Medicine:Person-centered therapy

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Short description: form of psychotherapy developed by psychologist Carl Rogers
Person-centered therapy
MeSHD009629

Person-centered therapy, also known as person-centered psychotherapy, person-centered counseling, client-centered therapy and Rogerian psychotherapy, is a form of psychotherapy developed by psychologist Carl Rogers beginning in the 1940s[1] and extending into the 1980s.[2] Person-centered therapy seeks to facilitate a client's self-actualizing tendency, "an inbuilt proclivity toward growth and fulfillment",[3] via acceptance (unconditional positive regard), therapist congruence (genuineness), and empathic understanding.[4][5]

It is one of the most influential and fundamental modalities of treatment in modern psychological practice, and is applied almost universally in modern psychotherapy. Its radical non-directivity sets it apart from all other schools of therapy.

History and influences

Person-centered Therapy was developed by Carl Rogers in the 1940s and 1950s, and brought to public awareness largely through his highly influential book Client-centred Therapy, published in 1952. Its underlying theory arose from the results of empirical research, and it was the first theory of therapy to be research-driven,[6] with Rogers at pains to reassure other theorists that "the facts are always friendly".[7] Originally called non-directive therapy, it "offered a viable, coherent alternative to Freudian psychotherapy. …he redefined the therapeutic relationship to be different from the Freudian authoritarian pairing."[8]

Person-centered Therapy is often described as a humanistic therapy, but its main principles appear to have been established before those of humanistic psychology.[9] Arguably, "…it does not in fact have much in common with the other established humanistic therapies".[10] Despite the importance of the self to person-centered theory, the theory is fundamentally organismic and holistic in nature,[11] embracing the full person, with the individual’s unique self-concept at the center of the unique "sum total of the biochemical, physiological, perceptual, cognitive, emotional and interpersonal behavioural subsystems constituting the person".[12]

Rogers coined the term counselling in the 1940s because at that time psychologists were not legally permitted to provide psychotherapy in the US. Only medical practitioners were allowed to use the term psychotherapy to describe their work.[13]

Person-centered therapy, now considered a founding work in the humanistic school of psychotherapies, began with Carl Rogers,[14]:138 and is recognized as one of the major psychotherapy "schools" (theoretical orientations),[clarification needed] along with psychodynamic psychotherapy, psychoanalysis, classical Adlerian psychology, cognitive behavioral therapy, existential therapy, and others.[14]:3

Rogers affirmed individual personal experience as the basis and standard for living and therapeutic effect.[14]:142–143 This emphasis contrasts with the dispassionate position which may be intended in other therapies, particularly the behavioral therapies. Living in the present rather than the past or future, with organismic trust, naturalistic faith in one's own thoughts and the accuracy in one's feelings, and a responsible acknowledgment of one's freedom, with a view toward participating fully in our world, contributing to other peoples' lives, are hallmarks of Rogers's person-centered therapy.[citation needed] Rogers also claimed that the therapeutic process is, in essence, composed of the accomplishments made by the client. The client, having already progressed further along in their growth and maturation development, only progresses further with the aid of a psychologically favored environment.[15]

Although client-centered therapy has been criticized by behaviorists for lacking structure and by psychoanalysts for actually providing a conditional relationship,[14] it has been shown to be an effective[clarification needed] treatment.[16][17][18][19]

The necessary and sufficient conditions

Rogers (1957; 1959) stated that there are six necessary and sufficient conditions required for therapeutic change:[14]:142–143

  1. Therapist–client psychological contact: A relationship between client and therapist must exist, and it must be a relationship in which each person's perception of the other is important.
  2. Client incongruence: In-congruence exists between the client's experience and awareness.
  3. Therapist congruence, or genuineness: The therapist is congruent within the therapeutic relationship. The therapist is deeply involved—they are not "acting"—and they can draw on their own experiences (self-disclosure) to facilitate the relationship.
  4. Therapist unconditional positive regard: The therapist accepts the client unconditionally, without judgment, disapproval, or approval. This facilitates increased self-regard in the client, as they can begin to become aware of experiences in which their view of self-worth was distorted or denied.
  5. Therapist empathic understanding: The therapist experiences an empathic understanding of the client's internal frame of reference. Accurate empathy on the part of the therapist helps the client believe the therapist's unconditional regard for them.
  6. Client perception: The client perceives, to at least a minimal degree, the therapist's unconditional positive regard and empathic understanding.

