Friday, January 23, 2009

HPCE ERG – Part 7: Pushing to Finish & Tackling PE Therapy

Entry for 23 January 2009:

Time is beginning to run out for the Humanistic-Person-Centred-Experiential Therapy Competences Expert Reference Group (ERG), so when we met again today Tony Roth really put pressure on us to forge ahead. Tony did allow us to badger him and Steve Pilling for a bit about various political issues, such as whether anyone is likely to pay attention to our finished product, and whether it will have any impact on things like regulation and the NICE guidelines. The answers to these particular questions were not particularly clear, but what is clear is that what we’re doing is all part of the mix of things happening right now at lots of levels, even if though the effects may not be immediate or direct.

However, Tony really is anxious to see this thing done, to such an extent that he attempted, in behavioral fashion, to offer various incentives to keep us moving, such as offering a prize for coming up with the right wording for something (I won but then he reneged on the prize...) Most amusingly, he delayed our lunch some time, leaving the sandwiches there on the side table to spur us on to finish the Basic Competences section (or perhaps to stop obsessing on minor wording issues). Nevertheless, being strong of will and high in psychological reactance, we resisted the temptation to cut corners, and continued to fine-tooth comb this section, now virtually complete, in great detail. Finally, just about one o’clock, we finished the run-through, and fell upon our hard-won lunch.

As we ate, Tony and I worked away at a couple of loose ends from the morning. After reviewing these additional bits, we spent time discussing potential structural problems with the latter parts of the framework. As I’ve previously reported, the HPCE competence framework we’re working on has five sections: Common Competences (shared all major therapy approaches), Basic Competences (here Person-centred/Relational in nature), Specific Competences (shared by many but not all therapists within an approach), Specific Adaptations (specific approaches that have empirical support, perhaps for specific client populations), and Meta-competences (literally, competences about the use of competences, having to do with the thoughtful implementation, adaptation and balancing of competences). Andy Hill, who is doing the legwork of extracting competences, has been worried most of the PE therapy competences are being put under Specific Competences, leading to two problems: First, PE therapy material is danger of dominating this part of the framework, which feels somehow out of proportion. Second, there’s a danger of not enough material being left in the Specific Adaptations section, leaving it too thin.

Actually, neither of these problems particularly bothered me. It doesn’t surprise me that PE therapy material runs through the Specific Competences. For one thing, we had to leave them out the Basic Competences required of everyone in the approach, because many PE-specific competences are unacceptable to classical Person-Centred folks, so they had to go somewhere. More importantly, PE therapy is itself an integrative humanistic PCE therapy, having borrowed bits and pieces from Gestalt, Focusing-oriented and existential therapies, via the means of turning key elements of practice in these approaches into PE therapy tasks. The Specific Competences simply unpack some of this, giving a broader range of humanistic therapies something to hang their hats on in the framework. I see that as a strength, and I really like the idea that the PE therapy tasks live within the HPCE framework as Specific Competences, the groupings of which roughly correspond to the elements of the PE Emotion Scheme model.

However, in our discussions today, we took this further in a very nice way, by deciding to add one or more person-centred and/or relational Specific Competences. This strategy does away with the problem of PE therapy dominating this part of the framework, while simultaneously pointing to empathy/relational tasks that had so far been left out of the framework, because they had seemed to be implicit in the Basic Competences: Empathic Affirmative at Vulnerability, Relational Depth Encounter (for? I don’t know the marker for this one yet), Rigorous Nondirectivity (my term for what my colleague and friend Beth Freire does; again, I’m not sure what the marker for this is: a great topic for a research project!). Various subgroups of the ERG will tackle these Specific Competences between now and our next (and possibly final!) meeting in February.

As for the second concern, about there being little left to put down for PE therapy as specific adaptation, I’ve figured that this problem had already been dealt with, at least to Tony and Steve’s satisfaction, in the process of dealing with the CBT and Psychodynamic competences. In fact, this turned out to be the case: We are simply to replicate the relevant Basic and Specific Competences as appropriate for the PE therapy Specific Adaptation section.

As we broke up about 4:30 this afternoon, the rain had cleared and day was already fading in Central London, but our spirits were high and we were joking and talking energetically; the morale seemed distinctly positive, despite the political pressures. All of us could see the end in sight and were already feeling a sense of accomplishment. Catherine Clarke, our carer representative, is satisfied that we were able to include psychological contact in the Basic Competences (although I would add that in the future it would be good to be able to add Contact Work as Specific Competence and a Specific Adaptation both). Vanja Orlans seems reasonably content that we have managed to incorporate enough to provide a place for the HIPS section of UKCP. Andy seemed not only have gotten unstuck from the dilemma of how to deal with PE therapy, but was excited about the possibility of using the work to find a space between classical Person-Centred and Process-Experiential therapies. More than anything, a group of people who had often been at odds with each other over various issues (some quite long-standing), both within the HPCE world (Cooper, Tolan, Lietaer, Clarke, Elliott, Orlans) and outside it (Roth, Pilling) had come together. Over the months, this group (together with Nancy Rowland and Sally Aldridge form BACP) gradually earned each other’s (at first perhaps grudging) trust, and forged a working unit, in a kind of intra-/inter-modality team-building exercise. That in itself is an important accomplishment. Who knows where that will lead?


Ken Evans said...

Dear Robert,
I am responding to your blog about the HPCE ERG.
You have a very dated perception of working with the transference.This does not require an 'interpretation'from an 'expert'as you suggest.Most Integrative psychothrapists who are members of the European Association for Integrative Psychotheraoy would dispute your narrow perception as would most contemporary Dialogical Gestalt psychotherapists. Where have you been for the past 20 years? Clearly out of contact with growing edge developments in Integrative humanisitic therapies.
You appear to have fallen into the trap of purism in the guise of pluralism.
warm regards
Ken Evans

Robert Elliott said...

This comment actually goes with HPCE ERG - Part 8, but suffice it to say: (a) "Transference" is Freud's metaphor for general patterns of relating, and does not find favour with those of us on the person-centred end of the humanistic spectrum. (b) The issue is not whether we work with general interpersonal patterns that occur in many aspects of the client's life, including therapy -- which we all agree is important -- but what kind of language we use to talk about this work and whether that language makes the therapist into an expert on the client's experience. (b) When I took issue with language that could easily be understood as referring to therapist transference interpretation, I was advocating for less misleading language.