My personal interest in theresearch of cultural resourcesAs a novice counsellor I have personally encountered thedifficulties of encouraging clients to access their own cultural resources,mainly due to them viewing me as the expert and them being unaware of the factthat they can have agency and their own preferences within the counsellingrelationship. Another difficulty to overcome is to help the client realise thatthey do have access to these resources, but have not been in a frame of mindwhich would enable this, due to the issues that they present with. One of themajor benefits of actively using cultural resources with clients is that itprovides them with an arena in which they can pursue their own purposes. Clientagency and purpose explicitly inform the practice of pluralistic therapy.(McLeod, 2017). I consider myself to bea spiritual person and I am also very musical and am both motivated and movedby listening to, and playing (the piano) music.
This is my ‘go to’ when I needto calm down, rest and just switch off from the general pressures of life. I also am a very keen walker and beachcomberand go walking (with music on my headphones) as much as I can to literallyrecharge my batteries and spend some time switching off from the world. These are my own personal cultural resourcesand I have an understanding of how these resources can affect my mood, mywellbeing and my mental health and also how I can access these resources whenrequired. Because I find it extremely easy to access my own personal culturalresources i.e. music, walking, I began to think about how difficult it could befor a client who has serious issues going on in their life, depression,anxiety, suicidal thoughts, etc. to be able to even contemplate accessingcultural resources. The question arises how can we, as counsellors activelyencourage our clients’ agency and pre-existing resources, knowing that they canbe of great benefit to their wellbeing, mental health and general mood? As I commenced working as a traineecounsellor in placement, I found that clients tended to look at me to providethem with their own cultural resources, and it became quite clear to me that inorder for a client to access their own cultural resources they must have someagency within the counselling relationship.
The competent skills required to enable this I feel, are lacking andcould be an area for future research in the training of counsellors in apluralistic framework. not alwayspractice in a manner that is consistent with that recognition (Tompkins, Swift,& Callahan, 2013). Instead,a”doctor-knows-best” model is often followed, where we make treatment decisionsbased on our knowledge ofresearch-supportedtechniques, our favorite theoretical orientation, or our accumulated clinicalexpertise (Swift ,2015).
Research also indicates that although clinicians want to know what theirclients think about treat-ment (Hat?eld& Ogles, 2007), many clinicians fail to seek feedback from their clients(Rousmaniere, 2017) and evenwhen feedbackis presented, often fail to pay adequate attention to it (Boswell, Kraus,Miller, & Lambert, 2015).As psychotherapyresearchers, we also often do not conduct our research in a manner that isconsistent with therecognitionof client expertise in psychotherapy. The bulk of the research that iscurrently being conducted focuses ontestingspeci?c treatment techniques (Wampold & Imel, 2015). This research oftenviews client variability as a threatto internalvalidity and thus seeks to minimize any effects that may be due to the uniqueattributes and views of theclient. Eventhe existing research that does focus on the client in psychotherapy hasprimarily been conducted fromtheresearcher or therapist perspective (Bohart & Wade, 2013). That is,researchers often quantitatively measure andtestvariables about the client (i.
e., motivation, expectations, attachment style)that they believe contribute to clientchange.Although theyare still relatively small, there are a few growing areas of research thatidentify clients as the expertsinpsychotherapy and seek to give them a voice in providing feedback to cliniciansand researchers about what worksand what doesnot work in treatment.
These areas include research on feedback informedtreatment, helpful and hin-dering eventsresearch, and qualitative studies that seek client insight on particulartreatment processes. TThebenefits of cultural resources within the pluralistic framework Cultural resources are a key element in the pluralisticframework for practice, where the therapist can tap into their own resourcesand the client can access other resources, often outwith the therapy room. Culturalresources from a pluralistic stance focus on the strengths of a client (Duncan,Miller and Sparks, 2004). They are viewed as both a form of resilience andstrength, but also a means by which a client can be connected to a socialnetwork outside of the therapy room.
