Person-Centered Theory and Therapy

Person-Centered Theory and Therapy

Chapter Five

Welcome

  • This week we’re focusing on person-centered theory and therapy (PCT).
  • This approach was developed by Carl Rogers.
  • The approach is deeply optimistic and guided by principles of trusting clients and an actualizing or formative tendency.

Biographical Information: Carl Rogers

  • Carl Rogers’s development as a person was characterized by the following (and more) events:
  • He rejected his parents’ conservative religious ideology.
  • He decided to marry his childhood sweetheart.
  • He decided to pursue graduate studies at the liberal Union Theological Seminary in New York City.
  • He studied clinical psychology at Columbia University.

Historical Context

  • Rogers adopted the following principles from Otto Rank:
  • Clients have creative powers.
  • Therapy should help clients accept their personal uniqueness and self-reliance.
  • The client is the central figure in the therapy process; the therapist only helps clients access their powers of self-creation.
  • Therapists shouldn’t seek to educate clients.
  • Therapists shouldn’t foster dependency with clients by becoming love objects.
  • Therapy works when clients are able to experience the present within the therapy setting (Raskin & Rogers, 1989).

Historical Context II

  • Rogers was also influenced by:
  • Elizabeth Davis
  • President Franklin D. Roosevelt
  • John Dewey
  • His relationship with his wife
  • His clients

Historical Context III

  • Honoring the Client
  • Rogers credited his clients as the greatest source of his development.
  • Natalie Rogers stated: “And so like Carl, I stayed open to learning from my clients. They are always our best teachers.” (J. Sommers-Flanagan, 2007, p. 122)

Historical Context IV

  • Struggles with Psychiatry and Psychology
  • Rogers had a blistering battle with psychiatry to obtain for psychologists the right to practice psychotherapy.
  • Rogers also felt like a respected gadfly within the psychology discipline.

Historical Context V

  • The Evolution of Person-Centered Therapy
  • Nondirective counseling
  • Cleint-centered therapy
  • Becoming a person
  • Worldwide issues

Theoretical Principles

  • Theory of Personality
  • Self theory
  • Phenomenology and the valuing of experience
  • Learning and growth potential
  • Conditions of worth
  • In sum, it emphasizes several concepts. It is the theory of self, experience, striving for maintenance and enhancement of the self, and learned needs of positive regard.

Theoretical Principles II

  • Theory of Psychopathology
  • Psychopathology can be a discrepancy between the real self and the ideal self.
  • It is also thought of as the failure to learn from experience.

Theoretical Principles III

  • Theory of Psychotherapy
  • It is related to Rogers’s theory of personality. For constructive personality change, it is necessary for the following core conditions to exist:
  • Two persons are in psychological contact.
  • The client is in a state of incongruence.
  • The therapist is congruent or integrated in the relationship.
  • The therapist experiences unconditional positive regard.
  • The therapist experiences an empathic understanding.
  • Communication of unconditional positive regard and empathic understanding is at least minimally achieved.

Theoretical Principles IV

  • Congruence
  • Authenticity or transparency
  • For example:

“The more that I can be genuine in the relationship the more helpful it will be.” (Rogers, 1961, p. 33)

  • How would you describe congruence?

Theoretical Principles V

  • Unconditional Positive Regard
  • Acceptance, respect, or prizing
  • Valuing a client as a separate person

“I find that the more acceptance and liking I feel toward this individual, the more I will be creating a relationship which he can use.” (Rogers, 1961, p. 34)

  • How would you describe unconditional positive regard?

Theoretical Principles VI

  • Accurate Empathy or Empathic Understanding
  • Noticing your clients’ feelings and feeling with them

“The most powerful thing from the client’s point of view is to be deeply heard.” (Natalie Rogers from Carlson, 2000)

  • How would you describe accurate empathy?
  • The Magic of Person-Centered Listening

The Practice of PCT:
A Way of Being With Clients

  • Two Types of Person-Centered Therapists
  • Classical
  • This group continues to uphold the position that the six core conditions articulated by Rogers in 1957 are both necessary and sufficient.
  • Contemporary
  • This group believes in person-centered principles, but feels free to be more active and directive and to blend PCT with other approaches.

The Practice of PCT:
A Way of Being With Clients II

  • Assessment Issues and Procedures
  • Classical person-centered therapists don’t employ standardized assessment or diagnostic procedures.
  • Contemporary person-centered approaches sometimes employ assessment procedures (e.g., emotion-focused therapy).

The Practice of PCT:
A Way of Being With Clients III

  • The Therapist’s Opening Statement
  • The main point is to convey to clients that they can take the lead in determining what to talk about.
  • Example: “Anything you’d like to tell me about yourself that will help me to know you better, I’d be very glad to hear.” (Rogers, 1963)

The Practice of PCT:
A Way of Being With Clients IV

  • Experiencing and Expressing Congruence
  • This can be tricky.
  • How do you think therapists should experience and express congruence?

The Practice of PCT:
A Way of Being With Clients V

  • Experiencing and Expressing Unconditional Positive Regard
  • This is also tricky.
  • It involves accepting clients as they are and avoiding judgments.
  • Is this possible?
  • How do you think you could experience and express unconditional positive regard?

The Practice of PCT:
A Way of Being With Clients VI

  • Experiencing and Expressing Empathic Understanding
  • Entering and becoming at home in the client’s personal perceptual world.
  • Being sensitive from moment to moment with the client’s changing meanings and emotions.
  • Temporarily living, and moving about delicately, in the client’s life.
  • Sensing deep meanings, but not uncovering feelings that are too far out of awareness.

The Practice of PCT:
A Way of Being With Clients VII

  • PCT has been integrated with other therapies. These include:
  • Motivational interviewing
  • Emotion-focused therapy
  • Nondirective play therapy

The Practice of PCT:
A Way of Being With Clients VIII

Motivational Interviewing (MI): A Contemporary PCT Approach

  • MI builds on person-centered principles by adding more focused theraputic targets and specific client goals.
  • Moving Away from Confrontation and Education

The Practice of PCT:
A Way of Being With Clients IX

  • Focusing on Client Ambivalence (primary target of MI)
  • Use reflective listening
  • Notice and develop the theme of discrepancy
  • Resistance with reflection
  • Self-efficacy

Cultural and Gender Considerations

  • Empowering of all persons, including women.
  • Designed to address the needs and interests of unique clients.
  • Too indirect for some cultures, but actually could be too direct (focusing on self and emotions) in other cases.

Evidence-Based Status

  • Rogers was the first to record his sessions.
  • He conducted some ambitions outcomes research.
  • ‘‘The efficacy of client centered psychotherapy for the client rests on 50 years of outcome and process research’’ and ‘‘Few therapies have such a long, storied, and successful research base.’’ (Lambert & Erekson, 2008, p. 225)
  • Of all the factors that therapists bring to the therapeutic endeavor, client ratings of their therapist’s empathy are the strongest predictor of positive treatment outcomes (Bohart, Elliott, Greenberg, & Watson, 2002).

Evidence-Based Status II

  • Recent research on the effectiveness of PCT has yielded small, but positive results.
  • PCT is consistently more effective than no treatment.
  • It is more effective than placebo treatment.
  • It is less effective than structured cognitive and behavioral treatments.

Concluding Comments

  • It may be that at least in some cases, the person of the therapist and the attitudes the therapist holds are more important than specific problems or techniques.