Both lives and behaviour. While many of

 

Both approaches attempt to return to the client a perception
of control over their own lives and behaviour. While many of the underlying
assumptions of CT and PCC seem congruent, the behaviour of the therapist in the
counselling environment can be radically different. While the Person Centred Therapist
tries to dissolve resistance by avoiding evaluation and advice, relying on the
client’s innate capacity for personal development to facilitate change; the
Reality Therapist actively encourages the client to evaluate their own
behaviour, and may offer advice or suggest specific plans for behavioural
change. The ‘demand characteristics’ of the client in PCC are of a gradually
more emotionally connected, present focused, self-actualizer; while in CT the
client is encouraged to become adept at reframing, planning and evaluation.

 

The great strength of
Choice Theory is its emphasis on rapid behavioural change and the improvement
of relationships. The faith of psychoanalytically derived therapies in the
power of insight to resolve psychological conflict ignores the very real
situational components of many psychological problems. By focusing only on that
element of the client’s world that they can change their behaviour, CT quickly
provides clients with the pragmatic advice that counselling efficacy
research shows they seek. Although the evidence based aspirations of PCC may
have been initially limited by simplistic statistical tools and inadequate methodological
rigour; PCC attempt to scientifically evaluate the efficacy of psychotherapy
prefigured today’s research based therapeutic approaches. By contrast, a
significant weakness of Choice Theory is Glasser’s tendency to substitute
aphorisms for references and research. One vivid example is his presentation of
a graph of human technical progress as compared to human progress since 1900,
which seems entirely arbitrary, ignoring the changes in human and civil rights
over the period; for example decolonization, suffrage for women and African
Americans, gay rights, the legalisation of contraception and the
acknowledgement of the criminal status of rape within a marriage. Another
weakness is Glasser’s assertion that external control psychology is
responsible for all social problems; ignoring the complex multi-factorial
components of such diverse issues as the construction of criminality and social
changes in attitudes towards sexual promiscuity. In advocating CT as a
methodology to prevent social problems, Glasser seems to make the logical
mistake of confusing the efficacy of an intervention with the underlying causation
of a problem, like a doctor deducing that a shortage of antibiotics is the
cause of a bacterial infection. Glasser’s four non-survival needs represent an
attempt to create a theory of personality and motivation ignorant of
psychological research into dimensional personality traits, for example the situational
trait approach; and Glasser provides no research evidence for their
pre-eminence over other well defined and researched needs (e.g.: sexual
intercourse, creativity, social dominance). Glasser’s concept of a creative
system responsible both for the development of psychosomatic illness and
problem solving, departs radically from contemporary psychological and neuro scientific.

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PCC is not problem focused, and it’s reliance on catharsis and the innate
tendency towards self actualisation may make it inappropriate for compulsive
and depressive problems. By allowing the client to direct the course of
discussion, and practicing unconditional positive regard, the person centred
counsellor could potentially collude in ignoring problematic behaviours and
irrational beliefs, and neglect unexpressed problems underlying dysfunction. In
the contemporary clinical setting, where the availability
of  psychopharmacological interventions and health insurance
emphasise brevity, the lengthy process of traditional Person Centred
Therapy may often be impossible. Applications of each model in a multicultural
setting the empathy and value neutrality of the person centred ‘way of being’ make
it ideal for use in a multicultural context. However, PCC emphasis on client
talk may run into difficulties with clients who don’t share the same native
language as their counsellor.  The emphasis on readily understandable
needs, wants and behavioural plans by CT / RT may make it more broadly
accessible cross culturally. However RT’s individualist focus and de-emphasis
of group dynamics, such as family role and religious observance
could potentially create conflicts with clients from collectivist
cultures. Glasser’s criticism of the ‘workless’, whom he likens to sociopaths and
suggests should be institutionalised limits Choice’s theories applicability
outside western capitalist systems of individuated personal
responsibility; or with clients who don’t share Glasser’s love for “our
economic system”. Choice theory suffers from blindness to situational
inequalities (physiological problems, varying intellectual resources, risk and resilience
factors etc).

  

 

 

 

Evaluation

PCC can be criticised for its absence of directivity. Watching
Roger’s perform therapy, his avoidance of advice is striking. While this
serves to reduce resistance, it does not necessarily accord with what clients
find helpful. CT avoidance of past trauma may make it unpalatable
for clients who feel the desire and seek in counselling the platform to catharsises
incidents of childhood abuse. In such circumstances the assertion that ‘present
relationships are always the problem’, seems disingenuous and reductive.
Relationship dysfunction may spring from underlying neurological disorder,
personality disorder or addiction: suggesting that in some cases relationships
or their lack may be a symptom of, rather than the problem underlying,
client distress. Implicit in Reality Therapy is the concept of mental illness
as ‘denial of reality’. Historically mental health services have often been
used to suppress dissent (for example within Soviet Psychiatry) – and a disagreement
about the aspects of our socially constructed reality underlies all social
development (e.g.: the emergence of feminist consciousness and the women’s
rights movement).

 “The reasonable man adapts himself to the world; the unreasonable man
persists in trying to adapt the world to himself. Therefore all progress
depends on the unreasonable man.”

George Bernard Shaw

Social deviance is not by itself ‘irrational’, and CT’s critique of psychoanalytic
opposition to “conventional morality” ignores the highly repressive and
patriarchal nature of late 19 and early 20 century social and sexual
relationships.

 

Conclusion

 

PCC and CT are approaches to the treatment of mental illness in radical
opposition to the rigid categorisation of mental illness. In an era of
commercialised bio-medical treatment of mental illness, both approaches offer a
humane alternative. While they disagree in their conception of the person and their
methodologies for intervention, both paradigms provide a positive, hopeful
engagement in which therapeutic change can occur. In the contemporary
integrative context, the core conditions of a person centred way of being
may offer a useful relational style for the Choice Therapist. While the plan
making, future focused positivity of Choice Therapy could offer a useful
addition to the skill set of Person Centred Therapists, especially with clients
who seek concrete changes in their lives, or whose time in therapy must be
brief.