PERSON-CENTERED THERAPY

Introduction

Carl Rogers (1902-1987)

 Carl Ransom Rogers was born in 1902 in Oak Hill, Illinois.

 His father was a civil engineer, and his mother was a housewife; he was the fourth child of six
children.
 He started reading before age 5 and was able to skip kindergarten and first grade.
 In 1919, he enrolled at the University of Wisconsin as an Agriculture major.
 Rogers began to question his career choice after attending a Christian conference in China in
1922.
 Changed his major to history with plans to become a minister.
 He graduated from the University in 1924, with a bachelor’s degree in history and enrolled at the
Union Theological Seminary.
 However, in 1926, he took educational psychology classes at Teachers College Columbia
University, where he began doing clinical work with children and received his PhD in 1931.
 After graduation, he began working at the Rochester Society for the Prevention of Cruelty to
Children.
 He became a professor of Clinical Psychology at Ohio State University, where he wrote
“Counseling and Psychotherapy.”
 In 1945, he moved to the University of Chicago and became interested in studying the
effectiveness of different methods of psychotherapy.
 He developed new ethical standards for psychotherapy that emphasized client agency and
confidentiality.
 He worked with the United Service Organization to develop a program for training others to
provide non-directive therapy.
 Rogers and other applied psychologists joined academic psychologists to reorganize the APA and
was elected President in 1947.
 In 1957, he left the University of Chicago to teach at the University of Wisconsin.
 1963, he moved to La Jolla, California and became a Western Behavioral Sciences Institute
resident.
 1973, he was the first recipient of the Distinguished Professional Contribution Award from the
APA.

FOUR PERIODS OF DEVELOPMENT OF THE APPROACH

FIRST PERIOD

 In the first period, during the 1940s, Rogers developed what was known as nondirective
counseling, while he was a professor at Ohio State University, Rogers published the “Counseling
and Psychotherapy: Newer Concepts in Practice” which described the philosophy and practice of
nondirective counseling.
 Rogers also challenged the validity of commonly accepted therapeutic procedures such as
advice, suggestion, direction, persuasion, and any other therapeutic concepts or procedures that
 therapists think will help their client because, in Rogers’s conviction, these diagnostic concepts
were inadequate, prejudicial, and often misused by the therapists that’s why he omitted these in
his approach. Nondirective counselors avoided sharing a great deal about themselves with
clients and instead focused mainly on reflecting and clarifying the client’s verbal and nonverbal
communication.

SECOND PERIOD

 During the 1950's, Rogers wrote the “Client-Centered Therapy.” This period was characterized by
a shift from clarification of feelings to a focus on the phenomenological world of the client. He
focused more explicitly on the actualizing tendency as the basic motivational force that leads to
client change.

ACTUALIZING TENDENCY – an innate drive to grow as individuals and to achieve their full potential.

SELF-ACTUALIZATION – is the fulfillment of one’s potential.

THIRD PERIOD

 Began in the late 1950s and extended into the 1970s, addressing the necessary and sufficient
conditions of therapy. A significant publication was “On Becoming a Person,” which addressed
the nature of “becoming the self that one truly is,” an idea he borrowed from Kierkegaard.
 In this book, he described the process of “becoming one’s experience,” which is characterized by
an openness to experience, a trust in one’s experience, an internal locus of evaluation, and the
willingness to be in the process.

FOURTH PERIOD

 Because of Rogers’s ever-widening scope of influence, including his interest in how people
obtain, possess, share, or surrender power and control over others and themselves, his theory
became known as the “person-centered approach.” The person-centered approach has been
applied mainly to individual and group counseling, important areas of further application include
education, family life, leadership & administration, organizational development, health care,
cross-cultural and interracial activity, and international relations.
 During the 1980s, Rogers directed his efforts toward applying the person-centered approach to
politics, especially to efforts related to the achievement of world peace.

