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My personal interest in the
research of cultural resources

As a novice counsellor I have personally encountered the
difficulties of encouraging clients to access their own cultural resources,
mainly due to them viewing me as the expert and them being unaware of the fact
that they can have agency and their own preferences within the counselling
relationship. Another difficulty to overcome is to help the client realise that
they do have access to these resources, but have not been in a frame of mind
which would enable this, due to the issues that they present with. One of the
major benefits of actively using cultural resources with clients is that it
provides them with an arena in which they can pursue their own purposes. Client
agency and purpose explicitly inform the practice of pluralistic therapy.
(McLeod, 2017).  I consider myself to be
a spiritual person and I am also very musical and am both motivated and moved
by listening to, and playing (the piano) music. This is my ‘go to’ when I need
to calm down, rest and just switch off from the general pressures of life.  I also am a very keen walker and beachcomber
and go walking (with music on my headphones) as much as I can to literally
recharge my batteries and spend some time switching off from the world.  These are my own personal cultural resources
and I have an understanding of how these resources can affect my mood, my
wellbeing and my mental health and also how I can access these resources when
required. Because I find it extremely easy to access my own personal cultural
resources i.e. music, walking, I began to think about how difficult it could be
for a client who has serious issues going on in their life, depression,
anxiety, suicidal thoughts, etc. to be able to even contemplate accessing
cultural resources. The question arises how can we, as counsellors actively
encourage our clients’ agency and pre-existing resources, knowing that they can
be of great benefit to their wellbeing, mental health and general mood?  As I commenced working as a trainee
counsellor in placement, I found that clients tended to look at me to provide
them with their own cultural resources, and it became quite clear to me that in
order for a client to access their own cultural resources they must have some
agency within the counselling relationship. 
The competent skills required to enable this I feel, are lacking and
could be an area for future research in the training of counsellors in a
pluralistic framework.

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not always
practice 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 decisions
based on our knowledge of

research-supported
techniques, our favorite theoretical orientation, or our accumulated clinical
expertise (Swift &

Greenberg,
2015). Research also indicates that although clinicians want to know what their
clients think about treat-

ment (Hat?eld
& Ogles, 2007), many clinicians fail to seek feedback from their clients
(Rousmaniere, 2017) and even

when feedback
is presented, often fail to pay adequate attention to it (Boswell, Kraus,
Miller, & Lambert, 2015).

As psychotherapy
researchers, we also often do not conduct our research in a manner that is
consistent with the

recognition
of client expertise in psychotherapy. The bulk of the research that is
currently being conducted focuses on

testing
speci?c treatment techniques (Wampold & Imel, 2015). This research often
views client variability as a threat

to internal
validity and thus seeks to minimize any effects that may be due to the unique
attributes and views of the

client. Even
the existing research that does focus on the client in psychotherapy has
primarily been conducted from

the
researcher or therapist perspective (Bohart & Wade, 2013). That is,
researchers often quantitatively measure and

test
variables about the client (i.e., motivation, expectations, attachment style)
that they believe contribute to client

change.

Although they
are still relatively small, there are a few growing areas of research that
identify clients as the experts

in
psychotherapy and seek to give them a voice in providing feedback to clinicians
and researchers about what works

and what does
not work in treatment. These areas include research on feedback informed
treatment, helpful and hin-

dering events
research, and qualitative studies that seek client insight on particular
treatment processes. T

The
benefits of cultural resources within the pluralistic framework

 

Cultural resources are a key element in the pluralistic
framework for practice, where the therapist can tap into their own resources
and the client can access other resources, often outwith the therapy room. Cultural
resources 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 and
strength, but also a means by which a client can be connected to a social
network outside of the therapy room.  In
many instances, clients are actively trying to deal with their issues before
they come to counselling and this is often ignored or overlooked by the
therapist.  Clients may try many forms of
alternative therapies or access cultural resources which they are already
familiar with. The positive impact on wellbeing and mental health using alternative
therapies such as spirituality, mindfulness, exercise, diet, yoga, walking,
music, etc. are all well documented.  The
prior knowledge of these resources by the client should be valued as having an
active and effective role in therapy. From a pluralistic perspective we have to
take into consideration the expertise and prior knowledge of the client. The
field of counselling often acknowledges that clients play a central role in
therapy, but as counsellors, we do not always recognise this in practice.
(Tompkins, Swift, & Callahan, 2013).

