Life change in non mental helth professionals trained in pca by ΒΑΣΙΛΗΣ ΜΠΛΙΤΣΑΣ

University of Strathclyde Department of Counselling Institute of Counselling and Psychological Studies

VASSILIOS BLITSAS

Dissertation Title

Life change in non mental health professionals trained in PCA: An Interpretative Phenomenological Analysis

A thesis presented in fulfilment of the requirements for the degree of Master of Science in Counselling

2014

The copyright of this thesis belongs to the author under the terms of the United Kingdom Copyright Acts as qualified by the University of Strathclyde Regulation 3.49. Due acknowledgement must always be made of the use of any material contained in, or derived from, this thesis.

Dedication

To my beloved Konstantina, to Orestis and Artemis the three most powerful reasons for me to continue dreaming

In loving memory of my father who inspired me to walk the path of knowledge

In loving memory of my spiritual father, trainer, facilitator and mentor in the Person-Centred Approach, Ioulios Iosiphides

Acknowledgments

First of all, I would like to thank my supervisor in this dissertation, Maria Kefalopoulou for all her help and support during the writing of this study. Maria, your help and mainly your presence has been valuable to me, in order to continue, despite my difficulties, and finally complete this dissertation. In addition, I would like to thank Dimitra with whom I shared countless hours of work, inspiration, enthusiasm, disappointment, fatigue and hope in the context of our collaboration, as she too was simultaneously preparing her dissertation. I would like to express my thanks and gratitude to the participants of my study, who so generously gave me their time and shared all these personal issues with me. Lastly, I would like to express my gratitude to Konstantina, my partner in life, who supported me through the difficult hours of writing. Her faith in me, her understanding, her encouragement and of course her practical help on every possible level was invaluable for the completion of this dissertation.

Tables Table 1: Demographic and other information

Table 2: Level of training in PCA

Table 3: Institution of training in PCA

Table 4: Previous studies and occupation

Table 5: Results

Abbreviations

PCA: Person-Centred Approach PCT: Person-Centred Training P: Participant WHO: World Health Organization NEAPCEPC: The Network of European Associations for Person-Centred and Experiential Psychotherapy and Counselling IPA: Interpretative Phenomenological Analysis MSc: Master of Science ICPS: Institute of Counselling and Psychological Studies P.S.L.: (Psychosocial Studies Laboratory)

Abstract The present dissertation attempts to approach, though research, the role of PCA training in life change under the spectrum of non mental health professionals. The participants in the study are 6 individuals whose common characteristics are that they have been trained in PCA to a minimum of the Certificate level and that they also have a non mental health background prior to their training. The data collection was conducted with the use of an in-depth semi-structured interview. IPA (Smith et al. 2009) is the method I used for the data analysis. From the data of the 6 transcribed interviews 4 superordinate themes that are comprised of secondary themes emerged. The findings show that: life change of non mental health professionals trained in PCA is experienced as a process of wholeness and expansion; they present training in PCA as a journey to selfawareness; individuals trained in PCA are presented to experience a new life stance as a continuing process; the profession of Counselling appears to be experienced as a precious gift for those trained in PCA. Most of the findings of this dissertation appear to be similar with previous studies, mostly quantitative but also some qualitative, that refer to PersonCentred Therapy. However, two new qualitative characteristics emerged in relation to life change that had not been found in previous studies. The first one concerns the concept of delimitation within the context of life change as continuing process. The second concerns the element of passion for self-awareness and learning through many dimensions. Limitations, implications and suggestions for further research were also mentioned.

Table of Contents Dedication

Acknowledgments

Tables

Abbreviations

Abstract

Table of Contents

Chapter 1 : Introduction

1.1. Background

1.2. Significance of the study

1.3. Aims of the study

1.4. Term

Chapter 2 : Literature Review

2.1. Quality of life - “The good life”

2.1.1. Quality of Life

2.1.2. Theoretical models of Quality of Life

2.2. Changes in life and self

2.2.1. Change after encounter groups or training groups in persons – relationships-organizations

2.3. Training in Counselling – Psychotherapy

2.4. Training in the Person-Centred Approach

2.5. Research Question and areas of research

Chapter 3: Methodology

3.1. Design

3.1.1. Qualitative method

3.1.2. Data Analysis â&#x20AC;&#x201C; IPA

3.2. Participants

3.3. Procedure

3.3.1. Data collection â&#x20AC;&#x201C;Interview

3.4. Ethical Issues

3.4.1. Confidentiality

3.4.2. Informed Consent

3.5. Reflexivity

Chapter 4: Findings

4.1 Life change as a process of wholeness and expansion

4.1.1 Change and the role of the Conditions

4.1.2 Change as a process of expansion and development of abilities

4.1.3 Change as a process of wholeness through trust and acceptance

4.1.4 Change as a process of Respect, Parity and self-care

4.2 Training in PCA as a journey of self-awareness

4.2.1 The need for self-awareness and the interest in the person as factors for choosing PCT

4.2.2 Choosing PCT through personal & professional anxieties

4.2.3 Experiencing training as an asset of development

4.2.4 Experiencing new horizons through training

4.3 Experiencing a new life stance as an ongoing process

4.3.1 An ongoing process through delimitation and choice

4.3.2 An ongoing process with difficulties, conflicts and renegotiation

4.3.3 A new life stance that focuses on here and now and the core conditions

4.3.4 A new life stance with passion for multi-dimensional knowledge and self-awareness

4.4 The profession of counselling as a valuable gift

4.4.1 Self-value as a Counsellorâ&#x20AC;&#x2122;s professional tool

4.4.2 A different life stance as a profession

4.4.3 Passing on a worthwhile experience

4.4.4 The profession of counselling as means for ethical elevation

4.4.5 Person Centered Training as asset for any profession

Chapter 5: Discussion

5.1 Limitations of the study

5.2 Implications of the study

5.3 Suggestions for further research

Chapter 6: Conclusions

References

Appendices

Information Sheet

Consent Form

Interview Questions

Chapter 1: Introduction 1.1 Background According to Carl Rogers, PCA is more a way of life, a way of being than a method or simply a therapeutic technique (Rogers, 1957,1970f,1972a,c,1977,1979,1980). In order to define a different way of life, Rogers also used the term “the good life”. He first negatively and then positively described “the good life” as follows:

“It is not, in my estimation, a state of virtue, or contentment, or nirvana, or happiness. It is not a condition in which the individual is adjusted or fulfilled or actualized. To use psychological terms, it is not a state of drive-reduction, or tension-reduction, or homeostasis. (Rogers, 1961:186).

and The good life is a process, not a state of being. It is a direction not a destination. The direction which constitutes the good life is that which is selected by the total organism, when there is psychological freedom to move in any direction. ... I can integrate these statements into a definition which can at least serve as a basis for consideration and discussion. The good life, from the point of view of my experience, is the process of movement in a direction which the human organism selects when it is inwardly free to move in any direction, and the general qualities of this selected direction appear to have a certain universality.. (Rogers, 1961:186). 11

It is, therefore, a possibility of change and movement of the definition of life from the priority of “acting” to the priority of “being” or “existing”.

From my personal experience through my training in PCA, as well as my experience as a trainer in PCA training programs, I have been fortunate enough to become a vessel of a deep and radical change in the quality of life and the relationships of the people trained in this approach. This experience involves both people that are trained in PCA that have a professional background in mental health as well as others that don’t. It seems to be fitting with Rogers’ belief that counselling can embrace other helping professions (Rogers, 1970). This dual experience together with my deep caring for the trainees in PCA, led me to propose the following research. .

1.2 Significance of the Study This dissertation is interested in the exploration of the value of person-centred training for individuals with a non mental health professional background, not only as a professional asset but foremost as a tool for developing “well-being” (Leijssen, 1990, Corcoran, 1981, Lovejoy, 1971, Mearns 1997b, Grafanaki 2002). In addition, the data and the findings presented in this dissertation can be very useful to people that don’t have a professional background in mental health and that plan to be trained in PCA, or who are already in training, in order to have an in-depth view of Person–Centred Training not only as a professional tool but also as the potential of changing their lives and relationships.

1.3 Aims of the Study Based on the research framework that has been described, the present dissertation attempts to approach, though research, the role of PCA training in life change under the spectrum of trained people that donâ&#x20AC;&#x2122;t have a professional background in mental health. Taking the above under consideration the aims of this dissertation can be grouped as follows: 1. To explore life changes of non mental health professionals trained in PCA through this training. 2. To examine if training in PCA contributes to the positive change of the counsellorâ&#x20AC;&#x2122;s quality of life in some way, as well as if it brings about difficulties in their life and relationships and what kind of difficulties.

1.4 Term Quality of life: Multi-dimensional concept that depends on a wealth of factors. The main distinction is between subjective and objective indictors for the measurement of quality of life. For the purposes of this study we will use Nollâ&#x20AC;&#x2122;s definition (1998) according to whom the subjective dimension (of quality of life) refers to the sense of well-being and the satisfaction one derives from people in their intimate environment. The objective dimension is connected to the satisfaction one derives from external conditions and especially those that relate to cultural and social demands (socio-cultural framework) in correlation with material prosperity, social standing and physical well-being (Noll 1998).

Chapter 2: Literature Review

2.1. Quality of Life – The Good Life Towards the end of the 19th century and the early 20th century, in advanced European countries and America the term “quality of life” arose through studies on living conditions. In its most general form the concept of “quality of life” is referred to as the living conditions that make up people’s everyday prosperity. This presupposes the securing of material and non material assets: health, safety in life, social serenity, harmonious conditions of people’s collective living, respect, joy, dignity, optimistic overview, aesthetic and cultural values, cultivation of body and spirit, good natural, ecological and social environment. (Andrews, 1986). In a broader perception of the person, as a personality through society, the term “quality of life” also obtains one more dimension: it refers to the subjective presuppositions in the internal, mental, ethical and intellectual world of a person. (Andrews, 1986). 2.1.1. Quality of life Aristotle [384-322 B.C.], one of the main voices of the philosophy of monism, attempts a first definition of quality of life in “Nicomachean Ethics”. There, it is mentioned that the crowd and the nobles perceive the concept of “well-being” or “being well” as the same as “being happy” (Aristotle, 2005). A great amount of discussion has been held about the translation of Aristotle’s term “eudemonia”. Among others Fayers and Machin (2000) chose the more appropriate term “well-being” instead of the term “happiness” in order to translate Aristotle’s “eudemonia” since the term implies an emotional state as well as a form of activity. However, in common language, the term definitely describes quality of life. Thus, according to Fayers and Machin (2000), although the term “quality of life” did not exist in Aristotle’s time, he 14

understood that “quality of life” did not only mean different things to different people but it also shifted depending on a person’s current circumstances. According to Shaw (1972, Vol. 2 p.p 1898-1910) the term “quality of life” was rarely mentioned prior to the 20 th century. As he, who was himself one of the first researchers on the issue, says: “Life in its grandeur leaves happiness behind and quite often cannot endure it… Happiness is not the goal of life: life has no goal: life is itself the goal and courage is shown in one’s readiness to sacrifice happiness for a more essential quality of life” (Shaw, 1972, Vol. 2 p.p. 1900). The term “quality of life” is a relatively new concept that first appeared in the U.S.A. in the 50’s. It was originally equated with the term of “standard of living” as it included concepts that had to do with a consumer society: owning electrical appliances, cars and homes. In 1960 the term was broadened to include education, health and wellbeing, economical and industrial growth (Fallowfield, 1990). Until 1992 there was no commonly accepted definition for quality of life. This is due to the fact that the concept was on the cusp of two humanistic sciences: social sciences and health sciences (Lamau, 1992). On a theoretical basis, quality of life could be defined as the description of the characteristic conditions or areas of life that are determinant to the independent operation of these areas. It therefore is the freedom of action, the signification of actions, professional and family recognition and the fulfilment of biological and psychological functions in everyday life and the maintenance of health (Lamau, 1992). Dalkey and Rourke et al (1972) defined quality of life as the persons’ sense of his/her degree of well-being, satisfaction about life and happiness concerning his/her health, actions, anxiety, goal achievement, self-esteem, depression, social and family support. Hornquist (1982) believes that quality of life as a whole has to do with the degree to which his/her needs concerning physical, psychological, social, material and structural areas of life are met. According to Lewis (1982) quality of life is the degree to which one has self-esteem, purpose in life and minimum stress. Generally, quality of life is considered to be the result of the interaction of many factors (health, society, economic status, environment) that affect the personal and social development in ways often unknown and unexplored (Treasury Board of Canada Secretariat, 2000). 15

