Client Centered Therapy

10 X INDIAN JOURNAL OF APPLIED RESEARCH

Volume : 4 | Issue : 2 | Feb 2014 | ISSN - 2249-555X

RESEARCH PAPER

Medical Science

Client Centered Therapy

Dr. Avinash De Sousa

Consultant Psychiatrist and Psychotherapist, Founder Trustee – Desousa Foundation, Mumbai

KEYWORDS

Client centered therapy, Psychotherapy

ABSTRACT Client-centered therapy, also called the person-centered approach, describes Carl

Rogers’ way of working with persons experiencing all types of personal disturbances or problems in living. As

early as 1939, Rogers developed his theory of psychotherapy with troubled children, and went on to expand his theoretical

approach to include work with couples, families, and groups. Over his long career, Rogers extrapolated client-centered

values to the education, marriage, group encounter, personal power, and conflict resolution. Today, the person-centered

approach is practiced in the United Kingdom, Germany, France, Greece, Portugal, Demark, Poland, Hungary, The Nether-

lands, Italy, Japan, Brazil,

Mexico, Australia, and South Africa, as well as here in the United States and Canada. A world association, which can be

contacted online, was founded in Lisbon in 1997 that reflects the growth and vitality of the approach entitled the World As-

sociation for Person-Centered and Experiential Psychotherapy and Counseling (WAPCEPC). The present chapter describes

the basic tenets of client centered and its applications in day to day clinical practice.

Introduction

Carl Rogers developed client-centered therapy as a reaction

against what he considered the basic limitations of psychoa-

nalysis. Essentially, the client-centered approach is a special-

ized branch of humanistic therapy that highlights the experi-

encing of a client and his or her subjective and phe nomenal

world (Gillon, 2007). The therapist functions mainly as a facili-

tator of personal growth by helping the client discover his or

her own capacities for solving problems. The client-centered

approach puts great faith in the client’s capac ity to lead the

way in therapy and find his or her own direction. The thera-

peutic relationship between the therapist and the client is the

catalyst for change; the client uses the unique relationship

as a means of increasing awareness and discovering latent

resources that he or she can use construc tively in changing

his or her life (Rogers, 1942).

Critical concepts in Client Centered Therapy

The client-centered view of human nature rejects the con-

cept of the individual’s basic negative tendencies. Whereas

some approaches assume that human beings are by nature

irrational and destructive of self and others unless they are

socialized, Rogers exhibits a deep faith in human beings. He

sees people as socialized and forward-moving, as striving to

become fully functioning, and as having at the deepest core

a positive goodness. In short, people are to be trusted, and,

as they are basically cooperative and construc tive, there is

no need to control their aggressive impulses (Rogers, 1951).

This positive view of human nature has significant implica-

tions for the practice of client-centered therapy. Because

of the philosophical view that the individual has inherent

capacity to move away from maladjustment to ward a state

of psychological health, the therapist places the primary re-

sponsibility for the process of therapy on the client (Rogers,

1951). The client-centered model rejects the concept of the

therapist as the authority who knows best and that of the pas-

sive client who merely follows the dictates of the ther apist.

Therapy is thus rooted in the client’s capacity for awareness

and the ability to make decisions (Rogers, 1957).

Rogers has not presented the client-centered theory as a

fixed and completed approach to therapy. He has hoped

that others would view his theory as a set of tentative princi-

ples relating to how the therapy process develops and not as

dogma. Rogers describes the charac teristics that distinguish

the client-centered approach from other models. An adapta-

tion of this description follows (Rogers, 1961) :

“The client-centered approach focuses on the client’s re-

sponsibility and capacity to discover ways to more fully en-

counter reality. The client, who knows himself or herself best,

is the one to discover more appropriate be havior for himself

or herself.”

The client-centered approach emphasizes the phenomenal

world of the client. With accurate empathy and an attempt

to apprehend the client’s in ternal frame of reference, the

therapist concerns himself or herself mainly with the client’s

self-perception and perception of the world (Rogers, 1961).

