The Theory Behind My Practice

Introduction

I am a person-centred helper, and I also consider myself pluralistic. I am using the person-centred creative arts approach as part of my practice.

This booklet is for those who want to know more about the theories my practice is based on.

In this booklet, I use mind maps from my art journal to represent how theory and practice are related in my mind. The mind maps are here as illustrations of my own thought process. All that is included in them, is also contained in the text below them.

The other illustrations are images from my art journal. Some of them have fragments of my notes around them.

Person-Centred and Pluralistic Therapeutic Work with Creative Arts

First and foremost, I follow Carl Rogers’ person-centred approach (see red branch of the mind map). Each person is unique, therefore there is no one-size-fits-all way to help and support them. The centre of the therapeutic process is the relationship between client and helper, therefore each and every therapeutic relationship is unique. The client themselves is the source and the focus of the therapeutic process. They have the right, the capability and resources to make the changes, they desire, happen in their lives. I am merely there to accompany them in their journey by providing therapeutic conditions: empathy, congruence and unconditional positive regard (see them on separate mind maps below).

Although I consider myself a person-centred helper, I am also committed to the pluralistic approach (see the green branch of the mind map). In my sessions, I use any method or technique that I consider the best suitable, at that given time, for the individual client I am working with. I rely on multiple sources of knowledge: common knowledge; the client’s own knowledge, insight, experiences, resources and preferences; and my own knowledge, personal and professional experience. I deconstruct and assimilate ideas and practices I have ever encountered, to find the way of helping that best suits that particular client I am working with.

I provide therapeutic conditions to facilitate the client fulfilling their unique potential (see blue branch of the mind map). Our relationship is based on collaboration to find the way for the therapeutic process that best suits the client’s needs and preferences at the moment. Of course, a person may need different approaches at different points of their journey towards self-awareness that leads to the change they desire.

Therapy itself is a creative process (see the orange branch of the mind map), a process of change. Creativity is not only about creating artworks. It is about using our imagination; perceiving new ways; finding hidden patterns; and solving problems. We are all creative. Creativity is a non-invasive way to get out of our everyday problems, and also to get very deep into the unconscious.

When the client creates an artwork in the session, that, in itself, is healing and therapeutic (see yellow branch of the mind map). The client’s experiences that are not yet in words, may get expressed symbolically, revealing a message from their unconscious. As the client reflects on this, they find a quicker way to self-awareness, that can lead to insight and change.

The Core Conditions of the Person-Centred Approach: Empathy, Congruence and Unconditional Positive Regard

Empathy

Carl Rogers identified six necessary and sufficient therapeutic conditions. As I mentioned earlier, I don’t agree with those who think these are the ones exclusively needed for a therapeutic process. My approach is pluralistic, relying on multiple sources of knowledge. I believe that stimulating experiences, like using creative arts, can enhance therapy. But I do agree that three therapeutic conditions that we now call core conditions, should form the base of a helper’s attitude towards the client: empathy, congruence and unconditional positive regard.

Empathy is the heart of the therapeutic relationship. The helper focuses their emotional and intellectual sensitivity on the client in order to be with them fully.

Empathy is not a feeling or a state, it is a continuing process throughout the therapeutic relationship. Being with the client, accurately perceiving them: seeing the world through their eyes; feeling through their heart; looking at the situation with the client’s values, past experiences and beliefs; understanding their situation from their own point of view; experiencing the world in their frame of reference. I am there to accompany the client on their journey; to stay with them, not pulling them away from what they are experiencing. I provide them with the experience that I am willing to be close to them, here and now, even in their distress; I support them to be able to express it, deepening their level of self-awareness, facilitating their self-agency that can lead to change.

Empathy strongly contributes to the establishment and maintenance of relational depth. I focus on getting as close as possible to the client’s current experience. I do my best to intensely and enduringly sense and respond to how the client perceives and experiences reality, putting aside my own way of perceiving and experiencing it. I listen and echo the client’s felt sense. I invite them to reflect on their current experiences, presenting them with a mirror.