As we saw previously, the concept of “happiness” was abandoned as too difficult to measure and was replaced with the concept of “satisfaction” in the definition of “quality of life”, accordingly it was viewed that the concept of “satisfaction” is not a stable concept as it constantly changes. So, in order to provide a solution to this question, De Haes and Van Knippenberg (1985) supported that satisfaction in relation to quality of life, refers to the total evaluation of the subjective experience of life. Thus, quality of life is defined as the physical and psychological state of a person that gives him/her the sense of satisfaction within a specific environment. Therefore, in one sense, quality of life can be defined as the degree to which the appropriate conditions exist, within a given environment, that give a person satisfaction. As a measurable variable, quality of life refers to the subject of research as well as to the object of research (Mucherjee, 1989). It includes the subjective evaluation by the individuals or groups regarding their satisfaction of their living conditions and their way of life in the environment they live in. For this reason, the study of quality of life takes the needs and the expectations of an individual or a community under consideration. In addition, the World Health Organization attempts to provide a definition of “quality of life” as follows: ‘an individual’s perception of their position in life in the context of the culture and value systems in which they live, and in relation to their goals, expectations, standards and concerns (WHO, 1992). From what has been mentioned above, it is made clear that quality of life is a multidimensional concept that is dependent on a wealth of factors. The basic distinction is between the subjective and objective markers on the measurement of quality of life. The subjective dimension (of quality of life) refers to the feeling of well-being and the satisfaction that people derive from their familiar environment. The objective dimension connects to the satisfaction that is derived from external bodies especially those that relate to cultural and social demands (social-cultural framework) combined with material prosperity, social standing and physical well-being (Noll, 1998).

Therefore, every study on quality of life must take one internal and one external dimension under consideration. The first dimension relates to the satisfaction that people feel about their life and the second to the physical objects that cause said satisfaction or relate to it (Pacione, 1982). The view that the studies that focus only on the subjective factors lead to a wealth of definitions of quality of life proportionate to the participants in the study, is attributed to supporters of objective factors in the definition of quality of life (Cantril, 1965; Szalai & Andrews, 1980). It is thus considered that quality of life can be studied and objectively measured in nine basic areas: Cost of life, crime, health care, occupation, transportation, education, the arts, recreation and climate (Boyer & Savageau, 1985, 1989, 1993). Other researchers focused mainly on demographic, socioeconomic and environmental factors in order to define quality of life. On the other hand the supporters of subjective factors in quality of life believe that taking only the objective factors under consideration, how citizens feel about their life is ignored (Türksever & Gündüz, 2001). Thus, it is viewed important in the study of quality of life to consider both the objective and the subjective markers. This way cognitive, social and emotional factors are studied, covering all aspects of human nature (Noll, 1998). 2.1.2. Theoretical models of quality of life A wealth of theoretical models were developed bearing significant differences among them, relative to the focus on different factors. Thus, models that prioritized basic needs following Maslow’s hierarchy of needs (1954, 1968) were developed. Others were based solely on psychological well-being, happiness and satisfaction in life (Andrews & Witney, 1976; Larson, 1978, Andrews; 1986), on social expectations (Calman, 1984) or on personal perceptions (Ο’Βoyle, 1997). According to Campbell et al. (1976) quality of life relates to the degree of satisfaction from life and living conditions. Young and Longman (1983) also supported that quality of life refers to the physical, material and psychological well-being of the individual. 17

Flanagan (1978, 1982) classified it in five large categories with fifteen factors that affect quality of life according to him: physical and material well-being (financial comfort and security and health), relationships with others (marital relationships, upbringing of children, relationships with relatives and close friends), social and communal activities (helping others, participation in local and national activities), personal growth and recognition (spiritual growth, personal goal setting and self-awareness, interest in occupation, creativity and experience) and lastly, free time (socialization, recreational activities). Rogerson (1997) agreed with the dual nature of quality of life and the objective living conditions of individuals. Thus, he focused on the influence of communal life on its members’ quality of life. Raphael et al (1998), on the other hand, believed that quality of life can be evaluated based on three basic areas: “being”, which means who the person is regarding one’s physical, psychological and spiritual characteristics, “belonging” that includes the relationship people have with their physical environment, their social environment and their community, and lastly, “becoming” that refers to the individual actions in order to achieve his/her personal goals and aspirations. Borsdford (1999) added the “objective-personal aspect” between the objective and subjective aspects of quality of life, which means the perception that people have of the objective provisions and services of their area. In this way the convergence of objectively good living conditions and their subjective evaluation was attempted. Lastly, the complete theory of quality of life, according to Ventegodt et al (2003), in the western world, includes all those elements that make a person happy, complete and satisfied in his/her needs, properly functioning in his/her social surroundings etc. According to this theory the above mentioned elements can be grouped in three different categories – aspects of well-being: The subjective quality of life that involves how good a life the individual evaluates he/she has. The existential quality of life, which means how the good in a person’s life is on a deeper level. Objective quality of life that relates to how the person’s life is perceived by the outside world and is affected by the culture 18

he/she belongs to. These three aspects of quality of life are connected in a continuum from the objective to the subjective. The existential element connects the subjective and the objective with one another representing the depth of a person’s prosperity.

From the above, the conclusion can be drawn that quality of life is a multidimensional concept that reflects the fulfilment and the function of all human aspects, meaning the physical, psychological, social and professional/educational aspect in the sphere of his/her everyday life (Levi & Drotar, 1998; Starfield, Riley & Drotar, 1998). In addition, according to the World Health Organization (WHO, 1992) the concepts of quality of life, prosperity, happiness, and satisfaction from life reflect what we call health and quality of life in general. In order to define “well-being” as well as what it reflects, there is, on the one hand, the modern investigative perceptions on quality of life (Guthrie, 1993) and a central, in this dissertation, concept of Rogers’ “the good life”, on the other hand, that is perceived in the context of one unified and organized Gestald, the self (Rogers 1961,190). 2.2. Changes in life and self Rogers devoted his entire life and work to empirically and through research establish the basic presupposition for life change. He thus posed the necessary and sufficient conditions for personal change: congruence, empathy and unconditional positive regard, which constituted the foundations of the Personal-Centred Approach (Rogers, 1957). Rogers attributed to congruence a prominent position in life change, as a continuing process and not as a goal or purpose (Merry, 1994). He considered that the person while being in touch with what is happening in him congruence could also be more open to the experience and in that way he can perceive life more as a process rather than as something consolidated – he/she can accept the changes, without being threatened by them, while changing constantly ( Rogers, 1961, p.182-186). 19

Another presupposition for the person is to receive unconditional positive regard for a sufficient period of time in order to start trusting and accepting the, in other circumstances threatening, internal experiences. This may happen when in a relationship the Other empathically experiences exactly what the person experiences while being in incongruence (Rogers, 1961, p.186 & Rogers, 1957).

Life change is strongly related to change in self. The concept of self and selfconcept hold a central position in the Person-Centred Approach (Brauns, 1979, Kropf, 1978: 57, Pervin & John 1999:242). In fact, according to Merry & Mearns the Personcentred Theory of Personality is often referred to as the “theory of self” (Merry, 1994, Mearns, 2002). Rogers defines self as: The organized, consistent, conceptual Gestalt composed of perceptions of the characteristics of the “I” or “me” and the relationships of the “I” or “me” to others and to various aspects of life, together with the values attached to these perceptions. It is a Gestalt available to awareness although not necessarily in awareness. It is a fluid and changing process, but at any given moment it is a specific entity […]It is a lasting reference point for the individual and he/she orients his/her actions towards it” (Rogers, 1977, p.36).

Therefore, it constitutes a constantly changing sum of all that is associated with these experiences, the perceptions, the beliefs and the way the person evaluates his/her relationship with others. But because “the self is not a little homunculus inside us […] it does not control the behaviour of the individual” (Pervin & John, 1999:242), the change of one aspect of self can change self-concept as a whole. Therefore, to the extent that the previously mentioned presuppositions exist for a sufficient period of time, the necessary and sufficient conditions for change, extremely significant changes in self-concept are observed (Tolan, 2002). In chapter 11 of Rogers’ “On becoming a person” a large scale study is presented with exceptional data relating to the possibility of measuring the changes that occur in 20

self through Person-Centred therapy. Thus, as is supported by Rogers, the road is opened to the study and research documentation of every theoretical structure relative to the change of personality or to the process of psychotherapy (Rogers, 1961: Chapter 11).

In 1953, Seeman & Raskin reported, describing 50 studies relative to clientcentred adult therapy and its effects in a variety of aspects of personality and self. In addition, in 1957, Cartwright published literature about the research of the theory of Person-centred Therapy that refers to 122 studies. In 1952, Ruskin published a survey about the focus of client’s evaluation in psychotherapy. Raskin’s basic question was whether or not the client’s focus-of-evaluation changes through psychotherapy (Raskin, 1952). Despite the small survey sample, it was the first time that it was documented via research that, through Person-Centred therapy, the client tends to reduce the need for support and evaluation of others while tends to increase trust in his/her own evaluation.

Several studies have also been conducted regarding the changes in self and selfperception of the client through Person-Centred therapy. Indicatively, the study of Butler & Haigh validated that the changes that occur through Person-Centred therapy in the client’s self-perception are in the direction of the clients appreciating themselves more and this change tends to last after the therapy ends (Butler & Haigh, 1954). Other studies also show that what mainly changes with therapy is the perception of self and not the ideal self (Rogers & Dymond, 1954).

Barret – Lennard conducted an exceptionally innovative study holding particular interest for the research question of the present study. In this study elements of psychotherapy that are capable of causing change were studied. For the first time the client’s change was connected to the necessary and sufficient conditions for change of the Person-Cantered Approach (Barrett – Lennard, 1959). 2.2.1

Change after encounter groups or training groups in personsrelationships-organizations

Several examples of change through encounter groups have been mentioned by Rogers himself as well as by many others more recently. These changes could be summarized in three categories a) in persons b) in relationships (personal, family, professional, social) c) organizations (such as schools, companies, universities, hospitals etc) (Rogers, 1970d,e,f). According to Jack Gimp, who analyzed 106 relative studies, also including 7 previous reviews, strong evidence was presented that the intense experiences that training groups have, produce therapeutic results. In addition, changes occur in their ability to regulate emotion and to express motivation, in their sensitivity, their bavior towards others and their “interdependence” (Gimp, 1970). Gimp refers to concepts such as self-actualization, self-identification, self-direction and self-acceptance (Rogers, 1970d) Another study that also deals with the nature and the process of change in the members of the group is that of Meador. The result of this study showed a significant degree of progress in the process towards greater adaptivity and expressiveness. According to Meador (1969) it became obvious that people that were strangers in the beginning related to a degree that is not commonplace in everyday life. In literature we find several meta-analysis studies of the researchers’ data as well an-speaking field. The results of these studies allow us to conclude that the Personcentred Approach is an adequately documented approach as concerns to its effectiveness, the absolute, the relative and the differential on the one hand and on the other adequately researched as concerns to the process relating to the therapist, the group and the interaction. Something that might have not been researched enough is the way in which the experiential training of counsellors (that is based on the same principles as PersonCentred therapy) affects their own lives and relationships. 2.3. Training in Counselling- Psychotherapy Almost from the beginning of the growth of research interest in psychotherapy an issue that appeared to motivate researchers’ interest was, among others, the idea that therapists with different theoretical orientation are also different in their totality from one another (Barron, 1957, 1978; Herron, 1978; Shaffer, 1953). The choice of one approach 22