Inmany instances, clients are actively trying to deal with their issues beforethey come to counselling and this is often ignored or overlooked by thetherapist. Clients may try many forms ofalternative therapies or access cultural resources which they are alreadyfamiliar with. The positive impact on wellbeing and mental health using alternativetherapies such as spirituality, mindfulness, exercise, diet, yoga, walking,music, etc. are all well documented. Theprior knowledge of these resources by the client should be valued as having anactive and effective role in therapy. From a pluralistic perspective we have totake into consideration the expertise and prior knowledge of the client. Thefield of counselling often acknowledges that clients play a central role intherapy, but as counsellors, we do not always recognise this in practice.(Tompkins, Swift, & Callahan, 2013).
Analysis of theoretical/philosophical perspectives surroundingcultural resourcesRecent research which is consistent with the recognition ofthe client as the expert tends to focus on certain treatment techniques(Wampold & Imel, 2015) and does not acknowledge the client’s agency. Mostof this research is from the therapist’s perspective. There are a few areas of research which focuson the client as the expert, such as helpful and hindering events research andfeedback informed treatment. (Love and Farber. 2017),(Black et al. 2017.
), (Swift JK, Tompkins, KA, Parkin SR 2017). A client who comes to therapy may havecultural resources that we, as the therapist have no prior knowledge of and thechallenge here is how we access and incorporate that into the collaborativerelationship, giving the client a sense of agency and power to theircounselling experience. Clients’ own strategies to pursue change can be viewedas an aspect of client agency. Thisnotion of client agency is highlighted in psychotherapy research which looks atand analyses how clients affect things, themselves, others and their lives, ornot. (Mackrill, in press). Research has also highlighted client agency outwithsessions, where clients have agency both before they start in therapy andduring therapy. Budman and Gurman (1988), statesthat clients’ lives are already changing before they enter therapy. Lambert and Bergin (1994, p.
175) state that, ‘distressed human beings donot sit like rats in cages waiting for the experiment to end. They act torelieve stress ‘. There is evidencewhich suggests that clients draw on their own strategies for change withinthemselves, both within therapy and also in between sessions. In a study doneby Dreier (1998. 2008) clients were shown to be able to have the agency tochange the conduct of their everyday lives whilst attending therapy.
However,this and other research tends to disregard the pre-existing strategies orresources that clients can bring with them into therapy sessions. Examplesof client in therapy I recently had aclient who just wanted me to ‘fix’ his situation where he was struggling withbeing signed off work and not earning money due to an operation on his kneewhich had left him in terrible pain. Each week he came with the same issue ofbeing lonely and isolated.
After a fewsessions I found out that he had been a musician in his youth and played theguitar. He told me that he had not played a guitar for years after he gave hisaway. The client had not thought about his guitar until we had done a Timelinetogether where he talked about his love of music and I tentatively encouragedhim to source another guitar and try to find some joy in it again, which he didand found it extremely beneficial as part of his own therapy outside ofcounselling, and that he felt it had “lifted his spirits”. Another client who I saw for ten sessions presented withanxiety issues about going outside her house and being in crowds ofpeople. This was preventing her fromsocialising and in having a normal life. This client had a very keen love of music and it was one way in whichshe, even prior to coming to counselling, managed to calm herself down and helpthe anxiety to abate. I used some CBTwith her and we collaboratively came up with an exercise for her to helprationalise the anxious thoughts when leaving the house. The client chose some favourite pieces ofmusic which always calmed her down when anxious, and she put them on a playliston her phone, and every day for two weeks, she attempted to leave the house butwith her headphones on and these pieces of music playing.
She was able to visualise how calm she feltlistening to the music in the house and then used it as a tool to take with herto keep her calm when going outside. Theclient still felt slightly anxious to a degree but not nearly as bad as before.Her style of music was not what I would have listened to for feeling calm, andit did annoy me but I let the client be active and agentic in choosing whatworked for her and accepted that this was working for her, even though I foundher choice of music extremely annoying. Her pre-existing resources were able tobe brought outside the therapy room and used as a tool to help her cope. Partof our work as therapists in relation to cultural resources and client agency,is to help clients remember what they have used in the past to help themselves.
My own sense of this and sometimes the questions/homework I give clients is:1. Whatbrings you Bliss? This is usually very personal, children, pets, relationships,nature.2. What getsyou through? Often this is extended family, religion, exercise, colleagues;and3. What isyour meaning and purpose in life? This is often work, spirituality, and isoften hard to find/first lost, when things are tough.
