Therapeutic Health Care: Person Centered Engagement with Clients

Therapeutic Health Care: Person Centered Engagement with Clients



In aiming to respect and figure out the needs of clients in developing therapeutic relationships, it is absolutely essential for healthcare providers to consider the personal perspectives of clients.  Increasing studies point to the fact that person centered interaction, such as described by the founding theorist Carl Rogers, involve helping the client to share personal beliefs and perspectives in the presence and care of genuinely interested health care providers.  Developing relationships based on trust and mutual respect is essential in developing positive working relationships with all clients, even the more difficult ones, and remembering that people have the right to their own unique perspectives enhances the ability of caregivers to listen, act genuinely, be compassionate, and aid in helping clients to be honest and expressive within a safe and nurturing environment (Brooker, 2008).  Being respectful of clients’ perspectives can be powerful in helping them to find their own ways to the best solutions regarding their health.

In looking to client care as a series of stages or having multiple parts, the person centered way of being can be organized into four realms, the prerequisites, acknowledging the personality and attributes of the caregiver, the care environment, placing interest on the context in which the helping relationship takes place, the person centered processes, which focus on the range of activities involved in the therapeutic relationship, and the expected outcomes, which are the results of effective person centered engagement (McCance & McCormack, 2006).  This outlook gives a general picture of the scene of high quality person centered care.  Health care providers interested in providing person centered services can take into consideration the attributes of their own personalities, how these personalities may affect other people.  Being a positive presence around other people is essential in developing rapport and trust.  The environment is also an important aspect of health care.  A client will feel much more comfortable in a holistically nurturing environment than in a harsh or unwelcoming one.  Considering all aspects of the context of the helping relationship will serve well in aiming for more client friendly provisions.  Person centered processes are perhaps the most important and involve specific behaviors which foster the therapeutic conversation, such as reflection (paraphrasing the client’s concerns after active listening) and open ended questioning, involving an active interest in gathering more information from the client regarding their interests and desires related to their health.  The expected outcomes of effective person centered interaction would be empowerment of the client and health care decisions being kindly left in the hands of the client.  Although a client deserves to be informed of the suggestions of health care providers, it also highly important to consider client perspectives and allow decision making to rest with the clients.  Hopefully, through person centered engagement with clients, clients will make the best decisions in the end regarding their health care.

The reaction of clients when faced with new health situations may invoke a variety of different emotions, which are dealt with well in a person centered relationship.  In appraising the new situation, coping with the implications, balancing the flow of actions and reactions, and finding relational meaning to this new information and new feelings, the client will be in need of a person who is well equipped to deal with what can be naturally upsetting or new reactions to new and sometimes disturbing health care diagnoses (Lazarus, 2005).  Person centered health care providers can help in actively listening to client concerns, asking open ended questions about how the client is feeling or how the client may want to move forward, and providing a  safe and nurturing environment in which to speak and emote.  In acknowledging and respecting a client’s emotional state, the health care provider forms a partnership with the client which works well to foster progress in positive outcomes regarding health care.  When the client views the health care provider as a compassionate ally, the level of client resistance lowers significantly and paves the way for finding positive health care solutions.

The person centered way of helping, being, or interacting has been described by many as an agent of change in that it fosters the rights, independence, choice, and inclusion of clients (Beadle-Brown & Mansell, 2005).  In order for positive change to occur, clients certainly have to feel as if they are agents of change, owning the right to make health care decisions, having the independence to move in their own directions, retaining the decision making capability and right of choice, and genuinely feeling included in health care processes and decisions which directly affect them.  In honoring these four important qualities of interaction or consideration of other people, health care providers move from being overlords to being partners, and effectively create a nonhierarchical system in which clients are free from demeaning and manipulative controls and empowered to make personal judgments within safe and constructive environments.

In considering the needs of children who are faced with new situations in their health care, it is important to note that although emphasis is sometimes placed on including children in the discussion and decision making process regarding their health care needs, current research points to the idea that although the shifting of care, care management and advocacy responsibilities is occurring, parents want to work collaboratively in making treatment decisions and implementing care plans which work best for their children and family (MacKean & Thurston, 2005).  Here it is important to consider the aspect of parental rights and to not presume the total autonomy of children.  In many cases, it may work best to interact more with the parent rather than the child is forming a partnership and person centered relationship.  The care of the child and decisions regarding child treatment will then filter down from parent to child.  Unlike a parallel relationship which occurs in healthy adult relationships, children are still very needy and rely on their parents for guidance, safety, and protection.

In the words of the great theorist Carl Rogers, who undoubtedly laid the foundation for person centered practice, “effective counseling consists of a definitely structured, permissive relationship which allows the client to gain an understanding of himself to a degree which enables him to take positive steps in light of his new orientation” (Rogers, 2008, p. 18).  Effective health care involves relating to clients in a gentle and unobtrusive manner and fosters clients’ understanding of themselves.  When this type of relationship is founded, one can have faith that the client will move in positive directions.  A highly resistant client may not move very far, but one can rest assured that person centered techniques will move them forward at least slowly and deter the client from becoming more resistant or moving backwards in treatment.  The best outcome that a person centered health provider can expect is one that is the genuine choice of the client, with treatment moving quickly and on task or with clients needing more time and space in finding their paths to treatment goals.










Beadle-Brown, J. & Mansell, J.  Person Centered Planning and Person Centered Action.  Cambridge, P. & Carnaby, S.  (2005)  Person centred planning and care management with people with learning disabilities.  Jessica Kingsley Publishers.


Brooker, D.  Person Centered Care.  Dening, T., Jacoby, R., & Oppenheimer, C.  (2008)  Oxford textbook of old age psychiatry.  Oxford University Press.


Lazarus, R.  (2005).  Emotions and Interpersonal Relationships: Toward a Person-Centered Conceptualization of Emotions and Coping.  Journal of Personality 74(1), pp. 9-46.


MacKean, G., Scott, C. & Thurston, W.  (2005).  Bridging the divide between families and health professionals’ perspectives on family-centered care.  Health Expectations 8(1), pp. 74-85.


McCance, T. & McCormack, B.  (2006).  Development of a framework for person-centered nursing.  Journal of Advanced Nursing 56(5), pp 472 – 479.


Rogers, C.  (2008).  Counseling and Psychotherapy.  Read Books.


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