Carl Rogers

  • Considered the founder of PCT
  • He wanted to create climate, growth and choice.
  • He believed that no one is necessarily evil
  • Opposed institutionalization of therapy ‘schools’ as they are narrow, rigid dogmatic perspectives

 

View of human nature

  • Humans are trustworthy and positive
  • Humans are capable of making changes and living productive, effective lives, forwardmoving organisms.
  • Given the right growth fostering conditions, humans strive to move forward and fulfil their creative potential
  • Humans gravitate toward self-actualization.

 

Maslow’s hierarchy of needs

  • Maslow (1943) stated that people are motivated to achieve certain needs
  • Once these physiological needs are catered for you can start to think about things
  • You need to have these four basic needs satisfied in order to self-actualize.
  • g. we cannot strive toward self-actualization if our self-esteem is low.

 

Person centred therapy

  • PCT challenges psychoanalytic and direction approaches: o Assumption that counsellor knows best o Validity of advice, suggestion, diagnosis etc. o The belief that clients can’t understand and resolve their problems without direct help
    • The focus on problems over people
    • Rigid observation of boundaries and non-disclosure
  • PCT is non-directive approach – The approach emphasizes:
    • Therapy as a journey shared by two fallible people
    • The person’s innate striving for self-actualization, which leads to increased selfawareness.
    • The personal characteristics of the therapist and the quality of the therapeutic relationshipàà strong evidence for the importance of the relationship in the success of the therapy.
    • The counsellor’s creation of a growth promoting client through empathic understanding of the client’s world
    • People are capable of self-directed growth if involved in a therapeutic relationship where there is a growth-promoting client.
  • Similarities between existential and person-centred approaches with regard to the clienttherapist relationship at the core of therapy.
    • Both focus on the client’s perceptions and call for the therapist to be fully present with the client
    • They both emphasize the client’s capacity for self-awareness and self-healing

 

Four periods of development of PCT

  1. In 1940s Rogers developed non-directive counselling àà focused mostly on reflecting and clarifying verbal and non-verbal communications.
  2. In 1950s he renamed it the Client-Centred Therapy. Emphasis on client rather than on the non-directive methods.
  3. During 1950s-1970s, therapy moved towards focusing ‘on becoming a person’àà it addressed the necessary and sufficient conditions of therapy and becoming the self that one truly is.

− Client-centred philosophy was called student-centred teaching when applied to education

− A lot more individualàà student centred focus, each student has his or her own student learning plant- this has only been developed recently.

  1. 1980s and 1990s his theory become known as the person-centred approachàà his interests focused on how people obtain, possess, share, or surrender power and control over others and themselves.

− He directed his efforts toward applying the person centred approach to politics and world peace

− Its about facilitating that client and their strengths so they can make decisions for themselves rather than seeking answers from someone else

 

Rogerian approach

  • Helping people to clarify their feelings (perceiving them accurately) and decreasing incongruence
  • This is achieved by decreasing defensive behaviour, increasing openness to experience, developing more positive feelings to self and shift from suing other values to evaluate own self
  • Aim is not to solve problems but to assist clients in their growth process so clients can better cope

 

Growth promoting climate

− Three therapist attributes create a growth-promoting climate in which individuals can move forward and become what they are capable of becoming o Congruence: genuine or realness o Unconditional positive regard: acceptance and caring

  • Accurate empathetic understanding: the ability to deeply grasp the subjective world of another person. Effective empathy is grounded in authentic caring for the client.
  • Presence: just being with someone

Therapeutic process

Therapeutic relationship

  • Rogers based his hypothesis of the necessary and sufficient conditions for therapeutic personality change on the quality of the relationship.
  • He hypothesized further that significant positive personality change does not occur except in a relationship.
  • Therapeutic core conditions:
    • Six conditions that are necessary and sufficient for personality changes to occur:
      1. Two persons are in psychological contact
      2. The first, the client, is experiencing incongruenceàà being anxious or vulnerable
      3. The second person, the therapist, iscongruent or integrated and fully present in the relationship.
      4. The therapist experiences unconditional positive regard or real caring for the client
      5. The therapist experiences empathy for the client’s internal frame of reference and endeavours to communicate this to the client.
      6. The communication to client-unconditional positive regard, and empathic understanding- is to some degree.
    • Rogers hypothesized that no other conditions were necessary.
    • If the therapeutic core conditions exist over some period of time, constructive personality change will occur.
    • The client –therapist relationship is characterized byequality.