Sometimes these are three different things,sometimes all the same, and looking at these three questions seems to help them’remember’ and if they can’t think of anything then I attempt to help them goback in time and find what used to work for them. Also, building a case formulation incollaboration with the client can help to establish a shared understanding ofthe issues, which in turn can build hope and also facilitate agency within theclient. Clients feel much morecomfortable within their own world where they are the expert. Whatexisting research on cultural resources and client agency has revealed Cultural resources can be viewed as both threats andopportunities within pluralistic practice. Clients should be encouraged to be selective and creative in how theymake use of what their therapist offers them (Bohart and Tallman, 2001). Inthis study, the client is viewed as being able to make their own choices aroundwhat the therapist is offering, to learn new strategies for coping and led bytheir ability to ‘self-heal’, acknowledging that client agency is an essentialpart of therapy. But it does not really give us an idea of how we can make thispossible for the client, and what the underlying factors are which enable themtowards self-healing.
Clients arewell-informed consumers of therapy and we need to harness what the clients sayand do outside of the counselling room. (Kate Smith, 2016: Lecture onPluralism). Pluralism is different to all other counselling therefore there areno strict rules regarding resourcefulness and counsellors can draw on alltherapies. Pluralism has a much moredistinctive perspective and looks at the social, moral and political valuesaround a client’s life. A goodpluralistic counsellor will learn from their clients and be open to newexperiences and embrace the agency of their client. A client has many ways ofbeing in the world and as pluralistic counsellors we have to think about their worldand their story and how their own agency can give them a sense of power. One researchpaper which looks at how counsellors actively encourage client agency has beenundertaken by Oddli and Ronnestad (2012).
In this paper they look at client agency, authority and choice, howclients and therapists share the basis for any decisions made and how collaborationplays a major role in expressing the client’s agency. Again thisresearch does not really suggest the ways in which a client feels able toaccess their personal resources or finding out how they can be active in being ‘agentic’.This could be an area for further research, how a therapist can tap into aclient’s own personal cultural resources, even when they do not know anythingabout that particular resource, and to give them a sense of owning their ownagency surrounding the use of these resources. Pluralistic theory involving metacommunication, shared decision-makingaround methods and tasks i.
e. case formulation and collaboration, along withclient preferences using cultural resources, attempts to guide the clienttowards making meaning of their life and core values, but it is how thetherapist encourages this, even when they have little or no real knowledge orunderstanding of a client’s own cultural resources. (McLeod, 2017) For example, Imentioned earlier that one of my own personal cultural resources is music.
Aclient and therapist could be at completely opposite ends of the spectrum whenit comes to their preferred styles of music and a client may find it hard toexplain or present their music to a therapist who has no interest or appreciationfor that particular style of music. Anotherarea where this can be difficult is when a client has a different faithbackground to the therapist and the counsellor finds it difficult to appreciateand encourage the client’s faith as a cultural resource due to them not havingany expertise or experience around it. This is where therapists require beingopen to new ways of learning from their clients and again a possible avenue formore research. Spiritualityand religion are clearly valued by a lot of the population, but manycounsellors have very little or no appreciation of either of these concepts andare unable to tap into how a faith in something can be extremely healing for aclient.
(Rose et al. 2001). Research undertaken by Delaney, Miller, and Bisono(2007) found that counselling students “receiveminimal education and training in religious/spiritual diversity andinterventions”. Outdoortherapy (walks and talk therapy) is another area in which there has been someresearch (Jordan, 2015); and (Revell and McLeod, 2016).
