clinical psychology

1. CLIENT CENTEREDCLIENT CENTERED
THERAPYTHERAPY
Lecture 31Lecture 31

2. DEFINITIONDEFINITION
Person-centered therapy, which is alsoPerson-centered therapy, which is also
known as client-centered, non-directive, orknown as client-centered, non-directive, or
Rogerian therapy, is an approach toRogerian therapy, is an approach to
counseling andcounseling and psychotherapypsychotherapy thatthat
places much of the responsibility for theplaces much of the responsibility for the
treatment process on the client, with thetreatment process on the client, with the
therapist taking a nondirective role.therapist taking a nondirective role.

3. PURPOSEPURPOSE
 Two primary goals of person-centered therapyTwo primary goals of person-centered therapy
are increased self-esteem and greaterare increased self-esteem and greater
openness to experience.openness to experience.
 Some of the related changes that this form ofSome of the related changes that this form of
therapy seeks to foster in clients include closertherapy seeks to foster in clients include closer
agreement between the client's idealized andagreement between the client's idealized and
actual selves; better self-understanding; loweractual selves; better self-understanding; lower
levels of defensiveness, guilt, and insecurity;levels of defensiveness, guilt, and insecurity;
more positive and comfortable relationships withmore positive and comfortable relationships with
others; and an increased capacity to experienceothers; and an increased capacity to experience
and express feelings at the moment they occur.and express feelings at the moment they occur.

4. DESCRIPTIONDESCRIPTION
BACKGROUNDBACKGROUND
 Developed in the 1930s by the AmericanDeveloped in the 1930s by the American
psychologistpsychologist Carl Rogers.Carl Rogers.
 Rogers believed that therapy should take placeRogers believed that therapy should take place
in a supportive environment created by a closein a supportive environment created by a close
personal relationship between client andpersonal relationship between client and
therapist.therapist.
 In person-centered therapy, the clientIn 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'swhile the therapist seeks to increase the client's
insight and self-understanding through informalinsight and self-understanding through informal
clarifying questions.clarifying questions.

5.  Beginning in the 1960s, person-centeredBeginning in the 1960s, person-centered
therapy became associated with the humantherapy became associated with the human
potential movement.potential movement.
 This movement, dating back to the beginning ofThis movement, dating back to the beginning of
the 1900s, reflected an altered perspective ofthe 1900s, reflected an altered perspective of
human nature.human nature.
 The human potential movement, definedThe human potential movement, defined
human nature as inherently good. From itshuman nature as inherently good. From its
perspective, human behavior is motivated by aperspective, human behavior is motivated by a
drive to achieve one's fullest potential.drive to achieve one's fullest potential.

6.  Self-actualization,Self-actualization, a term derived refers to thea 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 onThe concept of self-actualization focuses on
human strengths rather than humanhuman strengths rather than human
deficiencies.deficiencies.
 According to Rogers, self-actualization can beAccording 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" andcentered approach" and "way of being" and
began to focus on personal growth and self-began to focus on personal growth and self-
actualization.actualization.

7.  More recently, two major variations of person-centeredMore recently, two major variations of person-centered
therapy have developed:therapy have developed:
 Experiential therapy,Experiential therapy, developed by Eugene Gendlindeveloped 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 ofWhile person-centered therapy is considered one of
the major therapeutic approaches, along withthe major therapeutic approaches, along with
psychoanalytic andpsychoanalytic and cognitive-behavioral therapycognitive-behavioral therapy,,
Rogers's influence is felt in schools of therapy otherRogers's influence is felt in schools of therapy other
than his own. The concepts and methods hethan his own. The concepts and methods he
developed are used in an eclectic fashion by manydeveloped are used in an eclectic fashion by many
different types of counselors and therapists.different types of counselors and therapists.

8. PROCESSPROCESS
 Rogers believed that the most important factorRogers believed that the most important factor
in successful therapy was not the therapist'sin 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 theThree interrelated attitudes on the part of the
therapist aretherapist are
 CongruenceCongruence refers to the therapist's opennessrefers to the therapist's openness
and genuineness—the willingness to relate toand genuineness—the willingness to relate to
clients without hiding behind a professionalclients without hiding behind a professional
facade.facade.

