CLIENT CENTRED THERAPY

Definition:
Person-centered therapy, which is also known as client-centered, non-directive, or Rogerian
therapy, is an approach to counselling and psychotherapy that places much of the responsibility
for the treatment process on the client, with the therapist taking a nondirective role.

Person-centered therapy was developed by Carl Rogers in the 1940s. This type of therapy
diverged from the traditional model of the therapist as expert and moved instead toward a
nondirective, empathic approach that empowers and motivates the client in the therapeutic
process. The therapy is based on Rogers’s belief that every human being strives for and has the
capacity to fulfil his or her own potential. Person-centered therapy, also known as Rogerian
therapy, has had a tremendous impact on the field of psychotherapy and many other
disciplines.

History and Background:

Carl Rogers is widely regarded as one of the most influential psychologists of the 20th-century.
He was a humanist thinker and believed that people are fundamentally good. Rogers also
suggested that people have an actualizing tendency, or a desire to fulfil their potential and
become the best people that they can be.

Rogers initially started out calling his technique non-directive therapy. While his goal was to be
as non-directive as possible, he eventually realized that therapists guide clients even in subtle
ways. He also found that clients often do look to their therapists for some type of guidance or
direction. Eventually, the technique came to be known as client-centered therapy or person-
centered therapy. Today, Rogers' approach to therapy is often referred to by either of these
two names, but it is also frequently known simply as Rogerian therapy.

It is also important to note that Rogers was deliberate in his use of the term client rather than
patient. He believed that the term patient implied that the individual was sick and seeking a
cure from a therapist.

By using the term client instead, Rogers emphasized the importance of the individual in seeking
assistance, controlling their destiny, and overcoming their difficulties. This self-direction plays a
vital part of client-centered therapy.
Much like psychoanalyst Sigmund Freud, Rogers believed that the therapeutic relationship
could lead to insights and lasting changes in clients.

While Freud focused on offering interpretations of what he believed were the unconscious
conflicts that led to a client's troubles, Rogers believed that the therapist should remain non-
directive. That is to say, the therapist should not direct the client, should not pass judgments on
the client's feelings, and should not offer suggestions or solutions. Instead, the client should be
an equal partner in the therapeutic process.

Rather than viewing people as inherently flawed, with problematic behaviours and thoughts
that require treatment, person-centered therapy identifies that each person has the capacity
and desire for personal growth and change. Rogers termed this natural human inclination
“actualizing tendency,” or self-actualization. He likened it to the way that other living
organisms strive toward balance, order, and greater complexity. According to Rogers,
"Individuals have within themselves vast resources for self-understanding and for altering their
self-concepts, basic attitudes, and self-directed behavior; these resources can be tapped if a
definable climate of facilitative psychological attitudes can be provided."

The person-centered therapist learns to recognize and trust human potential, providing clients
with empathy and unconditional positive regard to help facilitate change. The therapist avoids
directing the course of therapy by following the client’s lead whenever possible. Instead, the
therapist offers support, guidance, and structure so that the client can discover personalized
solutions within themselves.

Person-centered therapy was at the forefront of the humanistic psychology movement, and it
has influenced many therapeutic techniques and the mental health field, in general. Rogerian
techniques have also influenced numerous other disciplines, from medicine to education.

Objectives:
Mental health professionals who utilize this approach strive to create a therapeutic
environment that is conformable, non-judgmental, and empathetic. Two of the key elements of
client-centered therapy are that it:

 Is non-directive. Therapists allow clients to lead the discussion and do not try to steer
the client in a particular direction.
 Emphasizes unconditional positive regard. Therapists show complete acceptance and
support for their clients without casting judgment.
According to Carl Rogers, a client-centered therapist needs three key qualities:

1. Genuineness

The therapist needs to share his or her feelings honestly. By modeling this behavior, the
therapist can help teach the client to also develop this important skill.

2. Unconditional Positive Regard

The therapist must accept the client for who they are and display support and care no matter
what the client is facing or experiencing.

Rogers believed that people often develop problems because they are accustomed to only
receiving conditional support; acceptance that is only offered if the person conforms to certain
expectations. By creating a climate of unconditional positive regard, the client feels able to
express his or her true emotions without fear of rejection.

3. Empathetic Understanding

The therapist needs to be reflective, acting as a mirror of the client's feelings and thoughts. The
goal of this is to allow the client to gain a clearer understanding of their own inner thoughts,
perceptions, and emotions.

By exhibiting these three characteristics, therapists can help clients grow psychologically,
become more self-aware, and change their behavior via self-direction. In this type of
environment, a client feels safe and free from judgment. Rogers believed that this type of
atmosphere allows clients to develop a healthier view of the world and a less distorted view of
themselves.

Purpose:
According to Rogers, there are six conditions necessary to enable real change. These are:

 There is psychological contact between the client and the counsellor.

 The client is emotionally upset, in a state of incongruence.
 The counsellor is genuine and aware of their own feelings (congruent).
 The counsellor has unconditional positive regard for the client.
 The counsellor has empathic understanding of the client and their internal frame of
reference, and looks to communicate this experience with the client.
 The client recognises that the counsellor has unconditional positive regard for them and
an understanding of their difficulties.
Conditions Required:
A variety of factors can affect an individual's ability to flourish, including low self-esteem, a lack
of self-reliance and very little openness to new experiences. The person-centred approach
recognises that an individual's social environment and personal relationships can greatly impact
these, so therapy is offered in a neutral and comfortable setting where a client can feel at ease,
authentic and open to learning about themselves. In this way, the approach offers individuals
the opportunity to counteract past experiences that affected conditions of worth (the
circumstances under which we approve or disapprove of ourselves).

