Chapter 14: Kelly – Personal Construct Theory
Part 3: The Role of the Psychotherapist
Kelly was first and foremost a clinical psychologist, and his writings are full of practical examples related to clinical work. Theories are of little value unless they are rooted in the values of the psychologists using them. Kelly considered this to be particularly true of clinical psychologists, since they are routinely dealing with clients (Kelly, 1955b). Kelly believed that the role of the psychotherapist involves not only the training and perspectives of the therapist, but also a need to understand the client, and essential ethical considerations:
The role of the psychotherapist involves keen alertness to what the client expects from psychotherapy and the initial acceptance of a wide variety of client misperceptions of what psychotherapy is…it involves certain ethical obligations that transcend mere legal status. (pg. 618; Kelly, 1955b)
In his typically practical style, Kelly provides lengthy lists of what psychotherapy means to the client, the client’s conceptualization of the therapist, the clinician’s conceptualization of their role, and basic approaches to revising the client’s constructs. At the beginning of therapy, it is unlikely that the client has a good concept of what therapy is and what it can accomplish. Nonetheless, the client has some construction of what will take place in therapy. The complaint presented by the client says something about what he or she thinks therapy can accomplish, and some see therapy as an end in itself. However, the reality is that therapy is a means to an end, and that end should be generating movement forward on the part of the client. In contrast, some clients are so ready for change that the therapist must be cautious in interpreting the client’s state of mind (Kelly, 1955b). Just as the client makes predictions about therapy, they will also have an initial conceptualization of the therapist. They may construe the therapist as a parent, an absolver of guilt, a companion, or even a threat. Hopefully, according to Kelly, the client may construe the therapist as a representative of reality. In this case, the client may feel free to experiment with his or her constructs without fear of failure. Most importantly, how the client construes the therapist will have a dramatic effect on their relationship:
From the client’s conceptualization of psychotherapy comes the role he expects to play and the role he expects the therapist to play…He may be bitterly disappointed in the therapist’s enactment of the expected role. He may stretch his perceptions of the therapist in order to construe him in the manner he expected to construe him rather than in the manner the therapist seeks to be construed….The client may then feel lost and insecure in the psychotherapeutic relationship. (pg. 575; Kelly, 1955b)
As the client is engaging in these processes, the clinician is also conceptualizing their own role. Overall, the goal of any therapist should be to assist in the continuous reconstruction of the client’s construct system, and the changes that take place in therapy should set the stage for continued reconstruction after therapy has been discontinued. Initially, the therapist may rely on a variety of techniques to accomplish superficial reconstructions. The therapist needs to be patient, and initially must accept the client’s construct systems as they are. The latter point is quite similar to the empathy described by Carl Rogers in humanistic, client-centered therapy, and Kelly does indeed use the word “empathize” in his own writings. As therapy progresses, the therapist needs to help the client select new conceptual elements, accelerate the tempo of the client’s experience, and design and implement experiments. Finally, the therapist serves to validate the client’s experiments as they attempt to reconstruct their construct systems (Kelly, 1955b).
Psychological Assessment Within Personal Construct Theory
Kelly believed that therapy was a joint effort between the therapist and the client, and since the goal was the ongoing reconstruction of the client’s psychological systems (even after therapy), the client ultimately needs to become his own therapist. Therefore, the psychotherapeutic interview (Note: by “interview,” Kelly means what we would commonly call a therapy session) becomes an essential part of therapy. Throughout the process of the interview, the therapist makes decisions regarding the course of the interchange between the therapist and the client. Overall, the decisions made by the therapist are tailored to the specific client, but still the therapist must remain in control of the interview. This requires that the therapist plan for the interview. Those plans include how often to interview the client, how long the interviews should last, the tempo of the interview, and when to terminate the interview. Since the client continues to live their life outside of the interview room, the therapist must also consider whether special circumstances will require special interview plans (Kelly, 1955b, 1958). One of the most practical aspects of the interview is that the client can simply provide information needed by the therapist, to a point.