EXISTENTIALISM & HUMANISM

 Existentialists tend to acknowledge the stark realities of human experience and their writings are
often focused on death, anxiety, depression, and isolation.
 Humanists take the somewhat less anxiety-evoking position and more optimistic view that each
of us has a natural potential that we can actualize and through which we can find meaning.

ABRAHAM MASLOW’S CONTRIBUTIONS TO HUMANISTIC PSYCHOLOGY

 Abraham Maslow (1970) was a pioneer in the development of humanistic psychology and was
influential in furthering the understanding of self-actualizing individuals. Many of Carl Rogers’s
 ideas, especially on the positive aspects of being human and a fully functioning person are built
on Maslow’s basic philosophy.
 Maslow criticized Freudian Psychology because he only saw the negative side of human nature.
He believes that too much research was being conducted on anxiety, hostility, and neuroses and
too little on joy, creativity, and self-fulfillment. That’s why self-actualization was the central
theme of the work of Abraham Maslow.
 Maslow studied what he called “self-actualizing people” and found that they differed in
important ways from so-called normal individuals. The core characteristics of self-actualizing
people are self-awareness, freedom, basic honesty and caring, and trust and autonomy. All these
personal characteristics have been identified by Rogers as being central to the person-centered
philosophy.
 Maslow postulated a “hierarchy of needs” as a source of motivation with the basic needs being
physiological needs. For instance, if we are hungry and thirsty, our attention is riveted on
meeting these basic needs. Next are the safety needs, which include a sense of security and
stability. Once our physical needs are fulfilled, we become concerned with meeting our needs for
belonging and love, followed by working on our need for esteem.

VISION OF HUMANISTIC PHILOSOPHY

 The humanistic philosophy on which the person-centered approach rests is expressed in

attitudes and behaviors that create a growth-producing climate. According to Rogers, when the
philosophy is lived, it helps people develop their capacities and stimulates constructive change in
others.
 The humanistic approach emphasizes the individual’s personal growth, the centrality of human
values, and the creative active nature of human beings. This approach is optimistic and focuses
on the noble human capacity to overcome hardship, pain, and despair.
 KEY CONCEPTS
 The common theme originating in Rogers’s early writing and continuing to permeate all of his
works is a basic sense of trust in the client’s ability to move forward in a constructive manner if
conditions fostering growth are present.
 Rogers firmly believed 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. When therapists can experience and communicate their realness, support, caring, and
nonjudgmental understanding, significant changes in the client are most likely to occur.

THREE THERAPISTS’ ATTRIBUTES THAT CREATE A GROWTH-PROMOTING CLIMATE IN INDIVIDUALS:

 Congruence (genuineness or realness)

 Unconditional Positive Regard (acceptance & caring)
 Accurate Empathic Understanding (ability to deeply grasp the subjective world of another
person)

- according to Rogers, if therapists communicate these attitudes, those being helped will become
less defensive and more open to themselves and their world, and they will behave in prosocial
and constructive ways.
  Brodley (1999) writes about the actualizing tendency, a directional process of striving toward
realization, fulfillment, autonomy, and self-determination. The person-centered approach
rejects the role of the therapist as the authority who knows best and of the passive client who
merely follows the beliefs of the therapist.
 In the person-centered approach, the emphasis is on how clients act in their world with others,
how they can move forward in constructive directions, and how they can successfully deal with
obstacles that are blocking their growth. Humanistic therapists emphasize a discovery-oriented
approach in which clients are the experts on their own inner experiences.
 they encourage clients to make changes that will lead to living fully and authentically, with the
realization that this kind of existence demands a continuing struggle. Maslow taught us that
becoming self-actualizing individuals is an ongoing process rather than a destination.

THE THERAPEUTIC PROCESS

THERAPEUTIC GOALS

 Rogers (1961) wrote that people who enter psychotherapy often ask: “How can I discover my
real self? How can I become what I deeply wish to become? How can I get behind my facades
and become myself?” The underlying aim of therapy is to provide a climate conducive to helping
the individual strive toward self-actualization.

