1

STUDENT DETAILS

ACAP Student ID: 174173

Name: Jamie Brown

Course: GDC 16

ASSESSMENT DETAILS

Unit/Module: Counselling Skills 2

Educator: Jenny Coburn

Assessment Name: Rose and Dr Berenson Case Study

Assessment Number: 1

Term & Year: Term 2/2011

Word Count:

DECLARATION

I declare that this assessment is my own work, based on my own personal

research/study. I also declare that this assessment, nor parts of it, has not been

previously submitted for any other unit/module or course, and that I have not copied in

part or whole or otherwise plagiarised the work of another student and/or persons. I

have read the ACAP Student Plagiarism and Academic Misconduct Policy and

understand its implications.

2

Introduction

Person Centred Counselling is a humanistic counselling process in which

peoples perception of their unconscious ideas or thoughts rather than the

counsellors interpretation of the same informs psychotherapy. Tools for person

centred counselling include genuineness, active listening, and paraphrasing

among others. The quintessence is that a client has answers to his problems even

before s/he meets a counsellor. The counsellors task then is only to lead the

client into understanding his feelings. As much of the process is introspection,

the greatest role of the counsellor is to bring to the fore internal conflicts that

affect the client in order that s/he may deal with the demands of external reality

more positively. This approach is illustrated in the case, Helping Rose. This

paper is a critical review a therapy session in light of person-centered theory.

Obviously, where a particular skill/technique was not used or where one was

incorrectly used, I will attempt to explain why, its effect and what the therapist

could have done.

Session Overview

The session between Rose and Dr Berenson is about 30 minutes in

length. Roses presenting issue is not being able to get her five-year-old daughter

to sleep a whole night in her own bed. During the course of the session, Rose is

able to explore the history of her conflict, the course of her worries, frustrations,

helplessness, desperation, failures, perceived weaknesses, misplaced priorities

and, above all, the hidden answers to her problem. She starts by exposing her

resolve to make her daughter sleep uninterrupted in her own bed. She moves to

describe how sad she felt that she (Rose) could let her be while the baby cried

3

and screamed all night. She described how her sympathy let her break her

promise not to intervene no matter what. At this point, Dr Berenson was able to

lead Rose into seeing her frustrations at making progress while losing track after

only a short while. Even with help and support from teachers (targeted at

rewarding little Santa for good performance at school), Rose could still not bring

her into sleeping without interruptions in her bed. With the lapses in the

suggested reinforcement techniques, Roses helplessness and desperation

continued. She was not free enough to enjoy her sleep beside her husband. She

admits her doubts about the effectiveness of the reinforcement techniques to Dr

Berenson and the fact that her resources and patience are running out such that

she may not want to continue with them.

Rose wants a stable solution for her problem, because her freedom is in

jeopardy. She admits feeling trapped, and angry with herself for not having

made a better effort early in Santas life. However, she is torn between seeing

her daughter suffering and spending peaceful nights in her bed. She is led to

admit that her heart is at crossroads and that a lasting strategy is necessary. At

this point, Dr Berenson appreciates Rose for being dutiful with the reinforcement

strategies but lead her to admitting that she feels a weakness that leads her into

thinking that she failed in enforcing the reinforcement strategies. Dr Berenson

leads Rose into further introspection which she feels weak despite the strength

of the strategy she uses; that she is not listening to the missing determination in

her resolve. She admits that Santas illness in infancy may have created an

unconditional stimulus in her that persisted, as the latter grew older.

4

Rose feels that her little girl is controlling her and she has failed totally

in her reinforcement schedule. She wants to control her, so she does not show her

love. She feels guilty, frustrated and hurt because she cannot love her daughter

as much as she would wish to. This makes her feel abusive to her daughter while

she knows too well that she provides for her. She admits that she lacks the

spontaneity to loving her daughter; that she has had to tolerate her behaviour

and compromise while she feels controlled by her. From this point on, Dr

Berenson leads Rose into admitting her greatest weakness; that she is feigning

firmness while in real sense, she is competing with her daughter for control.

Apparently, she is guilty about it because she cannot resolve the conflict between

loving her and letting her have control over her persistent behaviour.

Eventually, Dr Berenson leads Rose into accepting her own solution- not letting

up on her resolve to reinforce her daughter. As the session closes, Dr Berenson

says this, Then Im not telling you anything you dont already know about

yourself, to which Rose answers in the affirmative.

Evaluation of Dr Berensons effectiveness

Throughout the interview, Dr Berenson attempts to use the skills of

empathy, unconditional positive regard and congruency with varying success. He

initially leads Rose in a purely facilitative role that does not hint at any

problems. As the session progresses, Dr Berenson affirms Roses own admissions

in a manner that enables her to see her weaknesses and strengths outright.

