Person-Centred Experiential Counselling for Depression

1. Introduction

Version followed: PCE-CfD as defined by the UCL/BACP Counselling for Depression competence framework (Andy Hill, adapted from the humanistic framework of Roth, Hill & Pilling, 2009), with the four-phase structure named in Murphy (2019, 2nd ed.) and fidelity defined by the PCEPS-10 (v1.2). Murphy's practice chapters (4–7), Sanders & Hill (2014) and the 3rd edition (Murphy & Pearce, 2026) are not drawn on, so phase content is mapped from the competences [uncertain where marked].

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 combines classical person-centred therapy with process-guiding elements from emotion-focused therapy (EFT) [source: CfD clinician guide; Haake 2017; Sage 3rd-ed page]. It is a competence framework applied with judgement rather than a session-by-session script. The framework says it supports practice rather than prescribing it, and Haake argues that calling CfD "manualised" is misleading [source: UCL framework page; Haake 2017].

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 [source: CfD basic competences]. Depression is understood as a problem of emotional processing and self-organisation. It can involve over- or under-regulated emotion, blocked access to primary adaptive emotions, secondary or long-standing maladaptive emotions, hostile relationships between parts of the self (for example a harsh inner critic), unfinished business, and a gap between the actual self and an introjected ideal self [source: CfD basic competences; Murphy 2019 ch. 3]. The counsellor follows the client and also actively helps them access, symbolise, regulate and reconstrue emotional experience [source: CfD specific competences; PRaCTICED author version].

2. Framework

Format and dose

Individual, face-to-face talking therapy within a stepped-care service; PRaCTICED delivered it at step 3 of Sheffield IAPT [source: PRaCTICED, eprints record].
Session count: the framework normally recommends contracts of "6 – 10 sessions", and up to 20 for more severe depression [source: CfD clinician guide]. Haake reports 8–12 as usual, with a maximum of 20 [source: Haake 2017]. PRaCTICED capped treatment at 20 sessions and counted four or more as a per-protocol dose [source: PRaCTICED author version]. The sources differ, so agree the number at the start and state it.
Session length and frequency are not stated in the sources. The usual weekly session of about 50–60 minutes in NHS Talking Therapies is assumed [uncertain].
Indication: the framework applies to subthreshold, mild or moderate depression [source: CfD clinician guide]. PRaCTICED tested it in moderate–severe depression against CBT [source: PRaCTICED author version]. Severity limits therefore differ by version [uncertain].
Quality: practitioners train for about five days, then complete about 80 hours of supervised practice and submit four recorded sessions rated on the PCEPS [source: Haake 2017]. In PRaCTICED the pass mark was 40/60 on the 10-item PCEPS [source: PRaCTICED author version]. Regular individual or group supervision is expected [source: CfD clinician guide; PRaCTICED].

Phases. The chapter titles in Murphy (2019) are First meetings and the initial phase, Early sessions phase, Middle phase sessions, and Final phase and endings [source: Murphy 2019 contents]. The tasks under each phase below are mapped from the competence framework, because the chapters themselves are not drawn on [uncertain: allocation to phases is synthesis].

Phase	Goals	Main activities
Initial (first meeting, about sessions 1–2)	Make contact, get informed consent and agree an initial aim	Explain the rationale, say how you will work together, discuss expectations and responsibilities, take the client's own view of the problem, assess risk, take baseline measures, find a provisional focus [source: CfD basic competences; clinician guide]
Early	Build the relationship and an emotional focus	Empathic following, conveying acceptance, noticing emotionally significant areas and recurring patterns (markers), and finding out how the client regulates emotion [source: CfD basic and specific competences]
Middle (bulk of sessions)	Process emotion and meaning	Selective use of specific competences: accessing and articulating emotion, regulating arousal, working with problematic reactions and with parts or splits, unfinished business, reconstruing meanings [source: CfD specific competences; Murphy 2019 ch. 3; Haake 2017]
Final	Consolidate and end well	Review progress, recognise readiness, plan, work through feelings about ending, consider further help [source: CfD basic competences]

Moving between phases [synthesis; the sources give no explicit criteria]

Initial to early: rationale understood and accepted, a provisional focus agreed, risk assessed and managed, and the client returns.
Early to middle: the client can attend to their inner experience in session, and a recurring marker has appeared (a self-critical split, a puzzling reaction, unresolved feelings towards someone).
Middle to final: start two to three sessions before the contracted end, or earlier when the client shows signs of readiness (see 4.29). Revisit goals whenever measures or the client's report show a change.
The focus is renegotiated throughout [source: CfD basic competences].

3. Guiding principles

Source for the principles below: CfD basic competences, unless marked otherwise.

