Many topics have been covered, and covered really well, so today I’m going to share some of my musings in a manner that I hope will be useful for those who might peruse this post.
Why is it so difficult for us to change?  Most if not all of us are very cognizant of the need to change, that seems to be the easy part.  We also usually know what to do that will effect change as well, especially if we’ve sought any outside help from family, friends, and/or mental health professionals.  We daydream and long for what our life could be like if we could just change, then why the heck don’t we?
This is a question that many parents agonize over in relation to their daughter in treatment; they’re receiving treatment, all their basic needs appear to be met, so why aren’t they changing like we’d hoped, or they’re making progress but why not more quickly, etc.?   On the other side of the generation gap, the students labor over the same question themselves in many instances;  “why can’t I just seem to do it?”  One of the most important concepts gleaned as a pupil are the conditions requisite for change that were originally developed by the father of client centered humanistic psychotherapy, Carl Rogers, which are:
-Client feels a state of incongruence, which could also be called dissonance, such that it enters consciousness and highlights a need for change.  This may not often appear as a student approaching their parents or therapists conveying their need to change, more likely it will be manifested in an array of self-destructive behaviors.  The association with one’s behaviors and their direct negative outcomes is the genesis for the need to change.  It’s normal for a person to experience ambivalence in relation to his condition, and even throughout each stage of successful treatment; it’s ok, don’t panic when as a level 5 your daughter appears conflicted over changes made!
-The client feels they are being heard, understood, and empathized with.  The therapist will be their genuine self with the client while they jointly engage in psychological contact, also called therapy.  The client feels that they are accepted by the therapist with what Roger’s termed “unconditional positive regard.”
That’s it?  Yep.  Wait, you were expecting something more?   Ok, there is something else that even Rogers himself appropriately acknowledged:  A few aspects were omitted because they were not absolutely necessary conditions for change, however they are incredibly effective enhancers of the same.   I’ll aggregate the various theorems and principles into a simple one-word description.  What.  The “what” as in what do I need to do now that I’m interested in changing, and it’s at this point that we can explore the numerous therapies and interventions at our discretion to utilize in helping one work through their challenges.
To contrast this with Rollo May and Victor Frankl’s Logotherapy, which literally stands for “meaning making therapy,” the “why” has been sufficiently addressed by the conditions of change, and the “how or what” become primary after first being secondary concerns.  In essence, the required conditions for change fulfill the need to attach a purpose to change by allowing our growing valuation of self to become the “why.”  After this is accomplished, it will be accomplished a multitude of times in the course of change.  We then look with guarded optimism to what we need to do in order to fulfill our “why.”
For many, their outlook has been severely altered by a powerful feeling of helplessness, which is a manifestation of very weak self-efficacy, or belief that one can successfully change despite having a desire to do so.  Knowing what to do, and that it can actually work, greatly enhance motivation and the conditions for change to successfully occur.  The process of developing motivation for change and changing itself occur concurrently with interventions that provide a clear idea of the “what” to do in healthy change.   Right from the start we, parents, clinicians, and staff, can simultaneously form relationships while engaging in challenging therapeutic interventions that will bring about the most effective therapy possible; Success itself!  Success is the greatest motivating factor as evidenced by recent research from the field of Positive Psychology; we are motivated at the chance to be happy by avoiding sadness.  This applies to both parents and students, who are desperate to get some success under their belt to ward off debilitating and painful hopelessness.   In conclusion, I’ll reference an oft spoken platitude from the athletic domain, which is that a “good offense (think successes and conditions needed for change) is the best defense!”
– written by Allen Richards, CSW, Therapist