Core conditions

It is believed that the most important factor in successful therapy is the relational climate created by the therapist's attitude to their client. The therapist's attitude is defined by the three conditions focused on the therapist, which are often called the core conditions[citation needed] (3,4, and 5 of the six conditions):

  1. Congruence: The therapist is willing to transparently relate to clients without hiding behind a professional or personal facade.
  2. Unconditional positive regard: The therapist offers an acceptance and prizing for their client for who they are without conveying disapproving feelings, actions, or characteristics and demonstrating a willingness to attentively listen without interruption, judgement, or giving advice.
  3. Empathy: The therapist communicates their desire to understand and appreciate their client's perspective.

Processes

Rogers believed that a therapist who embodies the three critical and reflexive attitudes (the three core conditions) will help liberate their client to more confidently express their true feelings without fear of judgement. To achieve this, the client-centered therapist carefully avoids directly challenging their client's way of communicating themselves in the session in order to enable a deeper exploration of the issues most intimate to them and free from external referencing.[20] Rogers was not prescriptive in telling his clients what to do, but believed that the answers to the clients' questions were within the client and not the therapist. Accordingly, the therapist's role was to create a facilitative, empathic environment wherein the client could discover the answers for themselves.[21]

See also

References

  1. ↑ Rogers, Carl R. (1942). Counseling and psychotherapy. Cambridge, MA: Riverside Press. ISBN 978-1406760873. 
  2. ↑ I., Kaplan, Harold; J., Sadock, Benjamin (1985). "Client-centered psychotherapy". Comprehensive textbook of psychiatry. 2. Williams & Wilkins. pp. 1374–1388. ISBN 9780683045116. OCLC 491903721. https://archive.org/details/comprehensivetex00kapl/page/1374. 
  3. ↑ Rogers, Carl R. (1995). "Introduction". A way of being. Houghton Mifflin Co. p. xi. ISBN 9780395755303. OCLC 464424214. https://archive.org/details/wayofbeing00roge. 
  4. ↑ Rogers, Carl R. (1957). "The necessary and sufficient conditions of therapeutic personality change.". Journal of Consulting Psychology 21 (2): 95–103. doi:10.1037/h0045357. PMID 13416422. http://www.shoreline.edu/dchris/psych236/Documents/Rogers.pdf. 
  5. ↑ Rogers, Carl R. (1966). "Client-centered therapy". in Arieti, S.. American handbook of psychiatry. 3. New York City: Basic Books. pp. 183–200. 
  6. ↑ (Wilkins, p.27)
  7. ↑ (Rogers, 1961, p.25)
  8. ↑ (Woolfolk, 2015, p.28)
  9. ↑ (Merry, 1998, pp.96-103)
  10. ↑ (Mearns and Thorne, 2000, p.27)
  11. ↑ (Wilkins, 2016, p.34, Tudor and Worrall, 2006, pp.45-84)
  12. ↑ (Wilkins, 2016, p.12)
  13. ↑ (Joseph, 2010, p.8)
  14. ↑ 14.0 14.1 14.2 14.3 14.4 Prochaska, James O.; Norcross, John C. (2007). Systems of Psychotherapy: A Transtheoretical Analysis. Belmont, CA: Thomson/Brooks/Cole. ISBN 978-0495007777. OCLC 71366401. 
  15. ↑ Rogers, Carl (1951). Client-Centered Therapy. Cambridge Massachusetts: The Riverside Press.
  16. ↑ Cooper, M., Watson, J. C., & Hoeldampf, D. (2010). Person-centered and experiential therapies work: A review of the research on counseling, psychotherapy and related practices. Ross-on-Wye, UK: PCCS Books.
  17. ↑ Ward, E.; King, M.; Lloyd, M.; Bower, P.; Sibbald, B.; Farrelly, S.; Gabbay, M.; Tarrier, N. et al. (2000). "Randomised controlled trial of non-directive counselling, cognitive-behaviour therapy, and usual general practitioner care for patients with depression. I: Clinical effectiveness". BMJ 321 (7273): 1383–8. doi:10.1136/bmj.321.7273.1383. PMID 11099284. 
  18. ↑ Bower, P.; Byford, S.; Sibbald, B.; Ward, E.; King, M.; Lloyd, M.; Gabbay, M. (2000). "Randomised controlled trial of non-directive counselling, cognitive-behaviour therapy, and usual general practitioner care for patients with depression. II: Cost effectiveness". BMJ 321 (7273): 1389–92. doi:10.1136/bmj.321.7273.1389. PMID 11099285. 
  19. ↑ Shechtman, Zipora; Pastor, Ronit (2005). "Cognitive-Behavioral and Humanistic Group Treatment for Children with Learning Disabilities: A Comparison of Outcomes and Process". Journal of Counseling Psychology 52 (3): 322–336. doi:10.1037/0022-0167.52.3.322. 
  20. ↑ "Person-centered therapy" on the Encyclopedia of Mental Disorders website
  21. ↑ Rogers, Carl Ransom; Lyon, Harold C.; Tausch, Reinhard (2013). On Becoming an Effective Teacher: Person-centred Teaching, Psychology, Philosophy, and Dialogues with Carl R. Rogers. Routledge. p. 23. ISBN 978-0-415-81698-4. https://books.google.com/books?id=C5XbNAEACAAJ. 