In my opinion, empathy is learned through all our life experiences; observation of others; and relating to others in many different contexts. Empathy requires effort, concentration and discipline, as well as self-honesty, willingness and open-mindedness. My capability to empathise with the client is intertwined with my own self-awareness.

I need to effectively communicate my empathic understanding to the client.

Congruence

When I am with the client, I need to be able to be a real, genuine, authentic person – myself. I mustn’t hide behind a role or a mask; I mustn’t act like an expert (the client is the one who is the expert on own their life, not me); there mustn’t be a facade. Using Carl Rogers’ expression, I need to be ‘transparent’: I mustn’t be pretending anything or defending my position. I must openly be who I am. This communicates a powerful message for the client: it’s OK to be yourself, it’s OK to be real. Congruence promotes acceptance, it helps the client to dare taking risks in the therapeutic relationship.

Being able to be congruent, requires self-awareness. First, I need to be aware of my own experiencing of the client, our relationship and the therapeutic process. Furthermore, I need to effectively communicate my experiencing to the client.

Congruence is a state of being when my outward responses to the client constantly match my inner experiencing. My responses must be congruent and relevant to the concerns of the client. My congruence makes it possible for the client to trust me. I aspire to ‘show my working’ to the client, in order to demystify the therapeutic process; so they understand where I come from. I also have to be willing to be open about my weaknesses. I have to own my difficulties, genuinely owning problems as mine and not the client’s when that is the case. My self-acceptance is a model for the client, it helps them to become more congruent as well.

I need to constantly develop my congruence, this is a lifelong process: broadening and deepening the person who I am. Receiving feedback from clients and peers, keeping a reflective journal, and the supportive challenging by my supervisor helps me on this journey.

Unconditional Positive Regard (UPR)

Unconditional positive regard is the helper’s fundamental attitude towards the client. I need to fully and consistently accept the client and their individual experience of the world. I mustn’t judge them. I don’t necessarily have to agree with them or approve their behaviour, I don’t need to share their values. What I must consistently value, is the humanity of the client, affirming their value, even if they may not value themselves at the moment.

My attitude of unconditional positive regard also manifests itself in enduring, non-possessive and respectful warmth towards the client. I need to find the right way to communicate this to them, in ways that they are able to accept it.

We all have the basic human needs for love, approval, validation and freedom from threat. My unconditional positive regard has to counteract the client’s internalised conditions of worth, their inauthentic self-concept that they are only acceptable as long as they think, feel and behave in ways that are positively valued by others. These often come from parental attitudes the client has grown up with, and get reinforced by life experiences.

If I communicate it effectively, and the client experiences my unconditional positive regard, there is no need for them anymore to be self-protective in this relationship, they can feel safe enough to open up. As part of the therapeutic process, the client begins to experience the same attitude of unconditional positive regard towards themselves.

In order to be capable to have the attitude of unconditional positive regard, I need to enhance my own security, stability and self-acceptance, I need to value myself. So that I don’t need to carry conditionality in my therapeutic relationships. I have to clarify my own values, be aware of them and explore them further.

Key Principles of the Pluralistic Approach

As I mentioned before, I consider myself person-centred and also pluralistic, meaning that I don’t think sufficiency is the key question when we talk about therapeutic conditions. I firmly believe that different clients benefit from different types of therapeutic practices at different points of time. The path we follow in a therapeutic relationship needs to be collaboratively negotiated.

There isn’t one way to be pluralistic. My goal is to enhance the therapeutic process.

I shall outline the ten key principles of pluralistic approach below and their relevance to my practice.

1. Ethic of Care
   I need to have a genuine desire to engage with the client, and be responsive to their needs and preferences, in order to create a positive therapeutic relationship.