When she seems overwhelmed, he attempts to make Rose as comfortable as

possible while striking a balance between expediency/congruency and a non-

directive/non-judgmental approach. His empathy and absolute positive regard to

5

Rose leads her into a warm introspection that exposes the synergy between

several negatively reinforced behaviours.

Rogerian Counselling

Rogerian counselling is a nondirective method of group or individual

psychotherapy, originated by Carl Rogers, in which the therapist's role is to

listen to and then reflect or restate without judgment or interpretation the words

of the client. The goal of such therapy is personal growth achieved by the client's

increased awareness and understanding of his or her attitudes, feelings, and

behaviour (The Free Dictionary, 2011). Unlike other modalities of therapy the

client is responsible for improving their own lives not the therapist (Simply

Psychology, n.d.). This is a deliberate change from both psychoanalysis and

behavioural therapies where the patient is diagnosed and treated by a doctor. In

Person-Centred Therapy, the clients consciously and rationally decide for

themselves what is wrong and what should be done about it (Simply Psychology,

n.d.). However, in order for this to occur, Rogers (1967) writes that three core

conditions are required, namely unconditional positive regard, empathy and

congruency. In combination, these produce a growth promoting climate (PPC,

n.d.).

Identification and Evaluation of Rogers 3 Core Conditions

Unconditional positive regard

Unconditional positive regard is the term used to describe a condition used

in non-directive, client-centered therapy (About.com-Psychology, 2011).

According to Rogers (as cited in About.com-psychology, 2011), unconditional

positive regard involves showing complete support and acceptance of a person no

6

matter what that person says or does. However Rogers (as cited in Ilberg, n.d.)

acknowledges that unconditional positive regard occurs sometimes and not other

times and will vary in its intensity. Interestingly Ilberg (n.d.) writes that this

core condition is not only central to person centered therapy but it is also

important in everyday interpersonal relations.

Empathy

Empathy defies the capability of recognizing and possibly sharing feelings

of happiness but especially sadness of another fully sentient or semi-conscious

being. In human relations, it is considered the cornerstone of cordial relations. It

defines the degree of genuine compassion that one person can accord another

person. The conscious process takes into account the emotions of the other

person in the relationship. McLeod (2007) writes that empathic presence refers

to the physical and psychological presence therapists have with their clients (p.

18). Rogers (1967) writes that empathy helps to establish rapport, allows a

therapist to connect truly with their client and encourages self-exploration in the

client.

Congruency

Congruence can also be called genuineness (Simply Psychology,

n.d.). According to Rogers (1967), it is the most important of the three core

conditions. Unlike the psychodynamic therapist who generally maintains a

'blank screen' and reveals little of their own personality in therapy, the Rogerian

is keen to allow the client to experience them as they really are. In short, the

therapist is authentic (Simply Psychology, n.d.). However, congruence does not

mean that therapists disclose their own personal problems to clients in therapy

7

sessions or shift the focus of therapy to themselves in any way (Psychology.

jrank.org, 2011).

Implications for Rose

Rogers identified six circumstances necessary for finding solutions in PCT

sessions. These are relationship, genuineness on the part of the therapist,

clients vulnerability to anxiety, positive perception about the therapist's

genuineness, unconditional positive regard toward the client, and empathy. In

Roses case, these circumstances were presented in varying magnitudes, high

enough to make the session successful. From a positive appreciation of the client,

Dr Berenson was able to make her trust his genuineness, empathy and

eventually accord him rapport. This led her into admitting, one after another,

her self-perceived strengths and weaknesses before providing solutions for

herself. Dr Berenson remained an active facilitator for most part of the session.

According to Rogers (as cited by Prochaska and Norcross, 2007), the

standard and basis for a therapeutic effect is individual personal experience.

This implies a relatively simple way of understanding what informs ones

behaviour in a manner that it is- that ones actions and resolutions are within

his conscious thoughts. This has roundly been associated with ones capacity to

listen to his heart. As Dr Berenson roundly tells Rose, she needed to listen and

trust her heart to make out the best solution for her problem. This came of age

when Rose finally admitted having a resolve to help her daughter, which she

nevertheless did not push through with because she compromised herself. She

admits, Um, just trying to be so firm which you set out to be, breaking rules

along the way because you dont want to do that, at the same time, every time

8

you do it just gives it a little more leeway. Eventually, by listening to herself

and refusing to sensor her response, she eventually unearths the solution to her

problem; a solution that, hitherto, rests in her heart.

