Lesson 31

CLIENT CENTERED CLIENT CENTERED THERAPYTHERAPY

Lecture 31Lecture 31

DEFINITIONDEFINITION

Person-centered therapy, which is also Person-centered therapy, which is also known as client-centered, non-directive, or known as client-centered, non-directive, or Rogerian therapy, is an approach to Rogerian therapy, is an approach to counseling and counseling and psychotherapypsychotherapy that that places much of the responsibility for the places much of the responsibility for the treatment process on the client, with the treatment process on the client, with the therapist taking a nondirective role. therapist taking a nondirective role.

PURPOSEPURPOSE Two primary goals of person-centered therapy Two primary goals of person-centered therapy

are increased self-esteem and greater are increased self-esteem and greater openness to experience. openness to experience.

Some of the related changes that this form of Some of the related changes that this form of therapy seeks to foster in clients include closer therapy seeks to foster in clients include closer agreement between the client's idealized and agreement between the client's idealized and actual selves; better self-understanding; lower actual selves; better self-understanding; lower levels of defensiveness, guilt, and insecurity; levels of defensiveness, guilt, and insecurity; more positive and comfortable relationships with more positive and comfortable relationships with others; and an increased capacity to experience others; and an increased capacity to experience and express feelings at the moment they occur. and express feelings at the moment they occur.

DESCRIPTIONDESCRIPTION

BACKGROUNDBACKGROUND Developed in the 1930s by the American Developed in the 1930s by the American

psychologistpsychologist Carl Rogers.Carl Rogers. Rogers believed that therapy should take place Rogers believed that therapy should take place

in a supportive environment created by a close in a supportive environment created by a close personal relationship between client and personal relationship between client and therapist.therapist.

In person-centered therapy, the client In person-centered therapy, the client determines the general direction of therapy, determines the general direction of therapy, while the therapist seeks to increase the client's while the therapist seeks to increase the client's insight and self-understanding through informal insight and self-understanding through informal clarifying questions. clarifying questions.

Beginning in the 1960s, person-centered Beginning in the 1960s, person-centered therapy became associated with the human therapy became associated with the human potential movement.potential movement.

This movement, dating back to the beginning of This movement, dating back to the beginning of the 1900s, reflected an altered perspective of the 1900s, reflected an altered perspective of human nature.human nature.

The human potential movement, defined human The human potential movement, defined human nature as inherently good. From its perspective, nature as inherently good. From its perspective, human behavior is motivated by a drive to human behavior is motivated by a drive to achieve one's fullest potential.achieve one's fullest potential.

Self-actualization,Self-actualization, a term derived refers to the a term derived refers to the tendency of all human beings to move forward, tendency of all human beings to move forward, grow, and reach their fullest potential. grow, and reach their fullest potential.

The concept of self-actualization focuses on The concept of self-actualization focuses on human strengths rather than human human strengths rather than human deficiencies.deficiencies.

According to Rogers, self-actualization can be According to Rogers, self-actualization can be blocked by an unhealthy self-concept.blocked by an unhealthy self-concept.

Rogers adopted terms such as "person-Rogers adopted terms such as "person-centered approach" and "way of being" and centered approach" and "way of being" and began to focus on personal growth and self-began to focus on personal growth and self-actualization.actualization.

More recently, two major variations of person-centered More recently, two major variations of person-centered therapy have developed:therapy have developed:

Experiential therapy,Experiential therapy, developed by Eugene Gendlin developed by Eugene Gendlin in 1979; andin 1979; and

Process experiential therapyProcess experiential therapy, developed by Leslie , developed by Leslie Greenberg and colleagues in 1993.Greenberg and colleagues in 1993.

While person-centered therapy is considered one of While person-centered therapy is considered one of the major therapeutic approaches, along with the major therapeutic approaches, along with psychoanalytic and psychoanalytic and cognitive-behavioral therapycognitive-behavioral therapy, , Rogers's influence is felt in schools of therapy other Rogers's influence is felt in schools of therapy other than his own. The concepts and methods he than his own. The concepts and methods he developed are used in an eclectic fashion by many developed are used in an eclectic fashion by many different types of counselors and therapists.different types of counselors and therapists.

PROCESSPROCESS

Rogers believed that the most important factor Rogers believed that the most important factor in successful therapy was not the therapist's in successful therapy was not the therapist's skill or training, but rather his or her attitude.skill or training, but rather his or her attitude.

Three interrelated attitudes on the part of the Three interrelated attitudes on the part of the therapist aretherapist are

Congruence Congruence refers to the therapist's openness refers to the therapist's openness and genuineness—the willingness to relate to and genuineness—the willingness to relate to clients without hiding behind a professional clients without hiding behind a professional facade.facade.

