Humanistic‐experiential therapies in the treatment of generalised anxiety: A perspective

This study discusses the current status of evidence‐based psychological therapies for generalised anxiety disorder (GAD). It points to the dominance of cognitive‐behavioural therapies (CBTs) and compares this dominance with the position of humanistic‐experiential therapies (HEPs) in this area. The paper hypothesises several reasons for this situation, including historical developments as well as HEPs’ ambivalence around embracing mainstream mental health classification systems, and corresponding types of research. The paper then highlights some recent developments in HEPs for anxiety disorders (particularly emotion‐focused therapy; EFT); developments that are breaking new conceptual grounds while also generating new outcome research.     

Counselling children and young people: A review of the evidence for its effectiveness

This paper summarises and presents the results of a BACP commissioned systematic scoping review on the research evidence on counselling children and young people. The methodology was based on a structured, hierarchical, systematic approach to searching and reviewing the research literature. Inclusion criteria defined the scope of the review in relation to a range of issues in counselling children and young people: behavioural problems and conduct disorders; emotional problems including anxiety, depression and post‐traumatic stress; medical illness; school‐related issues; self‐harming practices and sexual abuse. Four groups of counselling approaches were examined: cognitive‐behavioural; psychoanalytic; humanistic; and creative therapies. The findings indicate that the four therapeutic approaches are effective to a greater or lesser degree in relation to the range of issues. Although the findings show that there is little or no evidence for the effectiveness of some therapies for particular issues, this may not reflect the lived experience of children and young people engaged in counselling in a range of community and institutional settings. Instead, the absence of evidence is likely to reflect a lack of published studies that fit the inclusion criteria for this review.     

A discourse analysis of power in relation to PSYCHLOPS (Psychological outcome profiles) in the context of CBT for psychosis

Aims: Outcome measures (OMs) and routine change measurement have developed dramatically in psychological therapies over the last two decades and some therapists have expressed concerns that this, depending on how it is handled by the parties involved, can markedly affect the therapy. However, little research has investigated this. It therefore seemed timely to explore discourses of OMs drawn upon by both parties in the therapy room. Method: PSYCHLOPS (Psychological Outcome Profiles) is a client‐centred measure which offered an opportunity to explore how therapists and clients receiving CBT for psychosis talked about OMs. A useful contrast was provided by the CORE‐OM (Clinical Outcomes in Routine Evaluation‐Outcome Measure). The discourses drawn upon by clients (n=4) and therapists (n=4) were analysed, informed by a Foucaultian framework. Results: OMs were constructed as empowering or disempowering of clients, as being able to do therapeutic work of engagement and containment, and as part of the apparatus of service power, positioning therapists as relatively powerless to question their use. Discussion: It is suggested that client‐centred measures like PSYCHLOPS, although partly aligned with a recovery framework, may become part of top‐down state and service power, and there is a need for more research into the different ways in which OMs are used in therapy and the impacts on therapists, clients and their relationships.     

The relation between personality and prejudice: a variable‐ and a person‐centred approach

The relationship between Big Five personality (measured by the NEO‐PI) and prejudice was examined using a variable‐ and a person‐centred approach. Big Five scores were related to a generalized prejudice factor based on seven different prejudice scales (racial prejudice, sexism, etc). A correlation analysis disclosed that Openness to Experience and Agreeableness were significantly related to prejudice, and a multiple regression analysis showed that a variable‐centred approach displayed a substantial cross‐validated relationship between the five personality factors and prejudice. A cluster analysis of the Big Five profiles yielded, in line with previous research, three personality types, but this person‐centred approach showed a low cross‐validated relationship between personality and prejudice, where the overcontrolled type showed the highest prejudice and the undercontrolled the lowest, with the resilient falling in between. A head‐to‐head comparison sustained the conclusion that, based on people's Big Five personalities, their generalized prejudice could be predicted more accurately by the variable‐ than the person‐centred approach. Copyright © 2003 John Wiley & Sons, Ltd.     

