chapter 13

Page 1:

  • Carl Rogers disagreed with Freud's assumptions about therapy and people

    • Rogers pioneered the humanistic movement in psychology and humanistic therapy

    • Humanistic approach stood in opposition to the Freudian view

  • Inner nature of people is good or neutral, not evil

    • It is best to bring out and encourage this inner nature

    • Denying or suppressing it can lead to sickness

Page 2:

  • Rogers' approach to therapy remains influential today

  • Rogers and his followers created a family of therapies known as humanistic therapy

  • Humanistic therapy aims to foster self-actualization

  • Psychological problems are seen as a result of a stifled growth process

  • The therapist's role is to create a climate for clients to resume their natural growth

Page 3:

  • The need for positive regard can override the natural tendency to self-actualize

  • Conditional positive regard can lead to a discrepancy between the real self and the ideal self

  • This discrepancy is called incongruence and is viewed as the root of psychopathology

  • Congruence is achieved when self-actualization is allowed to guide a person's life without interference from conditions of worth

  • Congruence leads to mental health optimization

  • Conditions of worth can eventually become incorporated into a person's own views of themselves

Page 4:

  • Humanists believe that people have an inborn tendency to grow and certain conditions foster their growth.

    • Unconditional positive regard from others brings forth unconditional positive self-regard.

  • Mark, a first-year college student, decided to become a lawyer due to strong encouragement from his parents.

    • His parents frequently commented on Mark's potential as a lawyer and showed little interest in his other activities.

  • Mark took an art history course and found himself fascinated by the subject, but hid his interest from his parents.

    • He sensed that his parents would reject him if they knew he was passionate about art.

  • Mark eventually became a lawyer but felt unhappy that his artistic side was never allowed to grow.

Page 5:

  • The therapist in humanistic psychotherapy fosters the client's self-healing tendencies toward growth.

  • The therapist creates a therapeutic relationship characterized by three essential conditions.

    • Empathy: The therapist experiences empathy for the client, understanding their experiences without judgment.

      • Empathy can have a positive impact on the client, helping them clarify their feelings and feel valued and supported.

    • Unconditional Positive Regard (UPR): The therapist fully accepts the client "no matter what."

      • UPR is like unobstructed sunlight for plants, providing the necessary conditions for growth.

Page 6: Considering Culture Empathy Across Cultures

  • Empathy is fundamental to successful psychotherapy according to the humanistic approach.

  • Culture may place limits on the extent to which a therapist can empathize with clients who differ from themselves in terms of ethnicity, gender, age, or other variables.

  • Examples of cultural differences impacting empathy:

    • Stephanie, a woman seeking therapy for depressive symptoms after a miscarriage. Would a female therapist be more capable of empathizing with her?

    • Namrata and Amit, a married couple arguing about the language they will speak at home after their baby is born. Would an Indian, bilingual therapist have a greater capacity for empathy?

    • Faye, a 75-year-old woman struggling with loss and health issues. Can a therapist half her age genuinely empathize with her?

  • Little empirical research has been conducted on this topic, and the results have been inconsistent.

Page 7: Genuineness Empathy and UPR

  • Unconditional Positive Regard (UPR) allows clients to grow in a self-directed way without fear of losing respect or acceptance.

  • Therapists unconditionally prizing clients can lead to clients prizing themselves unconditionally, facilitating higher levels of congruence and self-actualization.

  • An empirical study showed a strong correlation between increases in congruence and overall therapy benefits.

  • Humanistic therapists prioritize accepting clients entirely and unconditionally to promote natural growth.

  • Genuineness is essential in therapist-client relationships, where therapists truly empathize and unconditionally prize clients.

  • Being genuine helps establish therapeutic relationships that feel "real" and encourages clients to open up and engage more fully.

  • Humanistic therapists encourage transparency and self-disclosure, guided by the goal of benefiting the client.

Note: The transcript continues beyond page 7, but the given instructions only cover the content up to page 7.

Page 8:

  • Relationship characterized by genuineness and transparency

    • Therapist expresses real feelings

  • Warm acceptance and prizing of the other person as an individual

  • Sensitive ability to see the other person's world and themselves

  • Benefits for the other individual in the relationship

    • Experience and understand repressed aspects of themselves

    • Better integration and ability to function effectively

    • Becoming more similar to the person they want to be

    • Increased self-direction and self-confidence

    • Becoming more unique and self-expressive

    • Increased understanding and acceptance of others

    • Improved ability to cope with life's problems

Necessary and Sufficient? (Page 8)

  • Rogers claimed that empathy, unconditional positive regard (UPR), and genuineness are necessary and sufficient for successful psychotherapy

  • Research initially supported this claim, but more recent research suggests they are necessary but not always sufficient

  • Empathy, UPR, and genuineness are common factors in successful psychotherapy

Page 9:

  • The author has wrestled with Rogers's claim that the three core elements of humanistic therapy are necessary and sufficient