2. Primacy of the Client
   The client is the centre of the therapeutic process. I need to recognise their diversity and respect their individuality. Their needs, perspective and active involvement determines the path we take.

3. Recognition of Diversity
   Equality in the therapeutic relationship means including and equally validating all truths and experiences, while acknowledging the impact of the broader societal context as well.

4. Multiplicity of Approaches
   I believe that all psychological models are equally valid, and they all may be useful with different clients at different points of time. I am a lifelong learner, constantly studying different theories, I deconstruct and assimilate ideas to enhance my practice, trying to find the ways that best suit each individual client.

5. Uniqueness of Experience
   I acknowledge, appreciate and aspire to accommodate that different clients need different approaches at different times.

6. Knowledge
   I use multiple sources of knowledge for the enhancement of the therapeutic process: common knowledge, the client’s knowledge and my own.

7. Individualisation
   I aspire to co-create with the client a therapeutic relationship and process that best suits the individual client’s needs and preferences at the that point in time. I need to be flexible, responsive and adaptive. Each step of the therapeutic process needs to be collaboratively negotiated.

8. Realtionship
   The therapeutic relationship between me and the client works based on engagement, care, respect, trust, equality, dialogical process and collaboration.

9. Therapist Reflexivity
   I need to constantly monitor myself, working on my own self-awareness and self-knowledge.

10. Flexibility
    The therapeutic relationship, structure and process needs to be flexible, as well as the communication between me and the client.

How the Person-Centred and Pluralistic Approaches Work Together When Using the Person-Centred Creative Arts Approach

Each of us is a unique entity. In fact, we are so unique that a human being can never be fully understood by another one. (No wonder that so many of us, practitioners have a critical stance towards diagnosis.) We all have our own distinct individual wants, needs, preferences and knowledge.

The person-centred approach (see red branch of the mind map) focuses on the client’s autonomy. I believe that the client has the right, desire and ability to determine what is best for them and how they will achieve it. Our relationship is based on the fact that I respect the client’s autonomy. I am merely there to provide therapeutic conditions to facilitate the client’s own actualising tendency so they can fulfill their potential.

In the UK, there is a tendency to take Rogers’ six necessary and sufficient conditions rigorously (even if Rogers himself evolved his theories during his career), meaning that the helper shouldn’t introduce anything in the therapeutic process, they have to wait for the client to come up with something. There is a lot of debate around this. My opinion is that I should do anything and everything that can enhance the therapeutic process, including the introduction of stimulating experiences, like working with creative arts approach.

That’s why I consider myself pluralistic (see green branch of the mind map), as well as person-centred. I believe that there is no one-size-fits-all theory and practice. I believe that acknowledging and appreciating the uniqueness of each individual client means that I need to use different types of therapeutic practices with different clients at different points of time, focusing on what they benefit from the most.

Identifying what the client needs and wants and how they might achieve that, is collaborative work through a dialogical process in the therapeutic relationship. Rogers’ daughter Natalie Rogers proposed the concept of enhancing the therapeutic process by offering stimulating experiences. In the person-centred creative arts approach (see orange branch of the mind map) we identify seven facilitating conditions: psychological contact; client’s curiosity and motivation; offering stimulating experiences; congruence; witnessing the creative process with unconditional positive regard; empathic understanding; and communication consciously as well as unconsciously. These seven facilitative conditions will be discussed in more detail in the next mind map.

Seven Facilitative Conditions of the Person-Centred Creative Arts Approach

1. Psychological Contact
   The client and the helper are in psychological contact that provides a safe environment for the client to open up. Creating art in itself can promote the depth of contact with oneself and others.

2. Client’s Curiosity and Motivation
   Unlike in Rogers’ original six necessary and sufficient conditions, I don’t consider the client’s incongruence to be a requirement of the therapeutic process. It is possible that the client is congruent, and they are engaging in the process for personal development, for example. On the other hand, the client does need to be curious and motivated, desiring to better understand their internal experience and being motivated to explore the creative process.

