Person-centred counselling with clients presenting with drug and alcohol issues: an exploration of the client’s view Pauline Redgrift MA Client-Centred Psychotherapy, Leeds Metropolitan University May 2009

Research Presentation Rationale Aims and objectives Methodology Literature review Evidence, analysis and discussion Recommendations

Rationale Current political climate financial and clinical efficiency person-centred therapy viewed as generic Personal interest 10 years’ experience with client group pressures and marginalisation need for a choice of therapeutic interventions

Aims and Objectives To explore - from the client’s perspective - what had been helpful during the counselling process What does this tell us – or not - about the client’s perception of the therapeutic relationship What - if anything – does this tell us about the needs of this client group What does this show about the suitability – or otherwise - of person-centred therapy for clients presenting with drug or alcohol issues.

Methodology Data Grounded theory Limitations

Literature review Conclusions Equivalent outcomes Paucity of person-centred research and literature

Evidence, Analysis, Discussion Major findings from this research What the findings tell us How they relate to existing research

Evidence Four categories emerged communication change counsellor qualities structure.

Evidence Communication having someone to talk to having someone to listen freedom trust and safety.

Evidence Communication – the client’s voice “Feeling I can talk openly without feeling ashamed” “Freedom to discuss anything” “I’ve felt free to talk about personal things, without feeling silly or judged” “Knowing someone is there, to talk to, especially when something bad has happened is good”.

Evidence Change changes in awareness changes in behaviour changes in self-concept.

Evidence Change – the client’s voice “Has helped me to respond differently to difficult situations” “Coming here makes me think clearly, when I go away from here I know I’m OK, I trust myself more”. “I am in touch with my feelings now, whereas before I didn’t really think they mattered” “I like who I am becoming”.

Evidence Counsellor qualities the client’s experience of particular qualities related to the counsellor e.g. consistent, supporting, encouraging

Evidence Counsellor qualities – the client’s voice “Helps not to be judged, the counsellor doesn’t change her opinion of me whatever I say” “Good to have someone impartial to speak to, not judging, just say what you want to say” “The counsellor being a real person” “ Kindness - the counsellor calling when I haven’t attended”.

Evidence Structure the structure of a dedicated physical and emotional space the structure provided by the routine of attending a weekly session.

Evidence Structure – the client’s voice “A space once a week especially to talk” “A time and space to concentrate on what the problems are” ‘Weekly routine gives structure’ “The routine of coming is important”.

Analysis Findings and the research questions Findings and existing person-centred research/literature

Analysis Research findings perception of the therapeutic relationship the needs of this client group and the suitability of the therapeutic relationship

Analysis Findings and existing research/literature Lillie (2002), Moerman and McLeod (2006) other writers from within the person-centred approach

Discussion Significant Issues Co-morbidity Extra-therapeutic variables What is being measured Therapeutic personality change

Recommendations More person-centred, evidence-based research is urgently needed, particularly with specific client populations if this approach is not to be further marginalised by disorder- specific therapeutic interventions.

Recommendations A study of clients reporting no change or an increase in their substance use during therapy in order to explore if clients reported growth (therapeutic change) in other areas the nature of the changes the potential influence or not of extra therapeutic variables in supporting those changes.