‘A Person-Centred Approach in Psychotherapy’
Susan McKenna
This blog presents a discussion on the Person-Centred approach in psychotherapy looking specifically at its theoretical underpinnings and how this exemplifies in practice. Carl Rogers was an influential American psychologist, who was co-founder of the humanist approach to clinical psychology along with Abraham Maslow and his self-actualisation thesis. His humanist perspective evolved over the years and may be encapsulated by the notion that the provision of congruent empathy and unconditional positive regard by the therapist facilitates clients to undergo what he termed ‘constructive personality change’ (Rogers, 1957, p.96).
Person-Centred Therapy appears in the literature under three separate and/or interconnected titles; Rogerian therapy, client-centred and non-directive therapy. It embraces a particular perspective on and approach towards psychotherapy and counselling practice whereby emphais lies on the client and the therapist assumes a non-directive role. The interpersonal relationship between the client and therapist is core. Perhaps the most important skill from the therapist’s perspective is the ability to listen in a non judgemental manner (Rogers, 1939; 1940; 1957; 1959; 1961; 1977; 1980). The theoretical underpinning of this system is heavily influenced by Rogers’ notion that all individuals tend to seek positives rather than negatives in their lives and, further, that each individual holds the potentiality to fulfill his or her own potential.[1]
Roger’s early theoretical influences have been discussed by several authors (e.g. Barrett-Lennard, 1998 and Thorne, 2003) noting the place of clinical and edcational psychology when he held a position at Columbia University. We can trace back the theoretical underpinnings of Rogers’ theory to 1939. He became interested in the formation of positive and lasting relationships which he discussed in his first book titled, The Clinical Treatment of the Problem Child. This book resulted from his time working with the Rochester Society for the Prevention of Cruelty to Children and in this book he looked to the importance of self-directed processes (Rogers, 1939; Wampold, 2001). Rogers’ wrote, “The counsellor is often faced with situations in which he knows that he will be limited to but one interview, or in which he is sure that he cannot carry on extended treatment. In such instances, the common practice is to be completely directive” (Rogers 1942, p172).
In an early 1940 paper, Rogers developed a hypotheses that stayed running through his theoretical lens all through his career and explained it thus:
“It is essential that certain basic conditions be met…It is probably necessary that the client, whether child or adult, should feel some dissatisfaction with present adjustment, some fundamental need of help… Therapy has no chance of being successful if there is too heavy a weight of adverse social factors making adjustment impossible except through radical alteration of circumstances” (1940, p. 161).
Humanism, in the context of this blog, refers to a reactionary movement in to what Rogers and Maslow understood to be an over emphasis on ‘pessimistic determinism’ within psychoanalysis. Rogers fundamentally disagreed with the notion that humans were inherently passive actors in relation to the environment. Both the aforementioned believed that free will and subjective experiences and non experiences of individuals shaped their intent and actions. If these could be tapped into, there was a greater chance of success within the therapeutic experience.[2] What marks out this approach is the emphasis on what Rogers called the ‘growth potential’ of healthy individuals and Rogers wanted the emphasis to be placed on this understanding and away from negative pathologies. Indeed, Rogers coined the term actualizing tendency, which speaks to an individual’s basic and core drive to succeed at their highest potential. His theory of personality development, emphasised the potential for ‘goodness’ that lies within each of us.
Flowing out of the above interest in self and self actualisation, Rogers speaks about unconditional positive regard which, in his understanding, facilitates individuals to potentially fully actualize. The absence of articulated and/or demonstrable unconditional regard and love, stunts this from occuring. A divide, then, adds to incongruence (another of his much used notions) and a more significant and deep rooted identity between the ‘real self’ and the ‘ideal self’. This can last a life time and is one of the core reasons clients present to therapy. Rogers described six characteristics of what he considered to be ‘successful therapeutic experiences thus:
- Rapport is established.
- There is free expression of feeling on the part of the client.
- Recognition and acceptance, by the client, of his spontaneous self.
- The making of the responsible choices.
- The gaining of insight through assimilated interpretation.
- Growing into independence – with support. (1940, p. 162-3).
