The Gestalt Model of Counselling - Essay Example

Comparative Analysis of the Client-centered Model of Counselling and the Gestalt Model of Counselling al affiliation Both client-centered and Gestalt models of counselling have been practiced in many countries for more than half of a century. Aims and principles of these two therapies are quite similar. They both believe in human potential for growth and self-actualisation. They both help clients learn how to accept themselves and others. Differences lay in ways how these goals may be achieved. Perls, the father of Gestalt therapy, believed that his patients are supposed to see the total picture of a situation. Clients are supposed to understand what feelings their problems provoke and how these feelings may be changed. However, there is no sense to look for roots of their problems in the past. Person-oriented therapy does not focus on the roots of problems as well. Person-oriented therapy is suitable for those who lack communication and attention of other people. Client occupies active position in the course of person-oriented therapy sessions. Therapist’s task is to provide guidance and show sympathy. Relationships between therapist and client may sometimes predetermine eventual result of the therapy. The role of these relationships in Gestalt therapy is important as well. That is one of the similar features of both models of counselling. Each therapy has its own strengths and weaknesses. Sometimes it is appropriate to combine techniques and principles of both of them. For example, such an alliance proved its efficiency while working with people suffering low self-esteem. However, there is a number of cases when only one approach may be applied. Key words: client-centered and Gestalt models of counselling, potential for growth, relationships between therapist and client, sympathy. Comparative Analysis of the Client-centered Model of Counselling and the Gestalt Model of Counselling Both client-centered and Gestalt models of counselling are practiced worldwide. Sometimes it is possible to hear a statement that these two therapies are rather different. However, detailed analysis of these two approaches gives a reason to consider this statement doubtful. It is possible to observe many similarities between them. The aim of the first part of this paper is to give general outline of each approach. Its second part compares and contrasts these two therapies. It is also shown how they may form an alliance. Finally, the third part shows in what cases both therapies may be applied.  The client-centered therapy was elaborated by Carl Rogers, an American psychologist, in 1951. Its founder preferred to call his approach as “client-oriented” in order to emphasise the role of a client in the course of therapy (Rogers, 1976). In other words, the client is considered to be free to speak about anything he or she wants. The role of client is now equal to the one of the therapists. Even more, the client may be regarded a key figure, shaping the process of psychotherapeutic changes. That is why it is more appropriate to use the term “client” rather than “patient” in the context of this therapy. It emphasises the respect towards a person who requires help. In this case people are considered to be partially responsible for improvements in their health, so they cannot be referred to as objects of diagnostics and treatment. According to one of the hypothesis of client-centered therapy, the one who is able to understand and help client in the most effective way is the client themselves (Kirshenbaum & Henderson, 1997). The way this therapy is called reflects new focus of psychotherapy – factors, predetermining the client’s development. The emphasis is laid on the process of personality changes in the course of psychotherapeutic contact. Adherents of client-centered model of counselling very often concentrate their attention on inner feelings of their patients, but not on their actual problems. Practically it means that the client is welcome to talk about anything he or she wants in the course of psychotherapy sessions. Clients are not forced to discuss their actual problem. Instead, they may tell about the last achievements in their hobby. Therapists usually accept such a choice of their clients and do not insist to start discussing what makes them feel worried. Such a strategy cannot be adopted in many other psychotherapeutic problem-oriented approaches – such a talking about nothing is regarded as a form of treatment resistance. An important task of any therapist is to assure clients that they are heard and understood – it would exert positive impact on their self-concept. Thus, empathic understanding means to encourage patients to continue investigating their inner world (Kirshenbaum & Henderson, 1997). In such a case empathy may be regarded the core of psychotherapy, but not just its condition (like in many other approaches). Thus, adequate empathic reaction of a therapist may make a client think they are understood. It is possible to mention several Rogerian clichés which may be used with this purpose. However, trite phrases should be avoided. Thus, the