  • The author had a client, Anthony, who needed more than empathy, UPR, and genuineness

    • Cognitive therapy and behavioral activation were used to help Anthony challenge his negative thoughts and engage in positive behaviors

  • Not every client needs additional techniques, some are self-propelled and only need the core elements

  • The author had a client, Tiana, who was motivated to change and had insights into her issues

    • The therapeutic relationship, founded on the core elements, allowed her to work out her own issues

Page 10: Therapist Attitudes, Not Behaviors

  • Humanists view empathy, UPR, and genuineness as attitudes, not behaviors

  • Humanists emphasize how therapists should be with clients rather than specific actions

  • Therapists' attitudes are communicated to and perceived by the client, affecting success in therapy

Reflection: An Important Therapist Response

  • Humanists believe that reflection is a therapist behavior that contributes to the success of therapy

  • Reflection is a mechanism to communicate empathy, UPR, and genuineness

  • Reflection involves rephrasing or restating the client's statements to highlight their feelings or emotions

  • Humanistic therapists mirror their clients' affect, even if it is not explicitly stated

  • Reflection should not be a mechanical technique, but an attitude of questioning and checking perceptions

Page 11:

  • Rogers expressed regret about the way "reflection of feeling" had been used as a technique

  • Reflection should be an attitude rather than a technical skill

  • Therapists should ask clients if their understanding of their feelings is correct, rather than telling them how they feel

  • Rogers suggested using terms like "Testing Understandings" or "Checking Perceptions" instead of "Reflections of Feeling"

Metaphorically Speaking If You've Looked in a Magnifying Mirror, You Understand Reflection

  • Reflection in therapy is similar to looking in a mirror for feedback on appearance

  • Humanistic therapists provide clients with feedback about their emotions through reflection

  • Reflection helps clients better appreciate their emotional selves

  • Magnifying mirrors amplify features and show parts of ourselves we may not have been fully aware of

  • Emotional mirroring by humanistic therapists can highlight emotions that clients may not have been fully aware of

Page 12:

Alternatives to Humanism

  • Existential therapy and Gestalt therapy have been influenced by humanism

  • Existential therapy focuses on the premise that each person is essentially alone in the world, leading to anxiety and meaninglessness

  • Existential therapists emphasize clients' abilities to create their own meaning through their decisions

  • Gestalt therapy focuses on the here and now, emphasizing awareness and integration of thoughts, feelings, and actions

  • Both approaches continue to influence many therapists today

Page 13: Existential Therapy and Gestalt Therapy

  • Existential therapy focuses on individuals taking control of their lives and finding meaning

    • Not easily studied empirically

    • Meta-analysis found it works well for some clients, especially those who are physically ill or concerned with the meaning of life

  • Gestalt therapy emphasizes a holistic approach to enhancing the client's experience

    • Focuses on both mental and physical perceptions

    • Encourages clients to reach their full potential through role-play techniques

    • Emphasizes the present moment and integration and awareness of all parts of the self

Page 13-14: Motivational Interviewing

  • Motivational interviewing (MI) is a briefer approach to therapy

  • Developed by William Miller

  • Originally used to treat addictive behaviors, but now used for a wide range of client problems

  • MI addresses clients' ambivalence or uncertainty about making major changes to their way of life

  • MI therapists help clients see the discrepancy between their behavior and their own values

  • MI elicits motivation from within the clients, rather than imposing it from without

  • MI can be used as a full-fledged treatment or as an augmentation to other therapies

  • MI principles include expressing empathy, developing discrepancy, avoiding argumentation, rolling with resistance, identifying "sustain talk" and "change talk," and supporting self-efficacy

  • Research shows that MI produces beneficial outcomes for a wide range of problems, including psychological and physical symptoms

Page 15:

Main Ideas:

  • Motivational Interviewing (MI) is an effective approach in addressing various behavioral and psychological issues.

  • MI can be integrated into other forms of treatment.

  • Positive psychology movement overlaps with humanistic principles.

  • Positive interventions and strength-based counseling focus on enhancing well-being and strengths of individuals.

Supporting Details:

  • MI can help with smoking, exercise, weight-loss efforts, anxiety disorders, depression, violence toward intimate partners, HIV risk, cholesterol levels, diabetes management, and blood pressure.

    • MI sparks change in behaviors that worsen or enhance these issues.

  • MI is a bright spot for humanistic therapies in evidence-based treatments.

  • Positive psychology emphasizes human strengths and happiness in addition to symptom reduction.

  • Positive psychology acknowledges the potential of individuals to develop positive attributes and prevent psychological problems.

  • Positive interventions and strength-based counseling focus on enhancing positive emotions, engagement, relationships, meaning, and achievement.

  • Happiness is a protective factor against mental disorders.

  • Therapies derived from positive psychology nurture what is strong in clients.

