Catholic Medical Quarterly Volume 63(4) November 2013

Non-Directive Counselling; should we be concerned?

Andrew Plasom Scott

Introduction

I first encountered non-directive counselling when training for the student Counselling organisation Nightline, in Oxford in 1981 or thereabouts. We were taught that our role was to listen, empathise, and so forth, but never to offer advice, or our own opinions; students coming to us should be supported in whatever way they wanted, on the basis that their autonomous decisions would be the best ones for them. The only exception to that policy was a student who was contemplating or threatening suicide. In that case, non-directionality went out of the window, and we were allowed both to break confidentiality and to call the police (if someone was on the phone threatening imminent suicide, for example) and also to put ourselves on the line - as desperately caring that the individual should stay alive.

From that I concluded that the organisation did not really believe that autonomous decisions are always right for the person taking them, and that the organisation really believed suicide to be wrong - and implicitly that it did not so disapprove of drug taking, abortion, and the similar morally-contested issues with which students sometimes presented.

I now work as a freelance management training consultant; as part of that I offer coaching to executives, and can attest to the usefulness of a non-directive approach in many situations.

In this article, I seek to describe the non-directive approach to counselling and the thinking behind it, the strengths of it as technique, some criticisms of it, and the problems associated with adopting it as a philosophy, rather than one tool amongst many in the counsellor’s repertoire.

I should make it clear that although I have significant experience (and training) in coaching and counselling, I do not have any academic qualifications as a psychologist: this article is the view of an informed lay-person, not a professional clinician.

I am moved to write this particularly in the light of the recent controversy [1] surrounding the decision by Life, the pro-life charity, to commit to Non-Directive Counselling as the modus operandi of its counsellors.

What is Non-Directive Counselling

The essence of non-directive counselling is, as its name suggests, an approach to counselling in which the counsellor does not offer any direction. It is important to be clear here that, in its purest form, the lack of direction applies both to the content of the conversation (e.g. in the case of an unwanted pregnancy, any suggestion from the counsellor that one outcome would be better than another) and also to the scope of the conversation (e.g. any suggestion by the counsellor that the morality of the issues under discussion could usefully be discussed). The counsellor is meant to be led by the client in both areas: what aspects the client wishes to discuss (or doesn’t) and the conclusions the client chooses to reach.

This approach arises from the work of Carl Rogers, an extremely gifted and humane therapist who worked in the United States from the 1930s to his death in 1987. It is characteristic of his approach that, despite writing voluminously about his work, he shies away from formal definitions. The nearest I have been able to find to a definition of the non-directional approach (in his work) is that it is the same as the client-centered approach: ‘In this broadening stream of interest in and development of psychotherapeutic procedures, nondirective, or client-centered counselling has had its growth.’[2]

So far, so good, but a definition of Client-Centered Counselling is not forthcoming: instead one has to read the whole book to get an understanding of it. However, the essence is a profound respect for the individual seeking help, a conviction that the client will be able to find his or her own solutions to whatever issues he or she faces, if provided with sufficient support, and an assumption that any autonomous choice, freely made by an individual without external pressure, will be the best choice for that individual. The technique, therefore, is characterised in particular by active listening by a non-judgemental counsellor who provides the client with a completely safe space within which to explore his or her issues. The formal reason for this is elucidated in Rogers’ Theory of Personality and Behaviour:

XVII: Under certain conditions, involving primarily complete absence of any threat to the self-structure, experiences which are inconsistent with it may be perceived and examined and the structure of self revised to assimilate and include such experiences. [3]

Essentially, therefore, the counsellor is creating the safe space, and using skilled questions and listening, to help the client to explore difficult issues and find within himself or herself a satisfactory resolution. Originating in a therapeutic setting, the approach was also found to be effective in much broader areas, helping people to resolve difficult issues and accomplish desired change.

