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November 2019

"Client centered" it's a phrase that is common in the field of mental health. This phrase was coined by Carl Rogers and is supposed to be an
 
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Walk A Day In My Culture. . .

 

Are We REALLY Practicing
Client Centered Approaches?

"Client centered" it's a phrase that is common in the field of mental health. This phrase was coined by Carl Rogers and is supposed to be an indication that the work you do with a client is centered around THEM. Centered in a way to help them reach their goals by acknowledging that THEY have the ability to make improvement, allowing the client to be the expert on their lives as opposed the therapist taking that responsibility. But if we look at this on a deeper level, more so examining ourselves as therapist; how many of us are really, I mean REALLY, practice a client centered approach with our clients?

Today, I am going to structure things slightly differently. I am going to first ask you some questions based off of this theory, follow it up with an assumed response, and then give you some tips on how to have a better answer if you don't like the answer, or how to maintain your answer and continue increasing your cultural awareness. You ready? Here we go. . .

Do you consider your client to be the expert in the room?

No.
Yeah that may seem harsh for me to assume that you said no, but it's more so to truly challenge you. Really think about the question. Do you really consider your client the expert? Or is it a piece of you that believes you are the expert? Believing that your client would not have sought out services with you if you were not the expert. Truly think about this. Be honest with yourself, no one knows your answer but you.

Although a majority of theories used in therapy are European based and not necessarily effective for people of color, Rogers' theory seems to have some pockets that can really work well with clients of color, especially Black clients. An example of this is the question above. Rogers believed that as therapist we should look at ourselves as equal to our clients and I believe this is true. Think about this in relation to when you have sought help before, be it in therapy or the doctors office. How did you respond to a doctor telling you what was best for you and not considering what you said you needed? Or being in therapy when a therapist makes a suggestion that is totally against everything you believe in. Were you inclined to follow the suggestion? Did you feel heard? Did you feel like your needs were considered? Probably not.

For Black clients, it is key to consider what they need and to provide suggestions based off of what they have expressed as things they find helpful. Why? Because many times, society doesn't listen to our needs. We often have to fight to be heard and taken seriously. We are also often not looked at as equal, we have to work twice as hard to prove that we are just as equal as everyone else in society. So really consider this question and be honest with your answer - as a therapist it's crucial.

Considering our clients as equal to us is not a bad thing. We are all human. We all bleed the same. We all have the same set of feelings. We all have problems at some point or another. In many ways we are equal to our clients. Allowing your client to be the expert in their journey is a powerful thing to witness. Guiding them in a warm and gentle way will be received much better than you telling them what you think is going on based on the theories and skills you learned in school and your internship. Now, with that said, by no means am I saying to negate everything you have learned in school or the skills you worked hard to develop. I also am not saying that you are not skilled and well versed in your craft as a therapist (or other helping professional). But what I am saying is that to really be an expert in something, and to really help your clients flourish, you must allow them to bring their expertise into the room. You cannot deem yourself an expert in anything if you do not allow yourself to learn from others. And you sure cannot deem yourself the expert on your client's life. After all, your client is the only one living THEIR life, it's not your job to tell them how to live it. It's your job to guide them on how THEY want to live their lives, helping them see what THEY need to do to get there.

Do trust that your client has the ability to change their situation?

Maybe, it all depends.
Hmmmm. . . Think about it. Do you trust your client can make a change in the direction they want to go? Do you feel like it depends. What does it depend on? How difficult YOU feel their situation is to change? How often they engage in behaviors that keep them in the situation? How "eager and willing" they are to utilize the tools YOU suggest?

This is an area that Rogers makes a really good point around. In his theory, he believes that clients are the ones to determine what the problem is they are facing, and the therapist encourages the client in a way that helps the client reach their personal goals. The end goal is to help clients self-actualize, which is a life long process of someone learning how to reach their full potential. In order for a client to learn to self-actualize, you must allow them to explore things for themselves, and BELIEVE that they can change the situation they are in which is what caused them to seek therapy in the first place.

Again, for Black clients this is crucial. So many people don't believe in us and we often have to encourage ourselves. This is why community is so important to us, because we know that if no one cheers for us, at least our community will believe in our ability. To add to that, if we have a problem or make a mistake, these things are often held against us much longer than our white counterparts, and sometimes even longer than our fellow people of color. Sometimes to be Black is to be overlooked, underappreciated, and not believed in. So as a therapist of a Black client, you want to make sure you are not falling into the category of yet another person that doesn't believe in your client.