9.  Unconditional positive regardUnconditional positive regard means that themeans that the
therapist accepts the client totally for who he ortherapist accepts the client totally for who he or
she is without evaluating or censoring, andshe 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 theThe therapist communicates this attitude to the
client by a willingness to listen withoutclient by a willingness to listen without
interrupting, judging, or giving advice.interrupting, judging, or giving advice.
 This attitude of positive regard creates a nonThis attitude of positive regard creates a non
threatening context in which the client feels freethreatening 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 aboutor abnormal feelings without worrying about
personal rejection by the therapist.personal rejection by the therapist.

10.  The third necessary component of a therapist'sThe third necessary component of a therapist's
attitude isattitude is empathy.empathy.
 The therapist tries to appreciate the client'sThe therapist tries to appreciate the client's
situation from the client's point of view, showingsituation from the client's point of view, showing
an emotional understanding of and sensitivity toan emotional understanding of and sensitivity to
the client's feelings throughout the therapythe client's feelings throughout the therapy
session.session.
 In person-centered therapy, it actuallyIn person-centered therapy, it actually
constitutes a major portion of the therapeuticconstitutes a major portion of the therapeutic
work itself.work itself.
 Person centered therapists employ a specialPerson centered therapists employ a special
method calledmethod called reflection,reflection, which consists ofwhich consists of
paraphrasing and/or summarizing what a clientparaphrasing and/or summarizing what a client
has just said.has just said.

11.  According to Rogers, when these threeAccording to Rogers, when these three
attitudes (congruence, unconditional positiveattitudes (congruence, unconditional positive
regard, and empathy) are conveyed by aregard, and empathy) are conveyed by a
therapist, clients can freely express themselvestherapist, clients can freely express themselves
without having to worry about what the therapistwithout having to worry about what the therapist
thinks of them.thinks of them.
 Because of this nondirective approach, clientsBecause of this nondirective approach, clients
can explore the issues that are most importantcan explore the issues that are most important
to them—not those considered important by theto them—not those considered important by the
therapist.therapist.

12. APPLICATIONAPPLICATION
 Person centered therapy was not intended for aPerson centered therapy was not intended for a
specific age group or subpopulation but hasspecific 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 withRogers worked extensively with people with
schizophrenia,schizophrenia, depression, anxiety, alcoholdepression, anxiety, alcohol
disorders, cognitive dysfunction, anddisorders, cognitive dysfunction, and
personality disorders.personality disorders.
 The person-centered approach can be used inThe person-centered approach can be used in
individual, group, orindividual, group, or family therapyfamily therapy. With. With
young children, it is frequently employed asyoung children, it is frequently employed as
play therapyplay therapy..

13. NORMAL RESULTSNORMAL RESULTS
 The expected results of person-centeredThe expected results of person-centered
therapy includetherapy include
 Improved self-esteem;Improved self-esteem;
 Trust in one's inner feelings and experiences asTrust in one's inner feelings and experiences as
valuable sources of information for makingvaluable sources of information for making
decisions;decisions;
 Increased ability to learn from (rather thanIncreased ability to learn from (rather than
repeating) mistakes;repeating) mistakes;
 Decreased defensiveness, guilt, and insecurity;Decreased defensiveness, guilt, and insecurity;
more positive and comfortable relationshipsmore positive and comfortable relationships
with others;with others;

14.  An increased capacity to experience andAn 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 newAnd openness to new experiences and new
ways of thinking about life.ways of thinking about life.
 Person-centered therapy, appears to be slightlyPerson-centered therapy, appears to be slightly
less effective than other forms of humanisticless effective than other forms of humanistic
therapy in which therapists offer more advice totherapy in which therapists offer more advice to
clients and suggest topics to explore.clients and suggest topics to explore.

15. ABNORMAL RESULTSABNORMAL RESULTS
 If therapy has been unsuccessful, the client willIf therapy has been unsuccessful, the client will
not move in the direction of self-growth andnot move in the direction of self-growth and
self-acceptance.self-acceptance.
 Several factors may affect the success ofSeveral factors may affect the success of
person-centered therapy.person-centered therapy.
 Clients tend to overlook occasional therapistClients tend to overlook occasional therapist
failures if a satisfactory relationship has beenfailures if a satisfactory relationship has been
established.established.
 Some studies have suggested that certainSome studies have suggested that certain
clients may get bored, frustrated, or annoyedclients may get bored, frustrated, or annoyed
with a Rogerian style of therapeutic interaction.with a Rogerian style of therapeutic interaction.

