Carl Rogers stands out as one of the most influential in revolutionising the direction of counselling theory and practice. The person centred approach shares many concepts and values with the existential perspective. Rogers basic assumptions are that people are essentially trusthworthy, that they have a vast potential for understanding themselves and resolving their own problems without direct intervention on the therapists part and that they are capable of self-direction growth if they are involved in a specific kind of therapeutic relationship. Contemporary person-centred therapy is the result of an evolutionary process that continues to remain open to change and refinement. Rogers did not present the person-centred theory as a fixed and completed approach to therapy. Rogers expected his model to evolve and was open and receptive to change.
Four Period of Development of the Approach:
- 1940’s Rogers developed what was known as nondirective counselling which provided a powerful and revolutionary alternative to the directive and interpretive approaches to therapy then being practiced. Rogers also challenged the validity of commonly accepted therapeutic procedures such as advice, suggestion, direction, persuasion, teaching, diagnosis and interpretation
- 1950s renamed his approach, client-centered approach, which reflected his emphasis on the client rather than on non-directive methods. In addition, he started the Counselling Centre at the University of Chicago. Rogers assumed that the best vantage point for understanding how people behave was from their own internal frame of reference.
- Late 1950s and extended into the 1970s addressed the necessary and sufficient conditions of therapy. Rogers and his associates continued to test the underlying hypotheses of the client-centred approach by conducting extensive research on both the process and the outcomes of psychotherapy. For example, client centred philosophy was applied to education and was called student-centred teaching.
- 1980s and the 1990s was marked by considerable expansion to education, couples and families, industry, groups, conflict resolution, politics and the search for the world peace. His theory became known as person-centred therapy. Further applications include education, family life, leadership and administration, organisational development, health care, cross-cultural and interracial activity, and international relations.
In a comprehensive review of the research on person-centred therapy over a period of 60 years, Bozarth Zimring and Tausch 20002 concluded the following:
- In the earliest years of the approach the client rather than the therapist determined the direction and goals of therapy and the therapists role was to help the client clarify feelings. This style of nondirective therapy was associated with increased understanding, greater self-exploration, and improved self-concepts.
- Later a shift from clarification of feelings to a focus on the clients lived experiences took place
- As person-centred therapy developed further, research centred on the core conditions assumed to be both necessary and sufficient for successful therapy. The attitude of the therapist- an empathic understanding of the clients world and the ability to communicate a nonjudgemental stance to the client – along with the therapists genuiness were found to be basic to a successful therapy outcome
- The main source of successful psychotherapy is the client. The therapists attention to the clients frame of reference fosters the client utilisation of inner and outer resources.
Emotion Focused Therapy:
- Leslie Greenberg, a prominent figure in the development of this integrative approach, states that EFT is designed to help clients increase their awareness of their emotions and make productive use of them.
- EFT strategies focus on two major tasks, 1. Help the clients with too little emotions access their emotions, 2. Help clients who experience too much emotion contain their emotions. A main goal of EFT is to help indiviudals access and process emotions to construct new ways of being.
- EFT emphasises the importance of awareness, acceptance, and understanding the visceral experience of emtion
- Gesalt therapy has always emphasised experiencing and exploring emotions. McDonald 2015 – reports that a strength of EFT is that it is an empirically validated brief therapeutic approach with demonstrated effectiveness in treating anxiety, intimate partner violence, eating disorders and traumas.
Existentialism and Humanism:
- The connections between the terms existentialism and humanism have tended to be confusing for students and theorists alike.
- They have in common an emphasis on concepts such as freedom, choice, values, personal responsibility, autonomy, purpose and meaning.
- Existentialists tend to acknowledge the stark realities of human experience and their writings often focus on death, anxiety, meaninglessness and isolation.
- Humanistic, in contrast, take the somewhat less anxiety evoking and more optimistic view that each of us has a natural potential that we can actualise and through which we can find meaning
- Contemporary therorists call themselves existential-humanistic practitioners
- The phenomenological emphasis that is basic to the existentialist approach is also fundamental to person-centre therapy.