 The person-centered approach aims toward the client achieving a greater degree of
independence and integration(coordinate). Its focus is on the person, not on the person’s
presenting problem. Rogers did not believe the goal of therapy was merely to solve problems.
Rather, the goal is to assist clients in their growth process so clients can better cope with
problems as they identify them. This approach minimizes directive techniques, such as
interpretation, questioning, and collecting history, whilst also minimizing active listening,
reflection of feelings, and clarification.

Rogers (1951) emphasises the

attitudes and personal
characteristics of the
practitioner and the quality of
the relationship as the prime
determinant of the outcomes.
Rogers (1951) emphasises the
attitudes and personal
characteristics of the
practitioner and the quality of
the relationship as the prime
determinant of the outcomes.
Rogers (1951) emphasises the
attitudes and personal
characteristics of the
practitioner and the quality of
the relationship as the prime
determinant of the outcomes.
- Before clients can work toward the goal(self-actualization), they must first get behind the masks
they wear, which they develop through the process of socialization. Clients come to recognize
that they have lost contact with themselves by using facades.

What happens when the facades are being put aside during the therapeutic process?

 Rogers (1961), people who are becoming increasingly actualized are (1) open to experience, (2)
trust in themselves, (3) have an internal source of evaluation, and (4) willing to continue
growing. Person-centered therapists agree on the matter of not setting goals for what clients
need to change, yet they differ on how to best help clients achieve their own goals and to find
their own answers (Bohart & Watson, 2011).
THERAPIST’S FUNCTION AND ROLE

 Therapists use themselves as an instrument of change. When they encounter the client on a
person-to-person level, their “role” is to be without roles. It is the therapist’s attitude and belief
in the inner resources of the client that creates the therapeutic climate for growth (Bozarth et
al., 2002).
 The therapist serves as a guide and partner to the client, focusing especially on treating the
client with “unconditional positive regard” (i.e., genuine care and acceptance) while remaining
empathic and keeping their own personality and opinions out of the way. The focus is on the
client rather than on the therapist's interpretation of the client, and this can be freeing for the
client, who is not subject to someone else's often misguided opinions. The therapist
concentrates instead on helping the client identify their own feelings, questions, concerns, and
issues. The therapist fully encourages the client to express themselves without fear of judgment.
 Person-centered theory holds that the therapist’s function is to be present and accessible to
clients and to focus on their immediate experience. By being congruent, accepting, and
empathic, the therapist is a catalyst for change. Through the therapist’s attitude of genuine
caring, respect, acceptance, support, and understanding, clients can loosen their defenses and
rigid perceptions.
 Instead of viewing clients in preconceived diagnostic categories, the therapist meets them on a
moment-to-moment experiential basis and enters their world. When these therapist attitudes
are present, clients then have the necessary freedom to explore areas of their lives that were
either denied awareness or distorted.

CLIENT’S EXPERIENCE IN THERAPY

 One reason clients seek therapy is a feeling of basic helplessness, powerlessness, and inability to
make decisions or effectively direct their own lives. However, in the person-centered
framework, clients soon learn that they can be responsible for themselves in the relationship
and that they can learn to be freer by using the relationship to gain greater self-understanding.
 As counseling progresses, clients can explore a wider range of beliefs and feelings. With therapy,
people distort less and move to a greater acceptance and integration of conflicting and
confusing feelings. Individuals in therapy come to appreciate themselves more as they are, and
their behavior shows more flexibility and creativity.
 As clients feel understood and accepted, they become less defensive and become more open to
their experience. Because they feel safer and are less vulnerable, they become more realistic,
perceive others with greater accuracy, and become better able to understand and accept
others. They become less concerned about meeting others’ expectations and thus begin to
behave in ways that are truer to themselves. These individuals direct their own lives instead of
looking outside of themselves for answers. They move in the direction of being more in contact
with what they are experiencing now, less bound by the past, less determined, freer to make
decisions, and increasingly trusting in themselves to manage their own lives.
 Their experience in therapy is like throwing off the self-imposed shackles that had kept them in
a psychological prison. Person-centered therapy is grounded on the assumption that it is clients
who heal themselves, who create their own self-growth, and who are active self-healers (Bohart
& Tallman, 1999, 2010; Bohart & Watson, 2011).
RELATIONSHIP BETWEEN THERAPIST AND CLIENT