Experiencing is central. Attend to what the client is feeling, sensing, remembering and meaning now, rather than to symptom content alone.
People are relational. The real person-to-person relationship is the main vehicle of change [also Haake 2017].
Self-determination. The client directs their own change. Do not steer them towards your preferred solutions.
Actualising tendency. Assume the client has a drive towards growth that is blocked or stuck, not absent [also Haake 2017].
Holism and diversity. Hold intrapersonal, interpersonal, cultural, contextual and spiritual angles together. Value difference equally.
Conditions for change. Psychological contact, empathy, unconditional positive regard and congruence are offered every session. They are the treatment, not a prelude to it.
Conditions of worth. Assume rigid, introjected values ("shoulds" taken in from others) underlie much depression, and listen for them.
Client as expert and active collaborator. Use the client's own description, not diagnostic labels, and follow their meanings even when theory would predict something else [source: Murphy 2019 ch. 3, pp. 49–50, 58; CfD basic competences "Client's capacity"].
Track the client's frame of reference. Responses should follow the client's train of thought and add nothing new from you [source: PCEPS-10 item 1].
Low content directiveness, no dominance. Avoid explaining, advising and reassuring, and do not control the session. Guide the process of exploration and leave the content to the client [source: PCEPS-10 items 5, 7].
Core meaning and clarity. Reflect the essential feeling under the words. Keep responses short and simple [source: PCEPS-10 items 8, 9].
Emotion focus. Actively help the client attend to, name and deepen emotion [source: PCEPS-10 item 6; specific competences].
Experiential specificity. Move from generalities to concrete episodes, images and bodily sensations [source: PCEPS-10 item 3; Haake 2017].
Psychological holding. Stay steady and connected when the client is in pain or afraid [source: PCEPS-10 item 2].
Optimal arousal / regulation sensitivity. Aim for emotion that is felt, but not so much that the client can no longer reflect on it. Lower arousal when it is too high and raise it when it is too low [source: PCEPS-10 item 10; specific competences].
Offer, don't impose. Make every process suggestion tentatively and let the client decline it [source: Haake 2017; clinician guide: specific competences used according to "client preference"].
Equal empathy to all parts. In conflicts within the self, empathise with each side, including the critic [source: Haake 2017].
Collaborative, renegotiable focus. Agree goals together and revise them. Balance goal-setting against the relationship.
Balance non-directiveness against safety. Intervene directly when risk requires it [source: CfD clinician guide, metacompetences].
Balance task and relationship; metacommunicate. When something is off, talk with the client about how the two of you are communicating [source: CfD clinician guide, metacompetences].
Responsive, not mechanical. Balance adherence with flexibility and respond to client feedback [source: CfD clinician guide, generic metacompetences].
Congruent self-use. Notice your own reactions without judging them. Disclose them only when they are relevant, persistent or striking and likely to help.
Measure and supervise. Use outcome measures to guide the work, and bring recordings and your rejecting reactions to supervision [source: CfD clinician guide; basic competences].

4. Intervention inventory

The competence framework names competences, not packaged techniques. The headings below follow the framework's own items, plus the marker-guided tasks named in Murphy (2019, ch. 3) and Haake (2017). The step sequences are written by me from those competence descriptions, so the steps are operationalisations [synthesis] unless a source is cited. The specific competences (4.11–4.28) are used selectively, according to clinical judgement and client preference [source: CfD clinician guide]. All example wording is illustrative.

A. Relationship and structure (basic and generic competences)

4.1 Explaining the rationale and contracting

Purpose / when: First session, and again whenever the client is unsure what the work involves. This is how informed consent is obtained [source: CfD basic competences "Starting therapy"; clinician guide].
Steps: (1) Describe the approach briefly: the client is helped to find their own resources, and the work focuses on feelings and their meanings. (2) Describe your stance: an equal partnership in which you will be accepting, genuine and engaged. (3) Name likely effects: relief and feeling less alone, getting closer to feelings (which can hurt at times), and new awareness and new action. (4) Ask about the client's expectations and agree outcomes that are achievable in the number of sessions. (5) Clarify responsibilities on both sides: attendance, measures, risk, and the client's right to decline any suggestion. (6) Agree the number of sessions and the review points.
Example language (illustrative): "This counselling is less about me giving answers and more about us slowing down and making sense of what you're feeling, so you can find what you need. Sometimes I'll suggest we stay with a feeling for a while. You can always say no."
Watch for: The client expecting advice or homework (see 5.6). The client fearing that feelings will be too much (go gently, see 4.15). Success looks like the client describing the way of working back in their own words.