client’s problem itself is not the target of a therapist. Instead, the focus is made on inner world of a client and those feelings which they experience right here and now. Many clients cannot even form their problem during a therapy session. The formulation of problems or intimate feelings of a client may make them feel confused. On the one hand, it deprives clients of an opportunity to choose their own direction in the therapy. Secondly, it makes clients face their problems, though some of them may not be ready. If the problem of a client is formulated by the therapist, it means that the therapist is one step ahead of the client. According to the Rogerian model of counselling, initiative should belong to the client (Rogers, 1976). It is possible to provide an example of a common situation. The client may say that her husband is really busy at work and he pays little attention to her when he comes home. Her therapist may recognise a serious problem and ask “Do you feel lonely and unnecessary?” or “Do you think you husband does not love you?”. Such radical formulations may frighten clients and block any advances in the course of psychotherapeutic process, especially if they are voiced in a form of statements, but not questions. However, the tendency to avoid clear formulations of problems cannot be regarded an obligatory rule. Therapists may violate this rule if they are sure it will not exert any negative influence upon psychotherapeutic contact with their clients (Mearns & Thorne, 2005). As a rule, it becomes possible on late stages of psychotherapeutic process. Rogers has once come to the following conclusion. The more genuine is a therapist in his client’s opinion, the more sufficient and constructive changes the client is subject to are (Rogers, 1976). In such a context clients regard therapists “genuine” if they seem to understand and sympathise with their problems. The aim of the counselling is to boost the client’s self-respect and ability to make decisions. Thus, the therapist’s attention is concentrated on inner feelings of a client, but not on the problem itself. That is why the task which is supposed to be solved in the course of therapy sessions is to encourage personal advancement and growth of a client. The second task is to create the required psychological climate and contact. Rogers distinguishes certain conditions, necessary in order to create an atmosphere which would encourage the process of personal growth. First of all, therapists should always maintain positive attitude towards the client’s feelings and opinions, even if they contradict to their own ones. Clients should be sure that he or she is seen as a self-sufficient and independent people, free to speak and act the way they prefer. Empathy is important as well. Therapist should make an attempt to analyse the situation as viewed by the client and understand what the client feels. Client should never doubt sincerity of their therapists (Rogers, 1976). Finally, the main task of the therapist is not just to analyse the client’s problem and give them a clue how it may be solved. Instead, therapist is supposed to listen to the client and preform function of a mirror, reflecting their thoughts and emotions (Mearns & Thorne, 2005). It would give clients an opportunity to investigate their own inner world. The way clients perceive themselves and think they are perceived by other people would become more realistic. According to Rogers, abilities of people to solve emerging problems depend on how realistic self-concept is (Kirshenbaum & Henderson, 1997). In case these requirements are followed, the process of therapy is likely to have positive results. Gestalt therapy, developed by Fritz Perls in the 1940s, is sometimes also posed as a means of personality development. However, its true purposes are rather therapeutic than developmental. As a rule, Gestalt therapists deal with patients who suffer disorders and require treatment. That is why the role of client is not as sufficient in comparison to client-centered therapy – active stand belongs to the therapist (Perls, Hefferline, & Goodman, 1996). However, Gestalt therapy may sometimes been conducted in quite a relaxed form, showing certain developmental effects. The way Gestalt therapy is called may also throw light on its essence. Being derived from Gestalt psychology, this term refers to the way people perceive and evaluate the world around them. This German word defines certain patterning – its parts constitute the perception whole of a person (Perls et al., 1996). Gestalt may be called a result of integration of many factors, which are present in a given moment of a person’s life. In general, it refers to the process in the course of which human needs and desires appear. If a person fails to satisfy his or her needs, this process cannot be successfully completed. Unsatisfied needs make people feel frustrated and sometimes even unable to form new needs. Every day people create many figures (our most dominant needs) which interact with the external environment, or ground (Perls et al., 1996). Dominant needs of healthy people become ground when they are satisfied