Issue 10/2017 summary

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Issue 10/2017 summary

Mick Copper (Great Britain). A Pluralist Approach and Its Attitude to Existential Therapy (rendered by Tamara Sikorskaya)

The seminar of Mick Copper took place as part of the annual international conference in Birshtonas in 2014. The seminar minutes were taken by Tamara Sikorskaya.

At the beginning of the seminar, Mick speaks of his recently published book, co-authored with John McLeod Pluralistic Counselling and Psychotherapy. The following narrative is by Mick Cooper:

‘This pluralistic approach was developed based on the values and requirements of existential therapy. It gave me an opportunity to formulate what existential therapy means for me. It is an opportunity to be open to challenges and to try to be open to other opinions, to be flexible. And I really tried to hear the voices of the clients, who have experienced participating in such therapy. […] I think that this approach is close to existentialism, its openness. One focus of the pluralistic method is discussion with oneself while ascertaining what we offer to our clients.

‘Let us turn to the history of psychotherapy. It is characterised by the emergence of different psychotherapeutic schools, which originate from different standpoints. There is no doubt that these different schools can be very helpful. However, the history of schools is characterised by the phenomenon of schoolism, when convictions of a certain type become dogmatic, religious. And it is very easy to think that exactly this approach holds the single truth for people. Very often, we see this attachment to different schools as a certain rational thing based on logic and theory. In fact, I think that there are opinions about psychotherapy that are determined not so much by rational as by emotional and historical criteria.

And what are we trying to do in the pluralistic approach? We are trying to be really open to everything and not only to something characteristic of one school. We talk to clients in detail at the very beginning in order to assess his or her needs phenomenologically. Because we know that different things can be helpful and useful.

There are two basic suggestions related to the pluralistic approach:

  • There are many very different things that help a person. The pluralistic approach tries to be as open as possible to plural approaches.
  • If we really want to know what will be helpful for the client, let us do it. It does not mean to do more of the things the clients want. It is about being more pen to the client and to consider therapy from the client’s point of view.

There are three special elements of the pluralistic approach:

  • The general pluralistic standpoint. It is simply believing that different clients probably will benefit from different therapies at different types in the way that it can be offered.
  • Meta-therapeutic communication. It means the possibility of discussing the process of therapy with the client, co-operating with the clients in order to agree on the methods of therapy.
  • Doing different practices.

The pluralistic approach is a position in therapy as a whole, on the meta-therapeutic level, including all principles of existential therapy. It is important to distinguish these things – the general standpoint towards therapy and integrative factors.

What is the difference between pluralistic and integrative therapy? There are many conjunctions between them. One point is that the pluralistic approach derives from the existential standpoints rather than from the psychodynamic or personal approaches. If your work is integrative, you can see co-operation between the therapist and the client as in the pluralistic practice. However, both will have different means and approaches in talking to the client. There are dimensions where no crossover takes place. Integrativeness is a special form of practice. And the pluralistic position is rather a general philosophical standpoint. At the same time, the integrative practice does not pay so much attention to co-operation with the client. For the pluralistic practice, the idea of working and discussing the work with the client all the time is very important. The main thing is concentrating on what will be best for the client.

The pluralistic approach is also different from the eclectic one in that there is a strict, central nucleus of pluralism, an irrational understanding of existential methods and viewpoints. And because we know that this approach derives from the needs and wishes of the clients. We know that there are very many studies concerning decision making in therapy. From my experience, it is often important to ask the clients what they would like in therapy, maybe, at a definite time. If you ask them, then, maybe, after five or six sessions they will tell you what they would want. I mean creating this context of cooperation.

There were several important studies for finding evidence of the efficiency of the therapy. It is known as a special approach with a formative response. In relation to therapy, it is important to know that it is not a separate approach. The studies take measurements to see how the person undergoes the therapy. The measurements aid our understanding of how clients feel in therapy.

On what can a consultant base pluralistic therapy? Ethics is the basis, the unchanged foundation. It is the initial position that the therapist must view the client with respect and highly value the client. Values, not some theory, provide the basis and the foundation. The practice derives from the ethics.

Where can one study to become a pluralistic therapist? In Britain, we have a programme for the study of pluralistic therapy. It has a number of approaches we teach. Maybe, there are personal-centred, psychodynamic and behavioural-cognitive approaches. As to the pluralistic position, it is there from the beginning to the end. We say: “There are very many therapeutic approaches, which can be equally good for the client at different times, and we could begin education from them, but we will begin with the existential approach.” But we will rather stress that there are some methods that help people of certain kinds at definite moments, rather than there being a definite school.

The pluralistic approach is expressed in integration, the union of different approaches around the central focal point of conversation with the client. If the therapist speaks with the client and finds what he or she wants and how to achieve it, and, at the same time, to be open on how it can be done, it is the pluralistic approach. We have conducted certain studies and asked therapists practicing pluralistic therapy where and when they conducted these conversations. Some said that it was before the beginning of the therapy, possibly during the first diagnostic session, when discussing the contract. These conversations also take place during the session. The end of the therapy is also a good place for this talk, to find out what prevented and what helped, what could be useful to retain from therapy.

(Next, Mick offers several forms for assessing client’s conditions). ‘We often are not sure about such assessments, as if what they show us remains on the surface, at the level of symptoms. Besides, we spend time that could be spent on therapy. At the same time, there are many reasons for therapists working with the existential-humanist approach to use the systematic feedback regularly. One reason is that systematic feedback will help clients to express their diverse feelings, which are very numerous. They can express the feelings in one of these forms.

‘Another reason for using systematic feedback is that clients will be more useful for their therapy. […] It may not be true for all clients, but for those who do not improve, the very fact of using questionnaires can make improvement more likely. There is considerable evidence for it.

‘… For me, the central lived ethics is existential ethics, because I think that existentialism forms the question of how we can participate in humanity, it is a refusal to reducing people and treating them mechanically. Existentialism is the value of uniqueness of every individual.

‘The basis of the pluralistic ethics is respect to the plurality of meanings and diversity. Also, as in existentialism, it is a critical attitude to universalisation and unification. It criticizes the position according to which there is a single right answer. […] And even if we believe that we know what is better for someone, the ethic position leads to finding out what is best for him or her in his or her opinion.’

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