Unconditional positive regardUnconditional positive regard means that the means that the therapist accepts the client totally for who he or therapist accepts the client totally for who he or she is without evaluating or censoring, and she is without evaluating or censoring, and without disapproving of particular feelings, without disapproving of particular feelings, actions, or characteristics.actions, or characteristics.

The therapist communicates this attitude to the The therapist communicates this attitude to the client by a willingness to listen without client by a willingness to listen without interrupting, judging, or giving advice.interrupting, judging, or giving advice.

This attitude of positive regard creates a non This attitude of positive regard creates a non threatening context in which the client feels free threatening context in which the client feels free to explore and share painful, hostile, defensive, to explore and share painful, hostile, defensive, or abnormal feelings without worrying about or abnormal feelings without worrying about personal rejection by the therapist. personal rejection by the therapist.

The third necessary component of a therapist's The third necessary component of a therapist's attitude is attitude is empathy.empathy.

The therapist tries to appreciate the client's The therapist tries to appreciate the client's situation from the client's point of view, showing situation from the client's point of view, showing an emotional understanding of and sensitivity to an emotional understanding of and sensitivity to the client's feelings throughout the therapy the client's feelings throughout the therapy session.session.

In person-centered therapy, it actually In person-centered therapy, it actually constitutes a major portion of the therapeutic constitutes a major portion of the therapeutic work itself.work itself.

Person centered therapists employ a special Person centered therapists employ a special method called method called reflection,reflection, which consists of which consists of paraphrasing and/or summarizing what a client paraphrasing and/or summarizing what a client has just said.has just said.

According to Rogers, when these three According to Rogers, when these three attitudes (congruence, unconditional positive attitudes (congruence, unconditional positive regard, and empathy) are conveyed by a regard, and empathy) are conveyed by a therapist, clients can freely express themselves therapist, clients can freely express themselves without having to worry about what the therapist without having to worry about what the therapist thinks of them.thinks of them.

Because of this nondirective approach, clients Because of this nondirective approach, clients can explore the issues that are most important can explore the issues that are most important to them—not those considered important by the to them—not those considered important by the therapist.therapist.

APPLICATIONAPPLICATION Person centered therapy was not intended for a Person centered therapy was not intended for a

specific age group or subpopulation but has specific age group or subpopulation but has been used to treat a broad range of people.been used to treat a broad range of people.

Rogers worked extensively with people with Rogers worked extensively with people with schizophrenia, schizophrenia, depression, anxiety, alcohol depression, anxiety, alcohol disorders, cognitive dysfunction, and disorders, cognitive dysfunction, and personality disorders.personality disorders.

The person-centered approach can be used in The person-centered approach can be used in individual, group, or individual, group, or family therapyfamily therapy. With . With young children, it is frequently employed as young children, it is frequently employed as play therapyplay therapy..

NORMAL RESULTSNORMAL RESULTS The expected results of person-centered The expected results of person-centered

therapy includetherapy include Improved self-esteem;Improved self-esteem; Trust in one's inner feelings and experiences as Trust in one's inner feelings and experiences as

valuable sources of information for making valuable sources of information for making decisions;decisions;

Increased ability to learn from (rather than Increased ability to learn from (rather than repeating) mistakes;repeating) mistakes;

Decreased defensiveness, guilt, and insecurity; Decreased defensiveness, guilt, and insecurity; more positive and comfortable relationships more positive and comfortable relationships with others;with others;

An increased capacity to experience and An increased capacity to experience and express feelings at the moment they occur;express feelings at the moment they occur;

And openness to new experiences and new And openness to new experiences and new ways of thinking about life.ways of thinking about life.

Person-centered therapy, appears to be slightly Person-centered therapy, appears to be slightly

less effective than other forms of humanistic less effective than other forms of humanistic therapy in which therapists offer more advice to therapy in which therapists offer more advice to clients and suggest topics to explore. clients and suggest topics to explore.

ABNORMAL RESULTSABNORMAL RESULTS If therapy has been unsuccessful, the client will If therapy has been unsuccessful, the client will

not move in the direction of self-growth and not move in the direction of self-growth and self-acceptance.self-acceptance.

Several factors may affect the success of Several factors may affect the success of person-centered therapy.person-centered therapy.

Clients tend to overlook occasional therapist Clients tend to overlook occasional therapist failures if a satisfactory relationship has been failures if a satisfactory relationship has been established.established.

Some studies have suggested that certain Some studies have suggested that certain clients may get bored, frustrated, or annoyed clients may get bored, frustrated, or annoyed with a Rogerian style of therapeutic interaction. with a Rogerian style of therapeutic interaction.

