PCE2006
7th World Conference for
Person-Centered and Experiential Psychotherapy and Counseling

July 12–16, 2006, Potsdam, Germany

 

Topic:
The "Fully Functioning" Person, Congruence, Health, "Therapy Theory"

 

 

Symposia, Paper Sessions, Workshops, Round Table Discussion Groups:

 


Lecture: Human relationship: Linkage or life form?

Godfrey T. Barrett-Lennard
Ph.D., Honorary Fellow, School of Psychology, Murdoch University Perth, Australia, Postal (home) address: 110A Empire Ave., Wembley Downs, WA 6019, Australia, Phone: +61(0)8 9245 1700, Fax: +61(0)8 9245 5875, E-Mail: gt_barrett-lennard@iinet.net.au or G.Barrett-Lennard@murdoch.edu.au, Web:  http://www.psychology.murdoch.edu.au/staff/barrett-lennard.html

Abstract:

This paper searches beyond the level of our current theories to freshly ask "What is the phenomenon of human relationship, in its basic nature?" Two approaches to grasping its essence are distinguished. These approaches position the connection between person and relationship in distinctively different ways and have differing implications for the meaning of health in human life, and for the focusing and scope of helping practise.

In the first view, relationship is something that happens between the participants. Persons tend by nature to forge relational connections and each relation resides in the experience and interaction of the participants. A relationship amounts to an investment of self by the members, who remain the causative players in the continuance and the quality of their relation. Thus, persons are the agents of a relationship in its beginning, development, attenuation or ending.

In the other view, relationship itself is an emergent process entity that comes to have presence, life and influence. Within a relationship, each person is dynamically positioned at a level in between that of the subsystems of their organism (which in their intricate connective processes have given rise to the person whole) and the level of the emergent relational whole. Persons and their formed relational systems are interdependent.

The latter view implies that human problems essentially are problems in and of relation, at many interwoven levels (e.g., from subself to large system relations). Health of being is moved beyond its traditional locus in a bounded self and understood to pivot on health in relationship – with pervasive implications for person-centred theory and practice.


Lecture: Experiencing self-worth in biography and mental well being – empirical outcomes based upon the person-centered approach

Martina Becker
University of Vienna, Department of Educational Sciences, Garnisongasse 3, 1090 Vienna, Austria, phone: +43-1-4277-46793, e-mail: martina.becker@unvie.ac.at

Abstract:

In the person-centered approach the biographical aspects in the development of an individual’s personality have not been researched a lot so far. The lecture will include therefore empirical reports to the connection between experiences of ones life history and mental well being as well as other category groups which will be all discussed against the background of the person-centered approach.

Starting from a qualitative research where people were interviewed about experiences in their biography where they have had the feeling of self-worth, quantitative coherences were calculated between the reported experiences and measures for mental well being, satisfaction with life, congruence, the ability to symbolise experiences, emotional regulation, self-concept and interpersonal relations. The results approved the outstanding importance of appreciating, empathical and authentical relationship experiences in the course of biography and suggest that they are even more important as other reported worth-imparting experiences.The empirical results demonstrate the necessity of a increased attention towards the importance of biographical experiences within the build up of person-centered theory and practice.

 

Vortrag: Werterleben in der Biographie und seelische Gesundheit – empirische Ergebnisse auf der Grundlage des personzentrierten Ansatzes

Martina Becker
Universität Wien Abt. Erziehungswissenschaften, Garnisongasse 3, 1090 Wien, Österreich, Telefon: +43-1-4277-46793, e-mail: martina.becker@unvie.ac.at

Abstract:

Bisher wurden biographische Aspekte der Persönlichkeitsentwicklung im personenzentrierten Ansatz eher weniger erforscht.

Im Rahmen des Vortrages sollen daher empirische Befunde zum Zusammenhang zwischen lebensgeschichtlichen Erfahrungen und seelischer Gesundheit sowie weiteren Bereichen erörtert und vor dem Hintergrund des personenzentrierten Ansatzes diskutiert werden.

Ausgehend von einer qualitativen Untersuchung in der Personen nach lebensgeschichtlichen Erfahrungen befragt wurden, bei denen sie den eigenen Wert erfahren haben, wurden quantitative Zusammenhänge berechnet zwischen den berichteten Erfahrungen und Maßen für seelische Gesundheit, Lebenszufriedenheit, Kongruenz, Symbolisierungsfähigkeit, Emotionsregulation, Selbstkonzept und interpersonelle Beziehungen.

