiences, so they do hear the client clearly.
Dr. Garrett McAuliffe:
And you know, that brings up the issue of the counselor as authority. In some ways, being authority does not mean a person is in congruentbut it also tells me that you are not playing a role, some kind of official kind of capacity, that there is something about you as another human being in the room with the other person. That seems important to this approach.
Dr. Ed Neukrug:
Right. I certainly do not see it as my role to tell the client what to do. I view people as being self-determining and being able to make their own choices if they are in touch with themselves. And so, that is what I see as my purpose is being, to help be in touch with themselves so they can make good choices for themselves. I really liked what he said about clarity and choice and he felt like if we would become more clear within ourselves, then the choices become clearer.
Dr. Garrett McAuliffe:
OK. Does that mean – I guess it seems like that means you go with the flow as a counselor in the session? Rather than going against the flow which some counseling approaches more or less interrupt the person’s thinking. There is something about this approach that seems like it is going with the grain, going with the flow. On the other hand, are you adding anything to the person’s experience?
Dr. Ed Neukrug:
Excellent question. I have two thoughts on that. One is that I am going with the flow and I think throughout that session, you saw Jose saying “correct” to me. I was in line with him. I was hearing him correctly. He was telling me that. I am hearing that from him, and so I can keep going with it.
The other piece is do I add anything to it. Well, first the research on emphatic responding shows that if you just go with flow, that is going to be helpful for clients. But I do think you have opportunities for adding, and how do you add? You hear the client’s deeper feelings and you reflect it back to them, maybe feelings that they are not saying to themselves. I think I used the word “urgency” with Jose, and he was using that word with me when I reflected that back. And so you hear deeper levels of feelings and give it back to them. That is one way.
Other ways of adding to a session might be using metaphors or using analogies to help people view the situation in different ways. But you are using those metaphors and analogies based on what they have given you, not based on some type of preset model as a Freudian might do. And so there are multiple ways besides just kind of the traditional reflective listening or active listening ways of telling a client that you hear them in deep ways.
Dr. Garrett McAuliffe:
So what I am hearing is the classic notion and very difficult notion of empathy. In other words, it is no simple achievement to be empathic with another and you can be empathic in a more simple, interchangeable way. But you can also do it in a way in which you add a person’s understanding but you do not put in anything new to the client’s experience.
Dr. Ed Neukrug:
Exactly, right. In fact, Carl Rogers later in his life wrote an article about reflective listening. He said that in that article that he never actually used that reflective listening. Other people used that. What he said was show the client that you understand him or her and you can do that in multiple ways, as we just mentioned.
Dr. Garrett McAuliffe:
And one method that people give a name to is reflective responding and that is actually, it is an act of – it is a commitment you make which comes out as maybe a skill, we can call it – but it is in a frame of mind that you are in to be empathic.
Dr. Ed Neukrug:
Right, and that is one way. And again there are these other ways also.
Dr. Garrett McAuliffe:
I want to add one piece that seems important. At the end of the session, Jose said I would like to get some feedback and a sense of direction, and I thought to myself he might wind up with a sense of direction but I do not think it is going to come from you giving him feedback or giving him a sense of direction. Can you just say something about that?
Dr. Ed Neukrug:
Yes, he is asking me a very direct question and I do not want to avoid the question by just giving a reflective response. That would be kind of silly. I want to be real with him and I genuinely feel like I cannot give him a sense of direction but I also genuinely feel that I can help him find his own sense of direction. And that is basically what I said to him.
Dr. Garrett McAuliffe:
He will be giving himself a feedback in the process of you helping him discover his sense of direction.
Dr. Ed Neukrug:
Exactly.
Dr. Garrett McAuliffe:
Well, thank you. That really illuminates what we just saw in that session.
Dr. Ed Neukrug:
I appreciate you going over this with me.
Dr. Garrett McAuliffe:
You are welcome.