THE HUMANISTIC EXISTENTIAL THE HUMANISTIC EXISTENTIAL MOVEMENTMOVEMENT

The strands of phenomenology, humanism, and The strands of phenomenology, humanism, and existentialism in psychology are inextricably woven existentialism in psychology are inextricably woven together. We know the importance that Rogers together. We know the importance that Rogers attached to immediate experience. This is basic attached to immediate experience. This is basic phenomenology. At the same time, client-centered phenomenology. At the same time, client-centered approaches stress the worth, uniqueness, and dignity approaches stress the worth, uniqueness, and dignity of the client. This is basic humanism. Before we of the client. This is basic humanism. Before we proceed to discuss existential therapies, logotherapy, proceed to discuss existential therapies, logotherapy, and Gestalt therapy, let us pause to acknowledge the and Gestalt therapy, let us pause to acknowledge the humanistic tradition that pervades those therapies.humanistic tradition that pervades those therapies.

HUMANISMHUMANISM When one speaks of humanism, one thinks of When one speaks of humanism, one thinks of

psychologists such as Allport, Goldstein, psychologists such as Allport, Goldstein, James, Murray, and Rogers.James, Murray, and Rogers.

From a humanist perspective, people are not From a humanist perspective, people are not products of the past, the unconscious, or the products of the past, the unconscious, or the environment. Rather, they exercise free choice environment. Rather, they exercise free choice in the pursuit of their inner potential and self in the pursuit of their inner potential and self actualization.actualization.

They are not fragmented patch works of They are not fragmented patch works of cognitions, feelings, and aspirations; rather, cognitions, feelings, and aspirations; rather, they are unified, whole, and unique beings.they are unified, whole, and unique beings.

To understand is to appreciate those qualities, To understand is to appreciate those qualities, and this understanding can only be achieved and this understanding can only be achieved by an awareness of the person’s experience.by an awareness of the person’s experience.

The emphasis is not on sickness, deviations, or The emphasis is not on sickness, deviations, or diagnostic labels, but on positive striving, self-diagnostic labels, but on positive striving, self-actualization freedom and naturalness.actualization freedom and naturalness.

In one form or another humanism is expressed In one form or another humanism is expressed as a resistance to the positivistic determinism of as a resistance to the positivistic determinism of science and as an active embrace of the science and as an active embrace of the essential humanity of people.essential humanity of people.

EXISTENTIAL THERAPYEXISTENTIAL THERAPY Existential psychology rejects the mechanistic Existential psychology rejects the mechanistic

views of the Freudians and instead sees people views of the Freudians and instead sees people as engaged in a search for meaning.as engaged in a search for meaning.

It seems toIt seems to promise the restoration of meaning promise the restoration of meaning to life, an increased spiritual awakening, and to life, an increased spiritual awakening, and individual growth that will bring freedom from individual growth that will bring freedom from the conventional shackles created by a the conventional shackles created by a conformist society.conformist society.

Hardly a unified movement that speaks with a Hardly a unified movement that speaks with a single voice, the existential view actually turns single voice, the existential view actually turns out to be many viewsout to be many views

The existentialists make a number of assertions The existentialists make a number of assertions about human nature: the search for meaning.about human nature: the search for meaning.

From the From the standpoint standpoint of their physical, of their physical, environment and their biological environment, environment and their biological environment, people function in a social context.people function in a social context.

A crucial facet of personality is decision A crucial facet of personality is decision making, which involves the world of both facts making, which involves the world of both facts and possibilities.and possibilities.

Decision making involves a set of inevitable Decision making involves a set of inevitable choices. choices.

That choice will lead to guilt and remorse over That choice will lead to guilt and remorse over missed opportunities.missed opportunities.

But one can also choose alliance with the But one can also choose alliance with the future.future.

That choice propels the person into the future That choice propels the person into the future with an anxiety that stems from one's inability to with an anxiety that stems from one's inability to predict and control the unknown.predict and control the unknown.

It requires courage to choose the future and It requires courage to choose the future and suffer the inevitable anxieties that this -choice suffer the inevitable anxieties that this -choice entails.entails.

A person can find that courage by having faith A person can find that courage by having faith in self and by recognizing that choosing the in self and by recognizing that choosing the past will inevitably lead to a guilt that is even past will inevitably lead to a guilt that is even more terrifying than anxiety.more terrifying than anxiety.

THE GOALS OF THERAPY:THE GOALS OF THERAPY: The ultimate goal of existential psychotherapy The ultimate goal of existential psychotherapy

is to help the individual reach a point at which is to help the individual reach a point at which awareness and decision making can be awareness and decision making can be exercised responsibly.exercised responsibly.