Client and counsellor narrative accounts of congruence during the most helpful and hindering events of an initial counselling session

The role of congruence in establishing and maintaining a therapeutic alliance has been emphasized by theorists within the humanistic/person‐centred tradition. However, there appears to be a lack of research that explores the processes occurring during moments of congruence or incongruence. The main objective of the present study was to gather qualitative data about congruence based on both participants’ narrative accounts of their subjective reactions during the most helpful and the most hindering event of an initial counselling session. Client and counsellor recollections of their experiences during these two events were stimulated through the replay of a video‐tape after the session. The event identification came from the client through a Brief Structured Recall interview. During the hindering event, both participants were incongruent. There was a mismatch between what they were feeling and what they were expressing verbally and/or non‐verbally. At the same time the client was feeling criticised and offended by counsellor's confrontation. By contrast, during the helpful event both participants were congruent. The counsellor was experiencing empathic understanding toward his client and the client was feeling accepted and understood. The implication of these findings are discussed in terms of how congruence might affect the construction of significant events during the therapeutic hour.     

Experiential congruence: Qualitative analysis of client and counsellor narrative accounts of significant events in time‐limited person‐centred therapy

The concept of congruence represents a core theoretical construct in the development of client‐centred therapy, and remains fundamental to the practice of experiential approaches to psychotherapy. This study explores the ways in which congruence is experienced during significant moments of therapy. Client and counsellor accounts of moments of congruence/incongruence were collected from six cases of person‐centred counselling, and were analysed using a method of narrative analysis. It was found that participants experienced congruence in a variety of ways, suggesting that the construct does not describe a unitary phenomenon. Congruence was experienced as simultaneously intrapsychic and relational. The effective negotiation of episodes of incongruence comprised a necessary element of effective therapy. Further research into the nature of congruence may be valuable in contributing to new understandings of how therapeutic alliances are made, broken and repaired.     

On the Measurement of Meaning: Logotherapy's Empirical Contributions to Humanistic Psychology

Meaningful living is a central focus of several humanistic theories and therapies. Measurement of life meaning meets many obstacles, including pragmatic concerns, such as measuring subjective experiences, and theoretical objections often offered by humanistic psychologists. The purpose of this article is to summarize empirical efforts related to logotherapy, a humanistic–existential paradigm, to illustrate the utility of assessment within the larger context of humanistic psychology. An overview of five logotherapeutic measures of meaning is provided. These measures include the Purpose in Life test (PIL), the Life Purpose Questionnaire (LPQ), the Seeking of Noetic Goals test (SONG), the Meaning in Suffering Test (MIST), and the Life Attitude Profile Revised (LAP–R). Directions for use of such measures in future research are also offered.     

Person‐Centred and Experiential Psychotherapy Scale: Development and reliability of an adherence/competence measure for person‐centred and experiential psychotherapies

Aims: This study aimed to assess the reliability of the Person‐Centred and Experiential Psychotherapy Scale (PCEPS), a new adherence/competence measure of person‐centred and experiential psychotherapies. The PCEPS consists of 15 items with two subscales: Person-Centred Process and Experiential Process. Method: One‐hundred twenty audio‐recorded segments of therapy sessions were rated independently by two teams of three raters using the PCEPS. Half of the segments were 10 minutes long and the other half were 15 minutes long. Six therapists were experienced therapists and four were counsellors in training. Seven of the therapists identified their work as ‘person‐centred’, and three identified their work as ‘process‐experiential’. Three raters were qualified and experienced person‐centred therapists and three raters were person‐centred counselling trainees in their first year of training. Results: Interrater reliabilities were good (alpha: .68–.86), especially when ratings were averaged across items (alpha: .87); interitem reliabilities were quite high (alpha: .98). Exploratory factor analyses revealed a 12‐item facilitative relationship factor that cuts across Person‐Centred and Experiential subscales (alpha: .98), and a nonfacilitative directiveness factor (3 items, alpha: .89). Conclusions/Implications: The PCEPS has potential for use in RCT research as well as in counselling training and supervision, but will require further testing and validation.     

Reverie‐informed research interviewing

Drawing on Thomas Ogden's notion of ‘reverie’, the role of self‐reflection in research interviewing is explored. Ogden views reverie as a co‐created intersubjective phenomenon, a ‘third’, distinct from both analyst and patient. Two face‐to‐face research interviews with adolescent depression sufferers are described, showing how reverie can be used to help overcome impasse, and develop research hypotheses. Participant‐centred research interviews were thus shown to be enhanced by psychoanalytically informed self‐reflection as accessed through reverie. The role of reverie in research interviewing, in part spontaneous and ineffable, in part defined and systematic, is discussed.     