- This therapist aims to provide the client with a safe, responsive, and caring relationship to facilitate self-exploration, growth and healing.
Abraham Maslow’s Contributions to Humanistic Psychology:
- 1970 – self-actualising people
- Believed too much research was being conducted on anxiety, hostility and neuroses and too little into joy, creativity and self-fulfillment. Self actualisation was the central theme of the work of Abraham Maslow. The positive psychology movement
- Found that they differed in important ways from so called normal individuals
- The core characteristics of self-actualising people are self-awareness, freedom, basic honesty and caring, and trust and autonomy. Other characteristics of self-actualising individuals include a capacity to welcome uncertainty in their lives, acceptance of themselves and others, spontaneity and creativity, aneed for privacy and solitude, autonomy, a capacity for deep and intense interpersonal relationships, a genuine caring for others, an innterdirectness, the absence of artificial dichotomies within themselves, and a sense of humor.
- Maslow postulated the hierarchy of needs as a source of motivation. Once our physical and safety needs are fulfilled we become concerned with meeting our needs for belonging and love, followed by our need for esteem, both from self and others. We can self-actualising when our basic needs are met.
The vision of humanistic philosophy – we are faced at every moment with a choice about what to make of this condition. Maslows emphasis on the healthy side of being human and the emphasis on joy, creativity, and self-fulfillment are part of the person-centered philosophy.
Key Concepts – View of Human Nature – a common theme originating in Rogers early writing and continuing to permeate all of his works is a basic sense of trust in the clients ability to move forward in a constructive manner if conditions fostering growth are present. Rogers firmly maintainted that people are trustworthy, resourceful, capable of self-understanding and self-direction, able to make constructive changes and able to live effective and productive lives. 1. Congruence, 2. Unconditional positive regard, 3. Accurate empathic understanding. The actualizing tendency is a directional process of striving toward realisation, fulfillment, autonomy, and self-determination. Self-actualisation has implications – inherent capacity to move away from maladjustment and toward psychological health centred approach rejects the role of the therapist as the authoiry who knows best and of the passive client who depends on the therapists expertise. The person centred approach emphasises clients ability to engage their own resources to act in their world with others. Humanistic therapists emphasise a discovery-orientated approach, in which clients are the experts on their own inner experience.
The therapeutic process:
Goals – clients have come to recognise that they have lost contact with themselves by using facades. Person-centred therapists are in agreement on the matter of not setting goals for what clients need to change, yet they differ on the matter of how to best help clients achieve their own goals and to find their own answers.
Therapists Role and Functions – the role of person-centred therapists is rooted in their ways of being and attitudes, not in techniques designed to get the client to ‘do something’. Basically, therapists use themselves as an instrument of change by encountering clients on a person-to-person level. Holds that the therapist function is to be present and accessible to clietns and to focus on their immediate experience. First and foremost the therapist must be willing to be real in the relationship with clients. When these therapist attitudes are present, clients then have the necessary freedom to explore areas of their life that were either denied to awareness or distorted.
Clients Experience in Therapy – Clients come to the counsellor in a state of incongruence, that is, a discrepancy exists between their self-perception and their experience in reality. One reason clients seek therapy is a feeling of basic helplessness, powerlessness, and an inability to make decisions or effectively direct their own lives. As counselling progresses, clients are able to explore a wider range of beliefs and feelings. They can express their fears, anxiety, guilt, shame, hatred, anger and other emtions that they had deemed too negative to accept and incorporate into their self-structure, As clients feel understood and accepted. They become less concerned about meeting other expectations and thus begin to behave in ways that are truer to themselves. Person-centred therapy rests on the assumption that clients can create their own self growth and are active self-healers. Client openness and nondefensiveness are among the best predictors of a favorable outcome.
