Creating and developing an effective relationship

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Assignment for Counselling

Rogers Identifies three core conditions:

Describe and analyse each condition and explain it's contribution in creating and developing an effective relationship.

Have you ever wondered what counselling really is? Nearly everyone has done some kind of counselling. If you have listened intently to a needy person, then you have counselled. If you have sat with your neighbour to help out to comfort during bereavement, then you have counselled.  If you are a mother or father who has listened to the problems of their teenage offspring, you have counselled. But in the last 30 years, the professional approach to counselling has taken on many forms. One therapist, author Leona Tyler expressed the idea that the central purpose of counselling is to "facilitate wise choices and decisions, and to promote adjustment and mental health" (Tyler, L., 1962). According to this definition persons with problems may seek counselling in order to make better choices and become more effective in the business of living.  There is also befriending, helping, bringing warmth and comfort, rapport and encouragement. There is also the fact that counselling is not chiefly to give advice or guidance, but to actually enter into a relationship with the client. Therefore, counselling is essentially a relationship between the counsellor and the client. 

These counselling relationships can take the skilled counsellor quite a while to master, especially when he is not a naturally caring person.  Consequently, here I expound one key area of modern counselling. I will look into three core client centred approaches to counselling with the skills, goals and structures that are needed to equip the modern counsellor. Furthermore, I will also show how the self-actualisation of the client can bring about the desired outcome in the counselling relationship when these core approaches and settings within a professional framework are observed.

The three core characteristics that the effective counsellor needs for the therapeutic change to occur were identified by the American psychotherapist Carl Rogers when he developed a model for Client-Centred-Therapy (CCT) in the 1950's. These are:

  • Unconditional Positive Regardin which the counsellor genuinely cares for and accepts the client for who he is.
  • Empathic Understandingin which the counsellor puts himself in the place of the client to completely understand the problem, and
  • Congruence or Genuineness in which the counsellor's complete openness and honesty make him inwardly consistent, aware, and genuine. Rogers believed also that if the client were given a safe place in which to talk over his problem, insight would occur, the patient would understand his problem, and then he would get well (Rogers C. 1951).

Carl Rogers is not a medical doctor. His doctorate is in psychology. His book published in 1951 called 'Client-Centred Therapy' is self explanatory. He would put the client at the centre of all the healing work - instead of the physician as Freud had done. Rogers defined CCT this way: "It is that the individual has within him or her self vast resources for self-understanding, for altering her or his self-concept, attitudes, and self-directed behaviour and that these resources can be tapped if only a definable climate of facilitative psychological attitudes can be provided" (Rogers C., 1951). The counsellor directs the client in such a way for him to overcome his problem. Non-directive counselling is to help the client to see for himself how he can overcome his problem. This gives the client ownership of his problem. The counsellor draws out the client's own abilities to solve his problem by being an active listener.

First I want to explain and analyse what unconditional positive regard or acceptance means to the counsellor.  Rogers points out very essential qualities that the skilled counsellor needs for accepting the client for who they are without judgement or prejudice. He will have to give full attention to the client and be able to listen so well that the client will feel accepted and valued. He also talks of the attitude and orientation of the counsellor. Here is an extract from his writings:

"In any psychotherapy, the therapist himself is a highly important part of the human equation. What he does, the attitude he holds, his basic concept of his role, all influence therapy to a marked degree" (Rogers, C., 1951). The counsellor must not feel in any way superior or come across as patronising and arrogant to the client. In other words, he must feel a real acceptance of the client as a human being without putting tags on and discriminating to that person. He must truly believe that the client is more than capable in making positive decisions in solving the problem and progress toward healing and even growth. It is essential to accept the client without conditions just as he is.

It is also very essential to learn to become a good listener. A good listeneris accepting of what the person says, is caring, gives the speaker full attention; does not interrupt; recognises the importance of silences; is genuine, sincere - not someone just 'playing a role'. He limits his own talking because no one can talk and listen at the same time. The listener listens for overtones - you can learn a good deal from the way the person says things, and also from what they do not say. He is not judgmental about the person's problem and makes it clear that there is time to talk.  He avoids giving advice; does not undervalue the person's problem; shows warmth and caring - being concerned, accepting and friendly.