or no longer important. The aim of Gestalt counselling is to help patients create figures in adequate correlation with the ground. According to Perls’s theory, people are influenced not only by social and cultural factors, but physiological as well (Perls et al., 1996). Thus, if skills of self-regulation are suppressed, the contact with ground may be interrupted. If it happens, a person may feel that the situation is uncompleted. Such a situation will make this person feel worried and frustrated until the solution is found. Such a state may be referred to as neurotic. It is possible to provide an example – adults sometimes tend to behave in a childish way in some intricate situations (Mackewn, 2004). It may be explained by their subconscious desire to come back to their childhood, when some life circumstances provoked such a type of behaviour. However, Gestalt therapists prefer working with situations occurring right here and now. It is understandable, since central figure and ground may change rather drastically in quite a short period of time (Joyce & Sills, 2010). The principle of work is not to ignore the past, but to analyse those problematic situations which emerge right in the given moment. Perls was sure that people may develop only in case if they realise the realities and are not enthralled by illusions of the past or the future (Perls et al., 1996). The only possible way to live a full life is to accept and experience the present. It means that all the figures Perls talk about are formed under the influence of concrete situations in particular moments. However, the ground should not be underappreciated. It serves as a basis in the process of interaction between a person and environment. The aim of Gestalt therapy is to help people realise their needs, make them more precise. Finally, these needs are supposed to disappear. The last stage is a very important phase in existence of every figure. Gestalt loses its actuality and becomes a ground. New figure comes to the forefront. The main requirement which is necessary in order to form and neutralize the Gestalt is to make people be aware of themselves and their dominant needs (Joyce & Sills, 2010). Thus, currently dominant needs of a person should be paid a great deal of attention. It is possible to say that Rogerian and Gestalt models of counselling have much in common. Both of them are based on one philosophy. Adherents of both these approaches believe in human growth and potential, which may result from relationships between therapist and client. The ability to build a unique model of communication with every client during therapy sessions is one of the most necessary skills of a Gestalt therapist (Joyce & Sills, 2010). In other words, every client and situation require individual approach. This is especially important if to take into consideration one more peculiarity of Gestalt therapy – every client is considered an expert of his own life. That is why clients on their own are more responsible for their progress than Gestalt therapists. This is also true for client-oriented therapy. Rogers considered relationships between therapist and patient to be a determinant factor of advancement in treatment (Rogers, 1976). Peculiarities of relationships between therapist and client from the viewpoint of client-oriented approach have already been mentioned above. If to talk about Gestalt therapy, relationships between therapist and client are of crucial importance as well. Gestalt therapist is supposed to help clients to be conscious of their own self (Joyce & Sills, 2010). What they are supposed to develop is awareness of their needs. It cannot be achieved if the contact between client and therapist is not strong enough. Gestalt therapists focus special attention on their client’s reactions on physiological, mental, and emotional levels. At the same time, their own reactions and feelings are important as well. Therapists may sometimes share their thoughts with clients – it may be one more instrument of therapy. That is why Gestalt therapy sessions, as well as client-centered ones, are sometimes very emotional. Therapists of both models of counselling encourage their clients to share their blocked feelings, both positive and negative. If to compare status of a client in terms of these two models of counselling, it is a bit different. If to talk about person-oriented therapy, it was already mentioned that clients are free to talk about anything they want during therapy sessions. Statuses of therapist and client are equal since client is the key figure in the therapy advancement. But if to talk about Gestalt therapy, the status of therapist is higher than the client’s one (Joyce & Sills, 2010). Gestalt therapist is responsible for time frames of therapy sessions, treatment intervention, balance between support and frustration. Therapist may also use counter transferential relationships as driving force of the treatment. However, Gestalt therapists do not hold themselves out as the all-knowing guru, meeting an unexperienced pupils, or clients. That is why the boundary of contact is very important. Gestalt therapist may talk about their