 

The client’s experience

  • If the counsellor creates a climate conducive to self-exploration, clients have the opportunity to explore the full range of their experience.
  • Clients come to the counsellor in a state of incongruenceàà a discrepancy exists between self-perception and their experience in reality.
  • Individuals in therapy come to appreciate themselves more as they are, and their behaviours shows more flexibility and creativity.
  • They move in the direction of being more in contact with what they are experiencing at the present moment, less bound by the past, freer to make decisions.

 

Therapeutic goals

  • Aims towards the client achieving a greater degree of independence and integration. – Its focus is on the person, not the presenting problem.
  • Rogers believed that the goal of therapy is to assist clients in their growth process so clients can better cope with problems as they identify them.
  • The underlying aim is to provide a climate conducive to helping the individual strive toward self-actualization.
  • The therapist does not choose specific goals for the client
  • Clients in a relationship with a therapist have the capacity to define and clarify their own goals.

 

Therapist function/role

− The role of PCT therapists is rooted in their ways of being and attitudesàà not techniques

− Research on PCT indicates that the attitude of therapists rather than knowledge, theories or techniques, facilitate personality change.

− Therapists use themselves as an instrument of change.

− Person-centred 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.

− Therapist qualities:  

  • Therapist focuses on the quality of the therapeutic relationship o Does not find traditional assessment and diagnosis useful
  • Provides a supportive therapeutic environment in which the client is the agent of change and healing
  • Serves as a model of a human being struggling toward greater realness and an instrument of change for the client
  • They are genuine, integrated, and authentic, without a false front.
  • They can openly express feelings and attitudes that are present in the relationship with the client
  • They are invested in developing his or her own life experiences to deepen selfknowledge and move toward self-actualization

− When these therapist attitudes are present, clients then have the necessary freedom to explore areas of their life that were distorted or denied to awareness  

 

The actualizing tendency

  • Directional process of striving towards realization, fulfilment, autonomy, selfdetermination and perfection
  • Humans gravitate towards self-actualizing

 

Well functioning person

  • Well-functioning person is becoming self-actualized
  • They are open to experience and unafraid of own feelings
  • Trust own cognitive and emotional functioningàà less dependent on others
  • Internal source of evaluation
  • Willingness to continue growing
  • Enjoys life spontaneouslyàà able to live in the present

 

Incongruence

  • Experience does not match self-concept/perception – 3 solutions to incongruence:  
    • Change (get rid of) the experience to make it consistent with self-concept àà often use of defence mechanism (most common)
    • Alter self concept positively to include the new experience
    • Alter self conceptnegatively to include the new experience e.g. ‘I must be crazy because I have these feelings’
  • Defence mechanismsàà get rid of the incongruence.

 

Techniques

  • Reflective listening and paraphrasing o Paraphrasing is when the clinician restates the content of the client’s previous statement
    • Uses words that are similar but fewer
    • The purpose is to communicate to the client that you understand what he or she is saying.
    • It helps the clinician to reduce the client’s clutter
    • It helps the client realize that the counsellor understands what they are saying, clarify their remakes and focus on what is important.
  • Refection of feelings o Often people use the big emotions incorrectly and make their real feelings.
    • A therapist needs to listen careful and watch if non-verbal behaviours, tone of voice and context of situation match.
    • Reflection of feelings is when counsellor tries to perceive the emotional state of the client and then expresses the client’s feelings back to them in a tentative manner. oIt helps the clinician:
    • § Check whether or not they accurately understand what the client is feeling
    • § Tests hypotheses
    • § Brings out problem areas without the client being pushed o It helps the client:
    • § Realize that the counsellor understands what they feel
    • § Increase awareness of their feelings
    • § Learn that feelings and behaviours are connected.