16. THE HUMANISTIC EXISTENTIALTHE HUMANISTIC EXISTENTIAL
MOVEMENTMOVEMENT
 The strands of phenomenology, humanism, andThe strands of phenomenology, humanism, and
existentialism in psychology are inextricably wovenexistentialism in psychology are inextricably woven
together. We know the importance that Rogerstogether. We know the importance that Rogers
attached to immediate experience. This is basicattached to immediate experience. This is basic
phenomenology. At the same time, client-centeredphenomenology. At the same time, client-centered
approaches stress the worth, uniqueness, and dignityapproaches stress the worth, uniqueness, and dignity
of the client. This is basic humanism. Before weof 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 theand Gestalt therapy, let us pause to acknowledge the
humanistic tradition that pervades those therapies.humanistic tradition that pervades those therapies.

17. HUMANISMHUMANISM
 When one speaks of humanism, one thinks ofWhen 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 notFrom a humanist perspective, people are not
products of the past, the unconscious, or theproducts of the past, the unconscious, or the
environment. Rather, they exercise free choiceenvironment. Rather, they exercise free choice
in the pursuit of their inner potential and selfin the pursuit of their inner potential and self
actualization.actualization.
 They are not fragmented patch­works ofThey are not fragmented patch­works 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.

18.  To understand is to appreciate those qualities,To understand is to appreciate those qualities,
and this understanding can only be achievedand 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, orThe emphasis is not on sickness, deviations, or
diagnostic labels, but on positive striving, self­diagnostic labels, but on positive striving, self­
actualization freedom and naturalness.actualization freedom and naturalness.
 In one form or another humanism is expressedIn one form or another humanism is expressed
as a resistance to the positivistic determinismas a resistance to the positivistic determinism
of science and as an active embrace of theof science and as an active embrace of the
essential humanity of people.essential humanity of people.

19. EXISTENTIAL THERAPYEXISTENTIAL THERAPY
 Existential psychology rejects the mechanisticExistential psychology rejects the mechanistic
views of the Freudians and instead sees peopleviews 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 meaningpromise the restoration of meaning
to life, an increased spiritual awakening, andto life, an increased spiritual awakening, and
individual growth that will bring freedom fromindividual growth that will bring freedom from
the conventional shackles created by athe conventional shackles created by a
conformist society.conformist society.
 Hardly a unified movement that speaks with aHardly a unified movement that speaks with a
single voice, the existential view actually turnssingle voice, the existential view actually turns
out to be many viewsout to be many views

20.  The existentialists make a number of assertionsThe existentialists make a number of assertions
about human nature: the search for meaning.about human nature: the search for meaning.
 From theFrom the standpointstandpoint 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 decisionA crucial facet of personality is decision
making, which involves the world of both factsmaking, which involves the world of both facts
and possibilities.and possibilities.
 Decision making involves a set of inevitableDecision making involves a set of inevitable
choices.choices.
 That choice will lead to guilt and remorse ­overThat choice will lead to guilt and remorse ­over
missed opportunities.missed opportunities.
 But one can also choose alliance with theBut one can also choose alliance with the
future.future.

21.  That choice propels the person into the futureThat choice propels the person into the future
with an anxiety that stems from one's inability towith 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 andIt requires courage to choose ­the future and
suffer the inevitable anxieties that this ­choicesuffer the inevitable anxieties that this ­choice
entails.entails.
 A person can find that courage by having faithA person can find that courage by having faith
in self and by recognizing that choosing thein self and by recognizing that choosing the
past will inevitably lead to a guilt that is evenpast will inevitably lead to a guilt that is even
more terrifying than anxiety.more terrifying than anxiety.

22.  THE GOALS OF THERAPY:THE GOALS OF THERAPY:
 The ultimate goal of existential psychotherapyThe ultimate goal of existential psychotherapy
is to help the individual reach a point at whichis to help the individual reach a point at which
awareness and decision making can beawareness and decision making can be
exercised responsibly.exercised responsibly.
 Through therapy, one must learn to acceptThrough therapy, one must learn to accept
responsibility for one's own decisions and toresponsibility for one's own decisions and to
tolerate the anxiety that accumulates as onetolerate the anxiety that accumulates as one
moves toward change.moves toward change.
 This involves self­trust and also a capacity toThis involves self­trust and also a capacity to
accept those things in life that areaccept those things in life that are
unchangeable or inevitable.unchangeable or inevitable.

