Current Psychotherapies Person-Centered Therapy Chapter 5 Authors: Nathaniel J. Raskin & Carl R. Rogers Instructor: Jeff Garrett Ph.D.

Key Points and Terms Developed by Carl Rogers. Also termed Client-Centered. Humanistic, or Phenomenological Therapy The person is viewed as creative, responsible, developing individual By providing a therapeutic atmosphere which is real, caring, and non-judgmental the person can develop their full potential

Developed by Carl Rogers.

Also termed Client-Centered.

Humanistic, or Phenomenological Therapy

The person is viewed as creative, responsible, developing individual

By providing a therapeutic atmosphere which is real, caring, and non-judgmental the person can develop their full potential

Challenges PC challenges : The assumption that “ the counselor knows best” The validity of advice, suggestion, persuasion, teaching, diagnosis, and interpretation The belief that clients cannot understand and resolve their own problems without direct help The focus on problems over persons

PC challenges :

The assumption that “ the counselor knows best”

The validity of advice, suggestion, persuasion, teaching, diagnosis, and interpretation

The belief that clients cannot understand and resolve their own problems without direct help

The focus on problems over persons

Emphasizes Emphasizes: Therapy as a journey shared by two people The person’s innate striving for self-actualization The personal characteristics of the therapist The quality of the therapeutic relationship

Emphasizes:

Therapy as a journey shared by two people

The person’s innate striving for self-actualization

The personal characteristics of the therapist

The quality of the therapeutic relationship

Emphasizes Emphasizes: The counselor’s creation of a permissive, “growth promoting” climate People are capable of self-directed growth if involved in a therapeutic relationship Person-Centered Therapy is a form of humanistic therapy

Emphasizes:

The counselor’s creation of a permissive, “growth promoting” climate

People are capable of self-directed growth if involved in a therapeutic relationship

Person-Centered Therapy is a form of humanistic therapy

Roger’s Basic Assumptions Rogers believed in an actualizing tendency in all human beings Represented movement towards the realization of the individual’s full potential Viewed as part of a formative tendency Formative tendency represents movement toward order, complexity and interrelatedness Seen across aspects of nature including the stars, crystals, microorganisms and humans

Rogers believed in an actualizing tendency in all human beings

Represented movement towards the realization of the individual’s full potential

Viewed as part of a formative tendency

Formative tendency represents movement toward order, complexity and interrelatedness

Seen across aspects of nature including the stars, crystals, microorganisms and humans

Basic Requirements for the Therapeutic Environment (Therapist) Genuineness/Congruence Correspondence between the therapist’s thoughts and their behavior Unconditional Positive Regard Therapist’s regard/attitude remains unaltered regardless of the client’s choices Empathy Profound interest and care for the client’s perceptions and feelings

Genuineness/Congruence

Correspondence between the therapist’s thoughts and their behavior

Unconditional Positive Regard

Therapist’s regard/attitude remains unaltered regardless of the client’s choices

Empathy

Profound interest and care for the client’s perceptions and feelings

Basic Requirements for the Therapeutic Environment ( Client ) Self-concept At therapy onset, self regard/self-esteem often low Improvement correlated with success in therapy Locus-of-Evaluation At therapy onset, focus on what others think Progress associated with internal locus-of-evaluation Experiencing At therapy onset, rigid Success related to flexibility

Self-concept

At therapy onset, self regard/self-esteem often low

Improvement correlated with success in therapy

Locus-of-Evaluation

At therapy onset, focus on what others think

Progress associated with internal locus-of-evaluation

Experiencing

At therapy onset, rigid

Success related to flexibility

Distinctive Components of Person-Centered Therapy Therapist’s attitude can be necessary AND sufficient conditions for change Therapist needs to be immediately present and accessible to clients

Therapist’s attitude can be necessary AND sufficient conditions for change

Therapist needs to be immediately present and accessible to clients

Distinctive Components of Person-Centered Therapy Intensive, continuous focus on client's phenomenological world Process marked by client’s ability to live fully in the moment Focus on personality change , not structure of personality