The Role Construct Repertory Test (Rep Test) was developed by Kelly in order to understand how a client’s personal constructs influence their personal-social behavior. The client begins with a Role Title List, on which they list the names of important people in their lives (see Table below). The names are then grouped three at a time, and the client is asked to describe in what important way two of the three individuals are alike but different than the third person. A more organized form of the Rep Test, particularly useful for research purposes, involves creating the Repertory Grid. Once again, the client is asked to identify significant people in their life. The grid provides three-person pairings that address various relational factors (family, intimate friends, conflicted relationships, authority figures, and values), and as before, the client provides a construct that associates two of the people yet distinguishes them from the third. The common factor is listed as the emergent pole, the distinguishing factor is listed as the implicit pole. The Rep Test does not result in specific outcomes, so its interpretation is also subject to different methods. If the Rep Test is interpreted formally, it will provide results on the number and range of constructs present within the client’s construct systems. In the hands of an experienced and skilled examiner, information can be gleaned on the equivalence of constructs, thus providing deeper detail on the effective range of the client’s construct system. As more information is obtained from the Rep Test, the better able the therapist will be to guide the therapeutic process (Kelly, 1955a).
| The Role Title List Used for the Personal Construct Repertory Test |
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Fixed-role therapy is a technique derived from personal construct theory. First, the client prepares a self-characterization sketch, a technique in which the client is asked to write a character sketch about themselves as if they were the principal character in a play, but written as if by a friend who knows the client well. Using information from the self-characterization sketch, as well as from interviews and perhaps the Rep Test, the therapist then writes a fixed-role sketch. The client is asked to act out the fixed-role sketch over a period of weeks. Initially, Kelly and his colleagues emphasized minor changes in the client’s construct systems. However, they later found that it is often easier for a client to play out roles that are the opposite of their usual constructs, rather than making only minor changes in their behavior. Over time, it is expected that the client will learn that the new construct systems are more predictive than their old construct systems, and the fixed-role therapy will establish an ongoing process of reconstruction within the client (Kelly, 1955a).
Kelly’s fixed-role therapy requires the client to write a script for how they want to live their life. He found that sometimes it was easier for his clients to act out the opposite of their typical behavior. Would you find it easier to make minor changes in your behavior, or easier to make dramatic changes?
Connections Across Cultures: Understanding Culture’s Effects on Cognitive Style as a Prerequisite for Effective Cognitive-Behavioral Therapy
An essential element of all cognitive therapies is the desire to identify and challenge a client’s underlying dysfunctional cognitions, whether they are mistaken beliefs, schemas, automatic thoughts, cognitive distortions, whatever the case may be. To do so requires that the therapist knows when cognitions are dysfunctional, and to some extent, what would be a reasonable cognition in the client’s personal situation. While it may seem obvious that any psychologically healthy person, particularly a trained therapist, would be able to recognize the difference between functional and dysfunctional thoughts, feelings, and behaviors, this assumes that the therapist and the client come from similar environments. This may very well not be the case when the client and the therapist come from dramatically different cultures. Furthermore, as G. Morris Carstairs noted regarding psychiatric interviews (1961), it makes a significant difference whether it is the therapist or the client who is outside of their familiar culture. For example, when a psychologist conducts research in a foreign country, particularly in small towns or villages, local people may simply fear and avoid strangers.
Kelly discussed culture at length in The Psychology of Personal Constructs (Kelly, 1955a,b). Both the commonality corollary and the sociality corollary are directly influenced by our understanding of culture. We, and by “we” I mean to include therapists, tend to expect that people from similar cultures have experienced basically similar upbringings and environments. We also tend to believe that people from a given culture share their expectations regarding the behavior of others from that culture. Thus, in order for the therapist to gain access to the personal constructs of their client, it is important for the therapist to learn as much as possible about the client’s cultural heritage. Failure to do so may interfere with the therapist’s ability to understand some of the client’s disruptive anxieties about either therapy itself or their life in general. Indeed, Kelly shares an example in which a White therapist (whom Kelly was supervising) found it difficult to help a Black client, because the Black client was overly anxious about discussing racially charged feelings regarding interracial sexual relationships. Since the client had discussed sexual issues before, the White therapist did not readily recognize the discomfort with which the Black client addressed his attraction to White women (remember, this was in the 1950s!).
