Carl Rogers was way ahead of his time when, in 1957, he published his ‘necessary and sufficient conditions’ for therapeutic personality change. He and his research team were amongst the first counselling and psychotherapy clinicians to use research data as a way of informing their practice.
But, since then, many elements of the person-centred field have stalled. We don’t know the latest research findings, we don’t evaluate our approach, we don’t consider research as a useful source of information in developing our practice. How many person-centred counselling trainings, for instance, teach students about the latest evidence on empathy, congruence, and UPR, as detailed in the APA books on Psychotherapy Relationships that Work, or David Rennie’s research into client deference in person-centred therapy?
Research evidence is not the only valid source of guidance on how to practice—far from it—but it is one very valuable guide. Why? First, it’s a way of systematically generating knowledge so that, at least to some extent, we can stand back from our own biases, wants, and assumptions and see what is ‘out there’. We all, of course, believe our approach to practice is effective (and perhaps the most effective one) but research can help us see it from different angles, so that we discover, for instance, what clients experience, think or do, rather than just seeing a reflection of our own wants. Second, and even if we don’t value research evidence, commissioners and funders do. It’s just no good, these days, going to commissioners and saying, ‘I think you should fund me to do person-centred therapy because Carl Rogers said it was effective back in 1957’. What’s needed is contemporary, high quality evidence that can really convince those with the money that investing in what we think is worth investing in really is.
So without research, and without a research-informed mentality, I think there’s a very real danger that the person-centred approach may die. Die because it stops growing and learning and evolving; and instead stagnates in what was discovered over 60 years ago and refuses to move on. Die because it’s no longer fitted to the world around us and the kinds of things that clients, today, actually want and need. And die because no-one any more is willing to pay for it.
Very recently, we published the findings from our large-scale ETHOS trial of school-based person-centred counselling; and there’s the results of the PRaCTICED trial soon out, comparing person-centred counselling for depression against CBT in IAPT. Both of these sets of findings, which we’ll be presenting at the forthcoming BACP Research Conference, provide an invaluable opportunity to learn more about the processes and outcomes of person-centred therapy; and to look at how we might grow and evolve our approach. And there’s so much more research out there that has been done, and can be done, to really help us nuance, refine, and update our person-centred ways of working to maximise the benefits that we can give to clients.
For me, a lot of the responsibility here comes to person-centred trainers. I think people who run person-centred courses need to teach a form of person-centred that is open, flexible, and research-informed. That doesn’t mean abandoning principles like non-directivity or the ‘core conditions’—students need to learn a particular, specialised practice—but it does mean that all this is taught within a critical understanding of what the latest research evidence says, and an open-minded welcoming of multiple positions and perspectives. I know that isn’t easy—many counselling trainers aren’t that familiar with research terminology and methods—but having some knowledge and understanding in this area seems an essential competency, to me, of a training position. Would we be OK, for instance, if people who trained nurses or doctors had no knowledge of the latest research evidence in their fields? If we want counselling to be treated as a mature, serious profession, then we have to recognise the role that research plays—and will be expected to play—from the very inception of practice.
And, for trainers, I think we need to consider carefully how we define what it means to be person-centred. If we define it, for instance, in terms of the ‘core conditions’, then what do we do if the research shows that those relational conditions aren’t actually, that important to change; or that there’s other relational or technical factors that are most closely associated with growth? The more we define our approach in terms of particular methods or stances that we ‘know’ work, the more closed we are likely to be to the evidence and to revising our thinking and practice as new findings come in. I don’t think there are easy answers here but if, for instance, we defined person-centredness in terms of listening deeply to clients’ perspectives, or in terms of an ethic of respect and care, we might allow ourselves more space to incorporate new discoveries and findings as we continue to grow.
‘The facts are always friendly,’ writes Rogers. He states, ‘in our early investigations I can well remember the anxiety of waiting to see how the findings came out. Suppose our hypotheses were dis-proved! Suppose we were mistaken in our views! Suppose our opinions were not justified!’ However, he goes on to say:
At such times, as I look back, it seems to me that I disregarded the facts as potential enemies, as possible bearers of disaster. I have perhaps been slow in coming to realize that the facts are always friendly. Every bit of evidence one can acquire, in any area, leads one that much closer to what is true. And being closer to the truth can never be a harmful or dangerous or unsatisfying thing. So while I still hate to readjust my thinking, still hate to give up old ways of perceiving and conceptualizing, yet at some deeper level I have, to a considerable degree, come to realize that these painful reorganizations are what is known as learning, and that though painful they always lead to a more satisfying because somewhat more accurate way of seeing life.
[Image: johann-siemens, Unsplash]