Client‐centred group therapy for survivors of interpersonal trauma: A pilot investigation

Group therapy for trauma survivors provides an opportunity to share experiences with others in a supportive environment. Client‐centred groups have received very little attention as a way of working with traumatised people. Such groups promise to promote psychological growth following trauma. In this paper we present pilot data from a client‐centred group of six survivors of interpersonal violence who were experiencing complex posttraumatic stress reactions. Results suggested that those who perceived the presence of empathic listening within the group therapy sessions benefited from the group, showing greater positive changes. Clinical implications for working with trauma survivors, methodological considerations and directions for future research are discussed.     

Constructivist psychology of child abuse and implications for psychotherapy

Abstract

This paper reviews constructivist and related literature on child abuse and psychotherapy. Constructivist psychology, with its emphasis on the personal, socially embedded construction of meaning, is uniquely situated to contribute to humanistic psychotherapy for child victims and adult survivors. Conversely, work with abused clients deepens our understanding of developmental meaning‐making processes and the social ecologies of meaning within which they unfold.

Constructivist approaches to child abuse are inherently humanistic, focusing on the child victim's and adult survivor's attempts to make meaning of their experiences, including the often traumatic experiences of abuse and the relational contexts in which it occurs. This paper first discusses how constructivist psychology may deepen our understanding of the impact of abusive experiences, the reverberation of those experiences through subsequent living, and the role of constructivist therapies in the healing process. Secondly, this paper explores reflexive aspects of work with abuse survivors that may challenge our cultural and professional assumptions and deepen our commitment to constructivist, humanistic, and feminist psychotherapies.     

Chinese college students' general and relationship‐specific representations of adult attachment: Variable‐centred and person‐centred analysis

Formerly, researchers often treated adult attachment as a trait‐like construct with consistency across relationship contexts. However, recent studies have shown that people possess multiple relationship‐specific attachment representations, and inter‐correlations among them are only in a small‐to‐medium range. The aim of this study is to test whether these variable‐centred results could be replicated in China and further supplement them with a person‐centred analysis focusing on identifying prototypical patterns of multiple working models across relationships. We administrated measurements of general and four relationship‐specific (mother/father/best friend/romantic partner) working models and indicators of psychological adjustment upon 302 Chinese college students. Results from variable‐centred analysis demonstrated the cross‐relationship variability in working models. Furthermore, global indicators of psychological adjustment were better predicted by general models, while relationship‐specific indicators were better predicted by corresponding relationship‐specific models. These results largely replicate previous Western studies, supporting the existence of multiple attachment representations in China. In person‐centred analysis, a latent profile analysis identified four typical classes of working model profiles: all‐average, all‐secure, romantic‐insecure and peer‐secure. These classes differed not only in the cross‐relationship variability of their working models, but also in their levels of psychological adjustment. These interesting patterns may have theoretical implications and are worthy of further examination.     

Carl Rogers's Life and Work: An Assessment on the 100th Anniversary of His Birth

This article summarizes the life and work of America's most influential counselor and psychotherapist, Carl Rogers. He developed the client‐centered, person‐centered approach; popularized the term client; pioneered the recording of counseling cases; conducted landmark research on counseling and psychotherapy; and was a leader in the humanistic psychology movement, and more. Later, he applied the person‐centered approach to resolving intergroup and international conflict. Work on the client‐centered approach continues, and current research validates many of Rogers's earlier contributions.     

A Configurational Perspective on the Theory of Planned Behaviour to Understand Employees' Change‐Supportive Intentions

This study aims to deepen the understanding of the psychological processes involved in the formation of change‐supportive intentions by adopting a configurational perspective. To investigate potential configurations in relevant psychological processes suggested by the theory of planned behaviour (Ajzen, 1991 ), classical linear analytic methods are supplemented by the application of two case‐centred methods: latent profile analysis (LPA) and fuzzy set qualitative comparative analysis (fsQCA). The study uses data from two measurement times drawing on employees of a city council (t1: N = 1,589; t2: N = 1,524) undergoing complex and continuous organisational changes. While the case‐centred results from LPA and fsQCA generally accord well with the results from regression analysis, they consistently highlight the relevance of configurational patterns. Specifically, LPA and fsQCA reveal that different combinations of change‐related attitudes, subjective norms, and perceived behavioural control relate to the presence or absence of high supportive intentions. These results provide valuable insights for fostering employees' change‐supportive intentions. Moreover, the present study demonstrates that case‐centred analytical methods can essentially enrich research and theory‐building in change management as well as in the field of behavioural intention formation in general.     

