We Care, We Listen, We Help

What is Counselling? 

The Person Centred Approach, otherwise none as PCT (Person Centred Therapy)Counselling  is about being listened to and heard, in a place and with somebody who is there to explore with them any issues that they struggle to talk about or cope with confidentially and unjudgementally. But most importantly safely, ethically and professionally with someone who is skilled and qualified to help them with what changes, goals, aims expectations clients have or need.

  • Offering you insights into how you act, think and feel

  • Helping you to understand your Behaviour patterns

  • Gain Self Awareness

  • Acceptance of Self

  • Help you move towards wanted changes

  • Help you express your emotions, instead of bottling them up, in a way you feel able and safe to. 

Please read this case study, as an example of what happens in Counselling

Introduction


The information I have provided was based on exploration throughout the sessions together. We agreed at the assessment session to work with the Carl Rogers, Person Centred Approach or Person Centred Therapy (PCT) as this is the Methodology I favour in, and it was also the theory the client wanted as she had had PCT before. The presenting problem that my client (who I will now name as C) came with that of finding her sense of self again or for the first time, and so skills such as the Core Conditions, Congruence, Unconditional Positive Regard and Empathy were going to be strongly needed in further exploration with C as you will hear as the sessions went on.


Theory and Key Concepts:

PCT means putting the client’s needs the centre of the process, negotiating a contract together that the clients understands and is happy with, some clients may only need six sessions, C however had been in therapy for a long time before and so we initially agreed to have twelve sessions, as the sessions went on it became apparent that the sessions needed to be extended and so we agreed together to push it up to twenty sessions, this was done at session ten, when a review of sessions together happened before ending in session twelve, As PCT is strongly based around Beginnings, Middles, and Endings. Beginnings mainly consist of building a trusting relationship, exploration of the client, such as personal and past history, attachments, behaviour patterns, values, morals etc. providing a non- judgemental approach and an empathic listening ear so that the client gains a sense of security and a safe place to open up, and when they do that the therapy moves into the Middle stage, this is then when the client lets you know who they really are and how they really feel, it can also be the stage when a client can start to heavily rely on you for support and even push boundaries, but It’s all part of a test into them feeling that the relationship you share together is that of honesty, understanding, genuineness and a place where they can really tell or their inner most feelings to, without being persecuted for it and this can be known as the therapeutic movement. When the ending comes it can consist of many things, some therapy comes to a natural end, as the aims and goals or challenges that wanted to be worked on has occurred and so therapy is no longer needed or a feeling of self-worth, confidence, esteem have built within them and so they feel empowered and ready now to face the problems around them, or an ending can be that of sadness, especially with a client who has had twenty sessions like C as they have gotten used to filling their life coming to see you for an hour on the same day each week, this is when it endings can leave you with a sense of loss.

Challenges and Limitations:
I really questioned my limitations with C, as during the assessment C told me how much therapy she had already had, and that it was with a highly respected PC therapist known in the area , and who had died a couple of years ago, and so that was the reason she no longer saw her. C process when coming to therapy with me always consisted of her talking about her son and the pressure and strain he put on her that week, she would also talk about his behaviour, his nightmares, and his social life that week, and the only time she would talk about herself and how she felt was near the end when we would come close to running out of time, and so my biggest challenge in the early sessions together, I’d say until at least session ten, was to start the sessions talking about her and so I would change my opening line with “how are you”, rather than “how’s your week been” also I used the review in session ten to mention that she did this and further sessions would be more helpful if we talked about her more and what she wanted from therapy. What followed was every week her opening line would be was “I’m so exhausted because….”

Self-Awareness:

 I found I was really becoming self- aware of what my feelings were towards C. In our sessions together C informed me of an abuse that happened to her at age three, and how that beating has impacted on her beating herself up mentally and with imagery, and how much responsibility she felt on her to care for her mother when she was out of it drunk or stoned, how she hated boarding school and all it stood for, how she loved and lost and then married a man who abused her until she found the courage to leave him, how she went on to further education and become a teacher to inmates at a highly guarded prison and then to be knocked down by her condition Fibro Myalgia and then to have a son diagnosed with numerous issues, and now feels stuck in the state of no self- worth, tiredness, constant pain and financial strain now she can’t work, although she would love to and has lost all sense of self belief and confidence from being shunned above all this by her siblings. My feelings were that of compassion but also that of disappointment, why oh why is she allowing herself to be pulled down under by her condition and her son’s behaviour after so much hurt and pain she has already been through and withstood? Why is she fearing life and people now>? When she has faced and stood up to an abuser? Why can’t she stand up to her siblings and show them that she’s not their mother but suffering a real disability and has no choice but to take pills for her pain? Aware of my feelings I was aware at times during the middle part of therapy session three to fourteen that I was becoming directive in my approach I felt I was pushing C to become stronger and more empowered by letting out her emotions when they occurred, C would grind her teeth when I knew she was angry using immediacy I would say let it out, and she would shout it and then she would laugh or cry and then feel better for it, but although it worked I questioned my agenda, I did take these feelings to supervision, his advice was to ask how she felt about my approach, and so I did at session thirteen I asked if she felt therapy was working, and she told me that I was different to her last therapists I was more directive but went on to say she preferred it as she felt it’s what she needed to express herself, I knew at this point how highly self- aware C had become about herself too.

Working Ethically:

Ethically I felt my time with C was always genuine. When C told me in session three (this is when I knew we moved from beginning to middle) that she remembered a beating at age three from a trigger that occurred that week when at a friend’s house, had been repressed by her because of the trauma it caused her at such a young age I knew that this was something I would have to trend carefully in in regards to my abilities and so to uphold the ethical and good practice framework that I adhere to I asked if she would like me to refer her to my supervisor who specialises in trauma rewinds, I explained to her what he did and what the effects are, she said she knew a bit about it but wanted to think about it if that was ok, I also offered her the option to talk about with me as I wasn’t sweeping the subject away. The result was to talk to me, but ethically I gave her the choice, so I remained professional in my approach of PCT.


Conclusion :
Of the eighteen sessions that me and C have shared I use the word shared as I feel have learnt a lot about my -self also, I feel that PCT really underpinned the work we did together. The Core conditions used helped us gain that trusting, safe, therapeutic relationship that was needed for C to share her true feelings. The sense of unconditional positive regard helped me to understand her background, her values, her beliefs and how her life had made her the person she was at the start of therapy. Through using all skills, such as immediacy, reflection, summarisation, silence etc. we together have created change. C change occurred when on session thirteen she let rip. C spend half an hour of the hour session shouting, crying, laughing about all the things that she has let get her down, she yelled about her family, her condition, her upbringing, her ex, rude people, her unrealistic fears, her everything it seemed, but by the end of the session she had a sense of acceptance about these things, and on session fourteen she turned up glowing, full of plans, and looking to the future, she looked confident, empowered and above all happy. I learned that the challenge and immediacy I used in pushing her to express her emotions really had a positive effect. The sessions up to ending were C was full of self-awareness, reflection, coping strategies for her son’s behaviour and empowerment, but there was an aura around us that knew this was ending and she would now be alone again, and I would no longer see her journey, but we discussed levels of support and the changes she was making in her life, like moving home and choosing to be nearer to family  as ties were bing made with them, and  so although a sad moment, a happy one too as problems had receded, PCT had worked.

Can it work for you? why not give it go? if its not your thing, and it dosen't help, at least you can say you experienced it!