4.2 Collaborative assessment and locating a therapeutic focus

Purpose / when: Sessions 1–2, then revisited throughout [source: CfD basic competences "Assessment and establishing a therapeutic aim"].
Steps: (1) Ask how the client sees their main difficulties, in their own words, without diagnostic labels [Murphy 2019 ch. 3, p. 50]. (2) Track where emotion gathers as they speak: where their voice changes, where they pause, which topics they return to. (3) Explore how they perceive key events and how those events link to the current low mood. (4) Offer a tentative statement of focus and refine it with them. (5) Turn it into one to three primary goals the client endorses. (6) Renegotiate as therapy goes on, and don't let goal-setting take over the relationship.
Example language (illustrative): "When you talked about your sister you went quiet. Is that close to the heart of what's been weighing on you?"
Watch for: A focus that is the therapist's, not the client's. An over-long information-gathering phase that delays contact. It is working when the client recognises the focus as theirs and brings material related to it.

4.3 Risk assessment and responding to risk

Purpose / when: At assessment, whenever measures or content show hopelessness or suicidal thinking, and at every review. The framework lists risk assessment among the generic competences, and it is the main point at which the non-directive stance gives way to direct intervention [source: CfD clinician guide, generic competences and metacompetences].
Steps [synthesis following standard practice]: (1) Ask directly and calmly about suicidal thoughts, intent, plans, past attempts and protective factors. (2) Stay empathic while asking; do not switch into a cold checklist. (3) If risk is present, collaboratively make a safety plan. It should cover warning signs, coping steps, people and services to contact, and lethal-means counselling (safe storage or removal of means). (4) Follow service protocol: inform the clinical lead or GP and step up care if needed. (5) Record what you did, and keep reviewing.
Example language (illustrative): "You said you can't see a way forward. Sometimes people feeling that low have thoughts of ending their life. Is that happening for you?"
Watch for: The counsellor avoiding the topic to protect the relationship. A plan that lives only in the notes. A good sign is the client being able to talk about despair openly with you.

4.4 Using outcome measures to guide therapy

Purpose / when: Every session in NHS Talking Therapies. The framework lists using outcome measures to guide therapy and track progress as a generic competence [source: CfD clinician guide]. The specific instruments (in NHS Talking Therapies typically PHQ-9 and GAD-7) were not named in the sources [uncertain].
Steps [synthesis]: (1) Have the client complete the measures before or at the start of the session. (2) Look at the scores together briefly and ask what they reflect. (3) Treat changes as material to explore empathically, not as verdicts. (4) Use the trend to set review points and to decide whether to step up.
Example language (illustrative): "Your score's gone up this week. What was the week like?"
Watch for: Measures turning the session into an administrative routine. Clients scoring to please you. It is working when the scores open conversations rather than closing them.

4.5 Empathic following (tracking)

Purpose / when: Continuously. This is the default response mode [source: CfD basic competences "Empathy"; PCEPS-10 item 1; Haake 2017].
Steps: (1) Listen to the words and to the non-verbal and paralinguistic cues. (2) Respond with reflections, paraphrases, summaries, reflections of feeling and metaphor, staying inside the client's frame of reference. (3) Keep responses short and in plain language [PCEPS-10 item 8]. (4) Check whether you have it right and take the correction.
Example language (illustrative): "So you got through the whole day, and when you got home it all just collapsed." Then: "Have I got that right?"
Watch for: Long or clever reflections, and adding your own content. It is working when the client says "yes, and…" and goes deeper.

4.6 Responding to core meaning and implicit feelings (empathic guesses)

Purpose / when: When something felt but unspoken sits at the edge of what the client is saying [source: CfD specific competences 1 — listening empathically for implicit feelings, offering empathic guesses; PCEPS-10 item 9].
Steps: (1) Notice mismatches between words and tone or body, and contradictory feelings [basic competences]. (2) Offer a tentative guess about the feeling or meaning underneath. (3) Phrase it as a question or with "maybe". (4) Drop it at once if it doesn't fit, and follow the correction.
Example language (illustrative): "You say you're fine with it, but your voice sounds flat — maybe there's some hurt in there too?"
Watch for: Guesses turning into interpretations, or the client agreeing just to comply. It is working when the client sharpens or corrects the guess in their own words.

4.7 Conveying unconditional positive regard (accepting presence)

Purpose / when: Always, and above all when the client reveals shame, anger, or behaviour they expect you to judge [source: CfD basic competences "Unconditional positive regard"; PCEPS-10 item 4].
Steps: (1) Show welcome and non-judgement in your tone, posture and words. (2) Value the person regardless of what they say or do. (3) Notice in yourself any rejecting reactions or value clashes. (4) Work these through privately and in supervision rather than letting them leak into the session.
Example language (illustrative): "It makes sense you'd feel that, given everything."
Watch for: Subtle reassurance or praise used as acceptance; reassuring is content-directive [PCEPS-10 item 5]. It is working when the client discloses more, with less apology.