Based on the concept that the urge to move toward psycho-

logical maturity is deeply rooted in human nature, the princi-

ples of client-centered therapy apply to those who function

at relatively normal levels as well as to those who experience

a greater degree of psy chological maladjustment (Rogers,

1961). According to the client-centered approach, psycho-

therapy is only one example of all constructive personal

relationships. The client experiences psychotherapeutic

growth in and through the relationship with another per son

who helps the client do what the client cannot do alone. It

is the rela tionship with a congruent (matching external be-

havior and expression with internal feelings and thoughts),

accepting, and empathic counselor that serves as the agent

of therapeutic change for the client (Rogers, 1977).

Rogers proposes the hypothesis that there are certain atti-

tudes on the therapist’s part (genuineness, non-possessive

warmth and acceptance, and accurate empathy) that consti-

tute the necessary and sufficient conditions for therapeutic

effectiveness to occur within the client. Client-centered ther-

apy incorporates the concept that the therapist’s function is

to be immediately present and accessible to the client and to

focus on the here-and-now ex perience created by the rela-

tionship between the client and the therapist (Natiello, 2001).

Perhaps more than any other single approach to psychother-

apy, client-centered theory has developed through research

on the process and outcomes of therapy. The theory is not a

closed one but one that has grown through years of coun-

seling observations and that continues to change as new

research yields increased understanding of human nature

and the therapeutic process (Mearns & Thorne, 1999). Thus

Partial preview of the text

Download Client Centered Therapy and more Study notes Psychotherapy in PDF only on Docsity!

10 X INDIAN JOURNAL OF APPLIED RESEARCH

RESEARCH PAPER Medical Science Volume : 4 | Issue : 2 | Feb 2014 | ISSN - 2249-555X

Dr. Avinash De Sousa

Consultant Psychiatrist and Psychotherapist, Founder Trustee – Desousa Foundation, Mumbai

KEYWORDS Client centered therapy, Psychotherapy

ABSTRACT (^) Client-centered therapy, also called the person-centered approach, describes Carl Rogers’ way of working with persons experiencing all types of personal disturbances or problems in living. As early as 1939, Rogers developed his theory of psychotherapy with troubled children, and went on to expand his theoretical approach to include work with couples, families, and groups. Over his long career, Rogers extrapolated client-centered values to the education, marriage, group encounter, personal power, and conflict resolution. Today, the person-centered approach is practiced in the United Kingdom, Germany, France, Greece, Portugal, Demark, Poland, Hungary, The Nether- lands, Italy, Japan, Brazil, Mexico, Australia, and South Africa, as well as here in the United States and Canada. A world association, which can be contacted online, was founded in Lisbon in 1997 that reflects the growth and vitality of the approach entitled the World As- sociation for Person-Centered and Experiential Psychotherapy and Counseling (WAPCEPC). The present chapter describes the basic tenets of client centered and its applications in day to day clinical practice. Introduction Carl Rogers developed client-centered therapy as a reaction against what he considered the basic limitations of psychoa- nalysis. Essentially, the client-centered approach is a special- ized branch of humanistic therapy that highlights the experi- encing of a client and his or her subjective and phenomenal world (Gillon, 2007). The therapist functions mainly as a facili- tator of personal growth by helping the client discover his or her own capacities for solving problems. The client-centered approach puts great faith in the client’s capacity to lead the way in therapy and find his or her own direction. The thera- peutic relationship between the therapist and the client is the catalyst for change; the client uses the unique relationship as a means of increasing