Intensive, continuous focus on client's phenomenological world

Process marked by client’s ability to live fully in the moment

Focus on personality change , not structure of personality

Comparing Person-Centered Therapy with Psychoanalysis Language – Common Sense (PC) Esoteric (Psychoanalysis) How to Understand The individual – Subjective Interpersonal (PC) Objective intrapersonal (Psychoanalysis) Emphasis – Purpose (PC) Causality (Psychoanalysis) Characterization Of the individual – Holistic (PC) Reductionistic (Psychoanalysis) View of Human Nature – People are basically good (PC) People are bad (Psychoanalysis)

Language – Common Sense (PC)

Esoteric (Psychoanalysis)

How to

Understand

The individual – Subjective Interpersonal (PC)

Objective intrapersonal (Psychoanalysis)

Emphasis – Purpose (PC)

Causality (Psychoanalysis)

Characterization

Of the individual – Holistic (PC)

Reductionistic (Psychoanalysis)

View of Human

Nature – People are basically good (PC)

People are bad (Psychoanalysis)

Comparing Person-Centered Therapy with Psychoanalysis Role of Therapist – Facilitate self discovery (PC) Interpretation for the pt (Psychoanalysis) View of Transference – Not central to the client’s ability to change (PC) Fundamental to the change process (Psychoanalysis) Presentation Of Therapist – A caring person who is willing to listen (PC) Authority, teacher (Psychoanalysis)

Role of

Therapist – Facilitate self discovery (PC)

Interpretation for the pt (Psychoanalysis)

View of

Transference – Not central to the client’s ability to change (PC)

Fundamental to the change process (Psychoanalysis)

Presentation

Of Therapist – A caring person who is willing to listen (PC)

Authority, teacher (Psychoanalysis)

Differences between PC and REBT PC places greater value on relationship PC is more client directed PC is more accepting of client’s perceptions PC therapist typically relates to clients on a feeling level .

PC places greater value on relationship

PC is more client directed

PC is more accepting of client’s perceptions

PC therapist typically relates to clients on a feeling level .

Similarities between PC and REBT Great optimism in the ability of people to change Perception that individuals are often overly self critical Willingness to put forth great effort to help people Respect for science and research

Great optimism in the ability of people to change

Perception that individuals are often overly self critical

Willingness to put forth great effort to help people

Respect for science and research

Difference between PC Therapist and Behavior Therapist PC would argue that behavioral changes occur through internal factors whereas behavioral therapy sees behavior changing through external factors.

PC would argue that behavioral changes occur through internal factors whereas behavioral therapy sees behavior changing through external factors.

History of PC Therapy Carl Rogers was born 1902, Oak Park Illinois Family emphasized strong work ethic, responsibility and the fundamentals of religion. Graduated 1924 from University of Wisconsin Started at the Union Theological Seminary then transferred to Teacher’s College, Columbia University Worked for 12 years at a Child-Guidance Center In 1939 published Clinical Treatment of the Problem Child Offered professorship at Ohio State University 1940 Rogers presented Some Newer concepts in Psychotherapy at the University of Minnesota (viewed by most as the birth of Client-Centered Therapy) Published Counseling and Psychotherapy in 1942 During WWII served as Director of Counseling Services for the US Organizations Served as head of University of Chicago Counseling Center (12 years) In 1957, Rogers published classic paper on “necessary and sufficient conditions” for therapy. Rogers died in 1987

Carl Rogers was born 1902, Oak Park Illinois

Family emphasized strong work ethic, responsibility and the fundamentals of religion.

Graduated 1924 from University of Wisconsin

Started at the Union Theological Seminary then transferred to Teacher’s College, Columbia University

Worked for 12 years at a Child-Guidance Center

In 1939 published Clinical Treatment of the Problem Child

Offered professorship at Ohio State University

1940 Rogers presented Some Newer concepts in Psychotherapy at the University of Minnesota (viewed by most as the birth of Client-Centered Therapy)

Published Counseling and Psychotherapy in 1942

During WWII served as Director of Counseling Services for the US Organizations

Served as head of University of Chicago Counseling Center (12 years)

In 1957, Rogers published classic paper on “necessary and sufficient conditions” for therapy.

