Person-Centred Experiential Counselling for Depression

Domain III · Humanistic, existential & experiential · Andy Hill, Roth, Pilling · 2009 · United Kingdom

What it is

Counselling for Depression (CfD), later renamed Person-Centred Experiential Counselling for Depression (PCE-CfD), is a brief, NICE-recommended individual therapy for depression. BACP developed it in 2009 for IAPT, now NHS Talking Therapies, as the service's person-centred/experiential option. It…

Format

• Format and dose
• Individual, face-to-face talking therapy within a stepped-care service; PRaCTICED delivered it at step 3 of Sheffield IAPT.

Who practises it, and how they are trained or regulated

• How change happens: a relationship of empathy, unconditional acceptance and genuineness, with psychological contact, lets the client move from rigid to fluid functioning. The client becomes more aware of emotion, examines and revises beliefs, integrates experience and takes ownership of it. Depression is understood as a problem of emotional processing and self-organisation. It can involve over- or under-regulated…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• Accepting the first word too quickly. It is working when there is a click of fit ("yes, empty").
• Using it to defend yourself. It is working when the client's honesty about the relationship increases (see 5.5).
• Pushing; the client must be free to decline [Haake 2017]. It is working when the client slows down and elaborates.
• Hurrying the client towards acceptance. It is working when the outrage gives way to grief and then to a revised view.
• Long or clever reflections, and adding your own content. It is working when the client says "yes, and…" and goes deeper.

Problems the guide addresses

• Stuck client (circular storytelling, no movement)
• Avoidance; the client declines process invitations
• Emotional overwhelm in session
• Flat, numb or over-regulated client
• Ruptures (withdrawal or confrontation)
• Client wants advice, techniques or homework
• Harsh inner critic, and the therapist's pull to rescue
• Non-attendance and drop-out (non-adherence)
• Risk escalates during therapy
• Session limit reached; client not ready

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.