Client-Centered Psychotherapy

1. Client-Centered Psychotherapy Slides created by Barbara A. Cubic, Ph.D.Professor Eastern Virginia Medical School To accompany Current Psychotherapies10

2. Learning Objectives • This presentation will focus on: • An overview of phenomenological theory. • Similarities and differences between Rogers’ self-directed growth process and other types of psychotherapy. • The impact of the establishment of a genuine, nonjudgmental, caring and empathic therapy approach. • Client-centered psychotherapy.

3. Client-Centered Therapy • Developed by Carl Rogers • Also termed: • Client-centered therapy • Humanistic therapy • Phenomenological therapy

4. Client-Centered Therapy • A congruent therapist who provides unconditional positive regard and empathy can stimulate change in a vulnerable person to become a creative, responsible, developing individual. • By providing a therapeutic atmosphere that is real, caring, and nonjudgmental, the person can develop to their full potential.

5. Kurt Goldstein • Worked with brain-injured soldiers. • His holistic theory of personality emphasized that individuals must be understood as totalities striving to actualize themselves. • Basis of Rogers’ actualizing tendencies.

6. Rogers’ Basic Assumptions • Rogers believed in an actualizing tendency in all humans. • Represented movement towards the realization of the individual’s full potential. • Viewed as part of a formative tendency.

7. Rogers’s Basic Assumptions • This formative tendency: • Represented movement toward order, complexity and interrelatedness. • Can be seen across aspects of nature including the stars, crystals, microorganisms as well as humans.

8. Roger’s Theory Can be summed up in Clyde Kluckhohn’s dictum:“Each person is in some respect like every other person, like some other persons, and in some respects like noother person.”

9. Client-Centered Therapy is Different than Other Models • Medical model of therapy views person as “patients” with problematic “parts.” • Other forms of treatment are directed by “experts.” • Client-centered approaches focus on the client’s inborn capacity for “self healing.” • Difference for the therapist is between “using” the self and “being” oneself.

10. Core Conditions for Therapy(Therapist) T R U S T

11. Rogers’ Basic Assumptions(Therapist) • Genuineness/congruence: • Correspondence between the therapist’s thoughts and behavior. • Unconditional positive regard: • Therapist’s regard/attitude towards the patient remains unaltered regardless of the patient’s choices. • Empathy: • Profound interest and care for the patient’s perceptions and feelings.

12. Tout comprendre, c’est tout pardonner: “To understand all is to pardon all.”

13. Core Conditions for Therapy (Client) T R U S T

14. Rogers’ Basic Assumptions(Client) • Self-concept • At therapy onset, self-esteem often low. • Improvements correlated with therapy. • Locus-of-Evaluation • Pre-therapy focus on other’s opinions. • Progress associated with internal locus-of-evaluation. • Experiencing • At therapy onset, rigid. • Success related to flexibility.

15. Comparing Client-Centered Therapy with Other Approaches

16. Hereditary, environment and creative power are crucial forces. Anthropomorphic model preferred. Purpose is the decisive dynamic. Holistic approach most adequate. Human’s subjectivity critically important. Psychotherapy is based on a good relationship. Six Basic Premises of Humanistic Psychology

17. Therapist’s attitudes can be necessary and sufficient conditions for change. Therapist needs to be immediately present and accessible to clients. Intensive, continuous focus on client’s phenomenological world. Process marked by client’s ability to live fully in the moment. Focus on personality change, not structure of personality. Distinctive Components of Client-Centered Therapy

18. Need for continuing research on psychotherapy. Same principles of psychotherapy apply to all people, regardless of problem. Psychotherapy is a specialized example of constructive interpersonal relationships. Theoretical formulations built on experience. Concern with the philosophical issues derived from psychotherapy. Distinctive Components of Client-Centered Therapy

19. Client-Centered Therapy vs. Psychoanalysis

20. Client-Centered Therapy vs. Psychoanalysis

21. Client-Centered Therapy vs. Behavioral Therapy Client-Centered Behavior changes through internal factors. Behavioral Behavior changes through external factors.

22. Comparison of Client-Centered Therapy with Other Approaches High U s e Of E m p a t h y Client-Centered Psychoanalysis, Eclectic, REBT, Jungian Low

23. Client-Centered vs. REBT Rogers Deemed Equivalent to Ellis on Self-Confidence and Higher on Rogers Deemed Low on Therapist Directed

24. Client-Centered vs. REBT Ellis Deemed Equivalent to Rogers on Self-Confidence and Higher on Ellis Deemed Low on Unconditional Positive Regard

25. Client-Centered (CC) vs. REBT

26. History of Client-Centered Therapy

27. Influences on Rogers “From Whom “I first got the notion of responding almost entirely to the feelings being expressed … later called the reflection of feeling” Rogers

28. Rogers’ Life • Jan. 8, 1902 — Born in Oak Park, Illinois. • Family emphasized strong work ethic, responsibility and the fundamentals of religion. • 1924 — Graduated from Univ. of Wisconsin.

