Person-Centred Principles by Malcolm Macmillan

Carl Rogers (1986) wrote “…the individual has within himself or herself vast resources for self-understanding, for altering his or her self-concept, attitudes and self-directed behaviour- and that these resources can be tapped if only a definable climate of facilitative psychological attitudes can be provided.” (Rogers, C., 1986, as cited in Miller, A., 2012, Pg 5)

For me, these words epitomise the concept of the person-centred approach.  The individual at the core of what is taking place, whether support, therapy or intervention, is recognised not only as an important part of the process undertaken but is the lead on what is required and how this is to be achieved.  This involves a massive shift in thinking for some and a natural way of engaging for others when involved with an individual who, even in the short-term, requires support to manage an aspect of their life experience.  Even the very fact that individual’s providing support have their own individual approach to working with people in care, or who require therapy, indicates the requirement for individuals to receive a personalised approach to care provision. 

The person-centred approach is more than just considering the needs of the individual and being able to use professional assessment to ascertain the best way of meeting that individual’s needs.  It is more about seeking the answers within the individual as they are the expert in how to meet their needs and those who are facilitating the care provision, the meeting of that need, then use their knowledge and skill to meet the proposed requirement or need.

Valuing People State: “Person-centred care is a philosophical approach to service development and service delivery that sees services provided in a way that is respectful of, and responsive to, the preferences, needs and values of people and those who care for them.” (http://valuingpeople.org.au/the-resource/what-is-person-centred-care)

They cite the key principles of person-centredness as being:

  • ·         Valuing people”;
  • ·         “Autonomy”;
  • ·         “Life experience”;
  • ·         Understanding relationships”; and
  • ·         “Environment”.

The key principles enable the effective delivery of services for those in need and for those providing the service.  Each of these key principles are embedded into legal obligation of Human Rights legislation and key policy such as practice Codes of Practice and the National Care Standards. Whilst there is the professional element to what is seen to be basic requirements for care provision we must not miss the obvious.  We are working, caring for, valuable human beings.  Their value is not based on their contribution but their existence.  As a valued human being it should be expected that rights are upheld, that development is encouraged and life is cherished.  Again, each of these take on their individuality as what might constitute safety, as a right, will mean different things to different people.  The development expected or encouraged in one will differ from another.  Nevertheless; at the heart of it, however long or short, the life is cherished.

When we see the “Understanding relationship” of those working collaboratively to meet the “needs, preferences, and values” of individual’s we see the development of an environment where potential is realised, people relate and life is experienced in its individual fullness.  Recognising that whilst there may be diverse foci from different practitioners, the centrality of the individual ensures a pulling together to enable and empower the autonomous development of a valued person.  Valuing the work done by other practitioners enables a powerful backdrop for encouraging the development of autonomous individuals.

 “Gentle Teaching is a way of educating and raising children, or serving adults for who don’t automatically feel safe and connected with others. The main focus in Gentle Teaching is to establish the strong and unconditional individual relationships with, and the safe and caring community around each individual.” (http://www.gentleteaching.nl/gentle/index.php/en/home-en)

Although we are placing this into the concept of a method of intervention proponents of Gentle Teaching discuss this as a philosophy for life that should be integrated into all spheres of society.  It is though, held out as a way of encouraging interdependence and companionship which can enable an individual, who may be dependent on others, to be held in higher regard.  There is a shift from staff – client concepts to a co-existence without the power imbalance that so easily arises in care environments.

How often do we find ourselves caught up in a hierarchical set up that places those receiving care in a less favourable position than staff?  For some this may not seem to be an issue as it feels as if this set up fulfils a purpose that enables the element of control in the environment. 

French and Raven (1959) described five bases of power:

  • 1.       “Legitimate – This comes from the belief that a person has the formal right to make demands, and to expect others to be compliant and obedient.
  • 2.       Reward – This results from one person's ability to compensate another for compliance.
  • 3.       Expert – This is based on a person's high levels of skill and knowledge.
  • 4.       Referent – This is the result of a person's perceived attractiveness, worthiness and right to others' respect.
  • 5.       Coercive – This comes from the belief that a person can punish others for noncompliance.

Six years later, Raven added an extra power base:

  • 6.       Informational – This results from a person's ability to control the information that others need to accomplish something.”

(https://www.mindtools.com/pages/article/newLDR_56.htm)

It is important for us to reflect on how we use or power when providing services in social care.  Gentle Teaching suggests that the misuse of power is not necessary as having a level of interdependence and companionship is a more effective measure than a punitive power structure.  Control is not relinquished but shared with all who play an important role in the environment.

“Gentle Teaching is a non violent approach for helping people with special needs and sometimes challenging behaviors that focuses on four primary goals of care-giving:

  • I feel safe in your presence
  • I feel unconditionally loved by you
  • I feel loving towards you
  • I feel engaged with you and trust you”

( http://www.gentleteaching.nl/gentle/index.php/en/home-en)

There are many different ways of working with the individual to support them to experience life in a way the suits them.  The care planning process can bring into play a number of tools designed to fit the individual needs and practitioners need to be aware of what will suit that person right now.  It is not a case of “This is how I work!”  A needs led service focuses on what the recognised need is and how it is to be met based on the person at the centre of it all.  There are many tools discussed on the Inclusive Solutions (http://inclusive-solutions.com/ ) and Helen Sanderson Associates (http://www.helensandersonassociates.co.uk/person-centred-practice/)  websites.

 

References

Miller, Ali, 2012, Instructors Manual for Carl Rogers on Person-Centred Therapy, Mill Valley: Psychotherapy.net

Valuing People, What is Person-Centred Care, Available online at: http://valuingpeople.org.au/the-resource/what-is-person-centred-care, Last Accessed 21/09/2016

 

Gentle Teaching, Available online at http://www.gentleteaching.nl/gentle/index.php/en/home-en , Last Accessed 14/09/2016

Category: Social Care