4.8 Congruence and therapeutic self-disclosure

Purpose / when: Throughout. Disclose only when your reaction is relevant, persistent or striking, and likely to help [source: CfD basic competences "Congruence/authenticity"].
Steps: (1) Notice your own emotional, bodily and cognitive reactions without judging them. (2) Keep what you show consistent with what you feel; drop the professional façade. (3) If you disclose, own it ("I notice…"), keep it brief, and bring the focus back to the client. (4) Stay non-defensive when you are challenged.
Example language (illustrative): "As you tell me this I notice I feel quite moved. I wonder what it's like for you to say it out loud."
Watch for: Disclosures that serve the therapist. It is working when the disclosure deepens contact and the client takes the focus back.

4.9 Psychological holding

Purpose / when: When the client is in pain, afraid or feeling exposed [source: PCEPS-10 item 2; Haake 2017].
Steps: (1) Slow down and soften your voice. (2) Stay with the client; do not rush to fix, reassure or change the subject. (3) Make brief, steady acknowledgements. (4) Before moving on, check how they are.
Example language (illustrative): "I'm right here. Take your time."
Watch for: Your own discomfort pulling you away from the pain. It is working when the client can stay with the feeling and still feel connected.

4.10 Metacommunication

Purpose / when: When the process feels stuck, tense or off-track, or when the client reacts to something you said [source: CfD clinician guide, counselling metacompetences].
Steps: (1) Notice the shift. (2) Name your observation of the interaction without blame. (3) Ask how it is for the client. (4) Own your part. (5) Agree together how to go on.
Example language (illustrative): "I've been asking you to stay with feelings quite a lot today, and you've gone quieter. I wonder how that's been for you?"
Watch for: Using it to defend yourself. It is working when the client's honesty about the relationship increases (see 5.5).

B. Accessing and regulating emotion (specific competences, section 1)

4.11 Directing attention inward (bodily felt sense)

Purpose / when: For clients who talk about feelings from a distance or describe vague heaviness. Helps them bring into awareness feelings that are currently outside it [source: CfD specific competences 1 — directing attention inward, focusing on bodily sensations]. Haake links this to focusing-oriented work on the "felt sense" and notes that not all clients find it helpful [source: Haake 2017]. Murphy treats bodily feelings in depression as a source of meaning [source: Murphy 2019 ch. 3, pp. 44–45].
Steps: (1) Ask permission. (2) Invite the client to slow down and notice where in the body the issue is felt. (3) Ask them to describe the sensation's quality, size and shape. (4) Wait, then invite a word or image that fits it. (5) Check the word against the sensation ("does that fit?"). (6) Reflect any shift and link it back to the issue.
Example language (illustrative): "If you just take a breath and notice inside — where do you feel this heaviness? … Is there a word that fits it?"
Watch for: Dissociation or panic: switch to grounding (4.15). Intellectualising about the body. Signs it is working: pauses, softer speech, "it's like…", and a felt shift.

4.12 Selective reflection and amplification

Purpose / when: When the client skips past emotionally loaded material [source: Haake 2017; CfD specific competences 1 — noticing moments of difficulty].
Steps: (1) Pick out the emotionally significant word or moment from a longer story. (2) Reflect it back, slightly slowed. (3) Invite the client to stay with it. (4) Accept it if they decline.
Example language (illustrative): "You said 'nobody came' very quickly there. Can we stay with that for a moment?"
Watch for: Pushing; the client must be free to decline [Haake 2017]. It is working when the client slows down and elaborates.

4.13 Experiential specificity

Purpose / when: When the talk is abstract or generalised ("I'm always useless") [source: PCEPS-10 item 3; Haake 2017].
Steps: (1) Ask for a recent, specific instance. (2) Help build vivid detail: where, when, who, what was said, what they felt in the body. (3) Use the present tense to bring it close. (4) Reflect the emotion that emerges.
Example language (illustrative): "Can you take me to a moment this week when you felt useless? Where were you?"
Watch for: Re-traumatising detail with trauma memories (titrate; see 4.15). It is working when the affect becomes live in the room.

4.14 Working with avoidance of emotion

Purpose / when: Once you have judged that reducing avoidance is appropriate, given the client's safety, resources and stage of therapy [source: CfD specific competences 1 — judging when to reduce avoidance; increasing contact with avoided emotion].
Steps: (1) Notice the moment of avoidance (laughing, changing topic, going blank) and gently point it out. (2) Explore together what makes the feeling hard to acknowledge. (3) Explore how they avoid it and where that comes from: past experiences of showing emotion, family or cultural attitudes. (4) Honour the avoidance's protective function. (5) Invite small steps of contact.
Example language (illustrative): "Just then, as you mentioned your dad, you smiled and moved on. What might happen if you let yourself feel that?"
Watch for: Shame at being "caught" avoiding. Cultural norms about expressing emotion. It is working when the client can name the avoided feeling and stays connected to you.