Die Ergebnisse bestätigen die herausragende Bedeutung von wertschätzenden, empathischen und authentischen Beziehungserfahrungen im biographischen Verlauf und zeigen diese als bedeutsamer als andere berichtete wertvermittelnde Erfahrungen.

Die empirischen Befunde legen die Notwendigkeit einer vermehrten Beachtung der Bedeutung lebensgeschichtlicher Erfahrungen bei der personenzentrierte Theoriebildung und Praxis nahe.


Lecture: Experiencing value in the biographical retrospection

Martina Becker
University of Vienna

Abstract:

In the development of an individual’s personality it is of particular importance to experience self-worth. Researches into the person-centered approach by Carl Rogers have shown that relationships in which empathy, a sense of acceptance and congruence are present support personal development, as well as the quality of human relations. At the same time Carl Rogers suggests that a relationship, in which one feels a strong sense of worth, encourages an independent and mature organismic valuing process. The present study documents the biographies of value experiences of twenty adults which were interviewed and the results analysed after the method of the "Personal Conversation" by Inghard Langer, professor at the University of Hamburg and research-partner of Reinhard Tausch. The underlying theoretical concept is the "Authentical Science" by Robert Hutterer, professor at the University of Vienna, and the concept of "Tacit Knowledge" by Michael Polanyi. The results of this study show that self-worth can be experienced in many different aspects of life. The interviewees mentioned: relationships to family members, experiences in groups, school, university, work, leisure, church, as well as looking after oneself, experiencing ones body and experiencing privacy. Following, the empirical results will be discussed in relation to the person-centered theory. Finally, the overall usability and generality of the results will be discussed.


Lecture: Nondirectivity and counseling

Arthur C. Bohart
Saybrook Graduate School and Research Center, e-mail: ABohart@saybrook.edu

Abstract:

In this presentation I hope to shed light on the meaning of nondirectivity from recent research on several of Carl Rogers' tapes. Nondirectivity has to do with intention, as numerous writers have argued. It does not have to do with impact. Of course therapists influence their clients. However there is a difference between someone who is intending to allow clients as much freedom as possible to explore their own worlds and those who intend in various ways to direct, influence, or shape. This is common sense and anyone who doubts this should think of the difference between someone who has "just listened" to you versus a strict school teacher or moralistic leader. To claim that "all is directivity" obfuscates crucial and key differences in human experience. All is not directivity: there is a world of difference between Carl Rogers doing therapy and Fritz Perls or Aaron Beck, as our data illustrate. Intention is key. This also does not mean that the therapist's responses will be devoid of the therapist. This is impossible. Therapists, even if intending to be nondirective and empathic, must "make" their responses out of the materials available to them: their own prior personal experience, their own ongoing experience with the client, their own prior experiences with other clients, and their own concepts. What is key to nondirectivity is listening and testing.

Nondirectivity needs to be thought of like science: as an ongoing process. Having delineated the nature of nondirectivity, I will conclude with a an argument for the importance of preserving a nondirective approach in an age when it could disappear due to concepts like "best practices" and "evidence-based therapy," concepts which serve to impose conformity rather than preserve the diversity inherent in the concept of nondirectivity.


Lecture: Working at relational depth

Mick Cooper 
Ph.D., UKCP Reg., Reader in Counselling, University of Strathclyde, 76 Southbrae Drive, Glasgow G13 1PP, phone: 0141-950 3361, fax: 0141-950 3329, mobile: 07734-558155, e-mail: mick.cooper@strath.ac.uk

Abstract:

What does it mean to meet another human being at a level of depth? What is the experience of intimate encounter and what is its place in person-centered and experiential psychotherapy? Drawing on theory and research from the recently published Working at Relational Depth in Counselling and Psychotherapy (Dave Mearns and Mick Cooper, Sage, 2005) this paper will present an in-depth examination of the phenomenon of relational depth and offer participants an opportunity to engage in an extended and critical discussion of this analysis. Issues that will be addressed include: the nature and definition of an in-depth encounter, therapists’ and clients’ experiences of relational depth, a relational perspective on psychological distress and its development, and the potential therapeutic value of a relationally-deep meeting. The presentation will also explore the growing development of a relational, intersubjective thread within the Person-centered and Experiential field.