Kelly goes on to discuss cultural differences in mannerisms, language, expectations regarding mental illness, the influence of religion, and how a therapist might go about learning more about a client’s cultural experiences. He does caution, however, that one should not attribute too much value to the influence of culture:
…It is important that the clinician be aware of cultural variations. Yet, from our theoretical view, we look upon the “influence” of culture in the same way as we look upon other events. The client is not merely the product of his culture, but it has undoubtedly provided him with much evidence of what is “true” and much of the data which his personal construct system has had to keep in systematic order. (pg. 688; Kelly, 1955b)
For example, it is often considered the mark of a sophisticated clinician that he considers all of his clients in terms of the culture groups to which they belong. Yet, in the final analysis, a client who is to be genuinely understood should never be confined to the stereotype of his culture. (pg. 833; Kelly, 1955b)
Albert Ellis and Aaron Beck, originators of the best known cognitive-behavioral therapies (see Beck & Weishaar, 1995; Ellis, 1995), also discussed cultural influences, though not as extensively as Kelly had. Ellis emphasized that each individual develops a belief system which helps them make judgments and evaluate situations. Although each person’s belief system is unique, they share many beliefs with other members of their society and/or culture. Perhaps more importantly, different cultures can have very different belief systems. To complicate the situation even further, cultural beliefs can change, either due to gradual evolution of the culture or in a more dramatic fashion when an influential thinker or leader offers a different perspective on life (Ellis, 1977). Beck has discussed how culturally-determined schemas can be so fundamental that they contribute to how and who we both love and hate (Beck, 1988, 1999).
Today, studies on the relationship between culture and cognition continue, both in clinical and non-clinical settings. There are at least two handbooks focusing on cross-cultural and multicultural factors in personality assessment (Dana, 2000; Suzuki, Ponterotto, & Meller, 2001). According to Suzuki, et al. (2001), these handbooks are necessary due to “the growing number of racial and ethnic minorities in the United States and in recognition of the multitude of variables that affect performance on cognitive and personality tests…” As assessment transitions to therapy, it becomes quite a challenge for any therapist to be familiar with the wide variety of cultures in America. Axelson (1999) has identified six basic cultural groups in America: native Americans, Anglo-Americans, European ethnic Americans, African Americans, Hispanic Americans, and Asian Americans. This list obviously does not include the many immigrants living in this country who are not considered to be American. When faced with such cross-cultural challenges, the essential skills for a therapist include careful and active listening, genuine verbal and nonverbal responses that indicate successful communication, being honest about what you do not understand, respecting and caring about the client, and being patient and optimistic (Axelson, 1999).
Additional studies have suggested that cultural knowledge influences the interpretation of stimuli in a dynamic, constructivist fashion (Hong, Morris, Chiu, & Benet-Martinez, 2000), that these processes occur automatically (Bargh & Williams, 2006), and that experiencing a wider variety of cultures in one’s education may actually lead to more complex cognitive processing (Antonio, Chang, Hakuta, Kenny, Levin, & Milem, 2004). When considering fundamental cultural differences, what some consider the core values that distinguish amongst cultures, most psychology students are familiar with the distinction between individualistic and collectivistic cultures (cultures in which one favors one’s own goals as compared to subordinating one’s own goals in favor of group goals). However, Laungani (1999) suggests that there are three other common dimensions: free will vs. determinism, materialism vs. spiritualism, and cognitivism vs. emotionalism. According to Laungani, Western cultures tend to be work- and activity-centered. Thus, they operate in a cognitive mode that emphasizes rational, logical, and controlled thought and behavior. Non-Western cultures, in contrast, tend to be relationship-centered, operating in an emotional mode. Public displays of feelings and emotions, both positive and negative, are not frowned upon (Laungani, 1999). These core values carry over into cognitive styles. For example, the cognitive style prevalent in Africa tends toward synthesis, as opposed to analysis. Africans tend to integrate their experiences into an inclusive whole, and they view such tendencies as more natural than the typical Western alternative (Okeke, Draguns, Sheku, & Allen, 1999). Thus, one can imagine a therapeutic situation in which the client resists analyzing their problems, and the therapist considers that resistance to be a specific problem unique to the client. Any subsequent attempts by the therapist to break down that resistance would be flawed, since the therapist has not understood the underlying cognitive style of the client. The failure of therapists to properly address the significance of cultural factors in therapy, regardless of whether or not their failure was unintentional, has been described as cultural malpractice (Iijima Hall, 1997).
Supplemental Materials
This video [3:34] summarizes the application of George Kelly’s theory, summarizing threat, guilt, anxiety and fear, as well as describing the approach to psychotherapy based on Kelly’s theory.
Source: https://youtu.be/Dqcl-mxtA5k
References
Text: Kelland, M. (2017). Personality Theory. OER Commons. Retrieved October 28, 2019, from https://www.oercommons.org/authoring/22859-personality-theory. Licensed under CC-BY-4.0.
Moi Lim. (2016, December 10). Applications of George Kelly. [Video File]. Retrieved from https://youtu.be/Dqcl-mxtA5k. Standard YouTube License.