4.15 Lowering overwhelming emotion (containment)

Purpose / when: When the client is flooded and can no longer reflect, or when the emotion is too big to engage with [source: CfD specific competences 1 — calm containing presence, containing imagery, self-soothing; Murphy 2019 ch. 3, p. 55: emotion may need to be "cut down to a digestible size"; PCEPS-10 item 10].
Steps: (1) Slow and steady your own voice and pace. (2) Acknowledge the intensity. (3) Help the client ground in breath, posture and the room. (4) Offer containing imagery, for example putting the feeling in a box or at a distance for now, and check that it suits them. (5) Invite self-soothing: what would comfort them, or what they would say to a friend feeling this. (6) Break the issue into one manageable piece. (7) Before ending the session, check that arousal has come back to a workable level.
Example language (illustrative): "This is a lot right now. Let's slow down together — feel your feet on the floor… Could we put most of this to one side and just look at one small part?"
Watch for: Dissociation, panic, or risk rising. It is working when breathing slows and the client can talk about the feeling while still feeling it.

4.16 Raising emotion when the client is out of touch

Purpose / when: For flat, numb or over-regulated clients [source: CfD specific competences 1 — review concerns and focus on the most significant; recall past episodes of heightened emotion; vivid imagery or language; active methods such as repeating a phrase more forcefully].
Steps: (1) Review the client's current concerns and invite them to choose the one that matters most. (2) Ask them to recall a specific time the feeling was strong. (3) Use vivid, evocative language and imagery in your reflections. (4) Invite them, with permission, to repeat a key phrase, louder or more slowly, and notice what happens. (5) Reflect the emotion that emerges and slow down there.
Example language (illustrative): "You said 'I just gave up.' Would you try saying that again, slowly, and notice what comes?"
Watch for: Overshooting into overwhelm (switch to 4.15). Performative emotion with no felt sense behind it. It is working when the affect is live and the client stays able to reflect.

4.17 Differentiating helpful from unhelpful emotions

Purpose / when: When one emotion seems to cover another (for example guilt in place of anger), or an old feeling does not fit the present situation [source: CfD specific competences 1; basic competences "Depression model" — primary adaptive, secondary, maladaptive core feelings; Murphy 2019 ch. 3, p. 58 "learned emotions"].
Steps: (1) Reflect the emotion that is present. (2) Ask what is underneath it or what came first. (3) Explore whether the feeling fits now or belongs to an earlier time. (4) Help the client name the more primary feeling and the need it carries (see 4.20). (5) The client, not you, decides what is adaptive [Murphy 2019 ch. 3, p. 58].
Example language (illustrative): "Underneath the guilt, I wonder if there's something else — maybe anger at how you were treated?"
Watch for: Imposing an emotion theory on the client. It is working when the client says something like "actually, I'm furious" and their posture changes.

C. Articulating emotion (specific competences, section 2)

4.18 Finding words for emotions

Purpose / when: When the client feels something but can't name it [source: CfD specific competences 2].
Steps: (1) Invite the client to stay with the feeling. (2) Offer several candidate words lightly. (3) Ask which fits best, or what is missing. (4) Keep refining the word against the felt experience.
Example language (illustrative): "Is it more like sad, or more like empty, or neither?"
Watch for: Accepting the first word too quickly. It is working when there is a click of fit ("yes, empty").

4.19 Verbalising meanings and memories that emerge when emotion is aroused

Purpose / when: When strong emotion is present and concerns, meanings or memories come up with it [source: CfD specific competences 2].
Steps: (1) Let the emotion be felt (with holding, 4.9). (2) Ask what it is about and what it says about them or their life. (3) Reflect the meaning in the client's words. (4) Connect it to the agreed focus.
Example language (illustrative): "As those tears come — what are they saying?"
Watch for: Asking for meaning too early, which takes the client into their head. It is working when emotion and meaning come together into a clear statement ("I've never been enough for him").

4.20 Identifying action tendencies, needs and wishes

Purpose / when: Once an emotion has been named, to find what it wants [source: CfD specific competences 2; Haake 2017 — fight, flee, freeze, get close].
Steps: (1) Ask what the feeling makes them want to do. (2) Ask what they need or long for. (3) Reflect the need with validation. (4) Explore what it would be like to act on it, or to honour it.
Example language (illustrative): "When you feel that hurt, what does it want — to pull away, or for someone to come close?"
Watch for: The client dismissing the need as "selfish". This is an introjected value; explore it (4.22). It is working when the client states a need with some firmness.