 From Rogers’s perspective the client-therapist relationship is characterized by equality.

Therapists do not keep their knowledge a secret or attempt to mystify the therapeutic process.
The process of change in the client depends to a large degree on the quality of this equal
relationship.
 As clients experience the therapist listening in an accepting way to them, they gradually learn
how to listen acceptingly to themselves. As they find the therapist caring for and valuing them
(even the aspects that have been hidden and regarded as negative), clients begin to see worth
and value in themselves. As they experience the realness of the therapist, clients drop many of
their pretenses and are real with both them and the therapist.
 This humanistic approach is perhaps best characterized as a way of being and as a shared
journey in which therapist and client reveal their humanness and participate in a growth
experience. The therapist can be a relational guide on this journey because he or she is usually
more experienced and more psychologically experienced in this role than the client.

CONGRUENCE

 Implies that therapists are real; that is, they are genuine, integrated, and authentic during the
therapy hour. They are without a false front, their inner experience and outer expression of that
experience match, and they can openly express feelings, thoughts, reactions, and attitudes that
are present in the relationship with the client. Through authenticity the therapist serves as a
model of a human being struggling toward greater realness.

UNCONDITIONAL POSITIVE REGARD AND ACCPETANCE

 Therapists value and warmly accept clients without placing stipulations on their acceptance. It is
not an attitude of “I’ll accept you when...” rather, it is one of “I’ll accept you as you are.”
Therapists communicate through their behavior that they value their clients as they are and that
clients are free to have feelings and experiences. Acceptance is the recognition of clients’ rights
to have their own beliefs and feelings; it is not the approval of behavior.
 According to Rogers’s (1977) research, the greater the degree of caring, accepting, and valuing
of the client in a no possessive way, the greater the chance that therapy will be successful.

ACCURATE EMPATHIC AND UNDERSTANDING

 Accurate empathic understanding implies that the therapist will sense clients’ feelings as if they
were their own without becoming lost in those feelings. It is a way for therapists to hear the
meanings expressed by their clients that often lie at the edge of their awareness. A primary
means of determining whether an individual experiences a therapists’ empathy is to secure
feedback from the client (Norcross, 2010).

THERAPEUTIC TECHNIQUES AND PROCEDURES

EVOLUTION OF PERSON-CENTERED METHODS

 One of Rogers’s main contributions to the counseling field is the notion that the quality of the
therapeutic relationship, as opposed to administering techniques, is the primary agent of
growth in the client. No techniques are basic to the practice of person-centered therapy, “being
 with” clients and entering imaginatively into their world of perceptions and feelings is sufficient
for facilitating a process of change. Techniques may be suggested when doing so fosters the
process of client and therapist being together in an empathic way.
 Traditional person-centered therapists would not tend to suggest a technique (Bohart &
Watson, 2011). What is essential for clients’ progress is the therapist’s presence, being
completely attentive to and immersed in the client as well as in the client’s expressed concerns
(Cain, 2010). This way of being is far more powerful than any technique a therapist might use to
bring about change. Qualities and skills such as listening, accepting, respecting, understanding,
and responding must be honest expressions by the therapist.
 Today, those who practice a person-centered approach work in diverse ways that reflect both
advances in theory and practice and plethora of personal styles. If we strive to model our style
after Rogers, and if that style does not fit for us, we are not being ourselves and we are not
being fully congruent.