As noted earlier, I can attest to the power of this approach in many situations. One of my coaching clients, for example, was a highly intelligent and talented academic, a world leader in his field, and certainly a far quicker thinker than I, with a knowledge of his particular domain of work as an academic leader that I could not begin to approach.

Nonetheless, he genuinely found it helpful to have coaching conversations with me on a regular basis, during which I would ask him questions, listen carefully, summarise what I had heard, ask further questions, and finally ask him what conclusions he was drawing and what he proposed to do about them. He always maintained that these sessions were of great value, and frequently thanked me, saying how useful he found my advice. I would smile to myself at that, as I certainly would not have presumed to offer him advice.

That is only one example, but there are many who report the same thing, both in my experience and in the academic literature: the approach has real value. Creating a safe space for people to talk, to be heard without judgement, and to be prompted to explore and untangle their own thoughts and follow them through to their conclusions, in the knowledge that the whole conversation is bounded by complete confidentiality, can be extremely helpful.

Indeed, the hypothesis is that by refusing to offer any advice, approval or disapproval as an individual works through his or her difficult issues, the counsellor is thereby increasing the individual’s sense of agency and potency, which will help him or her to effect the desired change, or take the desired actions. Again, I have both experienced that myself and read many accounts that back up that hypothesis.

In the context of an unplanned pregnancy, this approach could be very valuable indeed. A woman facing such a crisis will typically have a maelstrom of conflicting thoughts and emotions raging around within, and also may well find that those to whom she normally turns for support have their own strongly held views and opinions, and may also have similarly conflicting emotional responses. A conversation with them may be more confusing or distressing than it is helpful - or may indeed be unthinkable. Moreover, building on the work of Elizabeth Kübler-Ross on bereavement, [4] many who counsel people who have experienced a serious and unwanted change in their life, recognise that one of the early responses is denial: a denial of the reality of the situation or the impact of it. Providing a completely impartial and sympathetic space for the individual to start to sort through all of these issues, and even confront the reality of her situation, is doubtless of great value in many cases.

Does Non-Directive counselling have limitations?

However, there are clearly occasions when an entirely non-directive approach may not be the most helpful. For example, if the counsellor has knowledge, expertise or information that would be of value to the individual in making a decision, then it seems to me perverse to disallow the sharing of that as a matter of principle. The timing and manner of sharing are, of course, matters for the professional skill of the counsellor, but to withhold them altogether for dogmatic reasons seems ethically questionable, to say the least.

One of the bloggers commenting on this controversy wrote:

So there I was, at the level crossing, about to cross the high speed line. There was a lady standing there, and I asked if she was crossing too.

'Oh, I'm waiting while the white light goes on,' she said.

Sure enough, by the trackside, there was a sign: Do not cross while white light is showing.

As an accredited non-directive counsellor, I could not, of course, tell her directly that her dialect use of the word while (by which she meant until, since she came from the Nottinghamshire/Lincolnshire border where that usage is common) was different from the meaning intended by the signwriter.

Instead, I asked her questions to help her clarify her options, and in particular her understanding of the word while. But as an autonomous individual, she made her own choice to stick with her understanding of while. And as she walked in front of the 3.15 to Paddington, I reflected on the ethical way in which I had handled the conversation.

Or to put it another way, there is a time and a place (arguably) for non-directive counselling, but when somebody's life is at stake due to ignorance (for example) that is neither the time nor the place. [5]

Likewise, there is a risk that this approach so values the perspective of the individual, that wider issues are not included in the discussion. They may be, of course, if the individual raises them but if he or she does not do so, again the dogma suggests that the counsellor should not do so. So considerations of the morality, (or indeed legality) of a proposed course of action, or likewise of other parties’ interests and well-being may only be discussed if the individual wants to discuss them.

Moreover, if the individual wants to decide to keep her child, but knows that the forces ranged against her are strong (for example, the child’s father, her parents, her friends…) it seems to me to be more helpful for her to know that at least the counsellor (and indeed the whole organisation represented by the counsellor, and a wider constituency of support beyond that) are on her side and approve of her choice. But Rogers’ Non-Directional approach would prohibit such approval being expressed.