Relationship between therapist and client:
Rogers hypothesis was formulated on the basis of many years of his professional experience, and it remains basically unchanged:
1. 2 persons are in psychological contact
2. First, who we shall term the client, is in a state of incongruence, being vulnerable or anxious
3. The second person, whom we term the therapist, is congruent in the relationship and this congruence is perceived by the client
4. The therapist experiences unconditional positive regard for the client
5. The therapist experiences an empathic understanding of the clients internal frame of reference and endeavors to communicate this experience to the client
6. The communication to the client of the therapists empathic understanding and unconditional positive regard is to a minimal degree achieved.
If the therapeutic core condition exist over some period of time, constructive personality change will occur. The core conditions do not vary according to client type. Further, they are both necessary nd sufficient for therapeutic change to occur. The therapist alone does not establish the therapeutic alliance; the client and therapist together co-create the working alliance. The humanistic approach is perhaps best characteristed as a way of being as an shared journey in which therapist and client reveal their humanness and participate in a growth experience. Rogers admitted that his theory was strikingly provocative and radical. His formulation has generated considerable controversy, for he maintained that many conditions other therapists commonly regard as necessary for effective psychotherapy were nonessential.
Congruence or Genuiness – implies that therapists are real, they are genuie, integrated and authentic during the therapy hour. This communication is done with careful reflection and considered judgment on the therapists part. Through authenticity the therapist serves as a model of a human being struggling toward greater realness. Cain 2010 stresses that therapists need to be attuned to the emerging needs of the client and to respond in ways that are in the best interests of the individual. Does not imply that only a fully self-actualised therapist can be effective in counselling, therapists are human and cannot be expected to be fully authentic.
Unconditional positive regard – can be best achieved through empathic identification with the client. Therapists communicate through their behaviour that they value their clients as they are and that clients are free to have feelings and experiences. The greater the degree of caring, prizing, accepting and valuing of the client in a nonpossessive way, the greater the change that therapy will be successful. If therapists caring stems from their own need to be liked and appreciated, constructive change in the client is inhibited.
Accurate Empathic Understanding – strives to sense clients subjective experiences, particularly in the here and now. Empathy is deep and subjective understanding of the client with the client. Empathy is not sympathy or feeling sorry for a client. Therapists are able to share the clients subjective world by drawing from their own experiences that may be similar to the clients feelings. Cain 2016 states that consistent empathic attunement is the foundation of all therapeutic approaches and contends that therapist empathy is basic to establishing a therapeutic alliance with clients. Clark 2010 – describes an integral model o empathy in the counselling process that is based on 3 ways of knowing, 1. Subjective empathy enables practitioners to experience what it is like to be the client, 2. Interpersonal empathy pertains to understanding a clients internal frame of reference and conveying a sense of the private meanings to the person, 3. Objective empathy relies on knowledge sources outside of a clients frame of reference. Accurate empathic understanding implies that the therapist will sense clients feelings as if there were his or her own without becoming lost in those feelings. It is a therapist responsibility to monitor the quality of the therapeutic relationship, the progress of clients, and identify any strains in the relationship. Watson 2016 full empathy entails understanding the meaning and feeling of a clients experiencing. Empathy is an essential spect of successful therapy in every therapeutic modality.
Application: Therapeutic Techniques and Procedures;
Evolutions of Person-centered methods:
The therapists ability to establish a strong connection with clients is the critical factor of determining successful counselling outcomes. Effective therapy requires therapists to be fully present and engaged with their clients. Techniques may be suggested to some clients but they are not basic to the practice of person-centred therapy. What is essential for clients progress is the therapist presence. Qualities and skills such as listening, accepting, respecting, understanding, and responding must be honest expressions by the therapist. Immediacy or addressing what is going on between the client and therapist is highly values in his approach. Cain 2010, believes it is essential for therapists to adapt their therapeutic style to accommodate the unique needs of each client. Today those who priace a person-centred approach work in diverse ways that reflect both advances in theory and practice and a plethora of personal styles.