In order to assist your client in reaching a level of engaging in behaviors that will help THEM create change, you must be present and show up in a different type of way. You must show up through engaging in the work of attentive reflective listening and witnessing a client's experience. This is very different from listening so that you can connect what they disclose to a theory or to past experience that YOU believe is connected to the client's current behavior. No! You are being attentive in your listening and witnessing so you can help the client make the connections THEY need to make to get them to where they want to be. Not the other way around. You are not helping the client make the connections YOU need them to make to get them where YOU feel they should be. Leading me to my final question.

Do you have TRUE empathy and unconditional positive regard for your clients?

Sometimes, it depends on the client.
In this field we secretly do a lot of "it depends." I know we don't like to admit it, but if we took a long hard look at our thoughts and the reason behind those thoughts, we will find out that we do a lot of depending (pun intended). This isn't to judge or to make anyone feel bad, it is more so to help you keep it real and learn how to check your dependable attitude. It is hard to have empathy for a client and unconditional positive regard if you are struggling to get the client to see things from your perspective. It's also particularly hard to hold on to empathy and unconditional positive regard when you feel your client isn't doing what YOU feel like they should be doing.

This is where Rogers encourages the therapist to be accepting of the client and their process. If you can accept that the client has THEIR OWN process, separate from your process (there is often a parallel process), you will be able to have warmth and acceptance towards the client's experience. It is much easier to accept what a client is going through if you are able to SEE THEIR PROCESS, even if they keep getting entangled in the same situation. By witnessing the process, you can have empathy for the process, thus allowing you to have unconditional positive regard.

For Black clients (and Black people in general), genuine acceptance is important to us. The key word here is genuine. We can smell fakeness a mile away, and it is an instant turn off. You may think your client is opening up to you or that you have good rapport, but if you don't genuinely accept the client for who they are and what they are struggling with, rapport is where the buck stops so to speak. You will never build that therapeutic relationship that can enable the building of trust, which opens the door to change. Really seeing what your Black client is going through and their process can make a world of difference in treatment.

And yes I know, sometimes clients can get stuck in their process. This form of being stuck can be really tricky with Black clients because you don't want to engage in microaggressions in session, while you also want to try and help your client move through the process. But if you take a step back and witness why they are struggling and be curious with them, it may not be as tricky. Be curious to what makes THEM fall into the same pattern. Curious in a way that means just that. . . curious (period). Not curious and adding in your theory or suggestion. Just curious. Not curious where you mentally put your therapeutic spin on the situation. Just curious. Explore with the client, allowing THEM to lead the way. And if they get lost on the journey of exploration, simply bring it back to THEM and what you have witnessed thus far. Let's take this a step further.

Think about your experiences of self-discovery and change. Was your self-discovery and change more impactful when someone sat with you and allowed YOU to make the discovery, all while holding your experience with care and consideration? Or. . . Was your experience with self-discovery and change more impacted by someone telling you their thoughts about your situation and what THEY thought you should do? I would bet the first experience was more impactful and lasting for you, because after all when YOU make a discovery about yourself and decide to make a change, YOU become unstoppable, so allow your client's that same freedom. Until December. . .
Snippet For Next Month's Topic

Next month we are talking about "Cultural Boundaries Crossed Part One" this is a thorough topic that I plan on covering with you all in detail to help you be more culturally aware. Take a read below at a snippet from next month's issue:
I wanted to expand on this point so much more on my podcast, but I didn't want to make the episode too long. However, the great thing about my newsletters are that I can expand on points much more extensively, which I plan to do now. The complexities of skin tone in the Black community has a long history and that history runs deep, so making a comment about the level of melanin present in a persons skin tone is just inappropriate on so many levels. There are so many reasons why commenting on the skin tone of Black people is inappropriate, too many to count, but here are a few that I have expanded on from that episode of my podcast. Number 1. . .
Cultural Tidbits

This month I'm only including one cultural tidbit. 1) Because I want you to really ponder on the questions I asked in this newsletter and 2) I want you to be prepared for next months topic. I encourage you to listen to this episode I did a few weeks ago, it will help put things into context for you next month. Click the link below to listen, and if you haven't subscribed to my podcast you should. It's available everywhere podcast stream, if you love the newsletter you will love the podcast.

Walk A Day In My Culture (Podcast) - Bonus Episode: Cultural Boundaries Crossed
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