Person-centered therapy

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Person-centered therapy
MeSH D009629

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]

Contents

It is one of the most influential and fundamental modalities of treatment in modern psychological practice, and is applied almost universally in modern psychotherapy. However, it is rarely used on its own; typically it is combined with other forms of therapy.

History and influences

Person-centered therapy, now considered a founding work in the humanistic school of psychotherapies, began with Carl Rogers, [6] :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. [6] :3

Rogers affirmed individual personal experience as the basis and standard for living and therapeutic effect. [6] :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' person-centered therapy.[ citation needed ] Rogers also claimed that the therapeutic process is essentially 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. [7]

Although client-centered therapy has been criticized by behaviorists for lacking structure and by psychoanalysts for actually providing a conditional relationship, [6] it has been shown to be an effective[ clarification needed ] treatment. [8] [9] [10] [11]

The necessary and sufficient conditions

Rogers (1957; 1959) stated that there are six necessary and sufficient conditions required for therapeutic change: [6] :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: that 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: that 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 willingness 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 he or she is 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-centred 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. [12] 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 therapists' role was to create a facilitative, empathic environment wherein the client could discover the answers for him or herself. [13]

See also

Related Research Articles

Carl Rogers American psychologist

Carl Ransom Rogers was an American psychologist and among the founders of the humanistic approach in psychology. Rogers is widely considered to be one of the founding fathers of psychotherapy research and was honored for his pioneering research with the Award for Distinguished Scientific Contributions by the American Psychological Association (APA) in 1956.

Psychotherapy is the use of psychological methods, particularly when based on regular personal interaction with adults, to help a person change behavior and overcome problems in desired ways. Psychotherapy aims to improve an individual's well-being and mental health, to resolve or mitigate troublesome behaviors, beliefs, compulsions, thoughts, or emotions, and to improve relationships and social skills. There are also numerous types of psychotherapy designed for children and adolescents, such as play therapy. Certain psychotherapies are considered evidence-based for treating some diagnosed mental disorders. Others have been criticized as pseudoscience.

Humanistic psychology is a psychological perspective that rose to prominence in the mid-20th century in answer to the limitations of Sigmund Freud's psychoanalytic theory and B. F. Skinner's behaviorism. With its roots running from Socrates through the Renaissance, this approach emphasizes the individual's inherent drive toward self-actualization, the process of realizing and expressing one's own capabilities and creativity.

Gestalt therapy is a form of psychotherapy which emphasizes personal responsibility and focuses upon the individual's experience in the present moment, the therapist–client relationship, the environmental and social contexts of a person's life, and the self-regulating adjustments people make as a result of their overall situation. It was developed by Fritz Perls, Laura Perls and Paul Goodman in the 1940s and 1950s, and was first described in the 1951 book Gestalt Therapy.

Clinical psychology is an integration of science, theory, and clinical knowledge for the purpose of understanding, preventing, and relieving psychologically-based distress or dysfunction and to promote subjective well-being and personal development. Central to its practice are psychological assessment, clinical formulation, and psychotherapy, although clinical psychologists also engage in research, teaching, consultation, forensic testimony, and program development and administration. In many countries, clinical psychology is a regulated mental health profession.

Counseling psychology is a psychological specialty that encompasses research and applied work in several broad domains: counseling process and outcome; supervision and training; career development and counseling; and prevention and health. Some unifying themes among counseling psychologists include a focus on assets and strengths, person–environment interactions, educational and career development, brief interactions, and a focus on intact personalities.

Rational emotive behavior therapy (REBT), previously called rational therapy and rational emotive therapy, is an active-directive, philosophically and empirically based psychotherapy, the aim of which is to resolve emotional and behavioral problems and disturbances and to help people to lead happier and more fulfilling lives.

Unconditional positive regard, a concept developed by the humanistic psychologist Carl Rogers, is the basic acceptance and support of a person regardless of what the person says or does, especially in the context of client-centred therapy. Its founder, Carl Rogers, writes:

For me it expresses the primary theme of my whole professional life, as that theme has been clarified through experience, interaction with others, and research. This theme has been utilized and found effective in many different areas until the broad label 'a person-centred approach' seems the most descriptive. The central hypothesis of this approach can be briefly stated. It is that the individual has within him or her self vast resources for self-understanding, for altering her or his self-concept, attitudes, and self-directed behaviour—and that these resources can be tapped if only a definable climate of facilitative psychological attitudes can be provided.

The therapeutic relationship refers to the relationship between a healthcare professional and a client or patient. It is the means by which a therapist and a client hope to engage with each other and effect beneficial change in the client.

Child psychotherapy, or mental health interventions for children have developed varied approaches over the last century. Two distinct historic pathways can be identified for present-day provision in Western Europe and in the United States: one through the Child Guidance Movement, the other stemming from Adult psychiatry or Psychological Medicine, which evolved a separate Child psychiatry specialism.

Les Greenberg is a Canadian psychologist born in Johannesburg, South Africa, and is one of the originators and primary developers of Emotion-Focused Therapy for individuals and couples. He is a professor emeritus of psychology at York University in Toronto, and also director of the Emotion-Focused Therapy Clinic in Toronto. His research has addressed questions regarding empathy, psychotherapy process, the therapeutic alliance, and emotion in human functioning.

History of psychotherapy

Although modern, scientific psychology is often dated from the 1879 opening of the first psychological clinic by Wilhelm Wundt, attempts to create methods for assessing and treating mental distress existed long before. The earliest recorded approaches were a combination of religious, magical and/or medical perspectives. Early examples of such psychological thinkers included Patañjali, Padmasambhava, Rhazes, Avicenna and Rumi.

Emotionally focused therapy and emotion-focused therapy (EFT) are a family of related approaches to psychotherapy with individuals, couples, or families. EFT approaches include elements of experiential therapy, systemic therapy, and attachment theory. EFT is usually a short-term treatment. EFT approaches are based on the premise that human emotions are connected to human needs, and therefore emotions have an innately adaptive potential that, if activated and worked through, can help people change problematic emotional states and interpersonal relationships. Emotion-focused therapy for individuals was originally known as process-experiential therapy, and it is still sometimes called by that name.

Elias Hull Porter was an American psychologist. While at the University of Chicago Porter was a peer of other notable American psychologists, including Carl Rogers, Thomas Gordon, Abraham Maslow and Will Schutz. His work at Ohio State University and later at the University of Chicago contributed to Rogers’ development of client-centered therapy. Porter's primary contributions to the field of psychology were in the areas of non-directive approaches, relationship awareness theory and psychometric tests. His career included military, government, business and clinical settings.

Status dynamic psychotherapy (SDT) is an approach to psychotherapy that was created by Peter G. Ossorio at the University of Colorado in the late 1960s as part of a larger system known as "descriptive psychology". Its distinguishing characteristic is that it does not focus on the factors traditionally targeted by psychotherapy such as the client’s behaviors, cognitions, insight into unconscious factors, and patterns of interaction with significant others. Instead, it focuses on bringing about changes in clients’ statuses; i.e., the positions that they occupy in relation to everything in their worlds, including themselves and aspects of themselves. Proponents of SDT maintain:

Reflective listening is a communication strategy involving two key steps: seeking to understand a speaker's idea, then offering the idea back to the speaker, to confirm the idea has been understood correctly. It attempts to "reconstruct what the client is thinking and feeling and to relay this understanding back to the client". Reflective listening is a more specific strategy than the more general methods of active listening. It arose from Carl Rogers' school of client-centered therapy in counseling theory. Empathy is at the center of Rogers' approach.

Common factors theory, a theory guiding some research in clinical psychology and counseling psychology, proposes that different approaches and evidence-based practices in psychotherapy and counseling share common factors that account for much of the effectiveness of a psychological treatment. This is in contrast to the view that the effectiveness of psychotherapy and counseling is best explained by specific or unique factors that are suited to treatment of particular problems. According to one review, "it is widely recognized that the debate between common and unique factors in psychotherapy represents a false dichotomy, and these factors must be integrated to maximize effectiveness". In other words, "therapists must engage in specific forms of therapy for common factors to have a medium through which to operate". Common factors is one route by which psychotherapy researchers have attempted to integrate psychotherapies.

Accelerated experiential dynamic psychotherapy (AEDP) is a mind-body psychotherapy that is informed by research in the areas of attachment theory, emotion theory, and neuroscience of change. This model of psychotherapy incorporates techniques from experiential therapies and ISTDP.

The actualizing tendency is a fundamental element of Carl Rogers' theory of person-centered therapy (PCT). Rogers' theory is predicated on an individual's innate capacity to decide his/her own best directions in life, provided his/her circumstances are conducive to this, based on the organism's "universal need to drive or self-maintain, flourish, self-enhance and self-protect". Counsellors Keith Tudor and Mike Worrall proposed that analogues of the actualizing tendency can be found in texts by various writers from antiquity onward, such as Aristotle, Lucretius, Spinoza, Sándor Ferenczi, Jessie Taft, and Eric Berne.

References

  1. Rogers, Carl R. (1942). Counseling and psychotherapy. Cambridge, MA: Riverside Press. ISBN   978-1406760873.
  2. Rogers, Carl R.; Sanford, R. C. (1985). "Client-centered psychotherapy". Comprehensive textbook of psychiatry . By I., Kaplan, Harold; J., Sadock, Benjamin. 2. Williams & Wilkins. pp.  1374–1388. ISBN   9780683045116. OCLC   491903721.
  3. Yalom, Irvin D. (1995). Introduction. A way of being. By Rogers, Carl R. Houghton Mifflin Co. p. xi. ISBN   9780395755303. OCLC   464424214.
  4. Rogers, Carl R. (1957). "The necessary and sufficient conditions of therapeutic personality change" (PDF). Journal of Consulting Psychology. 21 (2): 95–103. doi:10.1037/h0045357. PMID   13416422.
  5. Rogers, Carl R. (1966). "Client-centered therapy". In Arieti, S. (ed.). American handbook of psychiatry. 3. New York City: Basic Books. pp. 183–200.
  6. 1 2 3 4 5 Prochaska, James O.; Norcross, John C. (2007). Systems of Psychotherapy: A Transtheoretical Analysis. Belmont, CA: Thomson/Brooks/Cole. ISBN   978-0495007777. OCLC   71366401.
  7. Rogers, Carl (1951). Client-Centered Therapy. Cambridge Massachusetts: The Riverside Press.
  8. 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.
  9. Ward, E.; King, M.; Lloyd, M.; Bower, P.; Sibbald, B.; Farrelly, S.; Gabbay, M.; Tarrier, N.; Addington-Hall, J. (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. PMC   27542 . PMID   11099284.
  10. 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. PMC   27543 . PMID   11099285.
  11. 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.
  12. "Person-centered therapy" on the Encyclopedia of Mental Disorders website
  13. 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.

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