4.21 Working with imagery and metaphor

Purpose / when: To deepen awareness and help the client say what is hard to put into literal words [source: CfD specific competences 2 and 3].
Steps: (1) Notice the client's own images or offer one tentatively. (2) Check whether it fits their experience. (3) Develop it together: what it looks like, how it feels, what happens next. (4) Keep it tied to the client's experiencing, not to an abstract story. (5) Help them build personal metaphors for emerging new experience [specific competences 3].
Example language (illustrative): "You said it's like being under water. What's it like down there? Is there any light?"
Watch for: The therapist's metaphor taking over. It is working when the client develops the image themselves and new meaning appears.

D. Reflecting on and developing meanings (specific competences, section 3)

4.22 Exploring and revising core assumptions (including self-discrepancy and introjected values)

Purpose / when: When implicit beliefs about self, others or the world hold up the low mood, for example "I must never need anyone", or a gap between who the client is and who they or others think they should be [source: CfD specific competences 3; basic competences "Depression model"; Murphy 2019 ch. 3, pp. 47–49, self-discrepancy as a signpost, not a diagnostic tool].
Steps: (1) Listen for "should", "must" and "always" statements. (2) Reflect the assumption explicitly. (3) Explore where it came from and whose voice it is. (4) Explore what it costs the client. (5) Invite them to check it against their own lived experience. (6) Help them revise it in their own terms.
Example language (illustrative): "There's a strong 'I should cope on my own.' Whose voice does that sound like?"
Watch for: Drifting into disputing beliefs in a cognitive style. The aim is the client's own felt re-evaluation. It is working when the client loosens the rule, for example "maybe it's okay to…".

4.23 Developing alternative understandings and new narratives

Purpose / when: Mid to late therapy, once emotion has shifted [source: CfD specific competences 3].
Steps: (1) Notice new views as they emerge. (2) Help the client explore and weigh them. (3) Help them describe themselves and others in new ways. (4) Help them build a new story about their life.
Example language (illustrative): "A few weeks ago you described yourself as weak. Today you're describing someone who survived a lot. How does that fit?"
Watch for: Narratives that come from you. Premature positivity. It is working when the client tells a new, more complex story in their own words.

4.24 Testing new meanings in context and action

Purpose / when: To consolidate change [source: CfD specific competences 3].
Steps: (1) Check the new meaning against how it feels inside. (2) Explore what follows from it. (3) Re-examine behaviour and consider alternative actions where appropriate. (4) Weigh the new view against the client's social context, values and life goals.
Example language (illustrative): "If it's true that you deserve support, what might you do differently with your partner this week?"
Watch for: Plans that are yours rather than the client's. It is working when the client reports acting differently and observing what happened.

E. Marker-guided tasks (specific competences section 4; Murphy 2019 ch. 3; Haake 2017)

4.25 Problematic reactions: reconstructing the situation

Marker: The client describes their own reaction as puzzling, out of character, or too strong or too weak for the situation ("I don't know why I snapped") [source: CfD specific competences 4; Murphy 2019 ch. 3, p. 55].
Steps: Sequence from the competences: (1) Recall how they felt just before the situation. (2) Re-imagine the scene vividly in the present tense. (3) Find the exact moment the reaction was triggered. (4) Explore the reaction itself. (5) Link it to how they took in the situation, its meaning for them. (6) Develop a new understanding of the situation and of themselves. The task resembles EFT's systematic evocative unfolding; the CfD sources do not use that name [uncertain].
Example language (illustrative): "Let's go back to just before your boss came in. How were you feeling? … And then what caught your attention?"
Watch for: Rushing to explanation. The breakthrough is usually a personal meaning of the trigger (for example, being dismissed again). It is working when the client says "so that's why" and is less self-critical.

4.26 Working with parts and self-critical splits

Marker: Conflict within the self, such as a harsh inner critic versus a collapsed or hopeless part, or two parts pulling in opposite directions; also stuckness and hopelessness [source: CfD basic competences "Depression model"; Murphy 2019 ch. 3, pp. 45–47, 51–54; Haake 2017].
Steps: (1) Reflect both sides of the split. (2) With permission, invite each part to speak in the first person. In CfD this often happens without chairs: Haake calls it "EFT without furniture", and the client's two hands can represent the two parts. Full two-chair work is EFT practice [uncertain: whether chairs are used varies]. (3) Bring out the critic's specific messages and the tone it uses. (4) Ask the criticised part how it feels hearing them, and what it needs. (5) Give each part equal empathy. Explore the critic's protective function [Haake 2017]. (6) Follow the dialogue until it softens or gets to a new understanding. (7) Debrief.
Example language (illustrative): "Could you let this hand be the part that says you're pathetic? What does it say to you? … And this other hand — how does it feel hearing that?"
Watch for: The therapist rescuing the client from the critic or arguing with it [Haake 2017]. The client becoming overwhelmed or ashamed (4.15). It is working when the critic softens, the criticised part stands up for itself, or compassion appears (in Haake's case example, a frustrated part became encouraging).