THE ROLE OF ASSESSMENT

 Person-centered therapists generally do not find traditional assessment and diagnosis to be

useful because these procedures encourage an external and expert perspective on the client
(Bohart & Watson, 2011). In the early development of nondirective therapy, Rogers
recommended caution in using psychometric measures or in taking a complete history at the
outset of counseling. Assessment seems to be gaining in importance in short-term treatments in
most counseling 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-CENTERED APPROACH

 Bozarth, Zimring, and Tausch (2002) cite studies done through the 1990s that revealed the
effectiveness of person-centered therapy with a wide range of client problems including anxiety
disorders, alcoholism, psychosomatic problems, agoraphobia, interpersonal difficulties,
depression, cancer, and personality disorders. The person-centered approach has been applied
extensively in training both professionals and paraprofessionals who work with people in a
variety of settings.

APPLICATION TO CRISIS INTERVENTION

 The person-centered approach is especially applicable in crisis intervention such as unwanted

pregnancy, an illness, a disastrous event, or the loss of a loved one. Sensitive listening, hearing,
and understanding are essential at this point. Being heard and understood helps ground people
in crises, helps to calm them in the midst of turmoil, and enables them to think more clearly and
make better decisions. In crisis situations person-centered therapists may need to provide more
structure and direction than would be the case for clients who are not experiencing a crisis.
 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. Genuine support, caring, and no
possessive warmth can go a long way in building bridges that can motivate people to do
something to work through and resolve a crisis. Communicating a deep sense of understanding
should always precede other problem-solving interventions.
APPLICATION TO GROUP COUNSELING

 The person-centered approach emphasizes the unique role of the group counselor as a facilitator
rather than a leader. The primary function of the facilitator is to create a safe and healing
climate, a place where the group members can interact in honest and meaningful ways. Group
members make their own choices and bring about change for themselves. Yet with the presence
of the facilitator and the support of other members, participants realize that they do not have to
experience the struggles of change alone and that groups as collective entities have their own
source of transformation.
 The role of the facilitator is to empathically understand what an individual is communicating
within the group. Instead of leading the members toward specific goals, the group facilitator
assists members in developing attitudes and behaviors of genuineness, acceptance, and
empathy, which enables the members to interact with each other in therapeutic ways to find
their own sense of direction as a group.

PERSON-CENTERED EXPRESSIVE ARTS THERAPY

PRINCIPLES OF EXPRESSIVE ARTS THERAPY

 Natalie Rogers (1993, 2011) expanded on her father, Carl Rogers’s theory of creativity using the
expressive arts to enhance personal growth for individuals and groups. Rogers’s approach,
known as “expressive arts therapy,” extends the person-centered approach to spontaneous
creative expression, which symbolizes deep and sometimes inaccessible feelings and emotional
states. Counselors trained in person-centered expressive arts offer their clients the opportunity
to create movement, visual art, journal writing, sound, and music to express their feelings and
gain insight from these activities.

The principles include the following:

 All people have an innate ability to be creative.

 The creative process is transformative and healing.
 Personal growth and higher states of consciousness are achieved through self-awareness, self-
understanding, and insight.
 Self-awareness, understanding, and insight are achieved by delving into our feelings of grief,
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 into the unconscious, thereby enabling us to express previously
unknown facets of ourselves and bring to light new information and awareness.
 One art form stimulates and nurtures the other, bringing us to an inner core or essence that is
our life energy.
 A connection exists between our life force—our inner core, or soul—and the essence of all
beings.
 As we journey inward to discover our essence or wholeness, we discover our relatedness to the
outer world, and the inner and outer become one.
Natalie Rogers’s approach is based on a person-centered theory of individual and group process. The
same conditions that Carl Rogers and his colleagues found basic to fostering a facilitative client–
counselor relationship also help support creativity.

