Person-Centred Therapy

Introduction

This essay will evaluate the claim that Person-Centred Therapy offers the Therapist all that he/she needs to treat clients. In order to do this effectively first, the Author will look a little at the origins of Person-Centred Therapy and evaluate the way in which this model works in practice by exploring the key characteristics which form the principals upon which this theory is formed. In the process of this research the Author will also look at some of the criticisms made by other writers on the subject of the person-centred approach to therapy. Once this is done the Author can then weigh up the pros and cons of this model and form a personal opinion as to whether or not the person-centred approach can indeed be used as the sole therapy model to treat all clients at all times irrespective of their presenting issue or issues.

Person-Centred Therapy – A Brief History

The person-centred approach to therapy is based on concepts from humanistic psychology. This approach to therapy was developed by Carl Rogers (1902-1987) as a rebellion against what he saw as the limitations of the Behaviorist and Psychodynamic psychology models. For this reason the humanistic approach is often referred to as the third force in psychology after psychoanalysis and behaviorism. Rogers first developed what was originally known as non-directive counselling in the 1940’s and used this approach with soldiers returning from World War Two. This was an alternative to the traditional psychoanalytical approaches (Corey 1996). His theory, which challenged the previously held views, that “the counselor knows best” centre on the creation of a non-directive permissive climate where there is no direct intervention from the therapist. The view therefore, of Rogers, being that the client is the best expert on themselves and if given the correct core conditions of Empathy, Congruence and Unconditional Positive Regard will be able to explore their feelings and in time work out their own solutions to the problems that are troubling them. This approach brought Rogers into conflict with behaviorism, which, he thought treated humans like animals or machines whose behavior could be predicted and controlled without any attention to consciousness.

In the 1950’s Rogers re-named this non-directive approach to reflect the fact that the focus of the therapy was the client and it then became known as Client-Centred Therapy, Rogers published a book of the same name in 1951. and continued to develop his theory that, providing the core conditions were met, that the clients subjective experience would allow them to make positive and constructive choices and in doing so heal themselves. This approach

was broadened still further in the 1970’s and 1980’s to include education and was known as student-centred learning. Rogers, at this time, also made a huge effort to apply the person-centred model to politics in an effort to achieve world peace. In an interview Rogers was asked what he would want his parents to know about his contributions if he could communicate with them. He replied that he could not imagine talking to his mother about anything of significance, because he was sure she would have some negative judgment. Interestingly, the core theme in his theory is that of the necessity for non-judgmental listening and acceptance if clients are to change (Hepppner,Rogers & Lee, 1984) It is easy to see why unconditional positive regard was something that was central to the approach of Carl Rogers. It is interesting to note here that Carl Rogers was nominated for the Nobel Peace prize for his efforts to achieve worldwide peace shortly before he died in 1987 (Corey 1996).

The Characteristics of Person-Centred Therapy

There are, according to Rogers, six characteristics of the therapeutic relationship that will cause, over a period of time, the necessary conditions under which constructive personality change will occur. (Sanders, Frankland & Wilkins, 2009)

1. Two persons are in psychological contact

2. The first, whom we shall term the client, is experiencing incongruence, being vulnerable or anxious.

3. The second person, whom we shall term the therapist, is congruent or integrated in the relationship.

4. The therapist experiences unconditional positive regard or real caring and acceptance for the client.

5. The therapist experiences an empathic understanding of the client’s internal frame of reference and endeavors’ to communicate this experience to the client.

6. The communication to the client of the therapist’s empathic understanding and unconditional positive regard is to a minimal degree achieved.

The basic concept, then, implies that people will move towards health and wellbeing if the way seems open for them to do so. So, client-centred therapy, in theory, frees the client to create those conditions that will enable them to engage in meaningful self-exploration. Rogers firmly believed that at the core of every individual there is a trustworthy centre and the therapist needs to trust that the client, ultimately, will know the answers to the issues that have brought them to therapy and with the right core conditions being met resolutions will become apparent.

Central to Rogers’s theory is that of self-concept, which is best explained as the perceptions and beliefs we each have of ourselves. Self-concept does not always fit with the reality of how others see us and this manifests itself as low self-esteem. For example a person may be very interesting to other people but regard themselves as boring, resulting in low self-esteem. Therefore, a person whose self-concept does not match their feelings or experiences begins to feel threatened and becomes defensive. The actual experiences and feelings of the individual were referred to by Rogers as the Organismic Self. The larger the gap between self-concept (how we want to perceive ourselves) and the organismic-self (how we are actually feeling) the greater the chance of confusion and this ultimately leads to incongruence.

Incongruence can develop from an early age as a result of conditional positive regard, that is to say that a person only feels loved and valued if they behave in a certain way. This is especially true of the relationships between parents and their children. The parents love to their child is conditional on the child behaving in a way that is acceptable to the parent. When this happens the child develops conditions of worth, and behaves in accordance with their parents’ ideals rather than their own self concept. If the standards set are particularly high this leaves the child with incongruence between their self-image and conditions of worth leaving them feeling that they are never good enough.

In order for the client to become congruent and move towards self-actualization, that is a fully functioning person who has wishes, desires and goals and the potential to reach these; the client needs, according to Rogers, at least one relationship in which they experience unconditional positive regard where the person is totally accepted and supported regardless of what they do feel and think. So, if a person receives unconditional positive regard, empathy and genuineness in a therapeutic context healing will take place.

The Pro’s and Con’s of the Person-Centred Approach

People seek out Counseling or Therapy in order to make some sense of their presenting issues and to receive guidance on how to solve or deal with their problems and move on with their lives. Client-centered therapists rarely ask questions, make diagnoses, provide interpretations or advice, offer reassurance or blame, agree or disagree with clients, or point out contradictions. Instead, they let clients tell their own stories, using the therapeutic relationship in their own way. The therapist listens without trying to

provide solutions and while clients can communicate their feelings with the certainty that they are being understood rather than being judged they have to work out their own solutions.

In the opinion of the Author there are both advantages and disadvantages of this model of therapy and as such it cannot offer all that a therapist needs to treat clients. While some aspects are essential to the therapeutic process and are present in other models of psychotherapeutic counselling for example empathy and rapport, others, such as lack of guidance and advice, may well leave the client feeling unsupported and frustrated. This is summed up well with this quote.

Clients come to therapists for solutions, help and advice rather than just for mirroring, listening and reflecting which often leave them frustrated. (Chrysalis 2010)

Firstly, person-centred therapy is far too simplistic with methods limited to listening and reflecting. This approach can lead to undirected ramblings by the client and focuses can easily then move away from the presenting issue. Person-centred therapy is not succinct by nature and as such can be an extremely long process lasting years rather than months, and during this time the client still has their issues which remain unresolved. Person-centred therapy also ignores the unconscious mind, many client issues stem from information stored in this area of the brain and stem back to childhood conditioning.

Secondly, clients that attend therapy in order to deal with a crisis learn coping skills or for help in dealing with psychosomatic symptoms do so with the expectation that they will receive guidance in a structured environment. Person-centred therapy will not meet these needs.

Thirdly, this model won’t work well with people who find it difficult to talk about themselves or have a mental illness that distorts their perceptions of reality. Not all clients have the capacity to trust their own inner directions and find their own answers (Corey 1996).

Finally, from the therapist’s point of view it is extremely difficult to offer the three core conditions to the client in all cases and at all times. An example of this would be if the client was a murderer, rapist or pedophile how, under these circumstances would the therapist be able to offer unconditional positive regard?

It is not realistic to expect that any therapist can be real, caring, understanding and accepting all of the time with all clients. (Sandford 1990)

There have, since its development, been debates regarding the claim that Person-Centred therapy offers the therapist all they need to effectively treat their clients. One of the most famous of these long running debates were those between Rogers and B.F Skinner (1904-1990). Skinner is seen as the founder of Radical Behaviourism, and his research, writing, and lecturing helped to spread his view of how change occurs. A prolific author, he published some 21 books and 180 articles. Skinner held the view that by obtaining a deeper understanding of the stimulus and response mechanisms of the client, we could gain better control over the environment and create a more humane and caring world as a result. (Dr. Ed Neukrug) This was, of course, in direct contrast to Rogers who felt that the client, rather than the therapist, held the answers and that the therapists role was no more than to listen in an empathetic and non judgemental way and in doing so the client would, in time, be able to work out their own solutions to any issues that were causing them to be incongruent.

More recently a pluralistic framework for counseling and psychotherapy has been introduced; an article explaining the principles behind this was published in a Counseling and Psychotherapy paper by Mick Cooper and John McLeod in 2007 after research by the University of Strathclyde. The basic principle for this theory is that a person’s experiences and emotions will be different at different points and therefore different therapeutic methods will be more helpful in these instances. This method also takes into account the increasing diversity in the cultural background of clients. This is summed up very well with this quote taken from the paper.

Psychological difficulties may have multiple causes and that there is unlikely to be one, ‘right’ therapeutic method that will be appropriate in all situations – different people are helped by different processes at different times. (Cooper & McLeod 2007)

Conclusion

The conclusion of the Author is, while there is a place for Person-Centred therapy, it should be treated as one of many tools in the repertoire of the therapists toolbox rather than as the sole technique. Central to the Rogerian approach is the assumption that the client can understand the factors in their life that are causing them to be unhappy. Clearly in some instances this won’t be the case as the issues the client is wrestling with lie hidden deep in the subconscious mind. The Person-Centred approach does not deal with this area at all. This theory also places primary responsibility for the direction of the therapy on the client. The client has to decide for themselves the direction of the therapy session. The problems with this can be two fold; firstly, many therapists have difficulty in allowing clients to decide

their specific goals in therapy, it takes a great deal of self control on the part of the therapist, especially when the choices the client makes are not those the therapist had hoped for. Secondly, this style of therapy can result in the main issues being skirted around and not discussed in detail leaving the client still trying to cope with the issues that they most need to be resolved.

Also to be considered is the expectation put on the Therapist that he/she will at all times offer unconditional positive regard, empathy and congruence to their client. As previously discussed this may not always be possible in extreme cases.

To sum up then, the psychological difficulties of each individual client may have multiple causes and as a result it is unlikely that one therapeutic method will be appropriate in all situations. It is far better to use a pluralistic approach which will allow the use of several theories, if this is deemed necessary by the therapist in order to achieve the best result for each client. Everyone is different and as such any therapy should be as individual as the client is.

BIBLIOGRAPGY

Chrysalis (2010) 08/2010 Module 2-1

Cooper, Mick & McLeod John (2007) A Pluralistic Framework for Counselling & PsychotherapyCounselling & Psychotherapy Research 7 135-143

Corey, Gerald (1996) The Theory & Practice of Counselling & Psychotherapy Brooks/Cole Publishing Company

Heppner, PP Rogers, ME & Lee LA (1984)Carl Rogers: Reflections on his LifeJournal of Counselling & Development

Sanders, Pete, Frankland Alan & Wilkins Paul (2009)Next Steps in Counselling - Second EditionPCCS Books

Sandford, R (1990). What is Psychotherapy? Contemporary Perspectives San Francisco Jossey-Bass

http://www.odu.edu/~eneukrug/therapists/skinner.html

Accessed 09/12/10