 

Analysis of theoretical/philosophical perspectives surrounding
cultural resources

Recent research which is consistent with the recognition of
the client as the expert tends to focus on certain treatment techniques
(Wampold & Imel, 2015) and does not acknowledge the client’s agency. Most
of this research is from the therapist’s perspective.  There are a few areas of research which focus
on the client as the expert, such as helpful and hindering events research and
feedback informed treatment. (Love and Farber. 2017),
(Black et al. 2017.), (Swift JK, Tompkins, KA, Parkin SR 2017). A client who comes to therapy may have
cultural resources that we, as the therapist have no prior knowledge of and the
challenge here is how we access and incorporate that into the collaborative
relationship, giving the client a sense of agency and power to their
counselling experience. Clients’ own strategies to pursue change can be viewed
as an aspect of client agency.  This
notion of client agency is highlighted in psychotherapy research which looks at
and analyses how clients affect things, themselves, others and their lives, or
not. (Mackrill, in press).  Research has also highlighted client agency outwith
sessions, where clients have agency both before they start in therapy and
during therapy.  Budman and Gurman (1988), states
that clients’ lives are already changing before they enter therapy.  Lambert and Bergin (1994, p.175) state that, ‘distressed human beings do
not sit like rats in cages waiting for the experiment to end. They act to
relieve stress ‘.  There is evidence
which suggests that clients draw on their own strategies for change within
themselves, both within therapy and also in between sessions. In a study done
by Dreier (1998. 2008) clients were shown to be able to have the agency to
change the conduct of their everyday lives whilst attending therapy. However,
this and other research tends to disregard the pre-existing strategies or
resources that clients can bring with them into therapy sessions.

 

Examples
of client in therapy

 

 I recently had a
client who just wanted me to ‘fix’ his situation where he was struggling with
being signed off work and not earning money due to an operation on his knee
which had left him in terrible pain. Each week he came with the same issue of
being lonely and isolated.  After a few
sessions I found out that he had been a musician in his youth and played the
guitar. He told me that he had not played a guitar for years after he gave his
away. The client had not thought about his guitar until we had done a Timeline
together where he talked about his love of music and I tentatively encouraged
him to source another guitar and try to find some joy in it again, which he did
and found it extremely beneficial as part of his own therapy outside of
counselling, and that he felt it had “lifted his spirits”.  

Another client who I saw for ten sessions presented with
anxiety issues about going outside her house and being in crowds of
people.  This was preventing her from
socialising and in having a normal life. 
This client had a very keen love of music and it was one way in which
she, even prior to coming to counselling, managed to calm herself down and help
the anxiety to abate.  I used some CBT
with her and we collaboratively came up with an exercise for her to help
rationalise the anxious thoughts when leaving the house.  The client chose some favourite pieces of
music which always calmed her down when anxious, and she put them on a playlist
on her phone, and every day for two weeks, she attempted to leave the house but
with her headphones on and these pieces of music playing.  She was able to visualise how calm she felt
listening to the music in the house and then used it as a tool to take with her
to keep her calm when going outside.  The
client 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, and
it did annoy me but I let the client be active and agentic in choosing what
worked for her and accepted that this was working for her, even though I found
her choice of music extremely annoying. Her pre-existing resources were able to
be brought outside the therapy room and used as a tool to help her cope.  Part
of 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.      What
brings you Bliss? This is usually very personal, children, pets, relationships,
nature.