On the other hand, if the counsellor says he understands the client before he knows him well and has an answer for the problem before hearing all; find the client boring without saying it; feels critical of the client's grammar, vocabulary or accent, then he is not listening. If the counsellor is communicating to someone else in the room; refuses thanks saying that he hasn't really done anything; does not really care; interrupts before the client has finished speaking or finishes the sentence for him; is dying to tell him something, then he is obviously not listening. Telling the client about his own experience can give the impression to the client that his problem seems unimportant (Samaritans UK 2003).

A good listener will come quietly into the client's private world letting him be himself and really try to understand even if he's not making much sense. He will grasp his point of view even when it's against his own sincere convictions. He will realise the hour he spent with the client has left him a bit tired and drained. Moreover he will allow client the dignity of making his own decisions even though he may think they might be wrong. A good listener will not take the problem from the client, but allow him to deal with it in his own way and hold back his desire to give good advice. He will give him enough room to discover for himself what is really going on and accept his gift of gratitude by telling him how good it makes him feel to know he has been helpful.

Secondly, concerning Roger's three core counselling qualities is the matter of empathy or empathic understanding, it is well known that a bit of loving warmth given to the sick or depressed can help them improve greatly but a cold uncaring doctor can make a person feel worse. When therapists show high levels of warmth, genuineness and accurate empathic understanding patients get better quicker. When these qualities are lacking, patients feel worse. I believe it goes without saying that counsellors and therapists or 'shrinks' were rather arrogant in believing that they could 'fix' peoples problems by their own expertise. For many years Americans have laid down on therapists couches to be told their problems by the 'expert'. If the so called expert lacks empathic understanding he will not progress with the client.

Let's take a closer look at empathy. What does a client think; how does he or she really feel inside; what are the client's values, beliefs, inner conflicts and hurts? The good counsellor is effective in communicating this understanding by words or gestures to the client. This ability to feel with the client is what is meant by accurate empathic understanding. It is possible to help people even when we don't understand because just by being warm and loving can have a remarkable therapeutic effect. Basically, accurate empathy is being able to feel what the other person feels. Carl Rogers (1951) puts it this way:

"In the emotional warmth of the relationship with the therapist, the client begins to experience a feeling of safety as he finds that whatever attitude he expresses is understood in almost the same way that he perceives it, and is accepted."

Acceptance implies a generalised belief in the other human being regardless of his behaviour. Acceptance implies a willingness to allow individuals to differ from one another in all kinds of ways. Acceptance implies respect for a person. But acceptance can be dangerous when not accompanied by discernment. Some people have become almost sentimental about acceptance, thinking that the counsellor must never disapprove of the other person's conduct. In his book on developmental counselling, Donald H. Blocher (1966) states that "Acceptance does not mean the absence of moral judgement about a client's behaviour." We cannot avoid making judgements of those we appreciate. If we accept someone, we believe in his or her worth. To Blocher, acceptance means "interest in and concern for a client." If you are accepting of your client, he will recognise such feelings as "boredom, disinterest, and lack of caring"

The third essential therapeutic quality that Carl Rogers identified is genuineness and sincere or congruent. The genuine counsellor is for real - an open, sincere person who avoids phoniness or the playing of some superior role. Genuineness implies spontaneity without impulsiveness and honesty without cruel confrontation. It means that the helper is deeply himself or herself - not thinking or feeling one thing and saying something different. Genuineness has to do with being real and transparent in a relationship.

 The author of 'The Skilled Counsellor' Gerard Egan (1990) describes genuineness with these points: The skilled counsellor dose not hide behind a role; is spontaneous, yet tactful. He is not rule or technique bound, is not impulsive, inhibited or defensive. He can 'hear' negative feedback and shares facial expressions rather than hiding. He shows consistency in thought, feeling and behaviour and shares self, both verbally and nonverbally.

Yet sometimes people get trapped by the idea that they can't really be themselves around others because they might be rejected. But I am discovering that what people usually reject is my mask. They really like me if I will let the true me show. People also have a preconceived idea about emotion which prevents them from being genuine. They think that they can't be angry. But anger that does not include violence is not a bad thing but needs an outlet and should not be hidden. There are also non verbal signs that reveal emotions even when a person tries to hide them. Non verbal expressions are a major part of our character. People cannot always hide them. If a counsellor sits awkwardly and fidgets by folding and unfolding his arms, looking bored or even checking their watch will only send the client negative messages that the counsellor is just not interested. If he is constantly looking out of the window he will only convey the message that he has other more important things to do. Even tapping on the table with his pen will signal impatience.