  • Therapies in positive psychology go by various names, such as positive interventions or strength-based counseling.

Page 16:

Main Ideas:

  • Therapists should consider both strengths and weaknesses of clients.

  • The "four-front approach" encourages therapists to consider four areas of a client's life.

  • Positive psychology techniques can be categorized into seven basic categories.

  • Positive interventions and strength-based counseling can be blended into other forms of therapy.

  • Positive interventions and strength-based counseling have empirical data supporting their benefits.

Supporting Details:

  • The "four-front approach" considers weaknesses, strengths, destructive factors, and resources in a client's life.

  • Positive psychology techniques include savoring, gratitude, kindness, empathy, optimism, strength-based activities, and meaning.

  • Positive interventions and strength-based counseling can be integrated into other forms of therapy.

  • Positive interventions and strength-based counseling have empirical data supporting their benefits in increasing happiness levels.

Page 17:

  • Positive psychology interventions have been found to be effective in reducing depressive symptoms and promoting posttraumatic growth and resilience.

    • Examples include interventions with individuals who have experienced traumatic events such as active military combat.

    • Positive psychology interventions may be more acceptable to clients and result in greater adherence and lower dropout rates compared to other types of therapy.

  • Emotionally Focused Therapy (EFT) is a short-term humanistic therapy that emphasizes the expression and healing power of emotions.

    • EFT is frequently practiced with couples and aims to enhance closeness and replace patterns of blaming and withdrawing with empathy and self-disclosure.

    • EFT has been found to be beneficial to couples and individuals with depression, PTSD, and other clinical issues.

  • Arthur Bohart and Karen Tallman have developed a modern adaptation of humanism that emphasizes the client's active role in generating their own solutions to personal problems.

    • Therapy is seen as creating a better problem-solving climate rather than trying to fix the person.

Page 18:

  • Bohart and Tallman argue against symptom-focused, technique-dominated approaches to therapy and believe in mobilizing clients to help themselves.

  • Carl Rogers was a pioneer of psychotherapy outcome research and attempted to present his ideas as testable hypotheses.

  • Recent meta-analyses of humanistic therapy outcome studies indicate that humanistic therapies are generally as effective as other major approaches to psychotherapy.

  • Humanistic therapies have been found to be effective for depression, relationship problems, coping with long-term illness, substance abuse, eating disorders, and psychotic disorders.

  • Empirical studies have shown that empathy, positive regard, and genuineness play important roles in the success of therapy, regardless of the therapeutic approach.

Note: This note provides an overview of positive psychology interventions, Emotionally Focused Therapy (EFT), a modern adaptation of humanism, and the effectiveness of humanistic therapies. It highlights the benefits of positive psychology interventions and EFT, as well as the importance of empathy, positive regard, and genuineness in therapy. The note also mentions the research efforts of Carl Rogers and the overall effectiveness of humanistic therapies compared to other approaches.

Page 19:

  • Empathy, positive regard, and genuineness are essential components of therapy

    • Supported by empirical research (R. Elliott, Bohart, Watson, & Greenberg, 2011; Farber & Doolin, 2011; Kolden, Klein, Wang, & Austin, 2011; Zuroff et al., 2010)

  • Motivational interviewing (MI) is an evidence-based psychotherapy

    • MI is effective for a wide range of psychological and physical problems

    • Supported by research (Arkowitz & Westra, 2009; Hettema et al., 2005; Jensen et al., 2011; Lundahl & Burke, 2009; W. R. Miller & Rose, 2009; Musser & Murphy, 2009; Rubak et al., 2005)

Denise in Humanistic Psychotherapy

  • Denise's dissatisfaction with her job and personal family history are discussed

  • Denise felt valued by her family for her cooking abilities

  • Her job as a chef provided similar opportunities for appreciation, but new policies limited her interaction with customers

  • Denise's self-worth became tied to cooking and meeting others' expectations

  • Therapist communicates empathy and acceptance of Denise's experiences

  • Therapist recognizes Denise's potential beyond cooking and encourages exploration of other interests

  • Denise expresses anger towards her family and boss, which is accepted and validated by the therapist

  • Over time, Denise accepts herself more fully and explores professional opportunities outside of cooking

  • Denise no longer depends on positive feedback from others and is able to give herself unconditional positive regard

Page 21:

  • Humanistic approach to psychotherapy is based on the belief that people strive to grow in a positive, healthy way

  • Incongruence between real and ideal selves leads to psychological problems

  • Humanistic therapists foster self-actualization by providing empathy, unconditional positive regard, and genuineness

  • Reflection of feeling is a key component of humanistic therapy

  • Humanistic principles influence other contemporary approaches such as motivational interviewing, positive interventions/strength-based counseling, and emotionally focused therapy

  • Motivational interviewing has extensive empirical research supporting its benefits

  • Limited empirical research on the benefits of humanistic therapy in general, but it is typically as beneficial as other approaches.