awareness and discovering latent resources that he or she can use constructively in changing his or her life (Rogers, 1942). Critical concepts in Client Centered Therapy The client-centered view of human nature rejects the con- cept of the individual’s basic negative tendencies. Whereas some approaches assume that human beings are by nature irrational and destructive of self and others unless they are socialized, Rogers exhibits a deep faith in human beings. He sees people as socialized and forward-moving, as striving to become fully functioning, and as having at the deepest core a positive goodness. In short, people are to be trusted, and, as they are basically cooperative and constructive, there is no need to control their aggressive impulses (Rogers, 1951). This positive view of human nature has significant implica- tions for the practice of client-centered therapy. Because of the philosophical view that the individual has inherent capacity to move away from maladjustment toward a state of psychological health, the therapist places the primary re- sponsibility for the process of therapy on the client (Rogers, 1951). The client-centered model rejects the concept of the therapist as the authority who knows best and that of the pas- sive client who merely follows the dictates of the therapist. Therapy is thus rooted in the client’s capacity for awareness and the ability to make decisions (Rogers, 1957). Rogers has not presented the client-centered theory as a fixed and completed approach to therapy. He has hoped that others would view his theory as a set of tentative princi- ples relating to how the therapy process develops and not as dogma. Rogers describes the characteristics that distinguish the client-centered approach from other models. An adapta- tion of this description follows (Rogers, 1961) : “The client-centered approach focuses on the client’s re- sponsibility and capacity to discover ways to more fully en- counter reality. The client, who knows himself or herself best, is the one to discover more appropriate behavior for himself or herself.” The client-centered approach emphasizes the phenomenal world of the client. With accurate empathy and an attempt to apprehend the client’s internal frame of reference, the therapist concerns himself or herself mainly with the client’s self-perception and perception of the world (Rogers, 1961). Based on the concept that the urge to move toward psycho- logical maturity is deeply rooted in human nature, the princi- ples of client-centered therapy apply to those who function at relatively normal levels as well as to those who experience a greater degree of psychological maladjustment (Rogers, 1961). According to the client-centered approach, psycho- therapy is only one example of all constructive personal relationships. The client experiences psychotherapeutic growth in and through the relationship with another person who helps the client do what the client cannot do alone. It is the relationship with a congruent (matching external be- havior and expression with internal feelings and thoughts), accepting, and empathic counselor that serves as the agent of therapeutic change for the client (Rogers, 1977). Rogers proposes the hypothesis that there are certain atti- tudes on the therapist’s part (genuineness, non-possessive warmth and acceptance, and accurate empathy) that consti- tute the necessary and sufficient conditions for therapeutic effectiveness to occur within the client. Client-centered ther- apy incorporates the concept that the therapist’s function is to be immediately present and accessible to the client and to focus on the here-and-now experience created by the rela- tionship between the client and the therapist (Natiello, 2001). Perhaps more than any other single approach to psychother- apy, client-centered theory has developed through research on the process and outcomes of therapy. The theory is not a closed one but one that has grown through years of coun- seling observations and that continues to change as new research yields increased understanding of human nature and the therapeutic process (Mearns & Thorne, 1999). Thus