23.  TECHNIQUES:TECHNIQUES:
 Existential therapy does not emphasizeExistential therapy does not emphasize
techniques.techniques.
 Instead, the emphasis is on understanding andInstead, the emphasis is on understanding and
on experiencing the client as­ a uniqueon experiencing the client as­ a unique
essence.essence.
 Therapy is an encounter that should enable theTherapy 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 clientSometimes the therapist will confront the client
with questions,­­for focusing.with questions,­­for focusing.
 Gendlin (1969, 1981) discusses focusing as aGendlin (1969, 1981) discusses focusing as a
means of reaching the pre­conceptual, feltmeans of reaching the pre­conceptual, felt
sense.sense.

24.  LOGOTHERAPYLOGOTHERAPY
 This technique encourages the client to findThis 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 heHe moved on an existential framework as he
tried to findtried to find waysways of dealing with experiences inof dealing with experiences in
Nazi concentrationNazi concentration camps.camps.
 What was required was a personal meaning forWhat was required was a personal meaning for
existence.existence.
 From his war­time experiences and theFrom his war­time experiences and the
existential insights that he felt permitted him toexistential insights that he felt permitted him to
survive, Frankl developed logotherapy (thesurvive, Frankl developed logotherapy (the
therapy of meaning)therapy of meaning)

25.  Logotherapy is designed not to replace but toLogotherapy is designed not to replace but to
complement more traditional psychotherapy.complement more traditional psychotherapy.
 Frankl regards logotherapy as the specificFrankl regards logotherapy as the specific
therapy of choice.therapy of choice.
 Logotherapy then strives to inculcate a senseLogotherapy then strives to inculcate a sense
of the client's own responsibility and obligationsof the client's own responsibility and obligations
to life.to life.
 Frankl makes much of responsibility, regardingFrankl makes much of responsibility, regarding
it as more important than historical events init as more important than historical events in
the client's life. What is crucial is the meaningthe client's life. What is crucial is the meaning
of the present and the outlook for the future.of the present and the outlook for the future.

26.  In particular, two techniques described byIn particular, two techniques described by
Frankl (1960) have gained considerableFrankl (1960) have gained considerable
exposure.exposure.
 Paradoxical intentionParadoxical intention isis a popular techniquea popular technique
in which the client is told to consciously at­in which the client is told to consciously at­
tempt to perform the very behavior ortempt to perform the very behavior or
response that is the object of anxiety andresponse that is the object of anxiety and
concern. Fear is thus replaced by aconcern. 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 troublesomeinstructs the client to ignore a troublesome
behavior or symptom.behavior or symptom.
 De­reflection attempts to divert the client'sDe­reflection attempts to divert the client's
attention to more constructive activities andattention to more constructive activities and
reflections

27.  GESTALT THERAPYGESTALT THERAPY
 InIn Gestalt therapy„ theGestalt therapy„ the emphasis is on recentemphasis is on recent
experience and on the immediate awareness ofexperience 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 thereplaces the
search for the origins of behavior.search for the origins of behavior.
 The "unreality" of computers and plastic creditThe "unreality" of computers and plastic credit
cards has overwhelmed the true meaning ofcards has overwhelmed the true meaning of
life, which can only be found in the immediatelife, which can only be found in the immediate
experience of emotions.experience of emotions.
 Gestalt therapy promises to restore theGestalt therapy promises to restore the
balance.balance.

28. ConclusionConclusion

29.  These forms of treatment; Client centered,These forms of treatment; Client centered,
Existential and Humanistic; have made severalExistential and Humanistic; have made several
noteworthy contributions to the field ofnoteworthy 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 theand growth potential have been brought to the
forefront. Demonstrating the importance of theforefront. Demonstrating the importance of the
therapeutic relationship and of rapport istherapeutic relationship and of rapport is
another major contribution.another major contribution.
 However, these forms of therapy also presentHowever, these forms of therapy also present
some problems.some problems.