Rogers died in 1987

Current Status of PC Therapy Special interest of Rogers was application of his theory to international relationships Since 1982 Biennial International Forums on PC approach Workshops at Warm Springs Person-Centered Review began to be published in 1986 (renamed The Person-Centered Journal)

Special interest of Rogers was application of his theory to international relationships

Since 1982 Biennial International Forums on PC approach

Workshops at Warm Springs

Person-Centered Review began to be published in 1986 (renamed The Person-Centered Journal)

Theory of Personality 19 Propositions 1. Individual is center of a continually changing world of experience 2. Organism reacts based on their reality 3. Organism reacts as an organized whole 4. Organism has one basic tendency – actualization 5. Behavior is goal directed based on perception of reality 6. Emotion accompanies and facilitates goal directed behavior

1. Individual is center of a continually changing world of experience

2. Organism reacts based on their reality

3. Organism reacts as an organized whole

4. Organism has one basic tendency – actualization

5. Behavior is goal directed based on perception of reality

6. Emotion accompanies and facilitates goal directed behavior

Theory of Personality 19 Propositions 7. Best point to understand behavior is from the individual’s frame of reference 8. Part of the perceptual field is differentiated as the self 9. Self is formed through interaction 10. Values come from experience and introjection from others

7. Best point to understand behavior is from the individual’s frame of reference

8. Part of the perceptual field is differentiated as the self

9. Self is formed through interaction

10. Values come from experience and introjection from others

Theory of Personality 19 Propositions 11. Experiences are integrated, ignored, or denied 12. Behavior is generally consistent with self concept 13. Behaviors inconsistent with self concept can occur but are seen as “not owned ” 14. Psychological maladjustment comes from denied experiences

11. Experiences are integrated, ignored, or denied

12. Behavior is generally consistent with self concept

13. Behaviors inconsistent with self concept can occur but are seen as “not owned ”

14. Psychological maladjustment comes from denied experiences

Theory of Personality 19 Propositions 15. Psychological adjustment occurs when experiences are assimilated 16. Experiences inconsistent with self-concept are perceived as threats 17. Under the right conditions inconsistent experiences can be examined/assimilated

15. Psychological adjustment occurs when experiences are assimilated

16. Experiences inconsistent with self-concept are perceived as threats

17. Under the right conditions inconsistent experiences can be examined/assimilated

Theory of Personality 19 Propositions 18. When the individual integrates in all of their experiences they are more understanding of others 19. As experiences are integrated an internal locus-of-evaluation develops

18. When the individual integrates in all of their experiences they are more understanding of others

19. As experiences are integrated an internal locus-of-evaluation develops

Roger’s Theory of Personality Summarized Behavior is best understood through the individual’s reality ( perception of experiences) For social purposes, reality is defined as common perceptions across individuals Personal growth occurs through decreased defensiveness

Behavior is best understood through the individual’s reality ( perception of experiences)

For social purposes, reality is defined as common perceptions across individuals

Personal growth occurs through decreased defensiveness

Roger’s Theory of Personality Summarized Self actualization is the organism’s one, basic tendency ( Rogers believed an organism has one basic tendency and striving which is to actualize, maintain and enhance the experiencing organism

Self actualization is the organism’s one, basic tendency ( Rogers believed an organism has one basic tendency and striving which is to actualize, maintain and enhance the experiencing organism

Roger’s Theory of Personality Summarized Experiences inconsistent with self concept are threats leading to increased rigidity Therapy allows the individual to accept and integrate all of their experiences In Roger's personality theory, behavior is defined as a goal directed attempt to satisfy an organism's needs

Experiences inconsistent with self concept are threats leading to increased rigidity

Therapy allows the individual to accept and integrate all of their experiences

In Roger's personality theory, behavior is defined as a goal directed attempt to satisfy an organism's needs

Other Concepts Experience is the private world of the individual Reality basically refers to the private perceptions of the individual; For social purposes , reality consists of perceptions that have a high degree of commonality among individuals

Experience is the private world of the individual

Reality basically refers to the private perceptions of the individual; For social purposes , reality consists of perceptions that have a high degree of commonality among individuals

Other Concepts Self is the organized gestalt of “I” and “me” According to Rogers, the center of an individual's world of experience is the individual The process by which an individual becomes aware of an experience is known as symbolization

Self is the organized gestalt of “I” and “me”

According to Rogers, the center of an individual's world of experience is the individual

The process by which an individual becomes aware of an experience is known as symbolization

Other Concepts In ambiguous situations individuals tend to symbolize experiences in a manner consistent with self concept Carl Rogers would view neurosis as the result of incongruence between the real self and the ideal self. All humans had an actualizing tendency , which he saw as a part of the formative tendency of the world

In ambiguous situations individuals tend to symbolize experiences in a manner consistent with self concept

Carl Rogers would view neurosis as the result of incongruence between the real self and the ideal self.