Concerns about Non-Directive Counselling

But my most serious concerns are more fundamental than that, and relate to the underlying philosophy and assumptions that Rogers made. At this level, the most compelling criticism, in my view, comes from Rogers’ long-term right-hand man, Dr William Coulson. Coulson worked with Rogers over many years, particularly in organisational consulting, and co-edited books with him (eg the Studies of the Person series of textbooks). Coulson’s perspective is particularly compelling for a number of reasons. One is that he was deeply immersed in Rogers’ work and approach, and then recanted, as it were; so he knows what he is talking about. Secondly, he is a Catholic, so reflects on Rogers’ work from that perspective. But third, and for me very important, is that he clearly continues to hold Rogers in very high esteem. I base my assessment on a series of recordings I have of talks he gave in and around 1991. I have not been able to find copies of these recordings currently available, but am happy to make my recordings available to verify what I write below.

Coulson’s analysis is that non-directive counselling, at its best, works by referring a person to his or her conscience. He makes the point, therefore, that it works well when people have a well-formed conscience, but that if they do not, or are subject to social norms or social pressures it is more questionable. Coulson quotes Abraham Maslow, another iconic psychologist of the time, as saying: ‘The trouble with Rogers et al [and Coulson adds as an aside: and I was the et al] is that they acted as though there were no SOBs or True Believers out there.’ [6]

That is, in my analysis, that Rogers’ philosophy was based on a secular humanistic assumption of the perfectibility of man, which took no account of Original Sin, nor of the damaging effects of cultural dysfunctions and societal pressures. This is supported by Rogers’ personal creed, which rejects anything beyond personal experience as being truly valid: ‘Experience is for me the highest authority. The touchstone of validity is my own experience. No other person’s ideas, and none of my own ideas, are as authoritative as my experience. It is to my experience that I must return again and again, to discover a closer approximation to truth as it is in the process of becoming in me. Neither the Bible nor the prophets - neither Freud nor research - neither the revelations of God nor man - can take precedence over my own direct experience.[7] ’

One of my concerns, therefore, is that this essential (anti-intellectual, anti-religious) narcissism of Rogers’ approach may be implicitly communicated to the subject of Non-Directional Counselling; so that the message received is: ‘It’s all about You! Whatever you imagine will make you happy is the ultimate good that you should seek.’

One of Coulson’s specific reservations is that this approach is not suitable for children or young people. Children need boundaries, and by withdrawing from a position of authority, and throwing the child entirely onto his or her own resources, the adult is doing them a serious disservice. Indeed the withdrawal of any moral judgement by a figure deemed by the individual to be an authority may implicitly teach that moral judgements are not a necessary consideration. Given that individuals presenting for pregnancy counselling may be of a very young age (or immature understanding), that is also concerning.

Coulson also notes, as a matter of record, that this approach was taken particularly with regards to drugs education, and was largely funded by a major tobacco company. He points out that this company was, on the one hand, advocating a non-directional approach to allow youth to decide (‘preaching doesn’t work’, was the mantra), but, on the other hand, spending millions of dollars a year preaching ‘Come to Marlboro country.’ By the same token, it is worth noting that all the organisations which provide abortions also advertise Non-Directional Counselling.

Coulson also thinks that Rogers attributed successes to his approach that were in fact attributable to Rogers' own personal skills as a therapist. The same approach, used by less skilled therapists, did not get the same results.

Reflecting on all this, it seems to me that the non-directional approach has real value in some situations. Indeed it may well be the best approach when an individual’s autonomous choice is the primary value: e.g.  where there are no moral considerations, and it is the commitment of the individual to the decision that is paramount (and that is the case in many work situations, for example); or when the individual has a strong moral framework for the decision. It may also be a very valuable tool for a counsellor in many other situations, to open up the conversation, build trust, and help the individual to start to sort through complex and conflicting thoughts and emotions.