The role of Assessment:
Assessment is frequently viewed as a prerequisite to the treatment process. Generally do not find traditional assessment and diagnosis to be useful because these procedures encourage an external and expert perspective on the client. Assessment seems to be gaining in importance in short-term treatments in most counselling agencies and it is imperative that clients be involved in a collaborative process in making decisions that are central to their therapy.
Application of the Philosophy of the Person-Centred Approach:
Person-centered therapy has been shown to be as viable as the more goal orientated therapies. Effective therapy is based on the client therapist relationship in combination with the inner and external resources of the client. The person-centered approach has been applied extensively in training both professionals and paraprofessionals who work with people in a variety of settings. Learning to listen to oneself with acceptance is a valuable life skill that enables individuals to be their own therapists. If counsellors are lacking in these relationship and communication skills they will not be effective in carrying out a treatment program for their clients. The person-centered approach demands a great deal of the therapists. Natalie Rogers 2011 points out that the person-centred approach is a way of being that is easy to understand intellectually but is very difficult to put into practice.
Application to Crisis intervention:
The person-centered approach is especially applicable in crisis intervention such as an unwanted pregnancy, an illness, a disastrous event, ot the loss of a loved one. When people are in a crisis one of the first steps is to give them an opportunity to fully express themselves. If the person in crisis does not feel understood and accepted he or she may lose hope of returning to normal and may not seek help in the future. In crisis situations, person-centred therapists may need to provide more structure and direction, that would be the case of clients who are experiencing a crisis.
Application to Group Counselling:
- The person-centered approach emphasises the unique role of the group counsellor as the facilitator rather than a leader. Create a safe and healing climate. Carl Rogers 1970 clearly believed that groups tend to move forward if the facilitator exhibits a deep sense of trust in the members and refrains from using techniques or exercise to get a group moving. Observations should come from members. Assists members in developing attitudes and behaviours of genuineness, acceptance, and empathy which enables the members to interact with each other in therapeutic ways to find their own sense of direct as a group.
Person Centered Expressive Arts Therapy
- Extends the person-centered approach to spontaneous creative expression, which symbolises deep and sometimes inaccessible feelings and emotional states.
- Expressive art therapy uses a various artistics forms, movement, drawing, painting, sculpting, music, writing and improvisation – toward the end of growth, healing and self-discovery.
- All people have an innate ability to be creative
- The creative process is transformative and healing. The healing aspects involve activities such as meditation, movement, art, music, and journal writing
- Personal growth and high states of consciousness are achieved through self-awareness
- Self-awareness, understanding, insight are achieved by delving into our feelings of frieg, anger, pain, fear, joy and ecstasy.
- Our feelings and emotions are an energy source that can be channeled into the expressive arts to be released and transformed
- The expressive arts lead us to unconsciously, express previously unknown
- One art form stimulates and nurtures the other
- A connection exists between our life force
- As we journey inward to discover our essence or wholeness.
- Natalie Rogers approach is based on a person-centered theory of individual and group process. Personal growth takes place in a safe, supportive environment created by counsellors or facilitators who are genuine, warm, empathic, open, honest, congruent and caring – qualities that are best learned by first being experienced
Creativity and Offering Stimulating Experience:
According to Natalie Rogers, this deep faith in the individuals innate drive to become fully oneself is basic to the work in person-centered expressive arts. Believes the tendency to actualise and become ones full potential, including innate creativity, is undervalued, discounted and frequently squashed in our society. Person-centered expressive art therapy utilised the arts of spontaneous creative expression that symbolises deep and sometimes inaccessible feelings and emotional states. Believes that we cheat ourselves out of a fulfilling and joyous source of creativity if we cling to the idea that an artist is the only one who can enter the realm of creativity.
Motivational Interviewing:
- Humanistic, client-centered psychosocial and modestly directive counselling approach developed by William R Miller and Stephen Rollnick in the early 1980s. MI is based on humanistic principles has many basic similarities with person-centered therapy and expands the traditional person-centered approach.