2.      What gets
you through? Often this is extended family, religion, exercise, colleagues;
and

3.      What is
your meaning and purpose in life? This is often work, spirituality, and is
often 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 go
back in time and find what used to work for them. Also, building a case formulation in
collaboration with the client can help to establish a shared understanding of
the issues, which in turn can build hope and also facilitate agency within the
client.  Clients feel much more
comfortable within their own world where they are the expert.  

 

What
existing research on cultural resources and client agency has revealed

 

Cultural resources can be viewed as both threats and
opportunities within pluralistic practice. 
Clients should be encouraged to be selective and creative in how they
make use of what their therapist offers them (Bohart and Tallman, 2001). In
this study, the client is viewed as being able to make their own choices around
what the therapist is offering, to learn new strategies for coping and led by
their ability to ‘self-heal’, acknowledging that client agency is an essential
part of therapy. But it does not really give us an idea of how we can make this
possible for the client, and what the underlying factors are which enable them
towards self-healing.  Clients are
well-informed consumers of therapy and we need to harness what the clients say
and do outside of the counselling room. (Kate Smith, 2016: Lecture on
Pluralism). Pluralism is different to all other counselling therefore there are
no strict rules regarding resourcefulness and counsellors can draw on all
therapies.  Pluralism has a much more
distinctive perspective and looks at the social, moral and political values
around a client’s life.  A good
pluralistic counsellor will learn from their clients and be open to new
experiences and embrace the agency of their client. A client has many ways of
being in the world and as pluralistic counsellors we have to think about their world
and their story and how their own agency can give them a sense of power. One research
paper which looks at how counsellors actively encourage client agency has been
undertaken by Oddli and Ronnestad (2012).  In this paper they look at client agency, authority and choice, how
clients and therapists share the basis for any decisions made and how collaboration
plays a major role in expressing the client’s agency. Again this
research does not really suggest the ways in which a client feels able to
access 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 a
client’s own personal cultural resources, even when they do not know anything
about that particular resource, and to give them a sense of owning their own
agency surrounding the use of these resources. 
Pluralistic theory involving metacommunication, shared decision-making
around methods and tasks i.e. case formulation and collaboration, along with
client preferences using cultural resources, attempts to guide the client
towards making meaning of their life and core values, but it is how the
therapist encourages this, even when they have little or no real knowledge or
understanding of a client’s own cultural resources. (McLeod, 2017)  For example, I
mentioned earlier that one of my own personal cultural resources is music. A
client and therapist could be at completely opposite ends of the spectrum when
it comes to their preferred styles of music and a client may find it hard to
explain or present their music to a therapist who has no interest or appreciation
for that particular style of music.  Another
area where this can be difficult is when a client has a different faith
background to the therapist and the counsellor finds it difficult to appreciate
and encourage the client’s faith as a cultural resource due to them not having
any expertise or experience around it. This is where therapists require being
open to new ways of learning from their clients and again a possible avenue for
more research.

 

Spirituality
and religion are clearly valued by a lot of the population, but many
counsellors have very little or no appreciation of either of these concepts and
are unable to tap into how a faith in something can be extremely healing for a
client. (Rose et al. 2001). Research undertaken by Delaney, Miller, and Bisono
(2007) found that counselling students “receive
minimal education and training in religious/spiritual diversity and
interventions”. Outdoor
therapy (walks and talk therapy) is another area in which there has been some
research (Jordan, 2015); and (Revell and McLeod, 2016). The participants in
these studies reported that walking and talking helped with them being ‘stuck’
and helped them to process things with more clarity. Therapists reported that
it helped with the collaborative relationship. Again, this research tended to
focus more on the therapist’s standpoint, but did report that it gave the
client agency in that it was their choice; it enhanced the personal beliefs of
the client and gave them a sense of equality in the collaborative relationship.
Hindering
factors included the weather, working with uncertainty, issues around maintaining
boundaries and the perception of clients.  For many clients the means by which they
access their own cultural resources are not quite clear to them, due to their
state of mind when they first come to counselling. Modern life dictates that
there are  many people who are carrying
deep rooted issues and they come to counselling for a place to stand back from
the details of their everyday life and gain some sense of who they are
(Giddens, 1991). 