Through therapy, one must learn to accept Through therapy, one must learn to accept responsibility for one's own decisions and to responsibility for one's own decisions and to tolerate the anxiety that accumulates as one tolerate the anxiety that accumulates as one moves toward change.moves toward change.

This involves self-trust and also a capacity to This involves self-trust and also a capacity to accept those things in life that are accept those things in life that are unchangeable or inevitable.unchangeable or inevitable.

TECHNIQUES:TECHNIQUES: Existential therapy does not emphasize Existential therapy does not emphasize

techniques.techniques. Instead, the emphasis is on understanding and Instead, the emphasis is on understanding and

on experiencing the client as a unique essence.on experiencing the client as a unique essence. Therapy is an encounter that should enable the Therapy is an encounter that should enable the

client to come closer to experience.client to come closer to experience. Sometimes the therapist will confront the client Sometimes the therapist will confront the client

with questions,--for focusing.with questions,--for focusing. Gendlin (1969, 1981) discusses focusing as a Gendlin (1969, 1981) discusses focusing as a

means of reaching the pre-conceptual, felt means of reaching the pre-conceptual, felt sense.sense.

LOGOTHERAPYLOGOTHERAPY This technique encourages the client to find This technique encourages the client to find

meaning in what appears to be a callous, meaning in what appears to be a callous, uncaring, and meaningless world.uncaring, and meaningless world.

Viktor Frankl developed the technique.Viktor Frankl developed the technique. He moved on an existential framework as he He moved on an existential framework as he

tried to find tried to find ways ways of dealing with experiences in of dealing with experiences in Nazi concentration Nazi concentration camps.camps.

What was required was a personal meaning for What was required was a personal meaning for existence.existence.

From his war time experiences and the From his war time experiences and the existential insights that he felt permitted him to existential insights that he felt permitted him to survive, Frankl developed logotherapy (the survive, Frankl developed logotherapy (the therapy of meaning)therapy of meaning)

Logotherapy is designed not to replace but to Logotherapy is designed not to replace but to complement more traditional psychotherapy.complement more traditional psychotherapy.

Frankl regards logotherapy as the specific Frankl regards logotherapy as the specific therapy of choice.therapy of choice.

Logotherapy then strives to inculcate a sense of Logotherapy then strives to inculcate a sense of the client's own responsibility and obligations to the client's own responsibility and obligations to life.life.

Frankl makes much of responsibility, regarding Frankl makes much of responsibility, regarding it as more important than historical events in it as more important than historical events in the client's life. What is crucial is the meaning of the client's life. What is crucial is the meaning of the present and the outlook for the future.the present and the outlook for the future.

In particular, two techniques described by In particular, two techniques described by Frankl (1960) have gained considerable Frankl (1960) have gained considerable exposure.exposure.

Paradoxical intentionParadoxical intention is is a popular technique a popular technique in which the client is told to consciously at in which the client is told to consciously at tempt to perform the very behavior or tempt to perform the very behavior or response that is the object of anxiety and response that is the object of anxiety and concern. Fear is thus replaced by a concern. Fear is thus replaced by a paradoxical wish.paradoxical wish.

The second techniqueThe second technique, , de-reflection,de-reflection, instructs the client to ignore a troublesome instructs the client to ignore a troublesome behavior or symptom. behavior or symptom.

De reflection attempts to divert the client's De reflection attempts to divert the client's attention to more constructive activities and attention to more constructive activities and reflectionsreflections

GESTALT THERAPYGESTALT THERAPY In In Gestalt therapy„ the Gestalt therapy„ the emphasis is on recent emphasis is on recent

experience and on the immediate awareness of experience and on the immediate awareness of emotion and action.emotion and action.

‘’‘’Being in touch" with one's feelingBeing in touch" with one's feeling replaces the replaces the search for the origins of behavior.search for the origins of behavior.

The "unreality" of computers and plastic credit The "unreality" of computers and plastic credit cards has overwhelmed the true meaning of cards has overwhelmed the true meaning of life, which can only be found in the immediate life, which can only be found in the immediate experience of emotions.experience of emotions.

Gestalt therapy promises to restore the Gestalt therapy promises to restore the balance.balance.

ConclusionConclusion

These forms of treatment; Client centered, These forms of treatment; Client centered, Existential and Humanistic; have made several Existential and Humanistic; have made several noteworthy contributions to the field of noteworthy contributions to the field of psychotherapy.psychotherapy.

Clients' internal experience, feelings, free will, Clients' internal experience, feelings, free will, and growth potential have been brought to the and growth potential have been brought to the forefront. Demonstrating the importance of the forefront. Demonstrating the importance of the therapeutic relationship and of rapport is therapeutic relationship and of rapport is another major contribution.another major contribution.

However, these forms of therapy also present However, these forms of therapy also present some problems.some problems.