Counsellors Application of Counselling Skills and Their Impact on Rose

During the session, Dr Berenson applies the three conditions of the

Rogerian counselling with relatively high success. He shows adeptness in client

empathy strategies by reaffirming Roses feelings of frustrations, hopelessness,

and desperation. For instance, when Rose asserts that despite her efforts, it

seemed that nothing would work, he interjects by saying that, That that that

had to be very frustrating for you because every time you made some

progress...Boom. Again, when Rose admits feeling guilty for not loving her

daughter enough despite providing her with all she needs, Dr Berenson

interjects to empathize with her. He says in regard, And, and it, it partly you

feel some guilt...Because you are torn...so one feeling compounds another...And

you dont end up with the focus you need. This creates rapport for him and

connects him to Rose much more. She is able to open up more as a result.

Dr Berenson is also skilled in showing unconditional positive regard; a

trait that assures him of Roses trust to the end. For instance, when Rose admits

her frustrations with the reinforcement techniques in dealing with her daughter,

she resigns by saying, ...what can you do to, um, t make it be effective and work

for a long period of time, and not, I mean, when this is ok.... To this, Dr

Berenson answers, Youre really at a loss...Because you have tried all these, ah,

techniques and now you are left wondering about um, your resources.

Apparently, he knows that Roses declared weakness is the main cause of her

9

giving up, but he maintains the unconditional positive regard to lead Rose ahead

into appreciating this weakness. This continues in other sections of the talk

where he neither approves nor disapproves Rose, which reinforces her self-

regard. He also appreciates her internal frame of reference, which then makes

Rose quite perceptive of herself.

Dr Berenson proceeds to create an environment of congruency between

him and Rose. He solemnly asks for a chance to be trusted. This secures Roses

perception of his and her importance in the process. He also moves steadily and

efficiently to reinforce the incongruence that exists between Roses experiences

and her awareness of the same. This sustains the client-therapist relationship.

He is also able to show deep involvement, often affirming Roses admissions by

an Mmmm or by completing her statements. The taped session concludes with

Dr Berenson thanking Rose for sharing with him. This positively reassured her

that she had done the right thing by consulting Dr Berenson.

Strategies for Improving Roses Experience of Counselling

Person Centred Counselling not only looks at the past, it also entails

building a fulfilling future. An examination of prospective behavioural,

attitudinal and transpersonal conflicts is thus necessary. In the case of Rose, it

was necessary to build even a more passionate position especially regarding her

future behaviour. While the therapy focuses on the past and present life, it would

be imperative to create a lasting cognizant trust and a sense of naturalistic faith

in the clients thoughts about the therapy. The accuracy of her feelings and a

responsible appreciation of the merit of therapy as well as an acknowledgement

of freedom from past weaknesses should have been ascertained fully before the

10

session ended. When these are guaranteed, PCT would affect how the client

contributes to others lives and participates in decisions to unlock challenges

similar to the one presented in the current therapy.

As sessions close, therapists should also be careful not to rush clients into

accepting a path of admission without fully appreciating the same. Dr Berenson,

for instance, seemed to have rushed Rose into accepting her previous strategies

as the best strategies for her case rather faster. While this was expected as the

ultimate step in the therapy, the swiftness could have drawn Rose into acting

out her agreement to his counsel.

11

References

About.com-Psycholoy. (2011).Unconditional Positive Regard. Retrieved from

http://psychology.about.com/od/uindex/g/unconditional-positive-regard.htm

Ilberg, J. R. (n.d.). Unconditional Positive Regard: Constituent Activities.

Retrieved from http://www.focusing.org/upr_iberg.pdf

McCleod, J. (2007). Counselling Skills. Maidenhead, England: Open University

Press.

Person Centered Counselling. (n.d.).Carl Rogers. Retrieved from

http://www.person-centered-counseling.com/carl_rogers.htm

Prochaska, J. O., and Norcross, J. C. (2007). Systems of Psychotherapy: A

Transtheoretical Analysis. Thompson Books/Cole: New York.

Psychology.jrank.org. (2011).Client Centered Therapy. Retrieved from

http://psychology.jrank.org/pages/118/Client-Centered-Therapy.html

Rogers. C.R. (1967).On becoming a person: A psychotherapists view of

psychotherapy. London, England: Constable & Co.

Simply Psychology, (n.d.).Carl Rogers Therapy. Retrieved from

http://www.simplypsychology.org/client-centred-therapy.html

The Free Dictionary.(2011). Client-centered therapy. Retrieved from

http://medical-dictionary.thefreedictionary.com/client-centered+therapy

Watson, J. C., Cooper, M., and Hoeldampf, D. (2010). Person-centred and

experiential therapies work: A review of the research on counselling,

psychotherapy and related practices. Ross-on-Wye, UK: PCCS Books.