depends on various variables and circumstances such as the availability of the specific training in their area, the institutional and cultural environment of the professional framework, the orientation of the trainers and supervisors early on in the prospective therapistsâ&#x20AC;&#x2122; career and the approach of the therapy that the prospective therapists have possibly received. (Guy, 1987). Therapists are trained and work in a specific theoretical model they possibly receive personal therapy in this model and are influenced in their self-concept, worldview and their personal life in various ways is also researched (Guy, 1987; Farber, 1983; Henry, Sims, & Spray, 1971, 1973). Thus, studies have shown that therapists that have been trained in different approaches aside from their differences in methods, technical and therapeutic orientations, also differ in their fundamental views of human nature, their perceptions on mental health and the epistemological and ontological background (Henry et al., 1973; Messer & Gurman, 2011). More specifically, other studies support that therapists of the Cognitivebehavioural approach were found to be more rational, objective, conscientious and less open to conversation (Arthur, 2000, 2001; Boswell, Castonguay, & Pincus, 2009; Buckman & Barker, 2010; Lyddon & Bradford, 1995; Poznanski & McLennan, 2003; Schacht & Black, 1985). It has also been observed that psychodynamic therapists are more intuitive with abstract and open thinking, are open to experiences, complex, serious and less conciliatory and compromising (Arthur, 2000, 2001; Buckman & Barker, 2010; Topolinski & Hertel, 2007; Walton, 1978). Therapists of humanistic approaches have also been proven to focus more on internal direction, self-realization and intuition (Poznanski & McLennan, 2003; Tremblay, Herron, & Schultz, 1986). It thus appears that therapistsâ&#x20AC;&#x2122; professional theoretical approach relates to the personal beliefs on human nature, their perception on mental health or the personâ&#x20AC;&#x2122;s desired condition, as well as the nature of reality in general (Sandell et al., 2004; Larsson, Kaldo, & Broberg, 2009). It is a fact that there are not enough studies that document the specific qualities in the personality of therapists depending on the approach and almost no relative studies 23

about the effect of training in psychotherapy in life change of the therapist him/herself. However, some limited studies have been conducted that show that psychodynamic therapists are more prone to the personal characteristics of â&#x20AC;&#x153;neurosisâ&#x20AC;? than therapists of other approaches (Boswell et al., 2009; Poznanski & McLennan, 2003). Cognitive behaviourists also have been found to be more dynamic and oriented towards action (Keinan, Almagor, & Ben-Porath, 1989; Scragg, Bor, & Watts, 1999). It has also been found that therapists of humanistic approaches are more spontaneous (Tremblay et al., 1986). In addition, studies about training in counselling and psychotherapy of other approaches seem to highlight the characteristics of the Counselling profession relative to the effectiveness and professional development combined in some instances with personal development (Heinonen & Orlinsky, 2013; Carlsson & Schubert, 2009; Fragkiadaki et al, 2013). There is a direct interdependence between the theoretical approach of psychotherapy on the one hand and personality, perceptions, beliefs, ontology, worldview and way of life of the therapist on the other. The kind of relationship and interaction between these two is considered to vary and depends on various parameters and there are not enough studies that accurately document it (Sandell et al., 2004; Larsson, Kaldo, & Broberg, 2009).

2.4. Training in the Person-Centred Approach But, life change of therapists can also be the effect o training in the PCA. Early on, with the beginning of the spread of the Person-Centred Approach in the U.S.A - as well as internationally, the need for the existence of specific training programs for Person-Centred counsellors, consistent with the principles of the approach, became apparent. This occurred because it very quickly became clear that a personâ&#x20AC;&#x2122;s academic 24

qualifications were not sufficient to be able to relate to this different, facilitative way with others, as it was introduced by Carl Rogers (Rogers, 1957, 1970a). For years Rogers resisted the establishment of a training program in the Person-Centred Approach organized to academic standards, since he found it conflicting with the principles of the approach (1970a).

But that changed in 1980 and the reasons for this change are

explained by Rogers himself in an interview he gave in 1981 saying: “I am a person who is reasonably sensitive emotionally, fairly intuitive, but I also like the fact that I have a brain, and I like to use it. This new direction is an attempt to discover ways in which people would both experience and learn a Person-Centred Approach as whole persons with experience and emotions involved, but with their intellects also involved.” (Natiello, 1998:39) Rogers’ new direction resulted in his creating the “Training Program in PersonCentered Approach” in 1980, in LaJolla – California. That same year Curtis Graf, Ruth Stanford and Peggy Natiello started the “In Depth Training Program in the PersonCentered Approach”. In these programs emphasis was given on the development of the communicational skills through lived experiences in encounter groups. At the same time there was a conscious effort to preserve their autonomy in the academic and university fields in order to preserve the congruence of the person-centred principles. Selfawareness, self-acceptance and self-responsibility and the ability to put all these in practice in the trainees’ relationships are educational goals of the specific programs (Natiello, 1998).

In Natiello’s “In Depth Training Program in the Person- Centered Approach” an independent study was conducted in order to measure the quality and the effectiveness of the program. The participants in the study were 80 people previously trained in the program. 60% of them had Master Degrees, 10% had Doctorates and 2% had some kind of college education without holding a postgraduate degree. The results of this study demonstrate that the training program remarkably benefited and had a strong positive effect on the lives of the trainees. The following benefits are indicatively mentioned: 44% felt that their participation had exceptionally established their social development. All the participants in the study also stated that, more or less, the training contributed to their 25

personal development. 98% stated that they were empowered through the training, 92% developed congruence, 90% developed empathy, 88% positive regard and 86% the trust to ask help from others in order to solve their problems (Natiello, 1998).

Similar training programs were developed in Europe as well in the 1980’s which spread to many European countries such as Holland, Germany, Belgium, Greece and Britain while smaller but equally powerful training programs were developed in France, Hungary, Italy, Switzerland, Portugal and Croatia. Dave Mearns describes four central dynamics of a Person-Centred program, as he saw them: 1st, the dynamics of responsibility, 2nd, the development of self-regard, 3rd, the individualization of teaching, 4th, the individualization of evaluation (Mearns 1997a). However, as was observed by Mearns, that despite the spread of PCA in Europe and internationally as well as the development of relative educational programs there was no development in the relative literature on Person-Centred training nor in the relative studies about the effect of the training in the life of the trainees (Mearns, 1997b). Leijssen (1990) highlights the need for training programs to be closer to an experiential process that is not only developed through therapy and supervision or even through practice, but also through the focus on “being” with other people, such as partners, friends, family etc. Corcoran (1981) and Lovejoy (1971) also agree with Leijssen and emphasize the need for the development of experiential empathy as well as the importance of physical work in the development of the councillor’s self-awareness.

However, as has been mentioned above, there has been some discussion initiated by Rogers himself, regarding training in Person-Centred Approach within academic frameworks. Thomas (1988/2002) refers to an experiential model of Person-Centred training within academic frameworks that could not have any other priority other than the development of congruence. We have already mentioned Natiello (1998) who approaches the academic integration of PCT with scepticism. Relative discussions on training in PCA have also begun in Great Britain in the past years (Embleton Tudor et all, 2004). Regarding the training of counsellors and psychotherapists, Combs (1986/2002) criticizes traditional behavioural counsellor training and emphasizes importance of training in the 26

Person-Centred Approach that focuses on the trainee’s beliefs and needs for knowledge. Thus, in 2001 NEAPCEPC approved a document that lists a number of points regarding Person-Centred and experiential training that includes the effort to connect experience and process aiming at a self-navigating way of learning and the elements of the training in personal development, the theory and practice based on Rogers’ Conditions. More recently, Embleton Tudor et all (2004) emphasize the importance of viewing PersonCentred training as a process of lifelong learning and Tudor & Lewin (2006) explore the importance of the agreement of the philosophy and the principles on which a training program is based and the organization and the direction of that organization.

As regards to the study of the effects of Person-Centred training we could not omit to mention the work of Rogers himself (1969, 1983), who presents a number of innovative relative studies. Aspy & Roebuck (1988/2002) refer to a study that gives us positive results in training relating to the level of congruence, unconditional positive regard and empathy of the trainers. Barrett – Lennard (1998) presents studies that show how the teacher-student relationship, when transcended by the therapeutic conditions, have a positive effect with the conquering of the students’ educational goals. Generally we could support, based on the above, that Person-Centred training in counselling, based mainly on congruence, empathy and unconditional positive regard is transcended (or should be transcended) by good facilitating (Rogers 1969, 1983, Aspy & Roebuck, 1988/2002, Barrett – Lennard, 1998).

However, as it mentioned by Grafanaki (2002), that there is a relative lack of literature and research documentation of Person-Centred training and especially of the effect of this training on the lives of the counsellors in training, in accordance to the fundamental principles of the Person-Centred Approach , that first and foremost relate to a way of life and existence in the direction of developing a fully functioning person. Carl Rogers (1951, 1957, 1961, 1977) 2.5. Research Question and areas of research

Based on the literature review we form the following research question and some more specific research questions which also emerge that could be encoded as follows: Research Question: How non mental health professionals trained in PCA experience change. Research questions: 1. How is life change perceived through training in the Person-Centred Approach? 2. How are self and changes in self and self-concept perceived? 3. Do changes in interpersonal and family relationships occur and what are these changes? 4. How are potential changes in social and professional life experienced?

Chapter 3: Methodology

3.1.

Design

3.1.1. Qualitative method 28

The choice of the appropriate methodology is guided by the aims of the study, as quantitative and qualitative research methods have a different philosophical and ontological background (Denzin & Lincoln, 2003). In this study, the qualitative method is a fitting way to explore the questions that relate to the ways with which we are led to understand a phenomenon and the way with which the subjects of the study create meaning and understanding from a secondary experience (Morrow, 2007, Bell, 2005). In addition, qualitative research, as defined by McLeod (1994), is the process of systematic exploration of the meanings people use to understand their experience and guide their behaviour. On the other hand, it focuses on the way with which the world is interpreted and understood and aims to the production of holistic and deeper understandings that emerge from its rich and detailed structure (Mason, 1996. Snape & Spencer, 2003). Thus, this is the best method to explore and answer the research question: How non mental health professionals trained in PCA experience change. Another reason that I chose the qualitative method is because it provides the possibility to the produce new ways of understanding as well as knowledge frameworks. A basic epistemological orientation of the qualitative method is social structuralism as was mentioned above according to which knowledge and reality are two socially constructed concepts. (Gergen, 1985). Thus the results of this study are not an objective truth but are co-constructed by the researcher and the participants (McLeod, 1994, 2003). Since the relative research regarding life change through training in PCA is very inadequate, as we have seen in the previous chapters, the formation of the appropriate theoretical framework of this phenomenon has not been feasible. At the same time the limited research coverage is also a result of the lack of a theoretical framework as qualitative research cannot be conducted easily without the appropriate theory (Bryman, 1992). An additional reason for choosing the qualitative research method is the importance it places on the perspective of the participants, the exploration of which is the basic aim of this dissertation (Polkinghorne, 1991). The phenomenological basis of the qualitative approach, that will be discussed in detail further on, focuses on the way 29

phenomena are perceived by the participants. Thus, for qualitative research the participants’ perceptions are considered of central importance and valid (Willig, 2001), while the choice of this methodology was made in the effort to explore new experiences (Rennie, 1996). Therefore, the goal is the in-depth understanding of the participants’ frame of reference, as well as the researchers’ since this knowledge is understood as an interpretation and not as an accepted truth (Schwandt, 1994). This way, the expression of the participants’ experience, which is recognized as a subjective perspective and not an objective overall knowledge, is facilitated. Qualitative research, instead of aiming at the empirical and statistical generalization, has a theoretically generalizable dynamic that many researchers use even in case studies. (Mitchell, 1983; Williams, 2004). Regarding the quality of a qualitative study, specific criteria are adopted by the theoreticians that refer to the study’s quality control and were used in this dissertation. Some of these criteria are: the proper understanding of epistemological theory, the clear and comprehensible description of the research processes, the inclusion of the necessary ethical principles in all stages of research, the triangulation of the data, the systematic revision of the data, reflexivity etc. (McLeod, 1994; Smith & Osborn, 2003; Tanji, 1999). All the above criteria were used in this study and will be thoroughly discussed in this chapter. Before we continue on, the four principles that assure the quality of a qualitative study, as they are suggested by Yardley (2000), should be mentioned since I aspire to them transcending this study. The four principles are: a) sensitivity to context, b) commitment and rigor c) transparency and coherence d) impact and importance. A criterion to which particular importance is given by IPA, which is the method of choice and analysis of data of this study that will be discussed in detail below, is the systematic review of the data. The circular process of analysis and export of the issues is considered of the upmost importance (Smith & Osborn, 2003). In addition, in this study McLeod’s (1994) systematic review was followed, according to which the different 30

interpretations of data are taken under consideration and the reason why a specific interpretation over another is preferred becomes clear.