3. Stimulating, Challenging Experiences with Materials
   I want to stimulate the client’s creativity by giving them the opportunity to explore, experiment and engage with the creative process. Working with an image is a gentle way, because of the perceptual distance from ourselves, to promote the depth of the client’s self-exploration that can lead to the change they desire.

4. Congruence, Curiosity and Integrity
   I have to be congruent, curious and integrated in the therapeutic relationship and process of art making and exploration.

5. Unconditional Positive Regard
   I am present in the therapeutic relationship and process, with my fundamental attitude of unconditional positive regard, aspiring for relational depth, to witness the client’s creative and expressive process.

6. Empathic Understanding
   I need to experience, and effectively communicate to the client, my empathic understanding of all the elements of the therapeutic process.

7. Communication
   As I do my best to communicate my curiosity, empathy and unconditional positive regard to the client, they receive it in both conscious and unconscious levels.

Person-Centred Creative Arts Approach

All art materials contain materials from all four levels of consciousness (see pink part of the mind map): the conscious part; the edge of awareness: feelings, thoughts, sensations from where denial and distortions can come; the unconscious where creativity comes from; and the universal unconscious, the collective, spiritual part where syncronicities come from. As we work with art material, our consciousness expands to let some unconscious material in; so that we can become more congruent. I need to witness, accept and respect the client’s current level of congruence.

There are five stages of therapeutic work with art material (see the purple part of the mind map), but this process is not necessarily linear, and the stages are fluid:

1. Symbolisation: The image comes up in the client’s mind.
2. Externalisation: They create a representation of this image in art form.
3. Verbalisation: They talk about the image they created, and I use the key skills of PCAT: I empathise, reflect and bridge.
4. Dialogue: We go more deeply into the unconscious.
5. Work on revealed meaning in the therapeutic process

There are some key skills that I use when working with art material (see the yellow part of the mind map). I listen empathically, I am fully engaged in the process. I reflect on what I hear, using clean language: I repeat the client’s own words back to them, as if holding a mirror for them. I do not name or label anything in their image. I do not interpret, identify or judge, I am just curious to witness how the meaning unfolds. I respond to them empathically. I use bridging to facilitate the unfolding of the meaning: the communication between unconscious and conscious. Often metaphors come up, with universal qualities and very personal meaning.

Ethical Practice

In the three mind maps below, I represented my understanding of the APCCA Ethical Principles and Framework for Practice (2025) and its relevance to my own practice.

The client is the centre of the therapeutic relationship and process, therefore the most important part of my ethical practice is the ethic of care for the client (see the yellow branch of the mind map). I have genuine desire to engage with my client, so I commit myself and take responsibility for engaging with them in helpful, respectful, empowering ways to promote their wellbeing and development. I have to clearly communicate and give information to the client about working with creative arts potentially bringing up powerful emotions from both conscious and unconscious.

In order to be able to care for my clients, I have to adhere to the ethic of care for myself (see the blue branch of the mind map) as well. I need to take care of my own wellbeing and continuous development by engaging in my own creative practice, continuing personal and professional development and regular skills practice, and in personal therapy when needed.

In my practice, I rely on my person-centred qualities (see the red branch of the mind map). I respect the client’s capacity to self-direct, I turn to them with empathy and unconditional positive regard and I don’t judge them. I express these qualities through non-interpretative attitude, reflexivity, flexibility, curiosity and the collaborative therapeutic relationship, promoted by my honesty, trustworthiness and integrity. In this therapeutic relationship, the client feels free from threat, so creativity, growth and healing can occur leading to the client’s self-actualisation, development of their self-awareness and psychological healing.

I value and respect individuality, uniqueness, difference and diversity (see the green branch of the mind map), and I communicate this through empathy, non-judgemental attitude and the collaborative relationship.