- Designed as a brief intervention for problem drinkning, but more recently this approach has been applied to a wide range of clinical problems including substance abuse, compulsive gambling, eating disorders, behaviour changing practices.
- MI stresses client self-responsibility and promotes an invitational style for working cooperatively with clients to generate alternative solutions to behavioural problems.
- The primary goal is to reduce client ambivalence about change and increase the clients own motivation for change
- Include open-ended questions, employing reflective listening, creating a safe climate, affirming and supporting the client, expressing empathy, responding to resistance in a nonconfrontational manner, guiding a discussion of ambivalence, summarising and linking at the end of each sessions and eliciting and reinforcing change talk. Practitioners assist clients in becoming their own advocates for change and the primary agents of change in their lives. Both MI and person-centered therapy are based on the premise that individuals have within themselves the capacity to generate an intrinsic motivation to change.
5 Principles of MI:
- Therapists strive to experience the world from the clients perspective without judgement or criticisms
- MI is designed to evoke to explore both discrepancies and ambivalence
- Reluctance to change is viewed as an expected part of the therapeutic process
- Practitioners supports clients self-efficacy, mainly by encouraging them to use their own resources to take necessary actions that can lead to success in changing
- When clients show signed of readiness to change through decreased resistance to change and increased talk about change, a critical phase of MI begins
The stages of change:
- Precontemplation stage – there is no intention of changing a behaviour patter in the near future
- Comtemplation stage – people are aware of a problem and are considering overcoming it but they have not yet made a commitment to take action to bring about the change
- Preparation stage – individuals tend to take action immediately and report some small behavioural changes
- Action stage – individuals are taking steps to modify their behaviour to solve their problems
- Maintenance stage – people work to consolidate their gains and prevent relapse.
- If change is initially unsuccessful, individuals may return to an earlier stage. If there is a mismatch between process and stage, movement through the stage will be impeded and is likely to be manidested in reluctant behaviour. Both necessary and sufficient in bringing about change.
Strengths:
- Europe – impact on education and cross cultural communication
- 30 countries published Rogers.
- Bohart and Watson 2011 – claim that the person-centered philosophy is particularly appropriate for working with diverse client populations because the counsellor does not assume the role of expert who is doing to impose a right way of being on the client
- MT, is culturally sensitive approach that can be effective across population domains, including gender, age, ethnicity and sexual orientation.
Shortcomings:
Although the person-centered approach has made significant contributions to counselling people from diverse social, political, and cultural backgrounds, there are short comings.
- Clients expect counsellors to provide guidance or give advice and can be put off by this unstructured approach
- It is difficult to translate the core therapeutic conditions into actual practice in certain cultures
- This approach extols the value of an internal locus of evaluation
- Despite these short comings the person-centered approach offers many opportunities for working with clients from diverse cultures.
Contributions:
- Rogers was a pioneer in shifting the therapeutic focus from an emphasis on technique and reliance on therapist authority to that of the power of the therapeutic relationship
- Natalie Rogers has made a significant contribution to the application of the person-centered approach by incorporating the expressive arts as a medium to facilitate healing and social change, primarily group setting,
- Kirschenbaum 2009 points out that the scope of influence of Rogers work has continued well beyond his death; the person centrered approach is alive and well and expanding
- Willingness to state his concepts as testable hypotheses and to submit them to research.
- Cain 2010, body of research over 70 years supports this therapy
- Critics gave Rogers credit for having conducted and inspired others to conduct extensive studies of counselling process and outcome.
Limitations:
- Accusations of the scientific shortcomings involve using control subjects who are not candidates for therapy, failing to use an untreated control group, failing to account for placebo effects, reliance on self-reports as a major way to assess the outcomes of therapy, and using inappropriate statistical procedures.
- There is a similar limitation shares by both the person-centered and existential approaches
- Is that some students in training and practitioners with this orientation may have a tendency to be very supportive of clients without being challenging
- Using this approach is truly support clients in finding their own way.
