In the ninth episode of the Counselling Tutor Podcast, Ken Kelly and Rory Lees-Oakes talk about the role of power in the therapeutic relationship. Rory presents on the life of Carl Rogers, while Ken explains the skill of challenging. In ‘Ask Ken and Rory’, there is a debate about different models in psychopathology.
While in some modalities of therapy, counsellors may choose to portray themselves as experts, the person-centred approach advocates reducing the power imbalance between client and therapist. Making the power balance completely equal is impossible, simply because the client comes to us in distress, wanting our assistance, while we are not distressed. And in fact, even in person-centred counselling, there are several good reasons to retain some power as the therapist.
First, we are professionals, who must work within the law (e.g. on confidentiality). Second, the late psychologist Petruska Clarkson spoke of the reparenting aspect of working with clients, in the sense of setting clear boundaries for them. Third, clients need to see us as dependable and able to offer hope – for example, it could be really damaging if a counsellor collapsed in tears after hearing a client’s story. And last but not least, sometimes we need to refer clients to a more appropriate therapist or service. All these occasions are times when retaining an appropriate degree of power is both useful and important.
However, there are ways we can avoid flaunting our power, and we must be open to clients’ sensitivities in this regard. Ken illustrates this using his experience of counselling in a GP surgery, where a huge, plush chair was provided for the professional and a small, rickety one for the patient/client; he fetched another small chair in an attempt to equalise status. Other inadvertent displays of power include certificates on the wall, family pictures in the therapy room, and expensive cars outside.
The key is how you, as therapist, utilise your power: like all tools, it can be used for good and for bad.
Carl Rogers’ Biography
Rory has a special interest in the life and work of Carl Rogers. Here, he dives into some lesser-known facts about the founder of the person-centred approach to counselling. It is a story not only of humanity but also of great courage, as Rogers faced significant opposition to his new ideas, believing strongly that it was the client not the therapist – who was the expert.
Rory describes Rogers’:
Together, these led to his development of an alternative approach to the psychoanalysis that was so popular at the time. When Rogers died in 1987, his obituary in the Guardian newspaper understatedly described him as ‘the quiet revolutionary’.
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Challenge (sometimes also known as ‘confrontation’) is an advanced skill in the therapeutic relationship. Although these terms may sound at odds with person-centred counselling, it can be useful for the client to recognise a mismatch – say between thoughts and feelings, or between words and body language.
Challenge must be used with great care, and only when the therapeutic relationship (and so trust) is established. Ken provides examples of gentle challenge, and looks at how this can help clients in their gradual move from rigidity to fluidity. He recommends the book Skills in Person-Centred Counselling & Psychotherapy (Sage, 2012) by Janet Tolan, who suggests that challenge arises from the core conditions.
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What is the difference between the social model and the medical model, in terms of psychopathology (the study of mental disorders)? Simply put, the medical model draws on physical explanations for mental-health problems – e.g. chemical imbalances in the brain, to be treated using medication. Meanwhile, psychology (drawing on the social model) offers an alternative paradigm, instead advocating talking therapies to improve people’s wellbeing. Sometimes one approach is particularly suitable, and sometimes the other is more appropriate; at other times, the two approaches can be used together to good effect.