The person centred approach in therapy tends to play itself out with the therapist being mindful of the importance of listening and being non-directive in approach. This is achieved by the therapist being comfortable with allowing the client to be genuinely in control of what he or she wants done, how this might best be done for him or her and how long this process should last (Rogers, 1961). Perhaps what signals this particular approach as different to others is the very specific role of compassionate facilitator accorded to the therapist (Sanders, 2004). The experiences of the client are acknowledged, but the therapist makes no attempt to redirect conversation in any other direction than the one chosen by the client. [3]
This is not to say that the therpaist remains mute in therapy sessions. He or she may restate words the client uses so that both the client and the therapist may make better sense of the meaning. This facilitates self-editing and clarification of thought process and intent. Encouragement is key in this process with the stated aim of, somehow, arriving at a point of self-discovery for the client. Interestingly, Rogers first used the term ‘counselling’ for what might be considered defensive reasons. At that time in the United States, one had to be a qualified medical practitioner to practice ‘psychotherapy’ (Thorne, 2003, p. 14). Thus, this particular approach has been under scrutiny for decades. Indeed, the ‘person-centred approach’ is now considered to include not only classical practitioners, who are once again increasingly identifying as ‘client-centred’, but also those who embrace experiential theories, primarily those of Gendlin, Rennie, Greenberg, Rice and Elliott.
We have seen in this blog that in the client centred approach, the client is in a powerful position in that he or she determines so much within the therapeutic relationship (Hynes, 2011). Further, the direction and strategy of the sessions are decided upon by the client and not the therapist. This takes particular skill and sensitivity from the therapist to ensure this occurs in a safe and non judgmental manner. It should be noted that a particular challenge to the person-centred approach is that it is so subjective both theoretically and how it is used in practice and, therefore, less objectively measurable.
*Susan McKenna has over two decades experience in social care practice and management and is a senior consultant to the Dissertation Doctors Clinic, Ireland.
References/Interesting Reading
Ablon, J. S., & Marci, C. (2004). Psychotherapy process: The missing link: Comment on Westen, Novotny and Thompson-Brenner (2004). Psychological Bulletin , 130 (4) 664-668.
Lennard, G. T. (1986). The relationship now: Issues and advances in theory, method and use. In L. S. Greenberg, & W. M. Pinsof (Editors), The psychotherapeutic process: A research handbook (pp. 439-476). New York: Guilford Press.
Beck, A. T. (1976). Cognitive therapy and the emotional disorders. London: Penguin.
Hynes, L. (2011). Person-centred counsellors’ experiences of working within time boundaries: A heuristic informed enquiry. (Unpublished master’s thesis). University of Chester, United Kingdom.
Rogers, C. (1939) The Clinical Treatment of the Problem Child. New York: Houghton Mifflin.
Rogers, C.R. (1940) Counselling and Psychotherapy. Newer Concepts in Practice . Boston, MA: Houghton Mifflin.
Rogers, C.R. (1957) The Necessary and Sufficient Conditions for Therapeutic Personality Change. Journal of Consulting Psychology.
Rogers, C. R. (1959) ‘A Theory of Personality and Interpersonal Relationships as Developed in the Client-Centred Framework.’ In S.Koch (Ed.), Psychology: A study of Science. New York: McGraw-Hill.
Rogers, C.R. (1977) Carl Rogers on Personal Power: Inner strength and its Revolutionary Impact. New York: Declacorte.
Rogers, CR. (1961) On Becoming a Person: A Ttherapists’ View of Psychotherapy. Boston: Houghton Mifflin.
Rogers, C.R. (1980) A Way of Being. Houghton Mifflin: New YorkSanders, P. (ed), (2004) TheTribes of the Person-Centred Nation. Ross-on-Wye: PCCS Books.
Thorne, B. (2003). Carl Rogers (Second edition). London: Sage.
Wampold, B. E. (2001). The great psychotherapy debate: Models, methods and findings. Mahwah, NJ: Lawrence Erlbaum Associates.
Watson, J. C., & Bedard, D. L. (2006). Clients’ emotional processing in psychotherapy: A comparison between cognitive-behavioural and process-experiential psychotherapies. Journal of Consulting and Clinical Psychology , 74 (1) 152-159.
Wilkins, P. (2003) Person Centred Therapy in Focus. London: Sage.
[1] Vincent stated over two decades ago that, “The person-centred approach is a broad umbrella and can be applied in so many different fields…” (1999, p15). Vincent and others distinguish two divisions within the approach; those theorists interested with further development of the theory from other diverse philosophies and sources and those who consider it erroneous to introduce other approaches because this weakens the theoretical base of Rogers’ thinking (Wampold, 2001).
[2] Rogers himself was aware that a theoretical limitation of this thinking and approach was that both were heavily based on his own (and, later, other therapists’) observations which were only qualitative and lacked quantative rigour.
[3] In relation to theory, it should be noted that person-centred psychotherapies have have not fared favourably in scientific critiques of ‘empirically supported therapies’ when one compares them with, for example, cognitive-behaviour therapy (Beck, 1976; Watson & Bedard, 2006).