Many key skills can be employed in the counselling setting, these include paraphrasing, reflecting back, confronting self-disclosure, structuring, summarising and referral. By using these skills at the appropriate time, they can greatly enhance the chances of the client gaining a measure of control over his problem.

Furthermore, there are the goals in counselling that will help the client toward a happier and more fulfilling life. First though, the counsellor must have a caring attitude and genuine desire to help the client. He must be altruistic or selfless and have a real desire to put other before himself. What is the counsellor's motive for becoming a counsellor? Is it to avoid his own problems, or to gain standing and importance, or could there be a more sinister motive? If the counsellor's motives are right, then he will be able to help the client recognise unconscious harmful attitudes, teach impersonal skills and new behaviours, show how to mobilize the inner resources of the client to face a crisis, or just be simply a shoulder to lean on. But they are not the only goals. Here are some that I feel are important.

 One is self-understanding. To understand one's self is often a first step in healing. Many problems are self imposed but the one being helped may fail to recognise that he or she has biased perceptions, harmful attitudes or self destructive behaviour. Consider for example, the person who complains, "Nobody likes me," but fails to see the complaining is one reason for this rejection by others. This goal of counselling is for an objective, perceptually alert helper to assist those being helped to get a true picture of what is going on within themselves and within the world around them.

Another is communication. It is well known that many marriage problems relate to a breakdown in husband-wife communication. The same is true of other problems. People are unable or unwilling to communicate. The client can learn how to communicate feelings, thoughts and attitudes both accurately and effectively. Such communication involves the expression of oneself, and the ability to give and receive accurate messages. Behaviour is directly related to communication problems. Most, if not all of our behaviour is learned. Counselling, therefore, involves helping clients unlearn ineffective behaviour and learn more efficient ways of acting. Such learning comes from instruction, imitation of a counsellor or other model, and trial and error. The helper must encourage the person he or she is helping to 'launch out' and practice the new learning. At times it also will be necessary to analyse what goes wrong when there is failure and the client must be urged to try again. Recent humanistic writers have stressed the importance of an individual's learning to and achieve maintain their optimal potential. This is termed self-actualisation and is proposed by some counsellors as the goal of all human beings whether or not they are in counselling (Rozell, J. V., 1997).

Often people are able to meet each of the above goals and to function effectively, except for temporary periods of unusual stress or crisis. Such persons can benefit from a period of support, encouragement, and 'burden bearing' until they are able to recover effectively their problems of living. In any kind of counselling it is often helpful if the counsellor and client establish clear goals or objectives for the counselling.

While objectives, strategies and skills that the counsellor employs in his profession are necessary, before all these things can take place, even before the counselling begins, certain agreements have to be laid down, namely, contract making. A contract is something that can be officially agreed upon between the counsellor and client after the initial interview to ensure that trust and professionalism are observed. The purpose of a contract is to establish a plan for the course of all the counselling sessions. There should be responsibility on both the counsellor and the client in bringing about the process of change. The client will want to understand what counselling will mean for him. What he hopes to get out of it and what kind of procedures are used? How long will the sessions last and how many? Keeping to the agreed goals for both counsellor and client will give the client a sense of achievement when reaching those goals and will provide legal cover. Structuring is felt by many writers to be a very important part of the counselling. It is based on the counsellor's perception of the client's need (Tyler, L. E., 1969).

There is also the subject of accountability and of course ethical and moral codes. One is confidentiality and while this is a vital part of the counselling relationship, it is not absolute. A governing body is the Standards and Ethics for Counselling in Action to ensure codes are observed. All counselling organisations are bound by the 'Ethical Framework for Good Practice in Counselling and Psychotherapy' (Course handout). There are certain issues that a counsellor must divulge if he comes across them during counselling. These are related to child abuse, terrorism, criminal activities and by law require the counsellor to report anything stated in these guidelines in that case to the police.

Another very important aspect of the counselling relationship is setting. It wouldn't be well to meet in the client's house because of possible interruptions. When a person is pouring out his heart there is nothing worse than when someone suddenly comes in or phones up. Consequently, a professional counsellor should have a counselling room in which to counsel. The typical setting should be comfortable, warm and free of outside noise and interruptions. The counsellor would make sure before hand to switch off his phone lines and see that no one will come into the room during a counselling period. Soft couches with lighting not too bright, would provide some kind of ambience and calming effect. All this would produce the kind of setting for a relaxed atmosphere.  Some soft drinks, tea or coffee should be available and tissues on hand in a moment's notice in a nearby drawer.

Meanwhile, for the attentive counsellor there are many different ways he can help a client. When the problem or problems have been aired, there are strategies that the counsellor and the client can do to improve the situation.  The Counsellor can offer some of his opinion and advice as to some positive ways forward based on his observations during the counselling sessions. Giving Information can be done simply by helping out with addresses of local agencies. Direct Action can be done by the counsellor, family or friends to help in many practical ways like sorting out some accommodation, organising a meal, or doing something they can't bring themselves to do at that time.

On the other side of the coin, it was recently pointed out in an article by professor Frank Furedi (2003) in a national newspaper that led with the heading 'A curse on counselling'  "that we have become a nation obsessed with counselling." The Welsh town of Aberfan experienced in 1966 one of our nation's worst disasters when a coal tip engulfed a school killing 144 people, most of them children. "No one demanded counselling for their distress. The community quickly rebuilt their lives and got on quietly with life." In comparison with today when even relatively small problems occur, many seek out therapy of some kind or another. Furedi wrote: "British society has become increasingly influenced by the therapeutic culture, which encourages us to believe that we do not have the emotional resources to handle problems without 'professional guidance'" Furedi went on: "As it's revealed Britain has more counsellors than soldiers, is this the real reason we're so depressed?" Yet counselling it seems, whether some may need it or not, is here to stay.

In conclusion, as all of the above clearly illustrates, counselling cannot be successful without the many skills, structures and setting being in place. But most of all, the counsellor must really have the heart for the people he counsels. There is no substitute for a caring and patient counsellor who wants to listen to the heart of the very important person they befriend. The person centred model for counselling that Carl Rogers identified is clearly the most effective way for a therapeutic change to take place in hurting people.

References 

Egan Gerard. (1990) The Skilled Helper A problem-Management and Opportunity-Development Approach to helping, Wandsworth Group, Pacific Grove CA.

Furedi, Frank (14/10/2003) A Curse On Counselling The Daily Mail (newspaper page 10), London.

Rogers Carl. (1961) On becoming a person. Houghton Mifflin. Boston.

Rogers Carl. Client Centred Therapy Constable. London. 1951

Tyler E. (1962) "Minimum Change Therapy," Counselling: Readings in Theory and practice, John F. McGowan and Lyle D. Schmidt, Holt, Rinehart and Winston, Inc., New York.

BIBLIOGRAPHY

Blocher, D. H., (1966) Developmental Counselling, The Ronald Press Company, New York.

Collins, R. Gary, (1985) Christian Counselling Word Publishing UK Ltd., Berkhamstead.

Egan Gerard. (1990) The Skilled Helper A problem-Management and Opportunity-Development Approach to helping, Wandsworth Group, Pacific Grove CA.

Furedi, Frank (2003) A Curse On Counselling The Daily Mail, Thursday 14 October, London.

Green  Jr, William W. 1976. Introduction to Psychology. A Study Guide. ICI University Press, Texas.

Rogers Carl. (1951) Client Centred Therapy Constable. London.

Rogers Carl. (1961) On becoming a person. Houghton Mifflin. Boston.

Rozell Jack V., (1997) Human Relations, An independent-Study Textbook, 5th Edition, ICI University Press. Texas.

Tyler, Leona E., (1969) The work of The Counsellor 3rd ed., Appleton-Centuary-Crofts, New York.

Tyler E. (1962) "Minimum Change Therapy," Counselling: Readings in Theory and practice, John F. McGowan and Lyle D. Schmidt, Holt, Rinehart and Winston, Inc., New York.

The Samaritan's Website (2003): http://www.samaritans.org/know/pdf/listen_up.pdf

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