3.1.2. Data analysis – IPA Interpretative Phenomenological Analysis (IPA) (Smith et al., 2009) is the method that will be used to analyze the data. This method was developed and an investigative approach to qualitative methodology by Jonathan Smith in the 1990’s especially for the science of psychology and the primary objective of studying the various ways in which different individuals understand the world (Langdridge, 2007; Smith, 1994, 1996; Smith & Osborn, 2004; Smith et al., 2009). Phenomenology, being one of the three epistemological bases of IPA, was created by the philosopher Edmund Husserl [1859-1938]. Phenomenology, which was adopted by this study, as a philosophical and epistemological base in IPA, studies the way with which the world is understood through the subject’s percpective, so that individual experience and subjectivity are valid sources (Smith et al., 2009). IPA’s attention is focused on the subjective, personal and lived experience that contain actions, memories and emotions (McLeod, 2001; Smith & Eatough, 2007). Thus, based on the specific epistemological view, the present study focuses on the experience of people with a non mental health background trained in the Person-Centred Approach and attempts to highlight their view regarding the effect of PCA training in life change. Interpretation, which is inextricably connected to phenomenology, is the second epistemological basis of IPA. According to the interpretive approach, knowledge can be extracted unaffected by the perceptions and the framework of the observing individual (Smith, Jarman & Osborne, 1999). This investigative process recognizes that phenomenology can theoretically be a descriptive concept but in its application can exist only through an interpretive view (Larkin & Thompson, 2011).

In IPA the effect of the researcher’s view is not only that of simple observation but it is a basic issue of the investigative process (Smith & Eatough, 2007). The basic aim of this dissertation is the inclusion of my own view as a researcher through “double hermeneutics” where I try to understand the participant while at the same time the participant tries to understand the phenomenon under investigation (Smith & Osborn, 2004). In addition, the inclusion of my own interpretive setting is done through the adoption of an investigative stance that combines empathy with suspicion (Smith et al., 2009). This means that the interpretive approach attempts interpretation from the standpoint of the participant (hermeneutic of empathy) in combination with interpretation as an expression of the researcher’s understanding of the participant’s experience (hermeneutic of suspicion). Thus, the analysis is developed through different levels of interpretation and continuously moves towards deeper interpretations with the reference point always being the research data and not the theoretical approaches that are adjusted to them (i.e. psychoanalytical theories) (Smith et al., 2009). The ideographic approach, which is the third epistemological basis of IPA, is also adopted by this dissertation (Smith et al., 2009; Smith & Eatough, 2007). The idiographic approach focuses on the “particular” in antithesis for example with the “nomothetic” approach that is oriented towards the generalization to the level of group or population. This focus on the particular occurs on two levels. On the first level there is a commitment to the particular, in the sense of detailed and in-depth analysis and on a second level in the context of understanding of the way with which the phenomena are perceived by particular people in a particular context (Smith et al., 2009). The aim is to define the ways with which the generalizations can be extracted and at the same time be located in the particular. (Smith et al., 2009). The themes were grouped according to their content on a table of results in the next chapter (see table 5). On this table every conceptual group of themes is collected under a descriptive title (super-ordinate theme title) (Larkin & Thompson, 2011). This way a results table was created that includes the super-ordinate themes of the study and 32

the themes that belong to each super-ordinate theme. This table is a result of a circular process of constant re-evaluation of all the stages of analysis aiming at the preservation of the integrity of the experience and statements of the participants (Smith & Eatough, 2007). The last stage of the methodology, that is presented in detail in the next chapter, is the writing of a narrative account of the interaction of my investigative process and the participantsâ&#x20AC;&#x2122; experience as it was described by the participants themselves (Smith & Eatough, 2007). For the centrality of importance given by IPA in the highlighting of the participantsâ&#x20AC;&#x2122; experience to be fulfilled, every time that a new theme or a new datum is mentioned it is proven by at least one fragment from the transcribed interviews (Smith et al., 2009). Thus, a new way of understanding the writing of the analysis according to Smith et al. (2009), is to consider that the fragments from the interviews represent the phenomenological part of the method and the researcherâ&#x20AC;&#x2122;s remarks represent the interpretive part, so as to develop a dialogue between the researcher and the participant. In the analytical presentation of results in this dissertation, will be presented some typical examples that depict every theme combined with the citation of atypical fragments or fragments that are rich in emotion, metaphors or that in some way highlight the uniqueness of the experience. In this way an effort is made for the study to also address the idiographic needs of IPA (Smith et al., 2009).

3.2.

Participants The participants in the study are 6 individuals whose common characteristics are

that they have been trained in PCA to a minimum of the Certificate level and that also have a non mental health background prior to their training. This means that the participants in the study have been chosen because they meet specific characteristics that allow the exploration of the research aims (Ritchie, Lewis & Elam, 2003).

IPA, among other things, “is an idiographic approach, that is concerned with understanding particular phenomena in particular contexts, IPA studies are conducted in small sample sizes” (Smith, Flowers & Larkin, 2009, p:49). The size of the present sample can meet the theoretical bases and the practical requirements of this method. All six that met the previously mentioned criteria and finally became the participants of this study were women with an age range of 21 to 56 years. The average age of the participants was 37 (table 1). One participant had been trained in PCA at a Certificate level, two participants had the professional Diploma and three participants had a post-graduate Diploma (table 2). Regarding the participants’ previous studies and occupation, 4 participants belonged to the educational field in the broader sense: one was a university student of pre-school education, one was an English teacher, one was a special education teacher and one was a linguistics teacher of secondary education. One participant was an economist and an employee of the Ministry of Finance and one was a lawyer and an actress (table 4). The range of time that had passed from the minimum necessary level of training in PCA was from 0 to 4 years, with an average of 1,7 years (table 1). Three of the participants were trained in the Person-centred Approach exclusively in the Psychosocial Studies Laboratory in Alexandoupoli; one participant began her training in the Psychosocial Studies Laboratory and continued them in ICPS in Athens and two participants were trained exclusively at ICPS in Athens (table 3). Concerning the demographic data of the participants, five of them were of Greek ethnicity and one was of an ethnicity other than Greek. Two of the participants permanently reside in Athens, one temporarily resides in Athens, two permanently reside in Alexandroupoli and one temporarily resides in Alexandroupoli (table 1). The recruitment of the participants was made through an announcement of the study’s topic in the MSc’s group. A short description of the study and its aims was announced, as well as the required criteria. I sent an email to the 6 people that volunteered to participate in the study and met the criteria for participation, after

communicating with them on the telephone, which explained the rational of the study (appendix 1). These six individuals were the sample of my study.

In the following tables the demographic and other data of the sample that were mentioned above are described.

Table 1: Demographic and other information Number of participants Age Average age Sex Time since Certificate Average time since Certificate Greek Ethnicity Other Ethnicity Athens, permanent residence

6 21 - 56 years 37 years 6 females 0 â&#x20AC;&#x201C; 4 years 1,7 years 5 people 1 person 2 people 35

Athens, temporary residence

1 person

Alexandroupoli, permanent residence

2 people

Alexandroupoli, temporary residence

1 person

Table 2: Level of training in the Person-Centered Approach Professional Certificate Professional Diploma Post-graduate Diploma

1 person 2 people 3 people

Table 3: Institution of Training in the PCA Psychosocial Studies Laboratory (Alexandroupoli)

ICPS (Athens) P.S.L. & ICPS

3 people 2 people 1 person

Table 4: Previous studies and occupation Teachers (pre-school university student, English

4 people

teacher, special-ed teacher, linguistics teacher) Economist, Ministry of Finance employee Lawyer, actress

1 person 1 person

3.3.

Procedure

3.3.1. Data collection â&#x20AC;&#x201C; Interview The data collection was conducted with the use of an in-depth semi-structured interview. Interview is one of the most common forms of data collection in research in social sciences (Hugh-Jones, 2009). Interview is also the most common method of data collection in IPA (Smith et al., 2009). It is, therefore, an active social process in which two people participate (Baker, 2004. Holstein & Gubrium, 2004). The contents of the interview (appendix 3) was defined based on the research question, the secondary areas of research and the aims of the study that were described in the previous chapter. Special care was taken so the questions were as non threatening as 36

possible and as non leading as possible. Before the beginning of data collection a pilot interview with a colleague researcher was conducted in order to assure the structure of the questions and the easy flow of the process. The interview is without a doubt a much harder process that involves, among other things, the subjective experience of the researcher rather than a simple posing of questions. After the conduction of this pilot interview and taking under consideration many of the suggestions of my supervisor Mrs. Maria Kefalopoulou I made some adjustments to the wording of the interview and changed the order of one question. The interview started with the demographic questions regarding the participantsâ&#x20AC;&#x2122; age, sex and academic and professional background prior to their training in PCA. The interview questions, as can be seen in the appropriate appendix (appendix 3) consist of 10 open questions that attempt to explore in-depth life changes through training in PCA in various aspects such as changes in self, social life, interpersonal and family relationships, and professional relationships. They also attempt to explore the impact of these changes on the subjective experience of the participantsâ&#x20AC;&#x2122; lives after their training and relative to their decision or not to become counsellors. The interviews lasted between 35 and 70 minutes with an average of approximately 50 minutes. The interviews were conducted between April and June of 2014 and were digitally recorded in digital files that will be deleted after the end of this study. The digital files from which the date analysis emerged were later transcribed. 3.4.

Ethical Issues

3.4.1. Confidentiality In order to assure anonymity, as concerns to both the demographic data and the personal data of the participants they were safely kept in electronic folders that were 37

password protected on my computer that no one else had access to. The printed files were also locked in my desk drawer the key to which was only in my possession. In addition, during transcription and analysis all the names, places, as well as other personal details have been changed or deleted as was any information that suggested or indicated the identity of the participants. A participant could choose to keep some information from being recorded. I also explained to the participants beforehand that they can discuss any issues that might arise from the interview process, after the interview either with me or with another available counsellor. 3.4.2. Informed Consent In the beginning of the process of each interview I explained the rationale of the study to the participants, made reference to the content of the information letter that I had sent to the participants and gave them time for any questions or issues that needed clarifying. Before the interview began I gave the participants a consent form (appendix 2) that contained information about the study and the conduction of the interview that specified the anonymous nature of the study. It also contained the declaration of consent that the participants signed accepting to participate in the study maintaining the right to withdraw their participation. One copy of the consent form was kept in my file and one was given to the participants. Before each participant signed the letter of consent I discussed and re-examined its content with them thoroughly. I explained that they had the ability to postpone the interview for another date if they needed more time to make a decision. None of the participants required to postpone the date of the interview. It was made clear before the interview that they maintain the right to withdraw their participation from the study not only during the interview by after the interview as well. 3.5. Reflexivity My idea originally made me enthusiastic about the potential of contributing, even to a minimum, to the research documentation of my personal and professional experience relating to life change through training in the Person-Centred Approach. My original 38

enthusiasm though was gradually replaced by other feelings such as intense speculation, anxiety, concern and disappointment. The main reason for this gradual shift in my emotions was that early on I realized the lack of research literature relating to life change on the specific issue. I therefore needed to try very hard, trusting my experience and referencing general sources of the Person-Centred theory and mainly the works of Rogers himself, in order to formulate some research hypotheses on life change through training in the Person-Centred Approach, stemming from the way of deduction and the life change through the Person-Centred Approach in general. However, what caused me the most anxiety and insecurity was a feeling that I was walking a tight rope and I have great gratitude to my supervisor Maria Kefalopoulou who supported and encouraged me throughout the conduction of this study. On the other hand, I understand that precisely this dual experience that I had both as a trained counsellor in PCA as well as a trainer has affected my view of all the stages of my study as its theme is a integral part of my own personal and professional experience. This fact it gave me more supplies and material in order to creatively interact in a qualitative research framework with IPA. My original insecurity was magnified when I realized the lack of relative literature on the issue as was mentioned above. I now feel happy and grateful that I had the opportunity to experience this intensely rich journey. I can say that I feel enriched by the many exciting experiences and the fresh view towards research and science as a whole. I believe that the experience from this process was very important and so I site some important points that I gained from it. For example: a) The questions need to be asked as clearly as possible without the interference of the secondary questions from the beginning. b) The participant had to fully comprehend the question in order to avoid misunderstandings. It is better that the questions are posed clearly and briefly and then during the process of answering some connecting questions may be added. c) The best technique for the process to be applicable appears to be one question at a time d) An

interview based on the pattern question â&#x20AC;&#x201C; answer demands a high level of experience of the researcher.