own feeling and express emotions – it is an important element of the whole therapy (Joyce & Sills, 2010). This is also true for client-oriented therapy. Rogers has once coined the term “congruence” (Rogers, 1976), one of the main conditions of psychotherapeutic contact. A person may be called congruent if he or she is aware of feelings and emotions they experience. Such people may accept and share these emotions with people around them. They are open to others and feel no need to use defence mechanisms. This is one of the basic skills of therapists both in client-oriented and Gestalt models of counselling. Thus, the task of congruent therapists is not to play any roles or hide their feelings. Instead, their words are supposed to correspond to what they feel. Therapists observe their own flow of thoughts and share it with clients. In other words, they try to be their own self. However, it is possible to observe small difference. In person-centered therapy central position belongs to the client, while therapist is comparatively passive. The therapist’s task is to demonstrate empathic and non-judgmental approach. Meanwhile, he is supposed to observe how clients are moving towards self-actualisation. Clients are offered an opportunity to set the goals of the therapy. Therapist’s task is to guide this process. On the other hand, Gestalt therapist occupies much more active position. Client and therapist combine efforts in order to explore client’s inner world. Being responsible for their own actions, clients are supposed to understand how they may affect their problems. It presupposes an active position of therapist. One more thing which characterises both client-oriented and Gestalt therapies is the following. Therapists of both approaches work with subjective awareness of their clients. Clients are not stigmatized in the course of therapy. They are not given advices or shown the ways of problem solution. Instead, the aim of both models of counselling is to make clients realise their life circumstances and reasons of their behaviour. That is why empathic understanding of the client’s inner world, an integral component of client-oriented approach, is so important. Both client-oriented and Gestalt therapies are based on the belief that a person, requiring help of a therapist, actually knows possible solutions of their problems. The therapist’s task is to help clients become aware of their own potential. Some people may consider themselves to be sociable, friendly, and open to other people. Others may think that being alone is the best variant for them. Such a self-concept predetermines the way people behave. People always act in accordance with their self-concept. They evaluate the external environment through the prism of their inner world. Of course, it influences behavior. If self-concept of people does not correspond to their life experience, neurotic symptoms may appear. For example, a person who is always in need to wash their hands may feel some guilt. Their need to wash hands may reflect a subconscious necessity to get rid of this feeling. The aim of client-centered therapy is to help clients make their self-conception correspond to their life experience (Mearns & Thorne, 2005). They are taught how to accept their own self. If clients manage to learn this, they are able to unlock their potential. Client-centered therapists may often use various awareness experiments in order to achieve this aim. These techniques may resemble behavioural ones, but their aim is not just to teach clients how to control their behaviour. It is rather to make them aware of their own self. At the same time, as Perls states, the main task of the therapy is not to explain the client how his or her problems occurred, but to show how influential they are in the client’s life (Perls et al., 1996). Thus, to be aware of the self means to understand how certain problem is experienced. The way people experience certain situations may be observed through their primary and secondary processes. Primary process is a conversation – verbal expression of a problem. It is a rational, well-considered formulation. At the same time, people are hardly ever conscious of their secondary processes. Voice, pose, and facial expression of clients may change while they are talking about their problems. It is possible to observe different hand motions and vegetative reactions. Clients may feel discomfort and muscle strain. However, clients hardly ever relate these reactions to their actual problems. Many people do not even notice them. At the same time, such reactions may give a therapist much more information than the client’s words (Joyce & Sills, 2010). Thus, such reactions is an important indicator in both models of counselling, especially if to talk about Gestalt therapy. Gestalt therapists take into consideration all the aspects of a person’s life – physiological, psychological, social, and spiritual. That is what makes Gestalt therapy different from client-oriented approach, where attention is predominantly focused on inner world of a client. Adherents of both approaches prefer not to concentrate on the client’s problem. In