INDIAN JOURNAL OF APPLIED RESEARCH X 11 client-centered therapy is not a set of techniques, nor is it a dogma. Rooted in a set of attitudes and beliefs that the ther- apist dem onstrates, the client-centered approach is perhaps best characterized as a way of being and as a shared journey in which both therapist and client reveal their humanness and participate in a growth experience (Mearns & Thorne, 2000). The Therapeutic Process in Client Centered Therapy According to Rogers (1961), the question Who am I? brings most people into psychotherapy. They seem to ask: How can I discover my real self? How can I become what I deeply wish to become? How can I get behind my facades and become myself? A basic goal of therapy is to provide a climate condu- cive to helping the individual become a fully functioning per- son. Before one is able to work toward that goal, one must first get behind the masks one wears. One develops pretens- es and facades as defenses against threat. One’s games keep one from becoming fully real with others, and, in the process of attempting to deceive others, one eventually becomes a stranger to oneself (Rogers, 1977). When the facades are worn away during the therapeutic process, what kind of person emerges from behind the pre- tenses? Rogers (1961) described the characteristics of the person who is moving in the direction of becoming increas- ingly actualized: (1) an openness to experience, (2) a trust in one’s organism, (3) an internal locus of evaluation, and (4) the willingness to be a process. These characteristics constitute the basic goals of client-centered therapy. Openness to experience entails seeing reality without dis- torting it to fit a preconceived self-structure. The opposite of defensiveness, openness to experience implies becom- ing more aware of reality as it exists outside oneself. It also means that one’s beliefs are not rigid; one can remain open to further knowledge and growth and can tolerate ambigu- ity. One has an awareness of oneself in the present moment and the capacity to experience oneself in fresh ways (Barrett- Lennard, 1998). One goal of therapy is to help clients establish a sense of trust in themselves. Often, in the initial stages of therapy, cli- ents trust themselves and their own decisions very little. They typically seek advice and answers outside themselves for they basically do not trust their own capacities to direct their own lives. As clients become more open to their experiences, their sense of trust in self begins to emerge (Bozarth, 1998). Related to self-trust, there exists an internal locus of evalu- ation means looking more to oneself for the answers to the problems of existence. Instead of looking outside oneself for validation of personhood, one increasingly pays attention to one’s own center. One substitutes self-approval for the uni- versal approval of others. One decides one’s own standards of behavior and looks to oneself for the decisions and choic- es to live by (Evans, 1975). The concept of self in the process of becoming, as opposed to the concept of self as a product, is crucial. Although clients might enter therapy seeking some kind of formula for building a successful and happy state (an end product), they come to realize that growth is a continu- ing process. Rather than being fixed entities, clients in ther- apy are in a fluid process of challenging their perceptions and beliefs and opening themselves to new experiences and revisions (Mearns, 1997) Goals of client centered therapy The goals of therapy as just described are broad goals that provide a general framework for understanding the direction of therapeutic movement. The therapist does not choose specific goals for the client. The cornerstone of the client- centered theory is that clients in relationship with a facilitat- ing therapist have the capacity to define and clarify their own goals. Many counselors, however, will experience difficulty in allowing clients to decide for themselves their specific goals in therapy. Although it is easy to give lip service to the con- cept of clients’ finding their own way, it takes considerable respect for clients and courage on the therapist’s part to en- courage clients to listen to themselves and follow their own directions particularly when clients make choices that might not be the choices the therapist would hope for (Rogers, 1961). The role of the client-centered therapist is rooted in his or her ways of being and attitudes, not in the implementation of techniques designed to get the client to “do something.” Research on client-centered therapy seems to indicate that the attitudes of the therapist, rather than his or her knowl- edge, theories, or techniques, initiate personality change in the client. Basically, the therapist uses himself or herself as an instrument of change. By encountering the client on a person-to-person level, the therapist’s “role” is to be without roles. The therapist’s function is to establish a therapeutic cli- mate that facilitates the client’s growth along a process con- tinuum (Patterson, 2000). The client-centered therapist thus creates a helping relation- ship in which the client will experience the necessary free- dom to explore areas of his or her life that are now either denied to awareness or distorted. The client becomes less defensive and more open to possibilities within himself or herself and in the world (Patterson, 2000). First and foremost, the therapist must be willing to be real in the relationship with the client. Instead of perceiving the client in precon- ceived diagnostic categories, the therapist meets the client on a moment-to-moment experiential basis and helps the client by entering the client’s world. Through the therapist’s attitudes of genuine caring, respect, acceptance, and un- derstanding, the client is able to loosen his or her defenses and rigid perceptions and move to a higher level of personal functioning (Merry & Brodley, 2002). The client comes to the counselor in a state of incongruence; that is, a discrepancy exists between the client’s self-percep- tion and his or her experience in reality. For example, a col- lege student may see himself as a future physician, and yet most of his grades, which are below average, might exclude him from medical school. The discrepancy between how the client sees himself (self-concept) or how the client would like to view himself (ideal-self-concept) and the reality of his poor academic performance might result in anxiety and personal vulnerability, which can provide the necessary motivation to enter therapy. The client must perceive that a problem exists, or at least that he is uncomfortable enough with his present psychological adjustment to want to explore possibilities for change (Rogers, 1977). During the beginning stages of therapy, the client’s behav- ior and feelings might be characterized by extremely rigid beliefs and attitudes, much internal blockage, a lack of cen- teredness, a sense of being out of touch with his or her own feelings, an unwillingness to communicate deeper levels of the self, a fear of intimacy, a basic distrust in the self, a sense of fragmentation, and a tendency to externalize feelings and problems, just to mention a few. In the therapeutic climate created by the counselor, the client is able to explore in a safe and trusting environment the hidden aspects of his or her personal world. The therapist’s own realness, unconditional acceptance of the client’s feelings, and ability to assume the client’s internal frame of reference allow the client gradually to peel away layers of defenses and come to terms with what is behind the facades (Rogers, 1961). As therapy progresses, the client is able to explore a wider range of his or her feelings. Now the client is able to express fears, anxiety, guilt, shame, hatred, anger, and other feelings that he or she had deemed too negative to accept and incor- porate into the self-structure. Now the client constricts less, distorts less, and moves to a greater degree of willingness to accept and integrate some conflicting and confusing feel- ings related to self. Gradually, the client discovers aspects,