Lecture: From symptom to self in experiential psychotherapy

Frans Depestele
MD., MA., Psychiatrist-psychotherapist, Master in Philosophy, Grotstraat 100, B-3200 Aarschot, Belgium, e-mail: frans.depestele@skynet.be

Abstract:

Therapy tries to bring the client from blockage to inner freedom. A blockage occurs for example when a client says about a painful experience: "I must be able to accept that", so addressing themselves at the same time as suppressing the experiencing that cannot accept that. The same kind of thing seems to occur when a severe inner critic is at work, when an urge comes up to ask for reassurance or to reassure oneself, or an urge to overeat, or intrusive thoughts after a trauma, and also in more complex symptoms such as a delusion or a hallucination. Here the term "symptom" refers to small and big process blockages.

The leading hypothesis is that all symptoms have a similar form. Symptoms are de-self-ing: a part of the self is occupied by an urge (e.g. "I must be able to accept that") while another part of the self is prevented to "speak" (e.g. the experiencing that cannot accept that) and to come into existence. Complementary the aim of therapy will be to free the occupied part of the self (to free occupied self), and to give the suppressed part of the self an opportunity to come into existence (to form new self). These changes of the self go hand in hand with changes of the symptom.

The interplay between symptom and self will be explained – also with therapy examples – and laid open in such a way that, I hope, important leads for experiential therapy work will become visible.


Workshop: Two Rogers and congruence: The emergence of therapist-centered therapy and the demise of client-centered therapy

Marvin Frankel, Ph.D., Sarah Lawrence College, New York, e-mail: mfrankel@slc.edu

Lisbeth Sommerbeck, M.Sc., Bornholm Psychiatric Center, Denmark, e-mail: kws@privat.dk

Abstract:

In this presentation, we would like to demonstrate that person-centered therapists, as well as psychoanalysts, commit the category error and, in so doing, hopelessly confound the rules of their therapeutic discourse: The distinguishing features of psychoanalysis and person-centered therapy cease to exist. We will explain what it means to commit the category error and examples from psychoanalysis as well as from person-centered therapy are offered to illustrate how widespread this error is. More specifically, we will argue that in committing the category error by introducing therapist congruence as an independent therapeutic agent, Rogers’ theory of therapy changed radically from his pre-Wisconsin years to his post-Wisconsin years. We will also show that the reasons for this change in Rogers’ thinking shall be found in the therapists’ difficulties with the client-population of the Wisconsin research.


Lecture: "Kibanteki Seimei Kankaku" as new concept in psychotherapy: a comparison with the concept of "experiencing"

Hiroaki Kuwano
Psychotherapist, Kyushu Sangyo University Counseling Center, Royal hills # 405,5-24-12, Morooka, Hakata-ku, 816-0094 Fukuoka-si, Japan, e-mail: hiro.k@cronos.ocn.ne.jp

Abstract:

During Focusing sessions, we sometimes come across with a moment when the Focuser spontaneously goes forward to a positive direction using his/her own energy and/or his/her negative experience turns out to a positive experience. This is a life phenomena which often occurs outside of the listener’s expectation, and the Focuser describes this experience as "I feel a kind of warm sense inside, I can feel something bright". This is a new phenomena which could not be well explained by the traditional Experiencing theory.

In order to explain this phenomena, this study presents a new concept called "Kibanteki Seimei Kankaku" (fundamental life energy). It was assumed that this "Kibanteki Seimei Kankaku" or KSK is different from the change occurs in traditional focusing sessions from two points: ?it is not connected with a specific problem,?it does not require insight for a therapeutic change to happen. In other words, KSK is more body-centered and non-verbally oriented. KSK can contribute to clarify the therapeutic change which takes place at a somatic level and/or is harder to verbalize.

Furthermore, this study compared the case done by Gendlin with the case done by the author to illustrate the originality of KSK in a concrete way. This study showed the promising possibility of KSK as a variable to describe new aspect of therapeutic change.