4.27 Unfinished business

Marker: Lingering, unresolved feelings such as hurt, resentment, grief or guilt towards a significant other, past or present [source: Murphy 2019 ch. 3, p. 57; Haake 2017]. Some clients resolve this within the relationship itself. Others need more active methods [Murphy 2019 ch. 3, p. 58].
Steps: (1) Reflect the unresolved feeling and the person it concerns. (2) With permission, invite the client to imagine the person present, with vivid detail [experiential specificity]. (3) Invite them to speak directly to that person, to "speak their truth" [Haake 2017]. (4) Help them express the unexpressed feelings and the unmet needs. (5) Where useful, invite them to voice the other's possible response, then respond to it. (6) Follow towards letting go, holding the other accountable, or a new understanding. (7) Debrief.
Example language (illustrative): "If your dad could hear you now, what would you want him to know?"
Watch for: Re-traumatisation with abusive others: titrate, use 4.15, and get consent. Getting stuck in complaint without contact with the underlying hurt or need. It is working when anger becomes assertive rather than helpless, grief is allowed, or the client feels more separate. Haake's case examples show anger becoming protective, and an apology bringing a sense of forgiveness.

4.28 Meaning protest

Marker: A cherished belief has been violated, for example "I gave everything and he still left", leading to outrage followed by collapse [source: Murphy 2019 ch. 3, p. 56].
Steps [synthesis built from Murphy's description, pp. 56–57, that naming the protest and expressing the outrage can bring release]: (1) Reflect the shattered belief explicitly. (2) Validate the protest. (3) Invite the client to fully express the outrage or anguish. (4) Explore what the belief meant to them. (5) Help them re-evaluate it in their own terms (4.22).
Example language (illustrative): "You believed that if you were loyal, you'd be safe. And that turned out not to be true. No wonder you're so angry."
Watch for: Hurrying the client towards acceptance. It is working when the outrage gives way to grief and then to a revised view.

F. Ending

4.29 Ending therapy

Purpose / when: In the final phase. Raise it well before the last session [source: CfD basic competences "Ending therapy"; clinician guide "Concluding"].
Steps: (1) Recognise readiness together: the client is looking back, naming gains and thinking about the future. (2) Raise the ending when appropriate and agree how it will happen. (3) Review progress, including the measures. (4) Develop strategies for change and plans for action. (5) Review future prospects in the client's social context. (6) Invite anything still unsaid, and feelings about ending: sadness, loss, dependency. (7) If the session limit, not the client, set the timing, talk this through openly in a way that supports autonomy. (8) Discuss options for further help where needed.
Example language (illustrative): "We've got three sessions left. How does it feel to think about stopping? … What would you want to make sure we look at before then?"
Watch for: Avoiding the ending (both parties). A sudden rise in symptoms near the end. It is working when the client can describe what has changed and how they will look after it.

5. Handling problems

The sources say little about troubleshooting. Each item below is tagged with its source; [synthesis] marks my own guidance, consistent with the competences and PCEPS.

5.1 Stuck client (circular storytelling, no movement)

Check you are tracking core meaning rather than surface content (PCEPS items 1 and 9) [source: PCEPS-10]. Move from abstract to specific episodes (4.13) [synthesis].
Look for an unnoticed marker: a split, unfinished business, a puzzling reaction or a meaning protest. Murphy describes stuckness and hopelessness as signs of conflict between parts of the self [source: Murphy 2019 ch. 3; basic competences].
Revisit the focus and goals together (4.2). Metacommunicate about the stuckness (4.10) [source: clinician guide; synthesis].

5.2 Avoidance; the client declines process invitations

Respect the refusal: the client chooses whether to follow an invitation [source: Haake 2017]. Explore what makes the feeling hard to approach, and the history and cultural attitudes behind that (4.14) [source: specific competences 1].
Treat avoidance as protective. Go at a slower pace, and use empathic tracking until there is enough safety [synthesis].

5.3 Emotional overwhelm in session

Lower arousal: calm presence, grounding, containing imagery, self-soothing, cutting the problem down to size (4.15) [source: specific competences 1; Murphy 2019 ch. 3].
Leave 10 minutes before the session ends to bring arousal down and debrief. Check risk if despair rose. Next time, raise the task gradually, with consent [synthesis].