INDIAN JOURNAL OF APPLIED RESEARCH X 13 Client-centered therapy places the primary responsibility for the direc tion of therapy on the client. The general goals are: becoming more open to experience, trusting in one’s organism, developing an internal locus of evaluation and a willingness to become a process, and in other ways moving toward higher levels of self-actualization. The therapist does not impose specific goals and values on the client; the client decides on his or her own specific values and life goals. The client-centered model is not a fixed theory. Rogers intended to develop a set of working principles that could be stated in the form of tentative hypotheses regarding the conditions facilitating personal growth. This is an open system, one that, after 30 years, is still in evolution. Formulations continue to be revised in light of new research findings (Purton, 2004). The client-centered approach emphasizes the personal re- lationship between client and therapist; the therapist’s atti- tudes are more critical than techniques, knowledge, or the- ory. If the therapist demonstrates and communicates to the client that the therapist is (1) a congruent person, (2) warmly and unconditionally accepting of the feelings and person- hood of the client, and (3) able to sensitively and accurately perceive the internal world as the client perceives it, then the client will use this relationship to unleash his or her growth potential and become more of the person he or she chooses to become (Rogers, 1977). Perhaps one of the dominant modes used in counselor edu- cation is the client-centered approach. One reason for this is its built-in safety features. It emphasizes active listening, respecting the client, adopting the internal frame of refer- ence of the client, and staying with the client as opposed to getting ahead of the client with interpretations. Client- centered therapists typically reflect content and feelings, clarify messages, help clients to muster their own resources, and encourage clients to find their own solutions. Hence, this approach is far safer than many models of therapy that put the therapist in the directive position of making interpreta- tions, forming diagnoses, probing the unconscious, analyz- ing dreams, and working toward more radical personality changes. For a person with limited background in counseling psychology, personality dynamics, and psychopathology, the client-centered approach offers more realistic assurance that prospective clients will not be psychologically harmed (Thorne & Lambers, 1998). The client-centered approach contributes in other ways to both indi vidual and group counseling situations. It offers a humanistic base from which to understand the subjective world of clients. It provides clients the rare opportunity to be really listened to and heard. Further, if clients feel that they are heard, they most likely will express their feelings in their own ways. They can be themselves, since they know that they will not be evaluated or judged. They can feel free to experi- ment with new behavior. They are expected to take responsi- bility for themselves, and it is they who set the pace in coun- seling. They decide what areas they wish to explore, on the basis of their own goals for change. The client-centered ap- proach pro vides the client with immediate and specific feed- back of what he or she has just communicated. The counselor acts as a mirror, reflecting the deeper feelings of a client. Thus the client has the possibility of gaining sharper focus and deeper meaning to aspects of his or her self-structure that were previously only partially known to him or her. The client’s attention is focused on many things that he or she has not attended to before. The client is thus able to increasingly own his or her total experiencing (Mearns & Cooper, 2005). Another major contribution to the field of psychotherapy has been Rogers’ willingness to state his formulations as testable hypotheses and to submit his hypotheses to research efforts. Even his critics give Rogers credit for having conducted and inspired others to conduct the most extensive research on counseling process and outcome of any school of psycho- therapy. Rogers’ theory of therapy and personality change has had tremendous heuristic effect, and, though much controversy surrounds this approach, Rogers’ work has chal- lenged practitioners and theoreticians to examine their own therapeutic styles and beliefs (Roth & Fonegy, 1996). Caveats of Client Centered Therapy A vulnerability of the client-centered approach lies in the manner in which some practitioners misinterpret or simplify the central attitudes of the client-centered position. Not all counselors can practice client-centered therapy for some do not really believe in the