client-oriented therapy clients are free not to discuss their problems at all. If to talk about Gestalt therapy, it does not seek to answer why a problem occurs. Instead, it raises a question “What am I feeling and how can I change it?” (Mackewn, 2004). In other words, Gestalt therapy is oriented on the awareness of a problem, but not on its reason. Gestalt therapists try to make their clients be aware of processes, occurring here and now. It helps clients develop awareness of their own self and accept responsibility for their life. One more similar feature of both therapies is the concentration on “here and now” (Perls et al., 1996). It means that attention is focused on current processes and issues, but not on the client’s past. Such an approach is opposite to the one of psychoanalytic therapy. This principle presupposes that attention should be concentrated on the present. There is no sense to look to the past or the future (our plans and dreams will not come true if there is no solid basis in the present). From this perspective human past and future are viewed as two illusive worlds. The essence of Gestalt therapy comes down to awareness of the here and now – it is a key point of self-cognition and therapy advancement. Perls insists that there is no sense to explore the unconscious (Perls et al., 1996). People should learn to observe obvious things. Mental disorders may occur if people fail to observe the obvious. Though the concept of “here and now” is not central in client-oriented approach, it is still important. It may be a significant resource encouraging the client’s development. Thus, client-oriented therapy is based on discussion of concrete situations (in accordance to “here and now” principle), but not on past experience of a client. It is possible to distinguish many other similarities and differences between person-oriented and Gestalt therapies. However, there is a widely-spread opinion that these two models may form a successful counselling alliance. Their approaches towards human nature and goals are quite similar. Many techniques of client-oriented approach may be used in order to strengthen the effect of Gestalt therapy. At the same time, techniques of Gestalt therapy may be used in the person-oriented one. Efficiency of such an alliance may be demonstrated on the example of people suffering low self-esteem. There is a wide-spread opinion that efficiency of treatment in both person-oriented and Gestalt therapies partially depends on interpersonal relationships between therapist and client. It has always been typical of person-oriented therapy. The level of empathy of a therapist may predetermine the therapy advancement. Gestalt therapists have not so long ago acknowledged the importance of empathy as well. The research of empathy in the context of Gestalt approach appeared in the study by OLeary in 1997. Alliance of two therapies may also help clients develop their external and internal resources. It has always been important in Gestalt therapy. Perls emphasises how important these resources are (Perls et al., 1996). Exploration of the inner self helps clients develop their inner resources. Perls also underlines the importance of external resources of a person – interpersonal contact is important for him. Person-oriented therapy views internal resources as means of personal development. The task of a therapist is to make clients aware of their own potential. Clients should understand they are free to speak and behave the way they want within socially accepted limits. In the course of a successfully conducted person-oriented therapy sessions clients become aware of their own self. They learn how to accept themselves and other people. That is why the combination of two models of counselling may provide more opportunities for therapists to help clients develop their external and internal resources. Self-actualisation has always been the goal of client-oriented approach (Rogers, 1976). However, Gestalt therapy may also help clients develop it. It is especially true in the process of work with college students, as OLeary states in his review of studies in Gestalt therapy. Thus, techniques of Gestalt therapy may be used in client-oriented approach in order to help clients develop self-actualisation. Finally, it was already mentioned that awareness is one of the key concepts in Gestalt therapy. Client’s awareness of their own body reactions is important as well. If to talk about person-centered therapy, it is also important to draw attention of clients to their own organismic experiences. It may demonstrate the process of awareness increase in general. That is why techniques of Gestalt therapy may be helpful here too. Thus, the alliance between client-oriented and Gestalt therapies is likely to demonstrate positive results. Techniques of these two approaches may strengthen eventual result of both ways of treatment. This alliance lets therapists investigate the client’s problem from different viewpoints, which would not be possible within one approach only. Person-centered therapy turns to be the most effective if the client’s aim is personality development (Mearns & Thorne, 2005). This therapy is often used in conflictology. It is especially effective if to talk about social and family conflicts. The form of non-directive play therapy may be especially effective while dealing with issues of development of a child. It is also effective in work with college students. It is also used in psychiatric hospitals. However, there is a number of restrictions, as Rogers acknowledges (Kirshenbaum & Henderson, 1997). Sometimes clients may feel euphoria which does not have any real ground. It means that the process of personality development is not successful. There is also another danger. Therapists in some cases tend to identify themselves with client’s personality and experiences too much. The therapy efficiency is unlikely to be high in such a situation. In addition, it may be harmful for the therapist themselves. Besides, it is sometimes unclear how long therapy sessions should last. It may be difficult to understand when clients are ready to refuse from psychocorrective help and face real life. Client-centered approach may be effective if a person lacks attention, sympathy, understanding, and warmth. This approach may be used if a person is supposed to learn how to accept themselves and others. It may be necessary for those who are sick and tired of being lonely. Thus, client-centered model of counselling may help those people who are looking for an emphatic and non-judgmental therapist. Its style of therapy sessions is rather mild, especially in comparison with Gestalt therapy. Gestalt therapy sessions may sometimes even shock an outside observer – many participants tend to express the extremity of their feelings (Mackewn, 2004). Person-centered therapy may show people how to use their internal and external resources. It may help those clients who want to achieve their goal and realise their potential. If to talk about Gestalt therapy, it is worthy to mention that very often it is conducted in a form of group sessions. It may be helpful in a group of two or more people, or even in a group of work colleagues (Mackewn, 2004). This model of counselling gives an opportunity to work with a variety of problems. It may be used while dealing with intimate issues and communication problems. However, sometimes it turns to be effective in case of psychosomatic disturbances, depression, and anxiety disorder. Gestalt therapy may be useful for married couples, especially for those who are on the brink of divorce. It may also help those who are going through difficult period in life. It is used while dealing with clients who have lost their jobs or loved ones. However, Gestalt therapy does not suit those people for whom it is difficult to draw a line between theoretical behavioural patterns and actions in real life (Mackewn, 2004). Gestalt therapy is quite popular among women – most of them like talking about their feelings and problems. Inner-oriented principle of Gestalt therapy corresponds to these preferences. At the same time, Gestalt therapy may sometimes seem boring to men. Many of them may consider therapy sessions, where attention is focuses on feelings of a person, to be slow-paced and impractical. However, therapist is still a key figure. Therapy efficiency is very often predetermined by competence and talent of a therapist, but not principles of a chosen approach. That is why first impressions of a therapist may become a determining factor for a client. Thus, both person-oriented and Gestalt models of counselling are unique and influential in its own way. Both of them have been practiced for more than a half of the last century. Both of them have their own advantages and disadvantages. It is possible to say they have more similarities rather than differences. They both believe in human growth and potential. However, treatment efficiency is especially high if adherents of both models of counselling borrow techniques from each other. Practice proves alliance of these to therapies to have really positive results. However, person-centered model of counselling is more popular among therapists. As it was mentioned, role of a therapist in the course of person-centered therapy is not as active as in Gestalt therapy. That is why person-centered therapy is easier to apply. In addition, techniques of Rogerian therapy are not so complicated as the ones of Gestalt therapy. Therapists should take into consideration that unprofessionally applied techniques may do much harm for a client. That is why it may even be better that Gestalt therapy is a bit less popular than person-oriented therapy. References Joyce, P. and Sills, C. (2001, 2010). Skills in Gestalt Counselling and Psychotherapy (2nd ed.). London: Sage. Kirshenbaum and Henderson (eds). (1997). The Carl Rogers Dialogues. London: Constable. Mackewn, J. (2004). Developing Gestalt Counselling. London: Sage. Mearns, D. and Thorne, B. (1999, 2005). Person-Centered Counselling in Action (2nd ed.). London: Sage. Perls, F., Hefferline, R., and Goodman, P. (1996). Gestalt Therapy: Excitement and Growth in the Human Personality. London: Souvenir Press. Rogers, C. (1976). Client Centered Therapy. London: Constable. Read More