Chapter 4: Findings The present chapter presents the findings of the study. The names have been changed in order to maintain the participantsâ&#x20AC;&#x2122; anonymity. Four super-ordinate themes that are comprised of themes emerged from the data of the 6 transcribed interviews that were conducted in this study. The terms superordinate themes and themes are taken from Storeyâ&#x20AC;&#x2122;s (2007) description on the method of conducting an Interpretative Phenomenological Analysis. The results are listed in the following table.

Table 5: Findings Super-Ordinate Themes

Themes

1.Life change as a process

1. Change and the role of the Conditions

of wholeness and expansion

2. Change as a process of expansion and development of abilities 3. Change as a process of wholeness through trust and acceptance 4. Change as a process of Respect, Parity and self-care

2.Training in PCA as a journey of self-awareness

1. The need for self-awareness and the interest in the person as factors for choosing PCT 2. Choosing PCT through personal & professional anxieties 3. Experiencing training as an asset of development

3. Experiencing a new life

4. Experiencing new horizons through training 1. An ongoing process through delimitation and choice

stance as an ongoing

2. An ongoing process with difficulties, conflicts and

process

renegotiation 3. A new life stance that focuses on here and now and the core conditions 4. A new life stance with passion for multi-dimensional

4. The profession of

knowledge and self-awareness 1. Self-value as a Counsellorâ&#x20AC;&#x2122;s professional tool

counselling as a valuable

2. A different life stance as a profession

gift

3. Passing-on a worthwhile experience 4. The profession of counselling as means for ethical elevation 5. PCT as an asset for any profession

4.1 Life change as a process of wholeness and expansion

The first super-ordinate theme that emerged through the analysis related to the process of expansion that the participants of the study experience. Life change through training in PCA exudes a general feeling of wholeness and expansion for the participants. For some of the participants this wholeness is connected to the development of abilities and self-care. . 4.1.1

Change and the role of the conditions

All the participants directly or indirectly refer to role of Carl Rogers’ three core conditions in the way that they experienced and experience life change from the beginning of their training and thereafter. The following fragment is exceptionally characteristic, where Participant 2 describes to us how she personally experienced the conditions through training. She also describes the manner in which her experience with the conditions gradually started transforming the way she interacted in her interpersonal relationships: “for example my difficulty in accepting some characteristics, some behaviours, that… as I saw them and saw that it was my own thing to a great degree, that means, it isn’t… it means that when the other person gets on my nerves, I am the one that gets angered with him for some reasons. And as I say that little – by – little it was easier for me to see it both in my personal relationships and it changed to a degree after this, because as I wanted, for example, to get along better with my friends I saw a change in this difficulty. Also, with the issue of positive regard, for example as I saw the facilitator, the trainer, the way that he communicates and accepts what everyone is bringing, how human everything is, um, I was helped as well… then… on the aspect of congruence I think, of.. what someone says to me, it has a, that is for me as well. And it is important for me to bring that too, and, with a, for me to enter, that is where empathy comes forth, on how I tell him so he can understand it, not to say, oh, I know he is stupid, but to somehow adjust my way…”P2 42

On the other hand, focusing on congruence as the crown that summarizes the other conditions, participant 4 describes to us in the following fragment the radical change in her life and her relationships. Her way of life has changed, as well as the way she communicates with herself and others: Everything became more congruent. They may be less in quantity, but they became more congruent. What I want to say is that I don’t expend myself for just anything. I say this now because first of all I felt the previous. That I was being expent there, for a reason, so I could have social contact. Now I prefer to be with a person that I can communicate with and I can be… congruent, in the sense, not to say things and hurt the other person, but to say guys now I feel the need to say something to you and I will do just that because that is how I feel. I see that that happens more easily, it is accepted…”P4 4.1.2

Change as a process of expansion and development of abilities

Life change is experienced as a process of expansion for most of the participants. This expansion occurs gradually for participant 2 as the core conditions are gradually incorporated in self and the need for a different way of relating emerges. “I feel that I have been expanded to a great extent. Generally, how I see people, slowly the conditions come, like they slowly come out of me, like I have the need for a way with which I communicate with people in any context, … while before they.. they didn’t exist in my perceptual field, things where always more specific” P3 The process of expansion is often connected to the development of abilities for some participants. The example of participant 1 who experiences the process of change,

among other things, as a professional development and evolution, simultaneously developing a new more fitting and effective way of relating to others is characteristic: “Yes, all the things and the assets that I have recognized to myself, that I could not see before, I didn’t know them, I feel like a whole person , how can I say it, I can’t um, an example, what can I say, for the professional part, from being a homemaker I became let’s say, I started an English school, I have kept it for 5 years, I have developed relationships with the students, one very important thing is how I feel in relation, in my relationships with people and the people I relate with constantly give me that, like feedback, I constantly receive that. Either with my daughter or my friends…”P1 Participant 4 prefers to use imagery and comparisons to describe this experience. “I have opened my windows and there are illuminated streets,…”P4

4.1.3

Change as a process of wholeness through trust and acceptance

One of the most important factors that emerge from the experience of change as a process of wholeness appears to be self-trust and self-acceptance. Participant 2 characteristically stands on the change of self-image through self-acceptance: “Ok, my self-concept has changed very much and initially in the aspect of self-acceptance, before I used to not be able to perceive what it was, like it didn’t exist, like it was, ehm… forbidden? Basically, it didn’t, it was like my self did not exist to me, like everybody else existed and I was trying to exist through them, but, now the exact opposite, um, not exactly, but to a significant degree, the opposite, I mean, that I understand that most things start with my, from within me, the part of….” P2

For participant 3, self-trust is contrasted with the professional uncertainty of the past: “Let’s say uncertainty existed many times in things that I chose to do in my work and then came self-trust…”P3 4.1.4

Change as a process of Respect, Parity and self-care

Quite often the experience of change is not always a road strewn with rose petals. But, even through difficulties, it appears that an optimistic view is developed in the direction of self-care. Participant 4, as we can see in the following fragment, seems to be saying “I am having difficulties, but I know now that I can take care of me”. “…the only thing that it tells me is that I still have a long way to go. It does not tire me, though. It is like having a room that I haven’t gone in to clean yet. I have the option of not cleaning it, when the time comes. That does not tire me, that is how I feel right now. But I still feel myself needing support. I can’t stand only by myself. But I see me stand, every once in a while.. I still need to work on myself”P4 However, the concept of self-care can also take on other forms. Participant 5, for example, a person especially strict with herself as she herself describes, is gradually transforming in the direction of allowing herself more and more personal care and attention. Thus, it appears that she cares for needs that she previously found unacceptable to care for: “and again in the context of this strictness, I think that I, wasn’t a person that easily justified self pampering. Anyway, to spoil myself, to … in the sense that maybe I consider something… for example the other day a friend was telling me that he liked to go to expensive hotels once in a while, to get pampered, to go to the spa, to get… and the first thing that came to my mind 45

was: such excess, to spend so much money for that and then I think, ok, that is part of what you don’t allow yourself, like you don’t need it. That, ok, I will spend some more money, but it will be for me, but it is something that I do for me and will feel very nice about the whole thing. So, that little by little has started to, like I give myself more, more room to take care of me.”P5 It also appears that through self-care the need emerges for care of relationships and others with respect and parity. “sometimes, I can’t easily relate with some of my students. It is obviously because of some of my own issues. I have seen some things and I have worked on them, and I have changed to a point, but generally I think that from what I get from the kids, I have a good relationship with them. And the most important point is, I think, that I can respect them”P1 This care and respect is often developed in the family as well, as participant 4 says about her relationship with her daughter: “My own children tell me that ‘mom, you have changed so much’ My relationship with my daughter completely changed. I don’t guide her or I guide her when she asks me to. I dissociate, as much as I can, because when things get hard I am still one with my daughter, but I keep this life stance of respect towards her being and her existence, it is not a typical respect, it is a life stance of respect. I don’t know, am I clear?”P4

4.2 Training in PCA as a journey of self-awareness

This super-ordinate theme that emerged from the interviews involves training in PCA as a journey of self-awareness. It refers to the deeper reasons for which people with a non mental health background chose this training, on the one hand and the way in which they experienced it on the other. Therefore, this journey of self-awareness is analyzed through four themes: The need for self-awareness and the interest in the person as factors in choosing PCT; choosing Person-Centered Training through personal and professional anxieties; experiencing training as an asset of development; experiencing new horizons through training. 4.2.1

The need for self-awareness & the interest in the person as factors of choosing PCT

Interest in deeper self-awareness and the person has been mentioned by many participants as one of the reasons, among others, that they chose to do this training. Participant 2 indicatively says: “In general it was my need, to explain peoples’ behaviours as well as my own” P2 Another participant also emphasizes that while she had no idea what the PersonCentered Approach was, her interest in the person, that had always been strong, finally led her to this journey of self-awareness. “For starters, when I made the decision to get involved with the aspect of counselling, I had no idea what the Person-Cantered Approach was, I just had this obsession since childhood of…, of being very interested in people, I was very interested in finding who I am, that is why I studied theatre, and theatre for me was the first step for this, this journey of self-awareness, let’s say.”P5

4.2.2

Choosing PCT through personal & professional anxieties

For some of the participants, personal and professional anxieties were associated with the choice of the specific training. The example of participant 1 is indicative of her journey that initially began through therapy. “It was due to the difficulties that I dealt with when my daughter was entering puberty, there were, some issues began emerging in the family – I was married then- that I could not handle, I didn’t…, it was a difficult situation and so I started, triggered by parenting school,… I went into therapy and after some workshops I participated in, I distinctly remember they had left me with, I was affected by what I had experienced in the workshops, from the way they were held, that the process evolved and all this came as a natural continuance of things.” P1 In addition, anxiety, this time professional, was the trigger for participant 3 to choose this training. “My anxiety on how I was in, on how I was in relation to my professional capacity, in the classroom. That I wasn’t enough the way I was and that I required something, more tools so I can stand as best I could and that I needed them, that something was missing.”P3

4.2.3

Experiencing training as a asset for development

For all the participants and regardless of the initial reasons why they chose training, this has been, in one way or another, an asset for development. In the following fragment participant 2 focuses on the experiential aspect of training and how that contributed to her personal development.

“…For starters, because training was very experiential and I brought my own things, … , that I believed that I couldn’t share with anyone, that I didn’t expect that they existed or that they affect me and how, all this, um, they came out because our empirical part was what we were working on and it was very facilitative for me to understand even more essentially, generally about the person”P2 Participant 6 also lived training as an experience of personal evolution. “It was probably two factors, the first factor was an internal search, for personal evolution and for the longest time that is how I was thinking…”P6

4.2.4

Experiencing new horizons through training

Lastly all the participants describe the experience of training in the Person-centred Approach as an experience of opening new horizons. The following description of participant 3’s training is rich in imagery.