29. Rogers’ Life • Started at the Union Theological Seminary then transferred to Teacher’s College, Columbia University. • Worked for 12 years at a Child-Guidance Center. • 1939 — Clinical Treatment of the Problem Child published. • Offered professorship at Ohio State University.

30. Rogers’ Life • Dec. 11, 1940 — Rogers presents “Some Newer Concepts in Psychotherapy” at the Univ. of Minnesota (viewed by most as the birth of Client-Centered Therapy). • 1942 — Counseling and Psychotherapy published. • During WWII, served as Director of Counseling Services for the US Organizations.

31. Rogers’ Life • Served as head of University of Chicago Counseling Center (12 years). • 1957 — Rogers published classic paper on “necessary and sufficient conditions” for therapy. • Feb. 4, 1987 — Carl Rogers died.

32. Current Status of Client-Centered Psychotherapy • Special interest of Rogers was application of his theory to international relationships. • Since 1982, Biennial International Forums on Client-Centered Approach. • Workshops annually at Warm Springs, GA.

33. Current Status of Client-Centered Psychotherapy • Person-Centered Review began in 1986 (renamed The Person-Centered Journalin 1992). • World Association for Person-Centered and Experiential Psychotherapy and Counseling (WAPCEPC) founded in 2000.

34. Rogers’ Theory of Personality19 Basic Propositions • Individual center of a changing world of experience. • Organism reacts based on their reality. • Organism reacts as a whole. • Organism has one basic tendency-actualization. • Behavior is goal-directed based on perception of reality.

35. Rogers’ Theory of Personality19 Basic Propositions • Emotion accompanies and facilitates goal-directed behavior. • Best point to understand behavior is from the individual’s frame of reference. • Part of the perceptual field is differentiated as the self.

36. Rogers’ Theory of Personality19 Basic Propositions • Self is formed through interaction. • Values come from experience and introjection from others. • Experiences are integrated, ignored or denied. • Behavior is generally consistent with self concept.

37. Rogers’ Theory of Personality19 Basic Propositions • Behaviors inconsistent with self concept can occur but are seen as “not owned.” • Psychological maladjustment comes from denied experiences. • Psychological adjustment occurs when experiences are assimilated.

38. Rogers’ Theory of Personality19 Basic Propositions • Inconsistent experiences are threats. • Under the right conditions, inconsistent experiences can be examined and assimilated. • Integrating experiences allows more understanding of others. • Integration leads to development of internal locus-of-evaluation.

39. Rogers’ Theory of Personality Summarized • Behavior is best understood through the individual’s reality (perception of experiences). • Personal growth occurs through decreased defensiveness. • Self actualization is the organism’s one, basic tendency.

40. Rogers’ Theory of Personality Summarized • Experiences inconsistent with self concept are threats leading to increased rigidity. • Therapy allows the individual to accept and integrate all of their experiences.

41. Rogers’ Theory of PersonalityOther Concepts Experience Reality Self Private world of the individual Basically refers to the private perceptions of the individual; Social reality consists of perceptions that have a high degree of commonality among individuals Organized gestalt of “I” or ‘me”

42. Rogers’ Theory of PersonalityOther Concepts Symbolization Organismic Valuing Process Fully Functioning Person Process by which an individual becomes aware of experiences Ongoing process in which individuals freely rely on the evidence of their own senses for making value judgments An individual who relies on the organismic valuing process

43. Self-Determination Theory (SDT) • Developed by Deci and Ryan. • Theory focuses on intrinsic motivation. • Theory has lead to several empirical investigations of the concept.

44. Bottom Line Congruence = psychological adjustment Lack of Congruence = psychological maladjustment

45. The Psychotherapy Process

46. Rogerian View of Psychotherapy Basic theory is simple. If the therapist conveys genuineness, unconditioned positive regard, and empathy, the client will make positive changes.

47. Implied Therapeutic Conditions • Client/therapist must be in psychological contact. • Client must be experiencing distress. • Client must be willing to receive conditions offered by therapist.

48. Process of Client-Centered Psychotherapy • Therapy at first contact. • Respect shown immediately to the client. • Therapy’s length determined by client. • Quick suggestions and reassurances are avoided.

49. Contrasting Client-Centered Therapy with Other Models • The traditional view is one of an uncovering of hidden or denied feelings or experiences: • Question is how these hidden experiences exist and how are they resolved. • Listening to client’s narratives are thought to be the avenue for helping the client deal with these internal conflicts.

50. Contrasting Client-Centered Therapy with Other Models • Or Zimring’s view (an example of a client-centered theorist) asserts a person becomes a person through interactions that occur within a cultural context. • Individuals born within a Western culture have a “buried conflict” as part of a cultural legacy.