 

 How to integrate theory and research on
cultural resources and client agency into working with clients

 

The concept of cultural resources has always been a key idea
within a pluralistic framework, the idea and resources for coping with issues
in life and how the task of therapy, namely collaboration can be utilised along
with the use of resources to help with these life issues.  One of the strengths of this pluralistic
approach 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 engage
in activities outside the therapy room which may be totally unrelated to what
goes on in the therapy room.  This is
supported by research which conveys that clients can facilitate a lot of change
outwith therapy sessions. (Dreier, 2008:17). 
However, in reality, at times of major emotional distress, loss or
crisis, clients do not often feel strong enough to access anything new within
cultural resources, but did often rely on coping strategies which they may have
used in childhood or at much happier times in their lives, ones which did not
require them to be confident or have to use their own initiative. (Marley,
2009).  It is this sense of agency in a
client that I feel could be harnessed more effectively in conjunction with their
own cultural resources which they find easy to access, ones which they have
used in the past and did not really have to think about because it is
instinctive and these resources were pre-existing. This is something that could
be researched further and also brought into the process of training for novice
counsellors, how to harness the resources and agency within a client which are
pre-existing and to facilitate their access to these resources collaboratively
both in and out of the therapy room.

 

CONCLUSION

 

So, what are the implications for theory, practice, research
and training? The theory of pluralism embraces diversity and is appreciative of
all modalities of therapy, thereby encouraging the therapist to learn from
clients. The use of cultural resources in therapy is paramount in contributing
to a client’s self-healing and in them embracing a sense of agency within the
collaborative relationship. It must also embrace the client’s strength and
resilience. Conceptually, cultural resources arise from theories of social and
cultural capital. (McLeod, 2017). In practice, the encouragement of the use of
cultural resources can have a major impact on the well-being and mental health
of clients but it is often difficult for the therapist to get past the barriers
that clients may put up in accessing their own resources. A resource can be
defined as something to resort to in difficult circumstances. (Wilson, J.
2017). Wilson’s book touches on client resources as sometimes being a “temporarily
lost capacity” and that as therapists we need to help the client  ‘re-establish’ this. This resource-making in
therapy sits well within a pluralistic framework, provided by the collaborative
relationship, especially when resonance, relational depth, moments in therapy
and empathic attunement are at work. This is where the therapist being open to
new experiences comes in, where they might commit to learning about the client’s
own resources, even if it is in total contrast to what they would consider to
be therapeutic. Being open to learning from our clients I feel is a fundamental
aspect of the pluralistic framework. 
Learning should be at the heart of our therapeutic practice, not just in
facilitating ways to resolve client issues, dilemmas and problems, but also through
being open and aware to the insights of our clients.  Clients come to therapy with expectations  and the hope that it is going to make a
difference to their lives, but on the whole, they tend to be unaware of the
theoretical differences in modalities and the beliefs and values embedded
within these, along with values which the therapist may bring to the
counselling room.  The explicit use of
education and further learning for therapists is fundamental to the
relationship with clients when using cultural resources.  Education is intrinsic in pluralism, for both
the therapist and the client, and occasionally, the client’s learning can be of
great benefit to the therapist and can encourage a very holistic learning
experience. Further research into the training of counsellors should address
this, therapists being actively involved in a client’s use of cultural
resources, and even participate in these resources in order to get a real
understanding of why that particular resource enables a client to find strength
and resilience. Therapists need to see that cultural activities do not always
slot into a client’s life naturally, clients often have to use the
collaborative relationship with their therapist to access and utilise it to its
full potential. Cultural resources need to be regarded as providing the client
with an array of possibilities. (Cooper, J. and McLeod, J. 2011). They should not
to be ‘prescribed’ by therapists, but negotiated respectfully and initiated by
the clients themselves.

 

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