All humans had an actualizing tendency , which he saw as a part of the formative tendency of the world

Rogerian View of Psychotherapy Implied Therapeutic Conditions Client and therapist must be in psychological contact Client must experience distress Client must be willing to receive conditions offered by therapist

Implied Therapeutic Conditions

Client and therapist must be in psychological contact

Client must experience distress

Client must be willing to receive conditions offered by therapist

Process of PC Therapy Therapy begins at first contact In the first interview, a person centered therapist will go where the client goes For Carl Rogers, empathy, unconditional positive regard, and congruence (genuineness) were the 3 basic requirements to create a therapeutic environment

Therapy begins at first contact

In the first interview, a person centered therapist will go where the client goes

For Carl Rogers, empathy, unconditional positive regard, and congruence (genuineness) were the 3 basic requirements to create a therapeutic environment

Process of PC Therapy Respect shown immediately for client In addition to the basic requirements of the therapeutic environment for the therapist, Rogers believed the client must focus on self-concept , locus-of-evaluation and experiencing Therapy’s length is determined by client (In person centered therapy termination is decided by the client)

Respect shown immediately for client

In addition to the basic requirements of the therapeutic environment for the therapist, Rogers believed the client must focus on self-concept , locus-of-evaluation and experiencing

Therapy’s length is determined by client (In person centered therapy termination is decided by the client)

Process of PC Therapy Quick suggestions and reassurances are avoided Empathy - Understanding another individual by "living" in their internal frame of reference Person centered therapists believe that empathy, unconditional positive regard, and congruence are necessary and sufficient conditions for therapeutic change

Quick suggestions and reassurances are avoided

Empathy - Understanding another individual by "living" in their internal frame of reference

Person centered therapists believe that empathy, unconditional positive regard, and congruence are necessary and sufficient conditions for therapeutic change

Process of PC Therapy Congruence - a correspondence between the thoughts and the behavior of a therapist Client centered therapy focuses most heavily on the present A successful person centered therapy outcome would be defined by the client's evaluation that therapy was beneficial

Congruence - a correspondence between the thoughts and the behavior of a therapist

Client centered therapy focuses most heavily on the present

A successful person centered therapy outcome would be defined by the client's evaluation that therapy was beneficial

Therapist Role and Function Function: to be present and accessible to clients, to focus on immediate experience, to be real in the relationship with clients Through the therapist’s attitude of genuine caring, respect, acceptance, and understanding, clients become less defensive and more open to their experience and facilitate the personal growth

Function: to be present and accessible to clients, to focus on immediate experience, to be real in the relationship with clients

Through the therapist’s attitude of genuine caring, respect, acceptance, and understanding, clients become less defensive and more open to their experience and facilitate the personal growth

Therapist Role and Function Role: Therapist’s attitude and belief in the inner resources of the client, not in techniques, facilitate personal change in the client Use of self as an instrument of change Focuses on the quality of the therapeutic relationship Serves as a model of a human being struggling toward greater realness Is genuine, integrated, and authentic Can openly express feelings and attitudes that are present in the relationship with the client

Role: Therapist’s attitude and belief in the inner resources of the client, not in techniques, facilitate personal change in the client

Use of self as an instrument of change

Focuses on the quality of the therapeutic relationship

Serves as a model of a human being struggling toward greater realness

Is genuine, integrated, and authentic

Can openly express feelings and attitudes that are present in the relationship with the client

Therapy Goals helping a person become a fully functioning person Clients have the capacity to define their goals an openness to experience A trust in themselves An internal source of evaluation A willingness to continue growing

helping a person become a fully functioning person

Clients have the capacity to define their goals

an openness to experience

A trust in themselves

An internal source of evaluation

A willingness to continue growing

Client’s Experience in Therapy Incongruence: discrepancy between self-perception and experience in reality  anxiety  motivation to help As clients feel understood and accepted, their defensiveness is less necessary and they become more open to their experiences Therapeutic relationship activates clients’ self-healing capacities