Bibliography

  • Arnold, Kyle (2014). "Behind the Mirror: Reflective Listening and its Tain in the Work of Carl Rogers". The Humanistic Psychologist 42 (4): 354–369. doi:10.1080/08873267.2014.913247. https://www.academia.edu/8874100. 
  • Bruno, Frank J. (1977). Client-Centered Counseling: Becoming a Person. In Human Adjustment and Personal Growth: Seven Pathways, pp. 362–370. John Wiley & Sons.
  • Cooper, M., O'Hara, M, Schmid, P., and Wyatt, G. (2007). The Handbook of person-centered psychotherapy and counseling. London: Palgrave MacMillan.
  • Rogers, Carl (1961). On Becoming a Person ISBN:0-395-75531-X
  • Rogers, C (1957). "The necessary and sufficient conditions of therapeutic personality change". Journal of Consulting Psychology 21 (2): 95–103. doi:10.1037/h0045357. PMID 13416422. 
  • Rogers, Carl. (1959). A Theory of Therapy, Personality and Interpersonal Relationships as Developed in the Client-centered Framework. In (ed.) S. Koch, Psychology: A Study of a Science. Vol. 3: Formulations of the Person and the Social Context. New York: McGraw Hill.
  • Rogers, Carl (1980). A Way of Being. Boston: Houghton Mifflin
  • Poyrazli, S. (2003). "Validity of Rogerian Therapy in Turkish Culture: A Cross-Cultural Perspective". Journal of Humanistic Counseling, Education and Development 42 (1): 107–115. doi:10.1002/j.2164-490x.2003.tb00172.x. 
  • Rogers, Carl (1951). "Client-Centered Therapy" Cambridge Massachusetts: The Riverside Press.
  • Rogers, Carl, Lyon, HC, Tausch, R. (2013). On Becoming an Effective Teacher – Person-centered teaching, Psychology, Philosophy, and Dialogues with Carl R. Rogers and Harold Lyon. London: Routledge, ISBN:978-0-415-81698-4: http://www.routledge.com/9780415816984/
  • Wilkins, P. (2016) Person-centred therapy: 100 key points and techniques. 2nd ed. London: Routledge. p.27
  • Woolfolk, R. L. (2015) The value of psychotherapy - the talking cure in an age of clinical science. London: Guilford. p.28
  • Merry, T. (1998) Client-centred therapy: origins and influences. Person-Centred Practice Vol 6 – 2. pp. 96-103.
  • Mearns, D. and Thorne, B. (2000) Person-Centred Therapy Today: New Frontiers in Theory and Practice. London: Sage. p.27.
  • Wilkins, P. ed. (2016). Person-centred and experiential therapies: contemporary approaches and issues in practice. London: Sage. p. 34.
  • Tudor, K. and Worrall, M. (2006) Person-centred therapy: a clinical philosophy. London: Routledge. pp.45-84.
  • Wilkins, P. (2016) Person-centred therapy: 100 key points and techniques. 2nd ed. London: Routledge. p. 12
  • Joseph, S. (2010) Theories of counselling and psychotherapy. London: Palgrave Macmillan. p.8


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