CREATIVITY AND OFFERING STIMULATING EXPERIENCES

 According to Natalie Rogers, this deep faith in the individual’s innate drive to become fully
oneself is basic to the work in person-centered expressive arts. Individuals have a tremendous
capacity for self-healing through creativity if given the proper environment. Person-centered
expressive arts therapy utilizes the arts for spontaneous creative expression that symbolizes
deep and sometimes inaccessible feelings and emotional states.

CONTRIBUTIONS OF NATALIE ROGERS

 Natalie Rogers (1928-2015) was an early contributor to the field of humanistic psychology and
the founder of Person-Centered Expressive Arts. Her work in developing expressive arts therapy
expanded upon traditional views of art therapy as pertaining to drawing, painting, and sculpture
to include other modalities of art into the therapeutic process.

MOTIVATIONAL INTERVIEWING

 is a counseling technique that helps people with behavioral problems change their behavior, this
is on the idea that people are more likely to make changes if they are motivated to do so.

THE MI SPIRIT

 the spirit of MI is based on 3 key elements: collaboration between the therapist and the client;
evoking or drawing out the client’s ideas about change; and emphasizing the autonomy of the
client.

THE STAGES OF CHANGE

The stages of change model assumes that people progress through a series of five identifiable
stages in the counseling process.
 Precontemplation stage - no intention of changing a behavior pattern in the future.
 Contemplation 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 behavioral
changes.
 Action stage - individuals are taking steps to modify their behavior to solve their problems.
 Maintenance stage - people work to consolidate their gains and prevent relapse.

The stages of the change model describe how an individual or organization integrates new behaviors,
goals, and programs at various levels. The five stages of the change model describe a series of changes
that people go through to change a problem behavior into maintaining a healthy behavior.

CONTRIBUTIONS OF THE PERSON-CENTERED APPROACH

  Kirschenbaum (2009) contends that the scope and influence of Rogers’s work have continued
well beyond his death; the person-centered approach is alive, well, and expanding. Although few
psychotherapists claim to have an exclusive person-centered theoretical orientation, the
philosophy and principles of this approach permeate the practice of most therapists.
 Person-centered therapy is strongly represented in Europe, and there is continuing interest in
this approach in both South America and the Far East. 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 in a group setting.

EMPHASIS ON RESEARCH

 One of Rogers’s contributions to the field of psychotherapy was his willingness to state his
concepts as testable hypotheses and to submit them to research.
 Cain (2010) concludes, “person-centered therapy is as vital and effective as it has ever been and
continues to develop in ways that will make it increasingly so in the years to come.”

IMPORTANCE OF EMPATHY

 Person-centered therapy has demonstrated that therapist empathy plays a vital role in
facilitating constructive change in the client.
 Watson’s (2002) comprehensive review of the research literature on therapeutic empathy has
consistently demonstrated that therapist empathy is the most potent predictor of client progress
in therapy.

EMOTION-FOCUSED THERAPY

 EFT is a therapeutic practice informed by an understanding of the role of emotion in

psychotherapeutic change. This approach has a good deal to offer with respect to teaching us
about the role of emotion in personal change and how emotional change can be a primary
pathway to cognitive and behavioral change.

LIMITATION AND CRITICISMS OF THE PERSON-CENTERED APPROACH

 One of the main criticisms of the person-centered approach is that it can be slow because the
therapist is not there to offer solutions or advice, progress may be slower than other types of
therapy.
 Another potential drawback is that person-centered therapy may not be effective for everyone.
 Person-centered therapy may not be appropriate for individuals with severe mental health
issues.
 A potential limitation of the person-centered approach is that some students-in-training and
practitioners with this orientation may tend to be very supportive of clients without being
challenging.
 A related challenge for counselors using this approach is to truly support clients in finding their
own way. Counselors sometimes experience difficulty in allowing clients to decide their own
specific goals in therapy.