The participants inthese studies reported that walking and talking helped with them being ‘stuck’and helped them to process things with more clarity. Therapists reported thatit helped with the collaborative relationship. Again, this research tended tofocus more on the therapist’s standpoint, but did report that it gave theclient agency in that it was their choice; it enhanced the personal beliefs ofthe client and gave them a sense of equality in the collaborative relationship.Hinderingfactors included the weather, working with uncertainty, issues around maintainingboundaries and the perception of clients. For many clients the means by which theyaccess their own cultural resources are not quite clear to them, due to theirstate of mind when they first come to counselling. Modern life dictates thatthere are many people who are carryingdeep rooted issues and they come to counselling for a place to stand back fromthe details of their everyday life and gain some sense of who they are(Giddens, 1991). How to integrate theory and research oncultural resources and client agency into working with clients The concept of cultural resources has always been a key ideawithin a pluralistic framework, the idea and resources for coping with issuesin life and how the task of therapy, namely collaboration can be utilised alongwith the use of resources to help with these life issues.
One of the strengths of this pluralisticapproach is that it considers all possibilities as being helpful (or not)without having to separate some cultural resources or activities from therapy.Given the value of cultural resources, clients themselves will actively engagein activities outside the therapy room which may be totally unrelated to whatgoes on in the therapy room. This issupported by research which conveys that clients can facilitate a lot of changeoutwith therapy sessions. (Dreier, 2008:17). However, in reality, at times of major emotional distress, loss orcrisis, clients do not often feel strong enough to access anything new withincultural resources, but did often rely on coping strategies which they may haveused in childhood or at much happier times in their lives, ones which did notrequire them to be confident or have to use their own initiative. (Marley,2009). It is this sense of agency in aclient that I feel could be harnessed more effectively in conjunction with theirown cultural resources which they find easy to access, ones which they haveused in the past and did not really have to think about because it isinstinctive and these resources were pre-existing. This is something that couldbe researched further and also brought into the process of training for novicecounsellors, how to harness the resources and agency within a client which arepre-existing and to facilitate their access to these resources collaborativelyboth in and out of the therapy room.
CONCLUSION So, what are the implications for theory, practice, researchand training? The theory of pluralism embraces diversity and is appreciative ofall modalities of therapy, thereby encouraging the therapist to learn fromclients. The use of cultural resources in therapy is paramount in contributingto a client’s self-healing and in them embracing a sense of agency within thecollaborative relationship. It must also embrace the client’s strength andresilience. Conceptually, cultural resources arise from theories of social andcultural capital. (McLeod, 2017).
In practice, the encouragement of the use ofcultural resources can have a major impact on the well-being and mental healthof clients but it is often difficult for the therapist to get past the barriersthat clients may put up in accessing their own resources. A resource can bedefined as something to resort to in difficult circumstances. (Wilson, J.
2017). Wilson’s book touches on client resources as sometimes being a “temporarilylost capacity” and that as therapists we need to help the client ‘re-establish’ this. This resource-making intherapy sits well within a pluralistic framework, provided by the collaborativerelationship, especially when resonance, relational depth, moments in therapyand empathic attunement are at work.
This is where the therapist being open tonew experiences comes in, where they might commit to learning about the client’sown resources, even if it is in total contrast to what they would consider tobe therapeutic. Being open to learning from our clients I feel is a fundamentalaspect of the pluralistic framework. Learning should be at the heart of our therapeutic practice, not just infacilitating ways to resolve client issues, dilemmas and problems, but also throughbeing open and aware to the insights of our clients. Clients come to therapy with expectations and the hope that it is going to make adifference to their lives, but on the whole, they tend to be unaware of thetheoretical differences in modalities and the beliefs and values embeddedwithin these, along with values which the therapist may bring to thecounselling room.
The explicit use ofeducation and further learning for therapists is fundamental to therelationship with clients when using cultural resources. Education is intrinsic in pluralism, for boththe therapist and the client, and occasionally, the client’s learning can be ofgreat benefit to the therapist and can encourage a very holistic learningexperience. Further research into the training of counsellors should addressthis, therapists being actively involved in a client’s use of culturalresources, and even participate in these resources in order to get a realunderstanding of why that particular resource enables a client to find strengthand resilience. Therapists need to see that cultural activities do not alwaysslot into a client’s life naturally, clients often have to use thecollaborative relationship with their therapist to access and utilise it to itsfull potential. Cultural resources need to be regarded as providing the clientwith an array of possibilities.
(Cooper, J. and McLeod, J. 2011). They should notto be ‘prescribed’ by therapists, but negotiated respectfully and initiated bythe clients themselves.