However, when there are serious moral issues at stake, when an individual’s choices will have life-or-death consequences, when the individual is in denial or in ignorance about some important facts, when the individual is not capable of acting as a free and mature moral agent, or when other peoples’ interests are involved to a serious extent, pure non-directive counselling may not allow the counsellor to help the individual recognise, let alone address, these issues.

Moreover, when Non-Directional Counselling is raised to the level of a philosophy, such that it becomes the only technique a counsellor may use, and indeed implicitly teaches truths (such as that an individual’s autonomous choice is always good) which are not in fact true, there is a significant risk of real harm.

Life and Non-Directive Counselling

So turning to the case of Life, the pro-life Charity which, along with its excellent caring and educational work, offers counselling, some serious questions arise.

The primary one is, why commit to using (only) Non-Directional Counselling? It has been suggested that the reason is to ensure BACP [8] accreditation, but interestingly, the BACP www site says that ‘in general, research shows that the relationship with your therapist or counsellor is more important than the method they use.’[9] That not only signals that a variety of methods are acceptable to them as the professional body in the field, but also that a dogmatic attachment to one method provides no benefit to the client.

Moreover, if one accepts the hypothesis that the quality of relationship between counsellor and the individual is a very important determinant of a successful counselling relationship, and further the assumption that authenticity or integrity on the part of the counsellor is most likely to result in a good relationship, that raises another question: if a Life counsellor passionately believes that abortion is an objective moral evil, and therefore, by definition, never good for the mother, how is the client served by the counsellor hiding that reality, and creating a facade of neutrality that is in fact inauthentic and lacking in integrity? Or does Life recruit as Counsellors only people who authentically feel neutral about abortion - and if so, why?

Assuming that some (most? all?) Life counsellors do in fact have a principled objection to abortion (given that is Life’s position as an organisation) is it likely that they will be able to maintain such a facade? In the immediacy and potentially emotionally-charged atmosphere of a counselling conversation, the risk of non-verbal leakage of the counsellor’s true position is very high. A look, a sigh, an involuntary clenching of muscles, a flushing of the skin: these are signs that people read, often intuitively, and which it is very hard to suppress. Incongruence between a Counsellor's presenting position of neutrality and such non-verbal clues is likely to undermine the relationship that is at the heart of effective counselling.

Moreover, asking counsellors to maintain such a stance also seems to me to attack their own integrity as individuals. How healthy is it to make people talk and behave in ways that ignore their deeply held beliefs?

The objection has been raised that Life should use Non-Directional Counselling, rather than simply trying to tell women what they should do. But that is not the only choice. I think that the techniques of Non-Directive Counselling are probably the right place to start when counselling a pregnant woman. However, if she is inclining towards the wrong choice - a choice which will result in the death of her child, and potentially catastrophic consequences for her (both emotionally and spiritually), is it really right to outlaw the Counsellor’s discretion to try other tacks which may help her to re-consider?

Likewise, if she is inclining towards the right choice, to refuse the idea of abortion, why should one outlaw the counsellor affirming that choice (which a strictly Non-Directive philosophy would certainly condemn)?

In summary, it seems that the Non-Directive Approach as a tool, or set of skills, has a lot to offer; but it should not be the only tool or set of skills available to a counsellor in many situations; and to elevate it to a philosophy raises serious concerns, when one considers the implications of doing so, and in particular the secular humanistic, and narcissistic, philosophy from which it springs.

Comment subsequent to publication.

Several attempts were made by the author to discuss the nature of the article with LIFE prior to publication without success as LIFE was busy with other obligations at that time. 
The editor has had a discussion with LIFE and it is clear that the organization does not adhere to strict Rogerian principles.
Along with other excellent pro-life organizations, LIFE deserves our gratitude and support.