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Mental Disorders Ob-Ps Person-centered therapy

Person-centered therapy

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Definition

Person-centered therapy, which is also known as client-centered, non-directive, or

Rogerian therapy, is an approach to counseling and psychotherapy that places
much of the responsibility for the treatment process on the client, with the therapist
taking a nondirective role.

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

Description
Background
Developed in the 1930s by the American psychologist Carl Rogers, client-centered
therapy departed from the typically formal, detached role of the therapist
emphasized in psychoanalysis and other forms of treatment. Rogers believed that
therapy should take place in a supportive environment created by a close personal
relationship between client and therapist. Rogers's introduction of the term "client"
rather than "patient" expresses his rejection of the traditionally hierarchical
relationship between therapist and client and his view of them as equals. In personcentered therapy, the client determines the general direction of therapy, while the
therapist seeks to increase the client's insight and self-understanding through
informal clarifying questions.
Beginning in the 1960s, person-centered therapy became associated with the human
potential movement. This movement, dating back to the beginning of the 1900s,
reflected an altered perspective of human nature. Previous psychological theories
viewed human beings as inherently selfish and corrupt. For example, Freud's theory
focused on sexual and aggressive tendencies as the primary forces driving human
behavior. The human potential movement, by contrast, defined human nature as
inherently good. From its perspective, human behavior is motivated by a drive to
achieve one's fullest potential.

Self-actualization, a term derived from the human potential movement, is an

important concept underlying person-centered therapy. It refers to the tendency of
all human beings to move forward, grow, and reach their fullest potential. When
humans move toward self-actualization, they are also pro-social; that is, they tend to
be concerned for others and behave in honest, dependable, and constructive ways.
The concept of self-actualization focuses on human strengths rather than human
deficiencies. According to Rogers, self-actualization can be blocked by an
unhealthy self-concept (negative or unrealistic attitudes about oneself).
Rogers adopted terms such as "person-centered approach" and "way of being" and
began to focus on personal growth and self-actualization. He also pioneered the use
of encounter groups, adapting the sensitivity training (T-group) methods developed
by Kurt Lewin (1890-1947) and other researchers at the National Training
Laboratories in the 1950s. More recently, two major variations of person-centered
therapy have developed: experiential therapy, developed by Eugene Gendlin in 1979;
and process-experiential therapy, developed by Leslie Greenberg and colleagues in
1993.
While person-centered therapy is considered one of the major therapeutic
approaches, along with psychoanalytic and cognitive-behavioral therapy ,
Rogers's influence is felt in schools of therapy other than his own. The concepts and
methods he developed are used in an eclectic fashion by many different types of
counselors and therapists.

Process
Rogers believed that the most important factor in successful therapy was not the
therapist's skill or training, but rather his or her attitude. Three interrelated attitudes
on the part of the therapist are central to the success of person-centered
therapy: congruence; unconditional positive regard; and empathy. Congruence refers
to the therapist's openness and genuinenessthe willingness to relate to clients
without hiding behind a professional facade. Therapists who function in this way
have all their feelings available to them in therapy sessions and may share significant
emotional reactions with their clients. Congruence does not mean, however, that
therapists disclose their own personal problems to clients in therapy sessions or shift
the focus of therapy to themselves in any other way.

Unconditional positive regard means that the therapist accepts the client totally for
who he or she is without evaluating or censoring, and without disapproving of
particular feelings, actions, or characteristics. The therapist communicates this
attitude to the client by a willingness to listen without interrupting, judging, or giving
advice. This attitude of positive regard creates a nonthreatening context in which the
client feels free to explore and share painful, hostile, defensive, or abnormal feelings
without worrying about personal rejection by the therapist.
The third necessary component of a therapist's attitude is empathy ("accurate
empathetic understanding"). The therapist tries to appreciate the client's situation
from the client's point of view, showing an emotional understanding of and
sensitivity to the client's feelings throughout the therapy session. In other systems of
therapy, empathy with the client would be considered a preliminary step
to enabling the therapeutic work to proceed; but in person-centered therapy, it
actually constitutes a major portion of the therapeutic work itself. A primary way of
conveying this empathy is by active listening that shows careful and perceptive
attention to what the client is saying. In addition to standard techniques, such as eye
contact, that are common to any good listener, person-centered therapists employ a
special method called reflection, which consists of paraphrasing and/or summarizing
what a client has just said. This technique shows that the therapist is listening
carefully and accurately, and gives clients an added opportunity to examine their own
thoughts and feelings as they hear them repeated by another person. Generally,
clients respond by elaborating further on the thoughts they have just expressed.
According to Rogers, when these three attitudes (congruence, unconditional positive
regard, and empathy) are conveyed by a therapist, clients can freely express
themselves without having to worry about what the therapist thinks of them. The
therapist does not attempt to change the client's thinking in any way. Even negative
expressions are validated as legitimate experiences. Because of this nondirective
approach, clients can explore the issues that are most important to themnot those
considered important by the therapist. Based on the principle of self-actualization,
this undirected, uncensored self-exploration allows clients to eventually recognize
alternative ways of thinking that will promote personal growth. The therapist merely
facilitates self-actualization by providing a climate in which clients can freely engage
in focused, in-depth self-exploration.