Incongruence: discrepancy between self-perception and experience in reality  anxiety  motivation to help

As clients feel understood and accepted, their defensiveness is less necessary and they become more open to their experiences

Therapeutic relationship activates clients’ self-healing capacities

Relationship between Therapist and Client Emphasizes the attitudes and personal characteristics of the therapist and the quality of therapeutic relationship. Therapist listening in an accepting way to their clients, they learn how to listen acceptingly to themselves.

Emphasizes the attitudes and personal characteristics of the therapist and the quality of therapeutic relationship.

Therapist listening in an accepting way to their clients, they learn how to listen acceptingly to themselves.

Relationship between Therapist and Client A central variable related to progress in person-centered therapy is the relationship between therapist and client A person-centered therapist is a facilitator

A central variable related to progress in person-centered therapy is the relationship between therapist and client

A person-centered therapist is a facilitator

Therapeutic Techniques It is not technique-oriented The therapeutic relationship is the primary agent of growth in the client Therapist’s presence: being completely engaged in the relationship with clients. The best source of knowledge about the client is the individual client Caring confrontations can be beneficial

It is not technique-oriented

The therapeutic relationship is the primary agent of growth in the client

Therapist’s presence: being completely engaged in the relationship with clients.

The best source of knowledge about the client is the individual client

Caring confrontations can be beneficial

Application individual counseling, group counseling, businesses, international relations, community development education, marriage and family … A variety of problems: anxiety, crisis intervention, interpersonal difficulties, depression, personality disorder…..

individual counseling, group counseling, businesses, international relations, community development education, marriage and family …

A variety of problems: anxiety, crisis intervention, interpersonal difficulties, depression, personality disorder…..

Contribution from a Multicultural Perspective Contributions Has reached more than 30 counties and has been translated to 12 languages Reduction of racial and political tensions… Limitations Some people need more structure, coping skills, directedness Some may focus on family or societal expectations instead of internal evaluation May be unfamiliar with people in different cultures

Contributions

Has reached more than 30 counties and has been translated to 12 languages

Reduction of racial and political tensions…

Limitations

Some people need more structure, coping skills, directedness

Some may focus on family or societal expectations instead of internal evaluation

May be unfamiliar with people in different cultures

Contribution of PC Therapy Contributions Active role of responsibility of client Inner and subjective experience Relationship-centered Focus on therapist’s attitudes Focus on empathy, being present, and respecting the clients’ values Value multicultural context

Contributions

Active role of responsibility of client

Inner and subjective experience

Relationship-centered

Focus on therapist’s attitudes

Focus on empathy, being present, and respecting the clients’ values

Value multicultural context

Summary and Evaluation Limitations Discount the significance of the past Misunderstanding the basic concept: e.g., reflecting feelings. People in crisis situations often need more directive intervention strategies. Client tend to expect a more structured approach.

Limitations

Discount the significance of the past

Misunderstanding the basic concept: e.g., reflecting feelings.

People in crisis situations often need more directive intervention strategies.

Client tend to expect a more structured approach.

Bozarth’s (1998) Summarization of Research on Psychotherapy According to Bozarth's summarization of research on psychotherapy, the most consistent variables affecting therapy are empathy, unconditional positive regard and congruence (genuineness) Effective psychotherapy predicated on: Relationship between therapist and client Internal and external Type of therapy, technique, training and experience of therapists are largely irrelevant Clients who receive psychotherapy improve more than those who do not Little support that specific treatments are best for particular issues Most consistent variables related to effectiveness are empathy, genuineness, and unconditional positive regard

According to Bozarth's summarization of research on psychotherapy, the most consistent variables affecting therapy are empathy, unconditional positive regard and congruence (genuineness)

Effective psychotherapy predicated on:

Relationship between therapist and client

Internal and external

Type of therapy, technique, training and experience of therapists are largely irrelevant

Clients who receive psychotherapy improve more than those who do not

Little support that specific treatments are best for particular issues

Most consistent variables related to effectiveness are empathy, genuineness, and unconditional positive regard