Lecture: Honorific animals in traditional Africa: An intercultural re-reading of Carl Rogers’ theory of the healthy personality

Prof. Augustine Nwoye, PhD
Chairman, Department of Psychology, Kenyatta University, Nairobi, Kenya, East Africa

Abstract:

The major purpose of this paper is to demonstrate that Carl Rogers’ theory of characteristics of the fully functioning persons has its equivalent in the psychological characterization of honorific animals in traditional Africa. The paper intends to name these animals and the aggregated psychological attributes with which they are associated in the traditional African imagination. The paper argues that most of the characteristics of fully functioning persons incorporated in Carl Rogers’ theory are similar to the ones assigned to honorific animals in traditional African worldview. The paper concludes in favor of the deep intercultural relevance of Carl Rogers’ theory of the healthy personality. Aspects of African notion of the healthy personality not covered in the Rogerian model are also highlighted.


Lecture: "Focusing" and "working at relational depth": why do they help?

Campbell Purton
Centre for Counselling Studies, University of East Anglia, UK.

Abstract:

In his 1964 paper on "A theory of personality change" Gendlin suggested that the two most central factors in therapeutic personality change are that it (a) "involves some sort of intense affective or feeling process occurring in the individual" and that (b) it "occurs nearly always in the context of an ongoing personal relationship". In this paper I suggest first that much recent research confirms Gendlin’s view. I then relate Gendlin’s "feeling process in the context of an ongoing personal relationship" to the work of Mearns and Cooper on "relational depth", and then, drawing on Gendlin’s later work, consider what theoretical explanation can be given for the effectiveness of working in this way with clients.


Lecture: Being-with and being-counter, a person-centered view on in-depth interaction in the therapeutic relationship – Part I. From presence to dialogue: Therapy as co-creative process of personalization

Peter F. Schmid, Univ.Doz. HSProf. Mag. Dr., University of Graz; Saybrook Graduate School and Research Center, San Francisco; IPS Austria, Koflergasse 4, A 1120 Vienna, Austria, tel: +43 1 8123746, fax: +43 1 8124578, e-mail: pfs@pfs-online.at, www: http://pca-online.net; http://pfs-online.at

Dave Mearns, Prof., tel: +44 1324 840575, fax: +44 1324 840575, e-mail: dave.mearns@virgin.net, Internet: www.davemearns.com

Abstract:

The more experience we gather and the more research we carry out in psychotherapy and counselling the more almost all schools of psychotherapy come to regard the relationship as the core of the therapeutic endeavour. From transference theory to existential being-together, from a pre-condition for re-learning to systemic perspectives a multitude of theories try to explain its nature. With this presentation we continue our in-depth investigation of the essence, character and quality of this liaison.

The client experiencing their self-in-development and the presence of the therapist enable both to work at relational depth, i.e. to encounter each other person to person. One of the central aspects of such an authentic relationship is the character of therapist responses which derive from their counter-position in the "en–counter" with the client. Within an empathic frame of reference clients often feel profoundly understood by therapists taking the position of the Other in their interaction thus making parts of therapy truly a dialogue. In the first part of this Powerpoint presentation we further examine presence, different forms of resonance offered by the therapist to the client as well as confrontation and dialogue from a person-centered perspective. After the presentation we wish to discuss these developments with the audience.


Lecture: Being-With and Being-Counter, a person-centered view on in-depth interaction in the therapeutic relationship – Part II. Relational depth: The challenge of fully meeting the client

Dave Mearns, Prof., tel: +44 1324 840575, fax: +44 1324 840575, e-mail: dave.mearns@virgin.net, Internet: www.davemearns.com

Peter F. Schmid, Univ.Doz. HSProf. Mag. Dr., University of Graz; Saybrook Graduate School and Research Center, San Francisco; IPS Austria, Koflergasse 4, A 1120 Vienna, Austria, tel: +43 1 8123746, fax: +43 1 8124578, e-mail: pfs@pfs-online.at, www: http://pca-online.net; http://pfs-online.at

Abstract:

Following-on from part I ("From Presence to Dialogue: Therapy as co-creative process of personalization" – see Schmid & Mearns) this presentation continues our investigation of the "relationship" emphasis within person-centered therapy. It explores the concept of relational depth, especially in regard to work with "hard-to-reach" clients, outlining the particular challenges to the therapist seeking to engage the different parts of the client, even those in self-protective conflict with the therapeutic process. Our thesis is that this depth of encounter can help clients to engage with psychotherapy in a fashion that reaches far beyond their "presentational level" of self and may engage parts that are fundamental to their sense of their own existence as a human being.