“How was it in training? It was like training came and opened a new chapter for me, that, on how I am in relation to others and how I am responsible for myself, but I can’t bear other peoples responsibility, something that troubled me a lot, that, it was very strong in me that you had to learn, the children had to learn something from me and that opened up a horizon, I started seeing better what happens in relation to that. In the end, person-centred gave me a sense of calmness in me for what happens in the classroom,.”P3

4.3

Experiencing an new life stance as an ongoing process 49

This super ordinate theme accentuated change as a continuous process. Life change is experienced not as something that happens one-out but as a process of ongoing change through delimitation and choice. This process often passes through difficulties and conflict and presupposes constant renegotiation. It is, however, a new life stance with the core conditions that constantly focuses on here and now and is, in the end, a life stance with passion for knowledge and self-awareness through its many dimensions. 4.3.1

An ongoing process though delimitation and choice

Delimitation and the ability to choose appear to be a factor of definitive importance in this continuous process of change. The boundaries appear to be necessary as is the ability to delimitate in order for the participants to feel that they can choose. “But now I have the need to have boundaries and to some extent to place them whenever I can. One time I can, another I can’t, but that part has changed. After…, concerning the aspect of congruence also has to do with the issue of parity, I think, in the relationship,…”P3

Boundaries and delimitation appear to be a determining factor in the metamorphosis of the ability to relate. “This means that no, I don’t need to take other people under consideration, that is not what I am saying.. that I can say no, I can say no, I can decline things without feeling obligated to do something else and that.. how can I say this, I don’t know… relationships have all changed and continue to change. Continuously, every time that I come in contact with people, they are different. Every time, every time I can be more delimitating in these relationships…”P1

The relation of delimitation and choice is clearly shown in the following description by participant 3: “I make choices regarding outings and people that I will relate with in an outing, I choose who I will be with, where I will go and I have the need to be with people that I can have conversations with, that I can say.. interesting things about me and others (laughs) and be understood and to communicate, and be in a place, I now ask, I say I want to listen to some nice music, and be in a nice environment.”P3 In addition, participant 6 using the proverb about the watermelons under one arm makes it very clear with her imaginative description how through delimitation the ability to make choices gradually emerges as well as the ability to prioritize these choices: “I was, I overloaded my schedule and I was the person that put too much under one arm, not only two watermelons, but more. Of course a lot of those fell down and became soup. So, in my social interactions I was more, let’s say, and I have chosen to keep people close to me that I feel that I relate to and that I relate means that I have fun with, I laugh and people that I might know that will advance me spiritually, that love me, I cleaned up so to speak and some people were set aside”P6 The ability to delimitate and make choices appears to gradually allow the hierarchy of priorities.

4.3.2

An ongoing process with difficulties, conflicts and renegotiation. 51

The concept of renegotiation in relation to change as a continuous process appears to be of crucial importance. Continuous renegotiation becomes necessary, especially in instances of difficulties and conflict relating to change: “I experience this part, this conflict, that although it is something learned that comes as well, it is also something else that comes to renovate it and I stand differently before what is happening to me… And this doesn’t mean that many times I don’t lose myself and try to find me again, just as I reach some particular limits, where again I start searching inside to see what has happened and I have reached those limits. And this renegotiation that I mentioned is 100% necessary…”P3 Many times the difficulties and conflicts have to do with the change itself and the environment’s difficulty to accept it. Participant 1, for example, as she was experiencing change, felt that her environment wanted to pull her back. “I dealt with difficulties, but I think that it is, now that I think of it couldn’t not be difficult, they changed, I changed, it was all changing. Or for those who knew me, it was, it wasn’t easy, they tried to turn me back to where I was before, I felt I was fighting with it, constantly, that the same thing was happening again, them wanting to pull me back to where I knew I was before, and again I was pulling”P1 On the other hand, change is often difficultly experienced from the participants themselves, especially in the beginning but also during training: “No, I think, basically, no. The only change that I sort of found difficult was the responsibility that was like a nudge, a push, something that pulled me out of my comfort zone, but also had to do with the fact that I am growing.”P2 52

Participant 5 refers to this difficulty focusing on the radical reformation of self-concept: “So, it was a very difficult time for me, because you lose a bit of yourself, meaning you have to fight and, and I guess redefine yourself. To include your new identity in your old one, without losing your old one. I find that very difficult.”P5 Other times, the experience of change is so profoundly deep that it causes fear as is described by participant 4: “In addition, with person-centred I managed to get closer to others, to get closer to each other with various opportunities, quite a bit, they also had a background, lately that is where I go. They had the background to accept these things. In fact, in one instance I had such communication that I became fearful. Fearful of this thing that was so new and so earth shattering…”P4 4.3.3

A new life stance focused on here and now and the core conditions

A new life stance appears to emerge as an ongoing process whose ontological characteristics consist of the core conditions and the constant focus on here and now. Participant 5 explains to us what this new life stance means for her in practice: “if something has changed, it is I think that I deal with things with less strictness and more positive regard, let’s say for example in the past a friend might have told me that she was with a guy and he treated her terribly ok? The first thing I would say would be ‘leave the asshole’. Now, I will think of it differently. I will see that there are things there, I will see that it is not just that she is weak and she can’t do it, I will see that it is very human, I will see that perspective too, but in the end I will not give her advice in that 53

direction, that ok, if you are not happy and it has been some time since you were happy, that sort of thing, maybe you, but it will be continuously more mildly with real empathy of what the other person is experiencing, as a totality and not as: good; problem-solution, you know, seeing things more peripherally. That has changed.”P5 Participant 6 also, in her own way tells us how with her new life stance changing herself experiences greater satisfaction in her life. This change for participant 6, beyond her training in PCA, comes through her personal training as well. Thus, satisfaction as it is experienced by participant 6 is an ongoing process of liberation for her: “I am now a more honest person….. Anyway to some degree. I did not confront situations head on, I was in a way, not in a way, I was very manipulative. Entering, doing this training I confronted myself, I changed some things, at the same time I was also in personal therapy, all this helped in me becoming better and to see who I am, because it seems I was in great confusion, to clearly see who I am, and finally managing to feel more satisfaction in my life.. I want to say something, more focus on here and now, and that means greater satisfaction in here and now, this realization that what is done is done. And that we don’t know what is coming, it was somewhat liberating to a great degree. Without that meaning that we don’t process what has happened and that we don’t make provisions or don’t plan for what is coming, the focus on here and now helps to make life better and basically live and not pass our days and our years without realizing it”P6

4.3.4

A new life stance with passion for multi-dimensional learning and self-awareness

What also emerges as a basic component of the continuous process of change is the passion for learning and self-awareness through many dimensions. For participant 3 this process has begun and does not ever stop as she tells us below:

“I think that the most import.., one of the important, in which I am during this period, is that, that it is ongoing situation, that it does not ever stop, that you go through a training and it is not ok, you have completed it all and you don’t need anything more. A constant, no a continuous I think is needed, how can I say it, to be in the midst of thing. If that, if the Person-Centred Approach has helped me and it has given me some things as a life stance as well up to now, that exist for the time being, I don’t know for the future, I believe that it definitely has given me many things to learn, to see relating to the approach and to discover, so it is something that does not ever stop, I would say”P3 For participant 4 the enjoyable experience of life change causes an intense thirst for selfawareness as she experienced it.

“I am on a different path, I am different now, and because I enjoy it I want even more. I want more and more to know who I am, how I am..”P4

Participant 3 also describes the multi-faceted character of this process relating to knowledge and learning to us in an exceptional way.

“The nice part, the particular thing is that here learning comes through many dimensions. It comes through training, it comes through therapy, mine, everybody’s really, through the Counselling that each person does, through groups in which a person can be in, with any capacity, through it, from this work that one does, to fit person-centred there. From what I read I have, either from articles based on the approach or not, and in some way all this comes to work together possibly in a new life stance and if finally 55

someone chooses to follow it, but it is very unique and special to see how everything connects with one another”P3

The profession of counselling as a valuable gift

4.4

All the participants recognize and attribute great value to the profession of counselling regardless of if they choose it as a main profession or not. Thus, the counsellor’s profession and counselling is highlighted here as precious gift to self and to others.

4.4.1

Self-value as a Counsellor’s professional tool.

The value and the characteristics of self are recognized and symbolized as a valuable gift, and also the only professional tool of the counsellor. Thus, the issue for participant 1 is to have a “good tool” and develop it. “Yes, I think of it, I think of it and I have said it twice in the past while that I have to, I feel that I can do many things because I, because I can offer, that I have a lot, my material is valuable and can be useful for, twice I said that I do not preclude making it my main profession at some point. I have symbolized it, I have understood this thing and I think I have a good tool…”P1

4.4.2

A different life stance as a profession

For some of the participants their experience in practicing counselling as a different life stance appears to be so pleasurable and meaningful that it tends to replace the previous profession. Specifically, for participant 4 although her current profession offers her prestige, money and power she feels that it does not fulfil her, as she mentions below: â&#x20AC;&#x153;For starters, it will be easy now for me to do it, because I have acquired a different life stance on some things and I believe that my abilities can improve and retrieve them, and the abilities that I acquire along the line will be perfected and it is something so pleasurable for me because the profession that I have, offers me prestige, money and power but does not fulfil me. P4

4.4.3

Passing-on a worthwhile experience

Participant 3 recognized the value and the preciousness of the profession of counselling and the value of as many people as possible living the experience of counselling as a valuable gift. I feel very good in this position, as a counsellor, because what I have received up to today from my experience is very positive, I have positive feedback and that is motivation to go on, because I believe in all this. I believe, I believe that it is worth it, for there to be counsellors, personcentred counsellors and more and more people can live this experience.â&#x20AC;? P3 For participant 5 the value of this gift goes both ways. A gift to self and a gift to others as an experience that is passed on to other people.

“I feel that they are helped and that is also something that fills me with joy, not in the sense that ‘oh, great you did it’, my satisfaction, but for others, I feel that this thing that goes through to the other person is so beneficial, and all this acceptance and this.. like touching them with a magic wand and it is so beautiful to watch it being passed on to other people, so it too is something that gives me great joy”P5

4.4.4

The profession of Counselling as a means of ethical elevation

For all the participants the profession of counselling appears to exude and connect with a kind of ethical elevation. The description of participant 5 below is characteristic. “It goes without saying that it is something that I really like, it suits me and makes me feel like a better person, every time that I am working with person-centred, … my occupation is my clients now, my supervision, every time that the days come that these things happen to me, when that day ends I feel, I feel like a better person, I can’t explain it, with love inside me, a calm overview of things”P5

4.4.5

Person-Centred Training as an asset in any profession

Participant 2 recognizes that beyond the profession of counselling, PCT is an excellent asset for any profession.

“I know that all this definitely exists in my profession. Either I am selling clothes or I become a pre-school teacher, I think that all these assets will exist in there and they will create a framework, at least that is what I want”P2 58

Participant 6 appears to promote the perspective of developing the professional Teacher – Counsellor for herself. Thus she describes to us her interest in combining parent counselling and teen counselling with her pre-existing profession, that of an educator.

“I have not rejected it, it is something open and in fact it is something that I have been thinking of more and more this past while, now that I have somewhat adapted in school, so I don’t have all that, The first two years I can say I had a lot to learn, so I needed to be focused. But now, because I have felt more secure in that, that ok I can live up to it, that is why I chose to complete my studies in counselling this year that is my third year in the school and I leave it open, I am very interested in both the aspect of counselling both parents and teens, again with things that relate to, around education again, you see? It is something that I think about a lot. At the same time… further down the line helping each other, something like that. Because my profession now leaves me the time for me to do this”P6

Chapter 5: Discussion

The aim of this study was to explore the value of Person-Centred training for individuals with a non mental health background trained in PCA, not only as a professional asset but first and foremost as a tool for developing “well being” (Leijssen, 1990, Corcoran, 1981, Lovejoy, 1971, Mearns 1997b, Grafanaki 2002). Interpretative Phenomenological Analysis (IPA) (Smith et al, 2009) that I chose to use to conduct my study and analyze my data was truly an extremely fitting way to comprehend the different ways of perception of the study’s participants focusing and interacting with their subjective experience regarding life change through training in PCA (Langdridge, 2007; Smith, 1994, 1996; Smith & Osborn, 2004; Smith et al, 2009). Four super-ordinate themes emerged from the 6 transcribed interviews that each have 4 themes. These findings show that life change of non mental health professionals trained in PCA is experienced as a process of wholeness and expansion. The findings also present training in the Person-centred Approach as a journey of self-awareness. The findings present the trainees in Person-centred experiencing a new life stance as an ongoing process. It also appears that the profession of counselling is experienced as a precious gift by the trainees in PCA. In this study it has been supported by the participants that non mental health professionals trained in the Person-Centred Approach experience life change as a process of wholeness and expansion. Looking back to one of the basic components of the Research Interest in this study: Roger’s “good life”, the relative description of Rogers himself seems to take life in the analysis of the findings of the previous chapter. A basic result that emerges from the analysis of the findings is that change that emerges through training in PCA constitutes a new life stance that is experienced as a continuous process. Exactly the same description is used by Rogers (1961:186) about the “good life”

An important finding that emerged from the analysis concerns the experience of wholeness and expansion that the study’s participants live in training in PCA. It appears that training in PCA, for the specific participants, affects the change of self-perception – 60

firstly – in the direction of expansion and wholeness. This finding appears to be fitting with previous studies about the effects of Person-Centred therapy on the client (Butler & Haigh, 1954) as well as a wealth of studies relating to change through encounter groups and training groups (Gimp, 1970; Rogers, 1970d,e,f).