Other related changes that can be cultivated from this therapy include:

 Closer agreement between an individual's idealised and actual selves.

 Better self-understanding and awareness.
 Decreased defensiveness, insecurity and guilt.
 Greater ability to trust oneself.
 Healthier relationships.
 Improvement in self-expression.
 Overall a healthy sense of change.

Techniques:
The techniques employed in person-centred therapy are different from those employed in
other therapies. The difference is that other therapies are often focused on something the
client can do during the therapy session, whereas the techniques used in person-centred
therapy are employed by the therapist to create an environment that facilitates the process of
self-awareness.

 Reflection – this is where the therapist summarizes what the client said and verbalizes
this summary back to the client to display listening and understanding. Sometimes a
therapist will pay special attention to reflecting the emotional content of a client’s
narrative.
 Active listening – the therapist is actively engaged in hearing the client as opposed to
seeking out information for some other purpose such as a problem or a symptom. The
goal is to listen and to empathize.
  Undirected uncensored experience leads to personal growth – The therapist does not
lead the client towards certain topics. The clients will take the therapy where is should
go

The following techniques will be discussed in relation to the person-centred approach:

congruence, unconditional positive regard and acceptance, empathy, and reflection of feelings.

 Congruence
Congruence is whether or not therapists are genuine and authentic in what they say and
do. Quite often, if the therapist is saying one thing but the body language is reflective of
something else, clients are aware of this and may impact on their trust and openness in
the therapeutic relationship (Seligman, 2006). For example, a therapist may say “I
understand where you are coming from” to a client but have a confused look on his or
her face. The client can see this confusion and feels uncomfortable with expressing
feelings from this point forward.
Therefore, a major role of therapists is to be aware of their body language and what
they are saying as well as being in the present moment. If confusion arises, the therapist
needs to be able to address this with the client. Going back to the previous example of
the therapist stating understanding and having a confused look, the therapist notices
the client looks uneasy after the comment about understanding and goes on to explain
to the client why and how he or she understands the statement. This puts the client at
ease and ensures the continuation of trust.

 Unconditional positive regard

Unconditional positive regard refers to the therapist accepting, respecting and caring
about clients (Seligman, 2006). It does not mean the therapist has to agree with
everything the client says or does, however, the therapist should see the client as doing
the best he or she can and demonstrate this by expressing concern rather than
disagreeing with him or her. Unconditional positive regard allows clients to express how
they are thinking without feeling judged, and help to facilitate the change process by
showing they can be accepted.
  Empathy
Empathy is a skill used by person-centred therapists to show understanding of the
Client’s emotions. Empathy is different to sympathy in that sympathy is often seen as
Feeling sorry for the client whereas empathy shows understanding and allows the client
to further open up (Seligman, 2006). An example follows:

Client: I feel as though no one cares about me and that I am all alone.
Empathy response: So you are feeling alone at the moment and as if no one cares.
Sympathy response: I’m sorry that you feel that way.

 Nondirectiveness
The person-centred approach utilises nondirectiveness as a technique by its therapists.
Nondirectiveness refers to allowing clients to be the focus of the therapy session
without the therapist giving advice or implementing strategies or activities.

Application:
The person-centred approach can be applied to working with individuals, groups and families
(Corey, 2005). The person-centred approach has been successful in treating problems including
anxiety disorders, alcoholism, psychosomatic problems, agoraphobia, interpersonal difficulties,
depression, and personality disorders (Bozrath, Zimring & Tausch, as cited in Corey, 2005). It
could also be used in counselling people with unwanted pregnancy, illness or loss of a loved
one. When compared with other therapies such as goal-focused therapies, person-centred
therapy has been shown to be as effective as them (Corey, 2005).

Stages in Client Centered Therapy:

 Stage 1: Clients are defensive and resistant to change. According to Rogers (1958),
clients in this stage refer to feelings and emotions as things of the past rather than the
present, as they react to past experiences rather than to present ones. Only when a
person feels fully accepted, can he or she progress to the next stage.
 Stage 2: Clients become slightly less rigid and begin to discuss external events or other
people. In this stage, feelings tend to be described as “unowned” or even as past
objects.
 Stage 3: Clients begin to discuss themselves, but as an object rather than a person. This
is because they are avoiding a discussion of the present.
 Stage 4: Clients progress to discussing deeper feelings as they develop a relationship
with the counsellor.
 Stage 5: Clients can express present emotions and begin to rely on their own decision-
making abilities. Subsequently, they begin to accept more responsibility for their
actions. They have a growing acceptance of contradictions and understanding of
incongruence.
 Stage 6: Clients show rapid growth towards congruence and often begin to develop
unconditional positive regard (UPR) for others. This stage indicates the client no longer
needs formal counselling (Wilkins, 2000).
 Stage 7: Clients are fully functioning, self-actualised and empathic, and can show UPR
towards others. The last and ultimate stage of person-centred therapy can be construed
as achieving movement from heteronomy (control by external forces) to autonomy
(control of inner forces) (Kensit, 2000).