117 – Are the Core Conditions in Counselling Necessary and Sufficient?

Working with Clients on Prescribed Medication – Counsellors with Tattoos

In episode 117 of the Counselling Tutor Podcast, Ken Kelly and Rory Lees-Oakes ask whether or not Carl Rogers’ core conditions in counselling are necessary and sufficient for psychological change. In ‘Practice Matters’, Rory then talks about how to work with clients on prescribed medication. Finally, the presenters discuss the topic of counsellors who have tattoos.

Are the Core Conditions in Counselling Necessary and Sufficient? (starts at 1.58 mins)

This topic was raised in our Counselling Tutor Facebook group, where you can find over 23,000 students, qualified practitioners, supervisors and tutors interested in the world of counselling and psychotherapy.

The term ‘core conditions’ in counselling– referring to therapist empathy, congruence and unconditional positive regard – was first used by social scientist Robert Carkhuff in relation to social work.

In fact, Carl Rogers described (in 1957, in the Journal of Consulting Psychology) not just three but six conditions that he claimed were both necessary and sufficient to bring about therapeutic personality change.

Rogers' approach was innovative at the time in the world of psychotherapy, where psychoanalysis (founded by Freud) was then the prevailing modality.

Rory and Ken believe that the core conditions in counseling are certainly necessary in therapy, and may well be sufficient for many clients.

But this does depend on the presenting issue – for example, a client presenting with a fear of flying may need a different approach from person-centred counselling. Or a client struggling with trauma may need psychological education to help them make sense of what they are experiencing.

While the core conditions may well be necessary for a counsellor-client relationship, Mick Cooper – in his work on pluralistic therapy – points out that psychological change can also result from solo work (e.g. journal-writing).

Given that Carl Rogers was himself a keen researcher, maybe he – if still alive today – would have moved on from his original stance on the sovereignty of the six conditions.

Working with Clients on Prescribed Medication (starts at 15.14 mins)

In our work as counsellors, we are likely to come across clients who are taking various psychotropic drugs prescribed by doctors – for example, antidepressants, anti-anxiety drugs and perhaps even antipsychotics.

Rory explores how these drugs might affect the therapeutic relationship, and what you need to know to work safely and professionally with clients taking them.

Rory’s handout on this topic can be downloaded here; it is also available through the Handouts Vault and Counselling Study Resource (CSR).

In it, you will find links to various research resources where you can gain a balanced view of such medication and how to work with clients using it.

Counsellors with Tattoos (starts at 20.53 mins)

Does it matter if you, as a counsellor, have tattoos (or, in today’s language, body art)?

This question was another that came up on our Facebook group, following one person’s experience of being told that they may have to work with young people and/or charities given their tattoos.

Can having tattoos really affect your employability as a counsellor?

Ken and Rory think not: counselling is very much about the relationship between counsellor and client, and their feeling is that in general, clients are likely to care less about whether you have tattoos than about whether the two of you can relate well.

Besides, we all have a variety of physical features (e.g. accent, physique etc.) that some clients may warm to and others not.

Some tattoos can have hidden meanings, of which Rory gives an example – if it is a concealed hate symbol, for example, then this is likely to be seen as inappropriate in the counselling environment.