Person-Centred and Pluralistic Approaches: Similarities and Differences
‘What’s the difference between pluralism and person-centred therapy?’ It’s a question I get asked fairly often; or the not-so-pleasant variant, ‘Isn’t pluralism just a re-hash of Rogers?’
Some preliminary distinctions
In answering this question, the first thing that’s important to recognise is that there’s lots of different kinds of person-centredness: it’s not just one thing. The best book on this is The Tribes of the Person-Centred Nation edited by Pete Sanders. So there’s ‘classical client-centred therapy’, ‘focusing-oriented psychotherapy’, ‘process-experiential’/’emotion-focused psychotherapy’… and they all take forward different elements of Rogerian thought and practice. So, for instance, the classical approach tends to develop the non-directive element of Rogers’s work, while process-experiential therapy develops the Rogerian emphasis on emotions. There’s also what we might call ‘person-centred values’ (as distinct from any particular practice), which is about really valuing the individual and believing that they have the capacity, and right, to actualise their own potential in their own way.
Second, we also need to distinguish between a pluralistic perspective, and a pluralistic practice. They’re related, but actually the research shows that the correlation between them is only modest. A pluralistic perspective is about a general worldview that there’s lots of different ways of helping clients: that’s there no one, best therapy out there. By contrast, a pluralistic practice is when we draw on therapeutic activities from a range of different approaches, collaborating with our clients to develop the therapy most suited to their wants and needs. To practice in a pluralistic way, we need to have a pluralistic perspective. But having a pluralistic perspective doesn’t mean we have to practice in a pluralistic way. For instance, we could practice in a solely psychodynamic or CBT way, but still value other approaches and recognise the limitations of what we offer.
The pluralistic perspective as a person-centred ‘meta-therapeutic’ stance
So when we look at the relationship between pluralism and the person-centred approach, perhaps the first thing we can say is that a pluralistic perspective is synonymous with a person-centred view of the therapeutic field as a whole: what you might call a ‘metatherapeutic’ stance. It means valuing and appreciating different approaches and understanding their roots: exactly what Rogers meant by the ‘core conditions’ of acceptance and empathy. That parallel, perhaps, isn’t surprising, given that both John McLeod and myself came from a person-centred background, and were deeply committed to the values of the person-centred approach.
So why do we need to call it something different? I guess my experience in the person-centred field is that, at the meta-therapeutic level, it often wasn’t that accepting and understanding of other therapies. For instance, when it came to CBT and CBT practitioners, there was often a real devaluing and judgement: that these therapists were less effective than us (‘Just doing the superficial work’), or controlling and manipulative of their clients. Those person-centred values of prizing the other and valuing their strengths—really valuing their strengths—just wasn’t always extended to other therapies. So while a ‘pluralistic perspective’ can be understood as a person-centred stance towards the therapeutic field as a whole, the use of a different term makes it clear that it’s something over and above being a person-centred practitioner, per se. It’s about really challenging ourselves to be person-centred in our attitudes towards other therapies, and to recognise where our biases and assumptions are: just as we would in other areas of our personal lives and histories (i.e., being congruent).
Pluralistic practice and person-centred practices
So what about pluralistic practice? How does that fit with being person-centred? Well, as discussed above, a lot of it depends on what kind of person-centredness you’re talking about. If it’s classical person-centred therapy, for instance as described by Tony Merry (see the Tribes book), then a pluralistic practice would be likely to use a wider range of pre-defined skills, techniques, and methods of assessments. So a pluralistic practitioner might invite a client to keep a thought diary if they were having a lot of negative thoughts, or introduce some psycho-education if they were struggling with anxiety, or perhaps look at transferential issues if their were problems in the therapy relationship. Here, then, there’d be a wider range of methods drawn on—not such a sole reliance on the therapist’s relational stance. Also, what you might see in pluralistic therapy is more ‘meta-therapeutic communication’ about what the client wants and needs. For instance, the therapist might ask, ‘How do you think we could best address this problem: Shall we talk about your current relationship, or perhaps do a timeline of your past?’ By contrast, in a classical person-centred approach, the determination of how the therapy should proceed might be more implicit: trusting the client’s and therapist’s intuitive sense of where best it should go.
When you take another person-centred practice, for instance focusing-oriented therapy, there’s some different differences but also some of the same ones. In particular, a pluralistic approaches tends to draw from a wider range of practices (both person-centred/humanistic and otherwise) and, again, there’s more metatherapeutic communication. By contrast, in focusing-oriented psychotherapy, there’s more specialised use of a particular method (or way of being), and a more homogeneous understanding of the client and how to help them.
What about integrative person-centred therapy?
And then there’s another way of thinking about person-centred therapy, which is a more integrative understanding (again, see the Tribes book). So here people ‘read’ the person-centred approach as saying that, actually, we should be meeting our individual clients at where they are at, and if that means drawing on different methods and practices from different therapies then that’s fine: that’s what it means to be person-centred. Indeed, some people would argue that a classical person-centred stance is inherently integrative, in that being congruent means drawing on whatever we feel is best for a particular client at a particular time. So, then, if a client asks for advice, or wants us to use a particular technique or give them homework, it’s entirely person-centred to do so.
And if that’s how we interpret what it means to be person-centred then, yes, you could say that person-centred practice and pluralistic practice are essentially the same. Indeed, in a recent blog, John McLeod and I described an understanding of person-centred therapy that is, in its essence, pluralistic. So why do we need to call it something different? I guess not everyone would agree with this definition of person-centred practice. For instance, people are often taught that being person-centred means not giving advice, or that it primarily involves working with an ‘empathic understanding response process’ (see Beth Freire’s chapter in The handbook of person-centred psychotherapy and counselling). Again, we can see that the relationship between pluralism and the person-centred approach is, to a great extent, dependent on how you define ‘person-centredness’, and there’s no right answers here. Different people understand it in different ways.
Does it really matter?
I think, for me, ultimately what is most important is what we do with clients, rather than what we call it. In my own practice, research, and writing, I really try (though no doubt fail) to come from a place which is as valuing, as much as possible, of the people we work with. So, for me, what’s important is that we talk to clients about what might be most helpful to them (rather than assuming we know best), and try and draw on whatever we think would be best to help them move forward in their lives. You could call that ‘pluralism’, or you could call that being ‘person-centred’, and I’m sure people from CBT would call that essential to their approach too–as would people from many other orientations. Of course, I love it when people use our own pluralistic terminology to describe this stance, but that’s more about my own ego and self-valuation than about what is genuinely most important for clients. And what we know is that, in reality, most clients don’t care too much what you call it (and certainly care even less about giving my ego a boost!). What they want is to feel better.
So if the term ‘pluralism’ feels redundant, that’s fine, and if the term feels helpful, that’s fine too. I guess, for me, it definitely articulates something that wasn’t that clear, or well-defined, before. But what’s so much more important is that we work with our clients in the best way that we can, and help them move from places of suffering to places of thriving and fulfilment in their lives.
[Photo credit: Dom Lavage https://www.flickr.com/photos/wickenden/3259826856 Attribution-ShareAlike 2.0 Generic (CC BY-SA 2.0)]