I aspire for equality in the therapeutic relationship (see the pink branch of the mind map).

I work on inclusivity (see the purple branch of the mind map), respecting individuality by anti-discrimination of characteristics, including gender, race, ethnicity, culture, age, sexual orientation, belief system, ability and disability.

I work on developing my cultural humility (see the blue branch of the mind map) practicing self-reflection self-critique, as well as openness and willingness to learn from others. I work on recognising, acknowledging and addressing power imbalances created by cultural, contextual and personal unconscious dynamics.

When I realise that I don’t have the relevant training and experience to work with a client, I refer or signpost them (see the brown branch of the mind map) to the relevant practitioners.

I commit myself to continuous personal and professional development (see the orange branch of the mind map) by practicing my own creative arts; working on developing my self-awareness; keeping a reflective journal, constantly reflecting on my practice; practicing my relevant skills regularly.

In supervision (see the red branch of the mind map), I have a supportive, confidential relationship and reflective place for receiving education, monitoring and support, as needed.

I adhere to the relevant regulations of data protection (see the brown branch of the mind map). I don’t use AI tools for any part of my record keeping.

I keep myself to the relevant rules and regulations of confidentiality (see the red branch of the mind map). I make sure my clients understand the boundaries and limitations of confidentiality. I safeguard all confidential information and the records I keep. If I have to disclose confidential information, I discuss it in supervision. I only disclose confidential information if the client gives their consent; if there is legal requirement to do so; if there is a safeguarding issue; if there are concerns for the client’s or my own safety.

I manage my work in a consistent and ethical way (see the blue branch of the mind map). At the beginning of our work together, I discuss our contract with the client, and we review this later if relevant or necessary. We agree on the aims and purpose of our therapeutic work together. I give all the relevant referral and signposting information to the client. I advise the client that when working with creative arts, they might quickly connect with a depth of emotion that they might find distressing or overwhelming. We discuss practical issues, such as the time and duration of the sessions; fees; boundaries and limitations of confidentiality; potential of dual relationships and conflicts of interest; boundaries with social media communication, if applicable.

When I work with a client online, we discuss the relevant practical considerations. I advise them about the potential of online disinhibition that can speed up and intensify the work with creative arts.

Wounded Creativity

All children are creative. They are, usually, perfectly happy to create any kind of artwork. Most of the adult clients, on the other hand, are hesitating - to say the least - to work with creative arts. Why is that?

In our society, therefore in our school system, creativity gets downgraded. Our right brain gets dismissed, and the left brain becomes dominant. Our creativity gets suppressed, or even buried, by criticism, judgement (including praise that implicates conditions of worth), fear of not being good enough, instructions (including ‘helping’) and grading. Eventually, we internalise these negative messages about our creativity; the perceived expectations of others become our own internal judgement, conditions of worth; and our self-image gets distorted. We can suffer real psychological injury and become ashamed of ourselves, incapable to creatively express ourselves. We might limit our lives, by dismissing our creativity entirely.

What can help? The medicine is creativity itself. Creative recovery or discovery is teachable. We just need the right place, the right conditions, perhaps the right person to be with, to rediscover our creativity. We need to play again, as we used to do when we were children, spontaneously, without structure, practicing non-judgemental attitude towards ourselves. Creativity and self-actualising tendency are intertwined.

Rediscovering our creativity, we can reach the state of flow again, where we lose track of time, we become fully involved in the creative activity, enjoying the experience, doing it just for the sake of doing it, where nothing else seems to matter.

We are all creative. We just need to find our inner child.

References

• APCCA Ethical Framework for Practice (2025)
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• de la Prida, Ani (2020) Bread and Jam and Sparkling Wine? Can I be Person-Centred and Pluralistic? (blog post) https://pluralisticpractice.com/main-blog/personal/bread-and-jam-and-sparkling-wine-can-i-be-person-centred-and-pluralistic/
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