Self Concept in Practice: Counselling of Hearing Impaired Individuals

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Hearing loss is a widespread condition, affecting approximately 432 million adults globally (World Health Organization, 2014). In general, having a hearing-impairment, whether it be mild or profound, makes communicating with the outside world difficult. A major focus of social work is to advocate for the rights of people at all levels (IFSW, 2014). When working with individuals with a hearing-impairment, it is imperative to establish a dialogue that invites information about the history and nature of the loss. Hearing-impairments range from mild to profound, with there being six degrees in total. Understanding an individual’s situation is imperative as not only are there different degrees of hearing loss, but also, each case is unique to the individual.

Person-centered practice encourages and supports service users to develop knowledge, skills and confidence in themselves in a non-judgmental environment supported by genuine and non-judgmental people (Casemore, 2011). Services must understand issues of diversity and equality and be accessible and inclusive, anti-oppressive practice means recognizing power imbalances and promoting change to redress the balance of power (Dalrymple and Burke, 1995). Unconditional positive regard and congruence are some of the core conditions for this practice. The ability to share feelings of another and understand them, empathy, is also integral in this approach. Carl Rogers (1902-1987) was the originator of the person-centered approach, he was the founder of what he originally called ‘non-directive therapy’ which today it is most commonly known as person-centered therapy.

“It is that the individual has within himself or herself vast resources for self-understanding, for altering his or her self-concept, attitudes and self-directed behaviour – and that these resources can be tapped if only a definable climate of facilitative psychological attitudes can be provided” (Rogers, 1980, p.115-117).

A person enters person centered therapy in a state of in-congruence. It is the role of the social worker with complete integrity to help reverse this situation with hope to help service users to achieve personal growth and eventually to self-actualize. Rogers (1959) called his therapeutic approach client-centered or person-centered therapy because of the focus on the person’s subjective view of the world. Helen Sanderson describes person-centered practice as “…a process of continual listening; focused on what is important to someone now, and for the future; and acting upon this in alliance with their family and friends” (Beresford, 2011). Social work should have an anti-oppressive framework which is client centered and empowering (Dalrymple and Burke, 1995).

Empathy is one of the core conditions underpinning the theory of person-centered practice. Rogers (1975) came to the conclusion that “a high degree of empathy in a relationship is possibly the most potent and certainly one of the most potent factors in bringing about change and learning”. He believed that when an individual felt understood they therefore felt less alone, empathy shows that the service user is accepted, valued and understood. By doing this rapport can be built. One of the best responses to a service user is to reflect their feelings back to the them, in doing this it demonstrates that they are being listened to, and that what they are saying is understood.

Another core condition is having an unconditional positive regard. This refer to having a genuine, deep care for the service user and maintaining a positive attitude even when disagreeing with actions or thoughts of the service user, emphasizing acceptance. Similarly to empathy, upholding an unconditional positive regard will allow the service user to feel valued in a non-judgmental environment and give them to ability to grow personally and fulfill their potential. Acceptance and being non-judgmental are core conditions under-pinning the theory of person-centered practice and vital for the desired outcome of person-centered practice. However, Rogers believed that the most important condition was congruence. Congruence and authenticity allow the practitioner to take a risk and share a feeling or give feedback that might improve the relationship with the service-user because it is genuinely expressed (Nelson-Jones, 2014) in controlled emotional involvement.

Overall, it may be said that some conditions are more important than others. However, each of the core conditions relate to each other and are all vital in achieving the desired outcome of person-centered practice.

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