An additional finding of this study is the prominent role that the necessary and sufficient conditions play in the – trained in PCA - participants’ life change. It is also highlighted in the findings that congruence is the crown that summarizes the other conditions. These findings are in agreement with Rogers’ basic claim, which is both empirically validated and documented through research, that the necessary and sufficient conditions are the basic presuppositions for change (Rogers, 1957, 1961; Merry, 1994).

The findings of the research also present life change as a process of expansion and development of the participants’ abilities. Therefore, expansion is often described as personal, social and professional development. This finding appears to be compatible, firstly, with older studies that concern the changes that can occur in encounter groups and training groups (Gimp, 1970). In one study that was conducted in “in-depth training program in the person centered approach” of Natiello in 1992 so as to measure the program’s quality, it was also found the participants established their social development (including professional development) through the training in addition to their personal development (Natiello, 1998).

For the participants, two of the most important factors that are emphasized in the process of life change appear to be self-trust and self-acceptance. In 1952 Raskin published a study in which it was documented for the first time through research that Person-Centred therapy tends to increase the client’s self-trust and self-acceptance. A wealth of studies have also been conducted relating to changes in self and self-perception of the client through Person-Centred therapy. The study of Butler & Haigh (1954) that documented that changes that occur through Person-Centred therapy in self-perception are in the direction of clients’ self-appreciation and the fact that this change tends to last past the end of therapy is indicatively mentioned. In addition, the findings of this study 61

about trust and self-acceptance appear to match the relative studies that relate to change through encounter groups and training groups (Rogers, 1970d,e,f ; Natiello, 1998).

A very important finding of this study regarding how participants experience life change is the development of respect, parity towards relationships and self-care. As was mentioned about the above findings, there is a relative lack of relevant research literature regarding training in the Person-Centred Approach. Concerning this finding it appears that that there is a study that refers to the development of the professional identity of Greek trainees in family therapy. In the specific study it is mentioned, among other things, that the development of self-care which is perceived as the decrease in strictness towards self and the acceptance of weaknesses (Fragkiadaki et al, 2013).

In addition, it emerged from the analysis of the findings that training in PCA was experienced as a journey of self-awareness. This appears to agree with the findings of several studies that have been conducted on the effect of encounter groups or training groups (Gimp, 1970). The initial motivation for the choice of this training in particular was shown in the findings that relate to the way that training was finally experienced. The need for self-awareness and the interest in the person, personal and professional anxieties are often factors in choosing a training that is experienced as an asset of development that opens up new horizons. This finding is compatible with previous studies (Poznanski & McLennan, 2003; Tremblay, Herron, & Schultz, 1986). Therefore, training in PCA as a journey of self-awareness refers to the deeper reasons for which the specific counsellors with a non mental health background chose this training on the one hand and the way with which they finally experienced it on the other. The interest in deeper self-awareness and in individuals was mentioned by all participants, among other reasons, as one of the reasons they chose to do this training. In addition, for some of the participants, intense personal and professional anxieties constituted additional motivation for choosing this particular training. This finding comes as an addition to the generally accepted bibliographical hypothesis that prospective therapists are led to train in one approach or another, among other reasons, based on specific personal characteristics (Guy, 1987). For example, more specifically, other studies support that therapists of the Cognitive62

behavioural approach were found to be more rational, objective, conscientious and less open to conversation (Arthur, 2000, 2001; Boswell, Castonguay, & Pincus, 2009; Buckman & Barker, 2010; Lyddon & Bradford, 1995; Poznanski & McLennan, 2003; Schacht & Black, 1985). Psychodynamic therapists are more intuitive to abstract and open thinking, are open to experiences, complex, serious and less conciliatory and compromising (Arthur, 2000, 2001; Buckman & Barker, 2010; Topolinski & Hertel, 2007; Walton, 1978). Nevertheless, there are not enough studies that accurately document the correlation between the qualities in the personality of therapists and the choice of one or the other approach. Other previous studies which support that therapists of humanistic approaches focus more on the internal direction, self-realization and intuition also appear to be relative to the specific finding. (Poznaski & McLenann, 2003; Tremblay, Herron & Schultz, 1986). The experience of the participants in the study from their training in the Person-Centred Approach is presented to be fitting to the previous theoretical literature regarding the characteristics that a training program in PCA needs to have. According to Natiello (1998) from the first training programs in the Person-Centred Approach that began with the initiative of Carl Rogers himself, self-awareness, self-acceptance, self-responsibility, congruence and the ability to apply all of the above in the trainees’ relationships. Therefore the participants’ experience of training in PCA as a journey of self-awareness is described by some as an exceptional asset for personal and professional development while it also opens up new horizons. The “requisite” of training in PCA according to Natiello (1998) and Mearns (1997a,b) regarding self-awareness and personal development in the present study appears to be achieved for the participants. More specifically, all the participants, regardless of the initial reasons for which they chose training in PCA, recognize that, in one way or the other, it was an asset for self-awareness and personal development. In addition, all the participants describe their experience in the Person-Centred Approach as an experience of opening new horizons. This finding is presented as an addition to the qualitative parameter of a previous quantitative study that was held in 1992 to the “In-depth training program in Person Centered Approach” that was conducted in order to measure the quality and effectiveness of this training. In the 63

study, among other things, it was found that the 80% of the participants felt that training majorly contributed to their personal development and self-awareness (Natiello, 1998).

The next finding that emerges from the analysis of the data concerns experience as a new life stance, which is lived as an ongoing process. This finding is highlighted as one of great importance for mainly two reasons. On the one hand it, in a way, by summarizing the findings of this study regarding life change it becomes important because it accurately corresponds to Rogers’ (1961) description regarding “the good life” and the fully functional individual. On the other hand, the finding is highlighted as one of great importance due to the particular qualitative parameters and characteristics that emerge from the analysis and make up this new life stance as an ongoing process. This means that this new life stance is experiences not as something that happens one-out but as a ongoing process through delimitation and choice. In this finding, what Rogers’ supported about “the good life” theoretically invoking his experience: “The good life is a procedure, not a state of being. It is a process, not a destination” (Rogers, 1961:186) appears to be absolutely true for the specific participants.

We could say that this new life stance, which is gradually adopted by the participants through training in PCA, constitutes an ongoing process of development and selfawareness with the qualitative characteristics of delimitation, choice and continuous renegotiation being the most prominent. This experience of the participants appears to fully agree with Rogers’ description of the “fully functioning person” and “the good life” as a procedure and not a state of being, a direction which is selected by the total organism, when there is psychological freedom to move in any direction. (Rogers, 1961, 1970f, 1980). In addition, this new life stance that is adopted by the participants is outlined by the focus on here and now and the core conditions, which are empathy, unconditional positive regard and above all congruence. It appears that the participants clearly support the role of the core conditions in the establishment and development of the “fully functioning person” as well as the entire structure of the Person-Centred Approach (Rogers, 1957, 1961, 1972a,c, 1980).

In this study delimitation becomes of determinant importance in this ongoing processes of change for the participants. The boundaries and the ability to delimitate are presented as necessary factors for the participants to feel that they can choose. In addition, this fact constitutes a characteristic that allows for the reformation of the ability to relate. Also delimitation, initially facilitating the ability to choose, then allows for the gradual hierarchy of priorities. It is here that the determinant role of delimitation emerges within the context of the definition of Rogers’ “the good life” potentially providing a very good detailed explanation of the way the total organism develops the ability to choose to move in every direction (Rogers, 1961). Of course, in the context of the broader Person-Centred literature, we do not often encounter the autonomous presentation of the concept of delimitation. Therefore, it would be valuable to further study the concept of delimitation in the context of congruence, something that Rogers himself had originally begun to correlate describing the theoretical structure of the “fully functioning person”. Among others, the “fully functioning person” moves towards an increasing openness in experience as one experiences agreement with the organismic self through the processes of free choice, delimitation and renegotiation. Of course, Rogers himself describes delimitation and free choice as a result of “the good life” and especially the agreement with the organismic self and its needs in an ongoing dialog of renegotiation with the environment. However the framework within which the “fully functioning person” is outlined is not deterministic, which means it is not transcended by strictly causal relationships, describes relationships of continuous interaction (Rogers, 1961). Thus, within this framework, it possibly has value to explore the issue of the concept of delimitation as an autonomous facilitative condition for the development of Rogers’ “the good life”. Focusing on here and now and the core conditions are also presented by the participants as basic characteristics of this new life stance as we have seen above. In fact, some of the participants highlight the particular role of personal therapy, beyond training, in relation to the development of these characteristics. This finding clearly identifies with several previous studies relating to the effect of the Person-Centred Approach on life change, starting with the studies of Rogers himself and up to the present day (Rogers,

1961; Seeman & Raskin, 1953; Cartwright, 1957; Barrett – Lennard, 1959; Elliott, 1994, 1996, 2002; Greenberk & Lietaer, 2003; Eckert, 2003; HÖger, 2003; Schwap, 2003).

What also emerges as a basic characteristic of the ongoing process of change is passion for self-awareness and learning through many dimensions. In addition, this finding concurs with several previous studies, both quantitative and qualitative regarding the development of self-awareness through the Person-Centred Approach (Rogers, 1961; Seeman & Raskin, 1953; Cartwright, 1957; Barrett – Lennard, 1959; Elliott, 1994, 1996, 2002; Greenberk & Lietaer, 2003; Eckert, 2003; HÖger, 2003; Schwap, 2003). What is different in this study and is not encountered in previous studies is both the element of passion that emerges as well as multi-dimensional character of learning through the Person-Centred Approach. The example of participant 4 where the enjoyable experience of life change creates an intense thirst and passion for self-awareness is indicative: “I am different now, because I enjoy it and I want even more. I want more and more to know who I am, how I am. Even more…” This description appears to eloquently depict the ascertainment of Rogers himself (1961, 1970f) in the early years about “the good life”, and it is also outlines the theoretical structure regarding the “fully functional person” in a tangible, and rich in analysis of qualitative characteristics, way. This means that a creative person with freedom of choice that lives, through delimitation and renegotiation, in harmony with himself and others, making passionate and brave choices and plunging in to life as an ongoing process of “becoming” is outlined by Rogers himself (Rogers,1957, 1961, 1970f, 1972a,c, 1977, 1979, 1980), something that also appears to identify with the experience described by the participants of the study. Therefore the element of passion for self-awareness and learning through many dimensions as it emerges from this study comes to contribute to the deeper understanding of the characteristics of Rogers’ theoretical structure about the “fully functioning person”. The element of passion was also found to emerge as a “passionate commitment” within the framework of a qualitative study about the development of emotional congruence strategies of Person-Centred counsellors (Lakioti, 2011). Although the subject of the study does not concern change of life through training in PCA, it does highlight the presence of the qualitative element of passion in the lives and stances of the Person66

Centred counsellors who participated in the study as is accordingly highlighted in the present study within the framework of life change as passion for self-awareness through multiple dimensions.