The end of theoretical orientations?

Theoretical orientation is the most pervasive organizing device in psychology. Ideas, books, people, therapies, and other salient matters are frequently classified into psychodynamic, behavioral, humanistic, cognitive, or other orientation categories. The continued prominence of theoretical-orientation classification belies a breakdown in its applicability to contemporary psychology. Psychotherapy remains a stronghold. However, with internal and external forces endorsing particular approaches, theoretically-based practices will be forced to yield to evidence-based ones. The final dismantling of traditional theoretical categories by evidence-based practice standards paradoxically provides a hopeful impetus to otherwise arrested theoretical development. Manifest avowed theoretical orientation is distinguished from a latent theoretical-orientation construct, and the ways a new kind of meta-theory of therapy will reduce the naivete and increase the applicability of clinical research is discussed.     

Working with suicidal clients: The person‐centred counsellor's experience and understanding of risk assessment

Background: Client risk assessment within the person‐centred paradigm is traditionally seen as squarely opposed to its ethos. Aim: To determine how the person‐centred counsellor experiences and understands the issue of risk assessment within the confines of their work ethos. Method: Semi‐structured interviews with seven person‐centred counsellors using thematic analysis were conducted. Findings: Three main themes emerged following thematic analysis: The impact of the risk assessment process on self; The counsellor's experience of self, and The therapeutic process in relation to risk assessment. Discussion: The findings suggest that person‐centred counsellors conduct risk assessments taking a holistic approach involving not only individual risk predictors and characteristics of the client but also individual factors related to self.     

What Every Therapist Should Know,Be and Do: Contributions from Humanistic Psychotherapies

Humanistic psychologists have made major contributions to the theory, practice and research in psychotherapy. Many of their contributions are applicable to a variety of therapeutic approaches. In this article I articulate what I believe to be some of the most useful things for all practitioners to consider incorporating into their therapeutic practice. Carl Rogers’ contributions are considered to be universal and foundational since his strong emphasis on the therapeutic relationship and the importance of empathic responding are considered to be core aspects of effective therapies. A variety of humanistic therapists have emphasized the importance of working with client emotion, effective use of the self, relational involvement and depth, working within the client’s frame of reference, focusing on the self-concept, being present and helping clients embrace choice and responsibility, all of which are addressed in this article.     

走向完善：人本主义心理学研究方案

为了完善人本主义心理学方法论,人本主义心理学家发展了多种研究方案。每一种方案都设定了自己特定的研究问题,确定了自己独特的研究过程。现象学、解释学、启发式和体验研究方案是其中较为重要的几种。这些方案体现出人本主义心理学家试图将心理学作为人文科学的努力,使人本主义心理学方法论不再流于理论倡导,而是融入到人性研究的具体实践并因此走向完善。在未来,它尚需以辩证唯物主义实践观看待人的本质,确立心理学的整合视野。     

A meditation on the nature of self‐healing and personality change in psychotherapy based on Gendlin's theory of experiencing

Abstract

From a humanistic point of view psychotherapy is a creative transformational process in which therapists assist clients’ intrinsic self‐healing tendencies. However the nature of the self‐healing process is poorly understood. I briefly consider two theories of self‐healing, Rogers’ self‐actualization theory and dialectical theory, but focus on Gendlin's theory of experiencing as providing a more complete explanation. I consider the fundamentally implicational nature of change and portray personal change as “paradigm evolution” rather than paradigm revolution. I conclude with an examination of the self‐healing process in therapies that provide minimal prosthetic assistance to the client: client‐centered therapy, eye movement desensitization and reprocessing, and focusing‐oriented therapy. I conclude that the self‐healing/self‐change process occurs when intellectual, “top‐down” cognitive and self‐critical activity is interrupted, and when clients adopt a receptive, listening attitude towards inner experience.