Just following on from my theme of non-directivity, I found this transcript of a presentation given by Margaret Warner, which I thought proposed a really interesting framework which might help us reflect on our own practice - both where it is and where we would like it to be.
Warner suggests that under the umbrella of client-centred practices, there are 5 levels of 'interventiveness' by which she means the degree to which the practitioner brings frameworks and ideas beyond the client's field of reference to the interventions.
Level 1 is really hypothetical. At Level 1, the practitioner brings nothing of themselves to the intervention and the dialogue and relationship exist entirely within the client's frame of reference. This is thought to be unrealistic (even if it were desirable, which is a moot point) as however skilful the practitioner, the client and practitioner are two different people and cannot inhabit the same psychological space.
At Level 2, the practitioner uses their own experiences and their frames of reference to help them to understand the client more fully. They are not trying in anyway to change the psychology of the client, just to understand it and walk in their client's shoes for a bit. The practitioner will try to communicate their understanding to the client, and if this works, the client will feel understood in that moment. The practitioner is aspiring to high levels of personal contact and low levels of control. Interventions at this level really are at the heart of Rogers's client centred approach.
At Level 3, the practitioner brings their own ideas, frames of reference and interpretations into the dialogue in order to allow the client to decide whether they are useful or relevant or not. The client is still responsible for the overall direction and content of the relationship and conversation. The relationship is very much one of equals.
At Level 4, the practitioner brings material to the dialogue from their frames of reference as an expert. This is a diagnostic model, where the practitioner finds out about the problem and makes a decision as to what kind of intervention is needed. The practitioner introduces these interventions to the client but from a position as the expert the assumption from both client and practitioner is that these should be implemented.
At Level 5, the practitioner introduces interventions without telling the client what they are doing or why. This contains the authoritative qualities of a Level 4 intervention but adds the idea that the client is unaware of what is being done to them.
Warner warns of the dangers of trying to incorporate interventions at different levels within the same therapeutic process, as the nature of the work alliance will be quite different at one level from another.
Levels 1 - 3 aim to foster a safe space in which the client can make their own decisions and where key issues can come to the fore. Levels 4 and 5 assume a considerable resistance in the client.
As I read these descriptions, I wonder if I'm a bit torn. If I think about what is going to be best for the client, I think I come down firmly in favour of Level 3. I am thoroughly sold on the self-actualizing tendency and the idea that the client is in the best place to make their own decisions. But I wonder if I am a little bit seduced by the notion of the expert in Level 4. I quite like the idea of being able to solve my clients' problems and I also wonder if clients themselves often see a value (or a security) in Level 4 interventions which might be harder to spot in Level 3.
I think this feeds into discussions about our own expertise. What is it that we can offer clients that no other practitioners can? I always come back to the idea that we are experts in the process of career and interventions - we know how people make career decisions and how to help them to make better career decisions. But where does that fit best? I think it is level 3. I think at level 3, practitioners can bring their own expertise, but they acknowledge that the client is the expert judge of whether these ideas are helpful. At level 4, our expertise is more obvious, but less helpful. But I think we as a profession need to be confident in order to position ourselves at Level 3.
“La
Psychotherapie Centree sur la Personne: Une nation, plusiers clans. Mouvence
Rogerienne—Nouvelle serie #9—Paris, Novembre 2004. (Translation by Cecile
Rousseau of ”Person-Centered Therapy: One Nation Many Tribes.”)
No comments:
Post a Comment