Lecture 4: client-centered therapy

Question 1

in welke periode werd client centered therapy uitgevonden

Answer 1

tijdens psychoanalyse en behaviourism. both largely saw humans as passive, influenced by their unconscious urges or the environment. in response, rogers started to focus more on people’s subjective experience and on the person in totality (=humanistic approach)

Question 2

self-actualizing tendency: wat wordt hiermee bedoeld?

Answer 2

self-actualization does not only mean growth, but also integration of different capacities, skills and knowledge.
it is important to see growth as the best possible adaptation to one’s environment; it does not have to be perfect to be functional in a maladaptive environment.

Question 3

overlap client centered therapy en motivational interviewing=

Answer 3

expressing empathy, being non-directive and supporting personal effectiveness

Question 4

reflective framework=

Answer 4

the classic Rogerian framework in which the focus is on exploring the client’s narrative by using empathic reflections.

Question 5

experiental framework =

Answer 5

framework that emphasizes a patient’s physical experiences and the emotions, images and thoughts that come up during them. bv focusing-oriented and emotion-focused therapy (EFT).

Question 6

interactional framework=

Answer 6

a framework that, next to exploring a patients inner world, focuses on what happens within the therapeutic relationship. patterns of interpersonal behaviour are explored through paying attention to a number of markers:
- withdrawal markers (denial of feelings or conflicts, changing subjects, rambling, rationalizing)
- confrontation markers: therapist (attitude, expertise), and therapy variables (method, type)

techniques: meta-communication, confrontation and directness.

Question 7

existential framework =

Answer 7

a framework that emphasizes that we have freedom, which comes with choices and taking responsibility for them. according to this framework, psychopathology is a choice and a form of avoiding responsibility, making choices or their consequences

Question 8

existential/well-being framework =

Answer 8

a framework in which the emphasis is mostly on the positive aspects of one’s life (positive psychology). bv solution-focused therapy, in which it is about what a patient wants to achieve and what is already going well (about bringing out inner strength.

Question 9

Rogers’ theory: historical framework, where did his theory arrive from

Answer 9

• psychoanalysis (influence of unconscious urges, relationship as repetition, (counter)transferance, resistance, interpretation)
• behaviourism (behaviour, environmental influences)
• humanistic approach (subjective experience, person in their totality (client/person-centered), the individual as active)

Question 10

self-actualizing tendency componenten

Answer 10

• growth: allowing capacities to develop
• integration: integrating new skills/knowledge
• not a bigger, but a stronger tree!
• human is an active organism: this is best seen in a child. limitations lead to the best possible adaptation.

Question 11

is rogers theory hebben ze het niet over labels, maar over…

Answer 11

the best possible way to survive

Question 12

Rogers: congruence vs. incongruence

Answer 12

1. congruence - fully functioning person (this is seen in a child: when they are happy, they show this. when they are angry, they show this as well).
   - healthy growth and integration
   - different pieces of the self fit together (are congruent)
   - fully lived-through experience
2. incongruence - psychopathology (soms gaat het leren van het reguleren en communiceren van emoties op een sociaal acceptabele manier iets te ver -> dan kan psychopathologie ontstaan).
   - internal and/or external conflicts which can lead to tension

Question 13

wat zei rogers over de therapeutische relatie

Answer 13

• relationship as vehicle: its a necessary breeding ground, provides the means to change
• three core conditions: congruence (genuineness), unconditional positive regard, empathy

Question 14

wat wordt vaak gezien als de belangrijkste

Answer 14

congruence/genuinenesss

Question 15

2 modellen om te kijken naar de therapeutische relatie

Answer 15

1. Diagnosis-prescription model
   – Directive, objectifying
   – Unequal relationship : “I need to solve your
   problems”
2. Cooperation model
   – Empathetic, actively involved
   – Equality: looking for solutions together

Question 16

congruence in rogers zijn woorden=

Answer 16

Genuineness in therapy means that the therapist does not deny to himself of herself the feelings being experienced in the relationship and that the therapist is willing to express and to be open about any persistent feelings that exist in the relationship and to communicate them if they persist.”

Question 17

components of congruence

Answer 17

• open to/in contact with own experiential flow
• in contact with here and now experience
• third ear (physical, emotions, images)
• self-knowledge, self-awareness, honesty

Question 18

congruence implications for our work

Answer 18

• Intervision and supervision
• (Group-)therapy
• Self-care, mindfulness, mildness
• Not trying to be super human

Question 19

transparency via congruence factors: hoe ziet dit er in de praktijk uit?

Answer 19

• personal presence
• appearance
• niet geforceerd
• consistent in verbaal en non-verbaal gedrag
• als je je niet goed voelt: laat dit weten, want clienten merken dat
• self-disclosure, if it is in the clients best interest
• disciplined spontaneity
• always in the context of empathy, acceptance and positive regard

Question 20

climate factors for unconditional positive regard

Answer 20

• non-judgemental acceptance
• suspending opinions, evaluations or criticism
• no conditions, self-interests or overly focus on results

(but; does not mean approval or agreement with the behaviour!)

Question 21

wat maakt die unconditional positive regard lastig

Answer 21

• Seeing psychopathology as “the best possible adjustment”: what does the behavior mean?
• Recognizing/acknowledging and guarding one’s own limits/boundaries

Question 22

empathy houdt in …

Answer 22

1. putting own frame of reference aside
2. creating space, resonating, validating
3. adress elements that move you or are expressed vividly (bv.; AAE/CO)
4. can also be expressed non-verbally

Question 23

hoe empathie in de praktijk uitvoeren

Answer 23

• Dare to interrupt
• Tentative and curious: “as if …”?
• The “ignorant/naive therapist”: (“Is that right?”, “Could that be possible?”, “What is that like for you?”)
• Adapt to language use
• Welcome the correction!
• Dare to use silences (but stay in contact)

Question 24

interactie tussen de core conditions

Answer 24

• congruence/genuineness as a basis for empathy
• from empathy assessing if transparency is relevant
• being more empathic through unconditional positive regard

Question 26

subtypes of client centered therapy

Answer 26

• existential framework (responsibility and choices)
• interpersonal framework (therapeutic relationship)
• reflective framework (rogerian, reflections)
• experiental framework (experiences/emotions/images/thoughts)
• existential/well being framework (positive factors)