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Psych 401 Person Centered Theory in Psychotherapy by Mick Cooper


  • Person-centered psychotherapy can be defined as a set of ideas and practices that are based, primarily or wholly, on the work of the American psychologist Carl Rogers

    • Radical, non pathologizing view of human well-being and distress

    • Client is the agent, optimize their psychological functioning 

    • Freeing them for norma; growth and development 

  • Main approach within the field of humanistic psychotherapy (humanism: the yearning to show regard for all that is human)

  • Goes back to Jean-Jacques Rousseau, Hebrew philosophers, Greek sages 

  • Engaging with clients in ways that recognize and dignify their humanity; focussed on a warm, understanding and genuine interpersonal connection

  • Being adopted in many parts of the world like Austria, Eastern Europe, South America, China, but not there in places like usa, uk, Germany. 

  • It can also be understood as an ethic and set of practice principles that underpins many other approaches to psychotherapeutic theory and practice (humanistic and others).

  • Rogerian: trying to understand the world from the client’s pov (empathy), providing unconditional positive regard, being congruent (genuine), reflection of feeling. Therapist does not know best. 


CLASSICAL PERSON-CENTERED THERAPY 

Theory of Personality 

  1. Phenomenological foundations 

    1. Understanding people as they experience their worlds

    2. Rogers challenged the assumption of a universal objective truth, said there’s “reality”

    3. Behaviour could not be wholly explained by stimuli, it has to be a person’s perception of stimuli

    4. Subception: discriminated without awareness because they do not fit in with a person’s concept of self 

  2. Development theory 

    1. Organismic valuing process 

    2. Early stages of life → infant is undifferentiated → as it develops, a part of experiences becomes “self-experiences” → self develops → influenced by expectations and judgments of the caregivers around it → infant has a need for positive regard 

    3. Greater levels of self-estrangement are associated with greater levels of psychological disturbances for the following reasons: 

      1. Less likely to engage in self-maintaining and self-enhancing activities (not take care of self)

      2. Engage in behaviors that are stagnation or self-destructive

      3. Continue to strive to maintain and enhance itself 


Non Directivity 

  • Extent to which clients are invited to lead the therapeutic process. Find their own unique pathways of change and growth


Therapeutic Conditions for Personality Change

  • Necessary and sufficient conditions for therapeutic change 

    • Two persons are in psychological contact. 

    • The first, whom we shall term the client, is in a state of incongruence, being vulnerable, or anxious. 

    • That the second person, whom we shall term the therapist, is congruent or integrated in the relationship.

    • The therapist experiences unconditional positive regard for the client. 

    • The therapist experiences an empathic understanding of the client’s internal frame of reference and endeavors to communicate this experience to the client. 

    • The communication to the client of the therapist’s empathic understanding and unconditional positive regard is to a minimal degree achieved. 

  1. Congruence 

    1. Genuineness, realness → consistency between individual’s organismic experiencing and their concept of self 

    2. Awareness of one’s immediate experience alongside an openness to what might unfold (might involve self-disclosure) 

    3. Psychotherapist congruence can be hypothesized to facilitate change in a number of ways 

      1. Authentic way of being to the client 

      2. Makes therapist more trustworthy, increases willingness to disclose

      3. Countertransferential work 

  2. Empathy 

    1. Understanding the client from the client’s own pov  or frame of reference 

    2. Allows the client to experience themselves in an accepting and safe space 

  3. Unconditional Positive Regard 

    1. Acceptance or non judgment of the client in their totality and completeness

  4. Integration of the six conditions, spirituality, and healing 

    1. Full of healing, therapeutic presence, relational depth


CRITICISMS

  1. Criticized for its ethnocentrism and lack of appreciation of different cultures and communities

    1. Individual needs > cultural needs

  2. Little evidence that the core conditions are necessary and sufficient for therapeutic personality change to occur across all clients at all times 

  3. Criticism of the classical approach is its nondirective stance - challenged for unnecessarily restricting psychotherapists in the range of responses available to learn

    1. Metatherapeutic nondirectivity  


CONTEMPORARY DEVELOPMENTS AND PRACTICE 

  • Consists of multiple forms of psychotherapy, which branch off from the classic client-centered approach 

  • Emotion focused psychotherapy - truly person centered (which is also called personal centered and experiential approach) 

  • Eligibility criteria: 

    • Have a community of currently active practitioners 

    • Are a comprehensive form of psychotherapy in themselves

    • Have trainings and resources currently active and available 


RESEARCH FINDINGS 

  • 50% increase in researches in the last 10 years (response to national guidelines)

  • National Institute for Health and Care Excellence (NICE) in the UK

  • Synthesized the efficacy of (a) humanistic experiential psychotherapies (b)eft (c) nondirective/supportive counseling (d) psychodrama (e) Gestalt therapy

    • Heps were as effective as cbt 

  • Clients in eft had the largest pre-post effects while nondirective/supportive therapies had the smallest effects

  • Empathy (r = .28) and positive regard (g = .28) are most important 

  • Classical is best for clients who are highly reactive, internalizers in high stress 

  • 3 main outcomes for HEP as synthesized from qualitative research: 

    • Appreciating experiences of self 

    • Appreciating experience of self in relationship to others 

    • Changed view of self/others


TRAINING AND SUPERVISION

  • Trainees have the knowledge and skills to develop as effective person-centered psychotherapists within themselves, thus highly self-directed structure of programs 

  • Pedagogic or theoretical input may be limited 

  • Learning is more experimental, you work with peers and with supervisors and basically practice on each other

  • Mainly the development of congruence and self-awareness, but more enabled to offer the condition of congruence to their clients

  • Explore countertransferential responses 

  • Supervisors provide the core conditions of congruence, empathy and acceptance to the supervisee, forming a relationship at depth


FUTURE DIRECTIONS 

  1. Focus development on research

    1. Qualitative research: developing an understanding of helpful and unhelpful practices 

    2. Correlational research: identify moderators and mediators of change a

  2. Move more specifically in the direction of process-guiding practices (Belgium, classical in UK)

  3. Focus research on those elements of person-centered theory and practice that “add value” to the field as a whole 

  4. Develop research into the particular client groups or client characteristics

  • Limitation of all of it is that they all assume psychotherapy has a universal effect and does not take into account that clients show differential benefit across psychotherapies 


CONCLUSION 

  • Growth oriented approach → an opportunity to develop and actualize ourselves in exciting and innovative ways.