5.4 Flat, numb or over-regulated client

Use the evoking methods (4.16) and the body (4.11). Accept that over-regulation is the depressive process itself, not resistance [source: specific competences 1; basic competences depression model].
Watch for depressive retardation that is severe enough to limit engagement. Consider stepping up or medical review [synthesis].

5.5 Ruptures (withdrawal or confrontation)

Signs: quieter compliance, missed sessions, criticism of you or the therapy. Respond with metacommunication (4.10): name the shift, invite the client's view, acknowledge your part without defensiveness (congruence), and adjust [source: clinician guide metacompetences; basic competences congruence — "non-defensive"; specific steps synthesis].
A common CfD-specific cause is that process guidance has been felt as pushing or as the therapist dominating (PCEPS item 7). Go back to following [synthesis].

5.6 Client wants advice, techniques or homework

Explain the rationale again (4.1) and acknowledge the wish. Explore the need under it, such as feeling helpless or wanting expert reassurance [synthesis].
Advising and reassuring count as content directiveness on the PCEPS [source: PCEPS-10 item 5]. Action planning still has a legitimate place in 4.24 and 4.29 [source: specific and basic competences].
If the client clearly prefers a structured approach, review modality choice with the service (CBT and other NHS Talking Therapies options) [synthesis].

5.7 Harsh inner critic, and the therapist's pull to rescue

Resist arguing with the critic or rescuing the client from it. Give the critic equal empathy and explore its protective function [source: Haake 2017].
If the critic is crushing, first build compassion and self-soothing (4.15), then return to dialogue (4.26) [synthesis].

5.8 Non-attendance and drop-out (non-adherence)

CfD has no homework, so "non-adherence" mostly means missed sessions or measures [synthesis].
Contact the client warmly and without blame. Explore what got in the way, including an unvoiced rupture (5.5) or fear of feelings, and renegotiate pace or focus. Follow service DNA policy [synthesis].
Missed sessions can also signal rising risk; check [synthesis].

5.9 Risk escalates during therapy

The metacompetences require balancing non-directiveness against the need to intervene on risk [source: clinician guide].
Assess directly, safety plan (lethal-means counselling covers storage and removal only), inform the clinical lead, consider stepping up, and stay empathically connected (4.3) [synthesis following standard practice].

5.10 Session limit reached; client not ready

Discuss the ending openly when the client had no informed choice about timing, in a way that supports progress. Explore options for further help [source: basic competences "Ending"]. Aim for greater autonomy for clients not ready to end in the brief frame [source: clinician guide].
Name the session limit from session 1 and mark the count at reviews. Agree with the service whether to extend within the 20-session ceiling, or to step up or refer [source: clinician guide for the ceiling; extension decision synthesis].

5.11 Severity or complexity beyond scope

The framework was written for subthreshold, mild or moderate depression [source: clinician guide]. PRaCTICED used it at step 3 for moderate–severe [source: PRaCTICED].
If depression is severe, bipolar features appear, or psychosis, substance dependence or high risk are present, review with your clinical lead. Knowledge of other mood disorders is a generic competence [source: clinician guide; action synthesis].

5.12 Client finds focusing, parts work or imagined-other work strange

Not all clients find focusing helpful [source: Haake 2017]. Offer a lighter version: talk about the part rather than as it, or use hands instead of chairs [source: Haake 2017 for hands; rest synthesis].
Explain the purpose briefly. Always offer a way out, and treat a "no" as useful information [synthesis].

5.13 Cultural and family norms about emotion

The competences ask you to explore how cultural or family attitudes shape avoidance of feelings, and to value diversity equally [source: specific competences 1; basic competences].
Adapt the form of emotional expression, for example quieter acknowledgement rather than cathartic expression, without assuming the norm is pathological [synthesis].

5.14 Therapist drift: too classical or too directive

CfD sits between classical non-directive practice and EFT process guidance. Counsellors may find the two in tension or find the new concepts confusing [source: Haake 2017].
Use recordings rated against the PCEPS in supervision. Low Emotion Focus or Experiential Specificity scores suggest too little guidance. High Content Directiveness or Dominance scores suggest too much [source: PCEPS-10; supervision use synthesis].
PRaCTICED reported a mean adherence just under its pass mark, alongside less supervision than the IAPT manual stipulated. Protect regular supervision [source: PRaCTICED author version].

5.15 Dependency or distress about ending

Work through feelings about ending (sadness, loss, dependency) explicitly in the final phase, and review gains and plans (4.29) [source: basic competences].
If symptoms rise near the end, treat this as ending-related material first, while checking risk [synthesis].

Sources

Sources: