Nondirective psychotherapy

Client-Centered Therapy (CCT) was developed by the humanist psychologist Carl Rogers in the 1940s and 1950s. It is used to help a person achieve personal growth and or come to terms with a specific event or problem they are having. CCT is based on the principal of talking therapy and is a non-directive approach. The therapist encourages the patient to express their feelings and does not suggest how the person might wish to change, but by listening and then mirroring back what the patient reveals to them, helps them to explore and understand their feelings for themselves. The patient is then able to decide what kind of changes they would like to make and can achieve personal growth. Although this technique has been criticized by some for its lack of structure and set method it has proved to be a hugely effective and popular treatment. CCT is predominately used by psychologists and counsellors in psychotherapy.

Introduction

Client-Centered Therapy or Person-Centered Therapy, now considered a founding work in the humanistic school of psychotherapies, began formally with Carl Rogers broadly considered the most influential US psychotherapist in the short history of this field.

Person-Centered Therapy was developed by Carl Rogers. He referred to it as counseling rather than psychotherapy. He also believed that the relationship between the client and the therapist is not a patient-doctor relationship in which the patient passively submits to something that is done to him/her by the healer. On the contrary, it should be a person-to-person relationship in which the therapists talks with the client. By using the word "client" instead of "patient," Rogers wanted to indicate that the client is not sick in any organic sense.

“Rogerian” psychotherapy is often identified as one of the major school groups, along with Psychoanalytic (most famously Sigmund Freud), Depth Therapy which bridges from Psychoanalytic through archetypal, mythographical, dream, and unconscious material to existentialists like Rollo May, and the increasingly popular Cognitive-Behavioral school. Others acknowledge Rogers' broad influence on approach, while naming a humanistic or humanistic-existentialist school group; there is large debate over what constitute major schools and cross-influences with more tangential candidates such as feminist, Gestalt, British school, self psychology, interpersonal, family systems, integrative, systemic and communicative, with several historical influences seeding them such as object-relations.

Personality Theory

Actualizing tendency

Rogers believed that all creatures have a built-in life force, that he called the "actualizing tendency," which is a motivation to develop one's potential as fully as possible. He saw psychological development as the process of a person becoming more fully themselves. Abraham Maslow referred to this tendency as "self-actualization."

Fully functioning person

Rogers termed the healthy person, the one who is clearly on the path of actualization, "fully functioning," and he identified five qualities that make us healthy:

Openness to experience

Openness to experience means that one is able to accurately perceive one's feelings and experiences in the world, and accept that reality. Openness includes feelings because these are what convey "organismic valuing," or the sense of whether something is good or bad for the person.

Existential living

Existential living means living in the present, rather than the past, which has gone, or the future, which does not yet exist. Rogers did not mean that the past and future do not exist, though, only that they should be recognized as what they are: the past is contained in memories which we can learn from, and the future contains our dreams, hopes, and plans for what we intend to do. The present, however is the reality we must deal with now.

Organismic trusting

Rogers believed that organisms know what is good for them: evolution has provided all living creatures, including plants, animals, and human beings, with senses to discriminate between what is good and what is bad for them. Therefore, people should allow themselves to be guided by this process, trusting their own thoughts and feelings as accurate, and doing what comes naturally as what feels right will be the right thing for us to do.

Here it is important to understand that Rogers did not advocate hurting others or oneself just because it might feel good! For Rogers, organismic trusting means trusting what your "real self" feels, which is in touch with what is actually good for you.

Experiential freedom

Experiential freedom refers to the feeling of freedom that we have when choices are available to us. Rogers noted that we are not free to do anthing we might want, but there are many aspects of life in which we make choices. Acknowledging these choices and taking responsibility for one's actions is how a fully functioning person experiences freedom.

Creativity

Rogers believed that the healthy, fully functioning person naturally participates in human society, and makes every effort to give their best possible contribution to the world. Such contributiions may be through one's work, social relationships, or creative work in the arts or sciences.

Psychological problems

Inocongruity

Rogers thought there were three selves in us: the self-concept, the real self, and the ideal self. The self-concept is the way a person sees him- or herself. The ideal self is who one would like to be or ought to be. The real self is who one actually is. Congruence is the amount of agreement between the self-concept, the real self and the ideal self. The more congruence, the more psychological health there is within the client. If a person’s idea of who she/he is bears a great similarity to what she/he wants to be, that person will be relatively self-accepting. It’s the aim of Person Centred Counselling to increase the client’s congruence.

Rogers called the "real self" that aspect of an individual that is pursuing the actualizing tendency, following organismic valuing, needing and receiving positive regard and self-regard. It is an individual's potential on the way to being realized. On the other hand, due to society imposing conditions of worth that are out of step with organismic valuing, such that individuals receive only conditional postive regard and self-worth, we develop an "ideal self." This ideal self is not real, a standard that cannot be met, an impossible goal to achieve. The gap between this "ideal self" and the "real self" Rogers termed "incongruity." The greater the gap, the greater the suffering a person experiences. This suffering due to the mismatch between one's idealized self and one's true self is Rogers' expression of neurosis.

Defenses

Therapy

Rogers took the approach that every individual has the resources for personal development and growth and that it is the role of the counsellor to provide the favourable conditions (which for Rogers were congruence, empathy and unconditional positive regard) for the natural phenomenon of personal development to occur.

Requirements of the therapist

Rogers affirmed individual personal experience as the basis and standard for living and therapeutic effect. Three attitudinal requirements in an effective therapist, in his view, include empathy with the patient's emotions and perspective, genuineness, and unconditional positive regard for the patient. Both active and passive aspects of empathy in the therapist have been identified. This emphasis contrasts with the dispassionate position which may be intended in other therapies. Living in the present rather than the past or future, with organismic trust, naturalistic faith in your own thoughts and the accuracy in your feelings, and a responsible acknowledgement of your freedom, with a view toward participating fully in our world, contributing to other people's lives, are hallmarks of Roger's Client-Centered Therapy.

Unconditional positive regard

To create an atmosphere of psychological safety within the counseling relationship, Rogers believed the therapist should have unconditional positive regard for the client – that is, not judge the client’s character. If the client feels that his/her character is being evaluated, he/she will put on a false front or perhaps leave therapy altogether. The client is free to explore all thoughts and feelings, positive or negative, without danger of rejection or condemnation. Crucially, the client is free to explore and to express without having to do anything in particular or meet any particular standards of behaviour to 'earn' positive regard from the counsellor. Low self-regard, or low congruence, is the result of the client’s having been judged in the past. Parents, teachers, and other authority figures often act as if the child has no intrinsic value as a person unless he/she behaves the way they say he/she ought to behave. Thus, their regard is conditional. The Person-Centered therapist gives unconditional positive regard as a partial antidote for the client’s earlier experiences.

Empathetic understanding

The person-centered therapist should sense the client’s world as if it were her/his own. However, the therapist must sense the client’s emotions without getting bound up in them. he second — empathic understanding — means that the counsellor accurately understands the client's thoughts, feelings, and meanings from the client's own perspective. When the counsellor perceives what the world is like from the client's point of view, it demonstrates not only that that view has value, but also that the client is being accepted.

Congruence

By "congruence" Rogers meant that a counselor should be authentic and genuine; he or she should not present an aloof professional facade, but rather be real and transparent to the client. There should be no air of authority or hidden knowledge. Thus, the client should feel that the counselor is being honest with them, responding as a true person, not analyzing the client's communication according to some theoretical system.

Reflection

Two processes foster empathetic understanding: reflection and clarification. Reflection occurs when the therapist repeats fragments of what the client has said with little change, conveying to the client a nonjudgmental understanding of his/her statements. Clarification occurs when the therapist abstracts the core or the essence of a set of remarks by the client.

Criticism

A frequent criticism of the person-centred approach is that delivering the core conditions is what all good therapists do anyway, before they move on to applying their expertise and doing the real work of 'making clients better'. On the face of it, this criticism reflects a misunderstanding of the real challenges of consistently manifesting unconditional positive regard, empathic understanding and congruence. This is especially true of congruence: to the extent that some therapeutic techniques deployed in some other traditions depend on the counsellor's willingness to 'hold back', mentally formulate hypotheses about the client, or conceal their own personal reactions behind a consistent professional face, there is a real challenge in applying these techniques with the openness and honesty which defines congruence. It may also demonstrate something of a reluctance to take seriously the empirical research on counselling effectiveness and the conclusion that the quality of the client-counsellor relationship is a leading predictor of therapeutic effectiveness — although this is somewhat more controversial, since one might argue that providing the core conditions is not the only way to achieve a quality relationship.

At a deeper level, however, there is a more sophisticated point lurking, which many expositions of person-centred theory seem to avoid addressing head-on. Namely, given that the self is the single most important resource the person-centred counsellor brings to the therapeutic relationship, it makes sense to ask: what (if anything) is it important that this self has, apart from the three core conditions? I.e., manifesting of the core conditions does not by itself tell us what experiences or philosophies the counsellor is bringing to the relationship. It tells us that the client will have transparent access to that self — because the counsellor is congruent — but it doesn't tell us anything else about that self. Whether or not that self should be developed in any particular way, or whether that self should acquire any particular background knowledge, seems to me a question which is more often side-stepped than answered within the person-centred tradition.

(Another way to understand this point is this: given two counsellors, each of whom manifests the core conditions to some specified degree, what else, if anything, matters? Would it be better for a given client to have the one who is an expert at astrophysics or the one who is an economist? Would it be better for a given client to have the one who struggled through a decade of ethnic cleansing in a war-torn country or the one who went to private school in an affluent suburb and subsequently worked as a stockbroker? Aside from academic expertise and personal history, what about personal philosophy, parenthood, and other factors?)

On the other hand, there is research that indicates that the personality of the therapist is a better predictor of success than the techniques used (Boeree, 2006). Thus, Rogers' emphasis on the harmonious relationship between counselor and client should be appreciated as a significant insight into the therapeutic process.

References
ISBN links support NWE through referral fees

Bruno, Frank J. (1977). Client-Centered Counseling: Becoming a Person. In Human Adjustment and Personal Growth: Seven Pathways, pp. 362-370. John Wiley & Sons.
Rogers, Carl R. 1942. Counseling and Psychotherapy. Houghton Mifflin. ISBN 0395053218
Rogers, Carl R. 1951. Client-centered Therapy. Houghton Mifflin College Division. ISBN 0395053226
Rogers, Carl R. 1961. On Becoming a Person. Houghton Mifflin. ISBN 0395081343
Rogers, Carl R. 1980. Becoming Partners: Marriage and Its Alternative. Dell Publishing Co.
Rogers, Carl R. 1980. A Way of Being. Houghton Mifflin. ISBN 0395299152
Rogers, Carl R. 1989. The Carl Rogers Reader. Mariner Books. ISBN 0395483573

External links

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