Applications
Rogers originally developed person-centered therapy in a children's clinic while he
was working there; however, person-centered therapy was not intended for a specific
age group or subpopulation but has been used to treat a broad range of people.
Rogers worked extensively with people with schizophrenia later in his career. His
therapy has also been applied to persons suffering from depression, anxiety, alcohol
disorders, cognitive dysfunction, and personality disorders . Some therapists
argue that person-centered therapy is not effective with non-verbal or poorly
educated individuals; others maintain that it can be successfully adapted to any type
of person. The person-centered approach can be used in individual, group, or family
therapy . With young children, it is frequently employed as play therapy .
There are no strict guidelines regarding the length or frequency of person-centered
therapy. Generally, therapists adhere to a one-hour session once per week. True to
the spirit of person-centered therapy, however, scheduling may be adjusted
according to the client's expressed needs. The client also decides when to terminate
therapy. Termination usually occurs when he or she feels able to better cope with
life's difficulties.

Normal results
The expected results of person-centered therapy include improved self-esteem; trust
in one's inner feelings and experiences as valuable sources of information for making
decisions; increased ability to learn from (rather than repeating) mistakes; decreased
defensiveness, guilt, and insecurity; more positive and comfortable relationships
with others; an increased capacity to experience and express feelings at the moment
they occur; and openness to new experiences and new ways of thinking about life.
Outcome studies of humanistic therapies in general and person-centered therapy in
particular indicate that people who have been treated with these approaches
maintain stable changes over extended periods of time; that they change
substantially compared to untreated persons; and that the changes are roughly
comparable to the changes in clients who have been treated by other types of
therapy. Humanistic therapies appear to be particularly effective in clients with
depression or relationship issues. Person-centered therapy, however, appears to be

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

Abnormal results
If therapy has been unsuccessful, the client will not move in the direction of selfgrowth and self-acceptance. Instead, he or she may continue to display behaviors
that reflect self-defeating attitudes or rigid patterns of thinking.
Several factors may affect the success of person-centered therapy. If an individual is
not interested in therapy (for example, if he or she was forced to attend therapy), that
person may not work well together with the therapist. The skill of the therapist may
be another factor. In general, clients tend to overlook occasional therapist failures if a
satisfactory relationship has been established. A therapist who continually fails to
demonstrate unconditional positive regard, congruence, or empathy cannot
effectively use this type of therapy. A third factor is the client's comfort level with
nondirective therapy. Some studies have suggested that certain clients may get
bored, frustrated, or annoyed with a Rogerian style of therapeutic interaction.

Resources
BOOKS
Cain, David J., ed. Humanistic Psychotherapies: Handbook of Research and
Practice. Washington, DC: American Psychological Association, 2001.
Greenberg, Leslie S., Jeanne C. Watson, and Germain Lietauer, eds. Handbook of
Experiential Psychotherapy. New York: Guilford Press, 1998.
Rogers, Carl. Client-Centered Therapy. Boston: Houghton Mifflin, 1951.
. On Becoming a Person. Boston: Houghton Mifflin, 1961.
. A Way of Being. Boston: Houghton Mifflin, 1980.
Sachse, Rainer, and Robert Elliott. "Process-Outcome Research on Humanistic
Therapy Variables." In Humanistic Psychotherapies: Handbook of Research

and Practice, edited by David J. Cain. Washington, DC: American Psychological

Association, 2001.
Thorne, Brian, and Elke Lambers, eds. Person-Centered Therapy: A European
Perspective. London, UK: Sage Publications, 1999.

PERIODICALS
Kahn, Edwin. "A Critique of Nondirectivity in the Person-Centered
Approach." Journal of Humanistic Psychology 39, no. 4 (1999): 94-110.
Kensit, Denise A. "Rogerian Theory: A Critique of the Effectiveness of Pure ClientCentred Therapy." Counselling Psychology Quarterly 13, no. 4 (2000): 345-351.
Myers, Sharon. "Empathic Listening: Reports on the Experience of Being
Heard." Journal of Humanistic Psychology 40, no. 2 (2000): 148-173.
Walker, Michael T. "Practical Applications of the Rogerian Perspective in
Postmodern Psychotherapy." Journal of Systemic Therapies 20, no. 2 (2001): 41-57.
Ward, Elaine, Michael King, Margaret Lloyd, Peter Bower, Bonnie Sibbald, Sharon
Farrelly, Mark Gabbay, Nicholas Tarrier, and Julia Addington-Hall. "Randomised
Controlled Trial of Non-Directive Counselling, Cognitive-Behaviour Therapy, and
Usual General Practitioner Care for Patients with Depression. I: Clinical
Effectiveness." British Medical Journal 321, no. 7273(2000): 1383-1388.

ORGANIZATIONS
Association for the Development of the Person-Centered
Approach. <http://www.adpca.org> .
Center for Studies of the Person. 1150 Silverado, Suite 112, La Jolla, California 92037.
(858) 459-3861. <http://www.centerfortheperson.org> .
World Association for Person-Centered and Experiential Psychotherapy and
Counseling (WAPCEPC). c/o SGGT Office, Josefstrasse 79, CH-8005 Zrich,
Switzerland. +41 1 2717170. <http://pce-world.org> .

Sandra L. Friedrich, M.A.

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