Furthermore, we explore the ethical boundaries of therapeutic confrontation and dialogue that constitutes relational depth and develop criteria when confrontation and dialogue is person-centered and when it is not. Finally, we deal with the developmental agenda for the therapist, with particular attention paid to the therapist’s development of existential touchstones.

The Powerpoint presentation will be followed by a discussion with the audience.


Lecture: A differential view on health, and congruence

Gert-W. Speierer
Prof. Dr. med., Dr. med. habil. Dipl.-Psych., Head of Dep. Medical Psychology, University of Regensburg, Postbox, 93040 Regensburg, Germany, phone: +49 941 9433114, fax.: +49 941 9433127, e-mail: gert.speierer@biologie.uni-regensburg.de

Abstract:

Different concepts of health are presented and compared with humanistic and person centred approaches. They will be linked to the concept of congruence and health within the 'differential incongruence model'. The experiences related to the self, other persons, the personal, and societal environment which indicate health by their congruence or self compatibility have been empirically identified as 'congruence-dynamic'. They include extended behaviours and experiencing, motivation for new experiences, insight in and taking responsibility for symptoms and problems as well for their reduction, self-confidence, autonomy, self-acceptance, contentment, calmness, healthy attitude change, realistic evaluation of self, others, and situation; cognitive strategies to differentiate, narrow down, relativise; resistance towards strain, personal power, tolerance against own deficits and mistakes, organismic instead of socialised values, realistic instead of illusory aims; positive valuing, -evaluation of and -experiences with significant others.

They show realistic aims for counselling and psychotherapy and meet also many concepts of health from different backgrounds.

From this differential viewpoint beyond it's material needs a good and healthy life may be characterised by a societal and a personal dimension. First: Living in a society which allows predominantly self compatible experiences in comparison to self-incompatible aspects of life which cannot be avoided. Second: Personal prerequisites of a good life are social and personal resources which allow to cope with self endangering strain of life from outside and inside the individual. In a human social climate flexibility and freedom allow alternate evaluations of and to be open to experiences for new individual and social perspectives of personal growth and development.

Literature: Speierer, G.-W. (2005): Das Differenzielle Inkongruenz Modell (DIM). Handbuch und Arbeitsbuch der Personzentrierten Psychotherapie (Gesprächspsychotherapie) als Inkongruenz- behandlung. Mit personzentriertem Gespräch, Kategorien und Checkliste zur Inkongruenzanalyse, Regensburger Inkongruenz Analyse Inventar (RIAI) und Materialien zur Qualitätskontrolle: Therapiedokumentation, Prozess- und Ergebnis-Evaluation 2. A. auf CD-ROM, ã G.-W. Speierer, Regensburg, (1.A. 1994 Heidelberg: Asanger)


Lecture: The goals of psychotherapy

Per-Anders Tengland
PhD, Health and Society, Malmö University, Malmö, Sweden

Abstract:

There appears to be a conflict between the idea that the therapist should not have any goal or aims in mind for the client, a fundamental claim in person-centered psychotherapy, and the common sense idea that psychotherapy should lead to some changes beneficial to the client. This conflict rests on the failure to differentiate sufficiently between specific goals that therapists might have, goals that can vary immensely, and the general goals of psychotherapy as such.

The aim of the paper is to argue and to show that we can state the goals of psychotherapy in very general terms without this meaning that psychotherapists have to, or should, set specific goals for specific clients. Several possible goals are presented and discussed, e.g. health, quality of life, well-being, welfare, empowerment, and congruence. And finally, it is concluded that, although all the suggestions discussed have something speaking for them, quality of life (i.e. to "lead a good life") is the ultimate goal for psychotherapy, even if psychotherapy might only lead to it indirectly, e.g. through health or empowerment.


Lecture: Psychological Health: Autonomy and Homonomy

Keith Tudor
Temenos, Sheffield; Liverpool John Moores University

Abstract:

"Health is more difficult to deal with than illness" (Winnicott). This paper, presented in two parts, firstly discusses the concept of psychological or mental health, and secondly how this informs the process and outcomes of person-centred psychotherapy. In the first part, concepts of mental health are discussed with reference to philosophical traditions; the mental hygiene movement; different psychotherapeutic traditions; and person-centred psychology – in terms of congruence, openness to experience, psychological adjustment, extensionality, and maturity – and homonomy as well as autonomy. Drawing on the work of Angyal, whose ideas influenced Rogers, the trend towards homonomy or belonging is viewed as just as much a part of human existence as the trend towards autonomy, and as an integral, if overlooked part of the concept of the fully functioning, authentic human being. The second part considers the importance of viewing the client as both healthy and ill, or of having healthy processes alongside neurotic or psychotic ones, and that the process of psychotherapy is – or should be – as much concerned with uncovering patterns and processes of health as with acknowledging processes of defensive. The acknowledgement and reclaiming of a homonomic trend is central for an understanding of the fully functioning person and engaged citizen of today – and tomorrow – in an increasingly conflictual world in which dominant "Western" societies emphasise autonomy at all costs. In both parts of this paper, the centrality of the organism to person-centred theory and practice is emphasised. Within the presentation there will be time for questions and discussion.


Lecture: Values, culture and Rogers’ way of being

Margaret S. Warner
Ph.D., Illinois School of Professional Psychology of Argosy University/Chicago, e-mail: mswarner@ripco.com

Abstract:

We live in times of great cultural complexity in which human beings struggle to find shared ways of living that will preserve life on the planet. What, if anything, does the person-centered approach have to say on these questions of human culture and values?

Often in Rogers’ writing, culture and received values are presented as distinctly problematic, causing "conditions of worth" that make it difficult for individuals to find their "true self." But, at other places in Rogers’ writing, he takes a more nuanced view in which received culture and individual processing both exist in relation to universal aspirations implicit in human nature and operate in a complex dialectic with each other.

In this presentation, I will build on this second view to consider what person-centered theory might have to say about culture and values in modern times.


Lecture: A Person-Centered Conception of Health: Non-Directivity, Neuroscience and the Fully Functioning Person

Carol Wolter-Gustafson
Ed. D., Salem State College, U.S.A., E-Mail: carolwg@earthlink.net

Abstract:

In order to create a person-centered model of health and wholeness, we need to pay particular attention to the body's place within the theory. Client-centered therapy, with its precise attention to verbal expression, can replicate the tendency to relegate the body to its instrumental status. I will draw from person-centered theorists (Carl Rogers, Jules Seeman, Eugene Gendlin), my personal immersion in several methods of body work, body work theorists (F.M. Alexander and Anna Halprin) and neuroscientist Candace Pert's "Psychosomatic Communication Network," to reveal a model respectful of body/mind integration in which non-directivity is an underlying method.

My best flashes of theoretic clarity and organismic well being come during body work sessions. Those flashes, regarding the nature of attention and the relationship between ends and means in health and wholeness, form the basis of the theory I want to develop in this paper.

We say a person has a body, or uses a body or does things to or for the body. These linguistic vestiges of the mind/body split are deeply rooted in culture and philosophy. But these formulations lead us to a mechanical self concept that results in unhealthy consequences for us. In contrast, Seeman, Gendlin and Pert offer an alternative meta-model of connection and communication. It is one rooted in our body's neuropeptides, implicit in Alexander's work and inherent in non-directive client-centered theory.


Symposium: Successful PCA applications: promoting health and wellbeing with the person centered approach

Alberto Zucconi, Prof., IACP, Piazza Vittorio Emanuele, 99, 00185 Roma, Italy, e-mail: azucconi@iacp.it

Giovannella Nasta Stropeni, IACP, Via Pirandello, 3, Genova, Italy, e-mail: giovannellastropeni@aliceposta.it

Abstract:

In this panel, we present and discuss the activities of training , research and consultation of our Health Promotion Department. We have a successful training program in Promoting Health with the Person-Centered Approach and our institute has been working for the past 15 years as a World Health Organization (WHO) Collaborating Centre for Health Promotion at the workplace and a collaborating Centre for the International Labour Organization (ILO) for the SOLVE programs (addressing psychosocial issue at work). We will illustrate the action research; the FOLIC program, financed by the Leonardo da Vinci Program of the UE and our on-line training program providing counselling to workers of 6 partner-countries on Health Promotion with a Person Centered Approach. We will discuss the action research we are doing financed by the Italian Ministry of Health to promote self-esteem and self-efficacy with the PCA in the Italian school system.

We will illustrate our variables of good practice: from need assessment to feasibility study and implementation in our various projects, how we apply the PCA, the bio-psycho-social paradigm and some aspects of the sociology of knowledge for the design and realization of this projects all focalized to promote empowerment and a proactive participation of all the stakeholders.