The last category of findings presents the relationship of the participants of the study with the profession of the Person-Centred counsellor as it has developed through training in the Person-Centred Approach. All the participants recognize and attribute great value to the profession of counselling, regardless of if they finally chose it as a main profession or not. Thus the profession of counsellor and counselling are highlighted in this study as a valuable gift to self and to others. Unfortunately, this finding canâ&#x20AC;&#x2122;t be compared to a relative older finding especially in the case where the persons trained in PCA are non mental health professionals, due to lack of relative studies. In addition, studies relative to training in counselling and psychotherapy of other approaches appear to highlight characteristics of the profession of counselling relative to efficiency and professional development, sometimes also combined with personal development (Heinonen & Orlinsky, 2013; Carlsson & Schubert, 2009; Fragkiadaki et al, 2013). Nevertheless, this finding comes to positively answer the commonly accepted issue of theoretical questions in the general Person-Centred literature regarding the value of Person-Centred training, not only as an asset but first and foremost as a tool for developing â&#x20AC;&#x153;well-beingâ&#x20AC;? (Leijssen, 1990; Corcoran, 1981; Lovejoy, 1971; Mearns, 1997b, Grafanaki, 2002). The value and the characteristics of self are recognized and symbolized by the participants as a valuable, but also the only professional tool of the counsellor. This finding comes to confirm the basic theoretical admission of the Person-Centred Approach about whether or not the Conditions as well as the presence of the counsellor constitute necessary and mainly sufficient elements in order for therapy to occur (Rogers, 1957). For some of the participants the experience of counselling as another life stance appears to be so pleasurable and meaningful that it tends to replace the previous profession. The value and the preciousness of the profession of counselling, as it is recognized by the participants not as something separate and autonomous but as a part of self, leads to the need for passing on this precious experience to others. In addition, for all the participants the profession of the counsellor appears to exude and connect with a kind of ethical 67

elevation. It its totality it appears that training in the Person-Centred Approach is perceived by the participants as an exceptional asset not only for the profession of counselling but also with applications in any profession, as well as, first and foremost, being an exceptional asset of “well-being”.

Therefore, in conclusion, we could say that the findings of the present study come to agree with the previous studies that verify the important admissions in the PersonCentred theory. Something, however, that the present study comes to offer regards how experiential training of counsellors affects their lives and relationships. In IPA the impact of the researcher’s view is not just simple observation but is a basic requirement of the investigative process (Smith & Eatough, 2007). Thus, the basic goal of this study is to include my perspective as a researcher through a “double hermeneutic” where I try to understand the participant while the participant tries to understand the phenomenon under investigation. (Smith & Osborn, 2004). In addition, the inclusion of my own hermeneutic framework is realized through the adoption of a hermeneutic stance that combines empathy and suspicion (Smith & Osborn, 2004).

The trained in the Person-Centred Approach counsellors with a non mental health background that participated in the study after experiencing training in PCA as journey in self-awareness and an asset for development that opened up new horizons for them, experienced life change as a process of wholeness and expansion as well as a process that continuously evolves. This ongoing process appears to be gradually adopted by the participants as a new life stance with the qualitative characteristics of delimitation, freedom of choice and constant renegotiation being most prominent. This new life stance that is adopted by the participants is outlined by the focus on here and now and the core conditions. A qualitative characteristic that also emerges is passion for self-awareness and multi-dimensional learning within the framework of this new life stance.

5.1 Limitations of the study

An important limitation of this study is that it was conducted on a relatively small sample of persons trained in PCA with a non mental health profession background. This meant that the sample may not be representative of the population and so the results of this study could possibly present difficulties in generalizing them to that population.

The fact that the participants in the study are non mental health professionals trained in PCA differentiates them from other Person-Centred counsellors who do have a background in mental health, such as psychologists and psychiatrists. This could also pose an interesting field for future research.

Thus the limited research framework although it renders this dissertation important, significantly limited the possibilities of this study. The lack of relative documentation in literature regarding the effect of training in the Person-Centred Approach in the counsellorâ&#x20AC;&#x2122;s life change, besides the fact that it posed a limitation relating to expansion of the basic research question, also significantly limited the possibility of relating the findings to other studies almost in the totality of this dissertation.

5.2 Implications of the Study

The findings that are presented in this dissertation are very useful, even valuable for those planning to train or are already in training in PCA, in order to have an in-depth view of Person-Centred training not only as a professional tool but also as a possibility for changing the quality of their lives as well as their relationships.

The specific findings are equally important for experienced professional PersonCentred counsellors as well as for trainers and supervisors in PCA. Besides, the specific findings, as we have seen above, appear to highlight issues of the Person-Centred therapy and personality theory to some degree forgotten by contemporary person-centred

literature but that lead us straight to the heart and essence of the Person-Centred Approach, possibly bringing us closer to the Rogers of the early years.

Training programs in the Person-Centred Approach could possibly focus even more on prioritizing the experience of life change as a continuous process. That is to say that the findings of this study within the framework of a broader discussion on PersonCentred training come to tilt the scales to the side of the reluctance towards the full and unconditional academic integration of the Person-Centred Approach.

5.3 Suggestions for further research

It would be useful to combine the findings of the present study with further quantitative research so as to more fully explore life change and quality of life of counsellors trained in PCA. The Life Quality Scale, various self-esteem questionnaires etc. are some examples of tools that could be used for this purpose.

The aim of this dissertation was also to explore the experience of life change through training in PCA of non mental health professionals. Thus, the people chosen as the sample were people that did not have a previous relation to the fields of psychology and psychiatry as per their professional and academic background prior to training. The findings of this study would have particular value if combined with further research in the direction of what occurs in relation to life change of trained counsellors who are also psychologists and psychiatrists.

An extremely important qualitative parameter that emerged in this study within the framework of life change, as we discussed above, is the parameter of delimitation. The determinant role of delimitation in Rogers’ “the good life” has already been discussed. Within the framework of the broader Person-Centred literature we don’t usually find an 70

autonomous presence of the concept of delimitation. It would thus be valuable to further research the concept of delimitation within the framework of congruence, something that Rogers’ (1961) had begun to correlate, describing the theoretical structure of the “fully functioning person”. Rogers himself describes delimitation and freedom of choice and especially the agreement with the organismic self as well as the need to be in a constant dialog of renegotiation with ones environment. The framework within which the “fully functioning person” is outlined is not deterministic, which means it is not transcended by strictly causal relationships, but describes relationships of continuous interaction (Rogers, 1961). Thus, within this framework, it possibly has value to explore the issue of the concept of delimitation as an autonomous facilitative condition for the development of Rogers’ “the good life”.

Chapter 6: Conclusions Most of the findings of this dissertation appear to be similar with those of previous studies, mostly quantitative but also some qualitative, that relate to PersonCentred therapy. Besides, as we have seen in the literature review, the Person-Centred Approach constitutes both a sufficiently documented approach as per its effectiveness, and sufficiently researched as per the process that concerns the client, the group and the interaction. Interpretative Phenomenological Analysis (IPA) (Smith et al, 2009) was truly an extremely fitting way to comprehend the different ways of perception of the study’s participants focusing and interacting with their subjective experience regarding life change through training in PCA (Langdridge, 2007; Smith, 1994, 1996; Smith & Osborn, 2004; Smith et al, 2009). Another concept that also emerged from this study was that of delimitation that is quite misunderstood in relation to the Person-Centred Approach. On the contrary, the determinant role of delimitation within the framework of Rogers’ “the good life” emerges, providing a very good and detailed explanation regarding the way that the total organism develops the ability to move in any direction (Rogers, 1961). In closing, this dissertation has positively responded to the initial research interest highlighting in addition new rich qualitative elements and characteristics of developing “well-being” through training in PCA. That is to say, that it is highlighted in the most emphatic way that the value of Person-Centred training in non mental health professionals, not only as a professional asset but also, first and foremost as a tool of developing “well-being”.

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Appendices Information sheet for participants This study is conducted by Vassilis Blitsas, Person-Centred Counsellor and Psychologist as a requirement of the MSc in Counselling. The study is conducted under the guidance of ICPS (Institute of Counselling and Psychological Studies), Athens, Greece and the supervision of Sophia Balamoutsou.

The aim of the study is to explore the role that training in PCA plays in the life change of non mental health professionals. According to the Person-Centred Theory, the aim of a Person-Centred Training Program is to facilitate the trained counsellors, not only to develop the core conditions but also to move towards the process of a fully functioning person. According to the experience of trained Person-Centred Counsellors there are many important changes in the lives through training in PCA. Thus, the study will focus on the experience of non mental health professionals who are trained in the Person-Centred Approach. They will be asked how they experience life change after training in PCA, how and if they perceive changes in self and what kind of changes do they perceive in their interpersonal, family, social and professional life. It is deemed important for there to be more studies relating to change of life through training in PCA in order to document through research that training in PCA is not only a professional asset for Counsellors but is also, first and foremost, a tool for the development of Rogers’ “good life” or “well-being”. It is desired that this study presents information that will develop an in-depth view on Person-Centred training of non mental health professionals and lead others to train in this approach. Should you agree to participate in this study, you will be required to give me an interview that will last for approximately 60 minutes, at a location that is convenient to you. The interview will be recorded and will later be transcribed. All the data, and the information pertaining to your identity, that you will provide in the interview will be kept in a secure locked folder on my computer. If the results of this study are published or are going to be used in other form, confidentiality will be secured and your personal data will not be identifiable. You will be asked to sign a consent form agreeing to the above. Although I do not believe that any considerable risk arises from your participation in this study, the discussion about life change may bring about questions that you would like to talk about. In this case, I will refer you to someone that can help you find some answers, through a one hour session – meeting. Your participation in this study is absolutely voluntary and will not in any way affect your present or future relationship with ICPS. Should you decide to participate, you can deny answering some questions; you can withdraw from the study at any point without having any obligation to continue. If you have any questions regarding the study you can ask them now or later contacting me via telephone or email on the number and at the address given below. Vassilis Blitsas 6938968474blitsas.student@icps.edu.gr 90

Consent Form Title of dissertation: Life change in non mental health professionals trained in PCA. An Interpretative Phenomenological Analysis. The study is conducted by Vassilios Blitsas . Letter of Consent I confirm that I have read and understood the Consent form about the aforementioned dissertation and that the researcher has satisfied me by answering any and all of my questions. I consent to participate in this research dissertation. I understand that my participation is voluntary and I am free to withdraw from the study at any point, without having to provide explanations and without any consequences. I understand that I can withdraw my data from the study at any point. I understand that the information I provide can be used in conventions or any other kind of research publication, but I will remain anonymous. I understand that any recorded information in the study will remain confidential and that no information that could allow my identification will be publicly available. I agree to be recorded as part of the studyâ&#x20AC;&#x2122;s process Participant (name):

________________________________

Participant (signature):

________________________________

Date:

INTERVIEW Title of dissertation: Life change of non mental health professionals trained in the PersonCentred Approach. An interpretative Phenomenological Analysis. The study is conducted by Vassilios Blitsas . Demographic questions Date: Name: Age: Sex: Marital status: Children: Occupation: Level of education in the Person-Centred Approach:

Professional experience prior to training:

Current profession:

Other professional and academic qualifications:

Interview Questions

Firstly, would you like to discuss how you presently experience your life after PCA training?

2. What led you to decide to train in Person-Centred Counselling? a) Have you had any previous contact with the field of Mental Health? b) Has this training lived up to your initial aspirations? c) To what degree? In what way? 3. How would you describe your life now compared to your life before PCA TRAINING? 4. How do you see you self today? 5. Could you describe the changes in your social life if there are any? Additional questions about: a) outings b) Social events c) Recreation â&#x20AC;&#x201C; entertainment 6. How do you experience interpersonal (close) and family relationships? a) Friendships b) Romantic relationships 7. How do you experience your professional relationships? a) Regarding any profession, be it Counselling or other 8. Which do you think are the most important changes in your life through training in PCA? a) Did any of these changes present difficulties in your life? b) Did any of these changes facilitate your life? c) If yes, would you like to talk to me about them? 9. Finally, are you contemplating becoming professionally involved in Counselling or not? a) If yes, for what reasons? b) If no, for what reasons? 10. Is there something else of importance that we should discuss? 93