underlying philosophy Many of Rogers’ followers have attempted to be carbon copies of Rogers himself and have misunderstood some of Rogers’ basic concepts. They limit their own range of responses and counseling styles to reflections and empathic listening. Surely there is value in listening to and really hearing a client and in reflecting and communicating understanding to the client. But psy chotherapy is, one hopes more than this. Perhaps lis- tening and reflecting constitute a requisite for establishing a therapeutic relationship, but they should not be confused with therapy itself (Sanders, 2000). One limitation of the approach is the way some practitioners become “client centered” and lose a sense of their own per- sonhood and uniqueness. Paradoxically, the counselor may focus on the client to such an extent that he or she diminishes the value of his or her own power as a person and thus loses the impact and influence of his or her personality on the cli- ent. The therapist may highlight the needs and purposes of the client, and yet at the same time feel free to bring his or her own personality into the therapeutic hour (Mearns, 1994). Thus one must be cautioned that this approach is something more than merely a listening and reflecting technique. It is based on a set of attitudes that the therapist brings to the relationship, and, more than any other quality, the therapist’s genuineness determines the power of the therapeutic re- lationship. If the therapist submerges his or her unique iden- tity and style in a passive and nondirective way, he or she may not be harming many clients but also may not be re- ally affecting clients in a positive way. Therapist authenticity and congruence are so vitally related to this approach that the therapist who practices within this framework must feel natural in doing so and must find a way to express his or her own reactions to clients. If not, a real possibility is that client-centered therapy would be reduced to a bland, safe, and ineffectual mode of working with clients (Worsley, 2002). REFERENCE Barret-Lennard, G.T. (1998). Carl Rogers’ Helping System : Journey and Substance. London : Sage Publications. | Bozarth, J.D. (1998). Person Centered Therapy : a revolutionary paradigm. Ross-on-Wye : PCCS Books. | Evans, R.I. (1975). Carl Rogers : The man and his ideas. New York : Dutton. | Gillon, E. (2007). Person Centered Counseling Psychology : an introduction. Sage Publications : London. | Mearns, D. (1994). Developing Person Centered Counseling. London : Sage Publications. | Mearns, D. (1997). Person Centered Counseling Training. London : Sage Publications. | Mearns, D., & Thorne, B. (1999). Person Centered Counseling in Action. London : Sage Publications. | Mearns, D., & Thorne, B. (2000). Person Centered Therapy Today : new frontiers in theory and practice. London : Sage Publications. | Mearns, D., & Cooper, M. (2005). Working at Relational Depth in Counseling and Psychotherapy. London : Sage Publications. | Merry, T., & Brodley, B.T. (2002). A Non Directive attitude to Client Centered Therapy. Journal of Humanistic Psychology, 42(2), 66-77. | Natiello, P. (2001). The Person Centered Approach : a passionate presence. Ross-on-Wye : PCCS Books. | Patterson, C.H. (2000). Understanding Psychotherapy : 50 years of client centered theory and practice. Ross-on-Wye : PCCS Books. | Purton, C. (2004). Person Centered therapy : a focusing oriented approach. Basingstoke : Palgrave Macmillan. | Rennie, D.L. (1998). Person Centered Counseling : an experiential approach. London : Sage Publications. | Rogers, C.R. (1942). Counseling and Psychotherapy : newer concepts in practice. Boston : Houghton Mifflin. | Rogers, C.R. (1951). Client Centered Therapy : its current practice, implications and theory. London : Constable. | Rogers, C.R. (1957). The necessary and sufficient conditions of therapeutic personality change. Journal of Consulting Psychology, 21, 95-103. | Rogers, C.R. (1961). On becoming a person : a therapists view of psychotherapy. London : Constable. | Rogers, C.R. (1977). Carl Rogers on Personal Power. New York : Delacorte Press. | Rogers, C.R. (1980). A Way of Being. Boston : Houghton Mifflin. | Sanders, P. (2000). Mapping person centered approaches to counseling and psychotherapy. Person Centered Practice, 8(2), 62-74. | Thorne, B. (1992). Carl Rogers. London : Sage Publications. | Worsley, R. (2002). Process work in Person Centered Psychotherapy : Phenomenological and Existential Perspectives. Basingstoke, Palgrave. | |

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Download Client Centered Therapy and more Study notes Psychotherapy in PDF only on Docsity!

10 X INDIAN JOURNAL OF APPLIED RESEARCH

RESEARCH PAPER Medical Science Volume : 4 | Issue : 2 | Feb 2014 | ISSN - 2249-555X