 

Motivational interviewing

  • Developed by William Miller and Stephen Rollnick in the early 1980s.
  • Shown to be effective as a relatively brief intervention
  • MI is a directive client centred counselling style for eliciting behaviour change by helping clients to explore and resolve ambivalence.
  • It is based on humanistic principles àà has some similarities with PCT – Initially design as a brief intervention for problem drinking.
  • MI stresses client self-responsibility
  • MI therapist avoids assuming a confrontational stance, reframes resistance as a healthy response, expresses empathy and listens reflectively.
  • They view clients as allies
  • Both MI and PCT believe in the client’s abilities, strengths, resources and competencies.
  • The underlying assumption is that clients want to be healthy and desire positive change
  • Five basic principles of motivational interviewing o Therapists practicing MI strive to experience the world from the client’s perspective without judgmentàà expressing empathy, reflective listening.
    • MI is designed to evoke and explore both discrepancies and ambivalence.
    • Reluctance to change is viewed as a normal and expected part of the therapeutic processàà central is to increase internal motivation to change based on the client’s personal goals/values.
    • Practitioners support clients’ self-efficacy, mainly by encouraging them to use their own resources to take necessary actions that can lead to success in changing. o When clients show signs of readiness to change through decreased resistance to change and increased talk about change, a critical phase of MI beginsààtherapist shift their focus toward strengthening client’s commitments to change and helping them implement a change plan.

 

Stages of Change model

–    Assumes that people progress through five identifiable stages in the counselling process

  1. Precontemplation stageàà no intention of changing behaviour in the near future. Therapist assumes the role of a nurturing parent.
  2. Contemplation stageàà people are aware of a problem and are considering overcoming it, but they have not yet made a commitment to take action. Therapists function as a Socratic teacher who encourages them to achieve their own insights.
  3. Preparation stageàà individuals intend to take action immediately and report some small behavioural changes. Therapists take the stance of an experienced coach.
  4. Action stageàà individuals are taking steps to modify their behaviour to solve their problems. In action and maintenance stage, the therapist’s function in the role of a consultant.
  5. Maintenance stageàà people work to consolidate their gains and prevent relapse. –    A client’s readiness can fluctuate throughout the change process.
  • MI therapists strive to match specific interventions with whatever stage of change the client is experiencing.

 

Application to group counselling

  • The therapist takes on the role of facilitator:
    • Creates therapeutic environment o Techniques are not stressed o Exhibits deep trust of the group members o Provides support for members
    • Allows group members to set groups for the group
    • The members to develop acceptance and empathy for one another in order to interest with each other in a therapeutic and supportive ways.
  • The group setting fosters an open and accepting community where members can work on self-acceptance
  • Individuals learn that they do not have to experience the process of change alone; they grow from the support of group members.
  • Also especially applicable to crisis intervention àà unwanted pregnancy, illness, a disastrous event or the loss of a loved one.

 

Person-centred expressive arts therapy

  • Form of therapy developed by Roger’s daughterààexpress our feelings through art.
  • Various creative forms- art therapy, dance therapy, drama, play therapy, sand-play therapy
  • Promote healing and self-discovery
  • Creative expression connects us to our feelings, which are a source of life energyàà feelings must be experienced to achieve self-awareness
  • Individuals explore new facets of the self and uncover insights that transform them, creating wholeness.
  • Discovery of wholeness leads to understanding of how we relate to the other world.
  • Conditions for creativity o Acceptance of the individual o A non-judgmental setting
    • Empathy o Psychological freedom
    • Stimulating and challenging experiences
    • Individuals who have experienced unsafe creative environments feel held back and may disengage from creative processes
    • Safe, creative environments give clients permission to be authentic and to delve deeply into their experiences.

 

Multicultural perspective

 

Strengths

  • Respect for clients values
  • Active listening
  • Welcoming differences
  • Non-judgmental attitude
  • Prizing cultural pluralism
  • Emphasis on core conditions  

 

Shortcomings

  • Lack of direction, techniques and structure may be a problem
  • Some core values may not be congruent e.g. internal locus of evaluation

 

Limitations

  • Lack of attention to proven techniques and strategies (EBP)àà making treatment difficult to standardize
  • Works well with articulate people- what about those with limited vocabulary?
  • Limits of the therapist as a person may interfere with developing a genuine therapeutic relationship.

 

Contributions

  • Research supports the effectiveness of PCT with a wide range of clients and problems of all ages
  • Alternative to directive approach of psychoanalysis
  • Shift in focus from technique/therapist authority to therapeutic relationship – Emphasis on research
  • Importance of empathy in facilitating constructive change
  • Natalie’s Roger’s use of non-verbal methods and expressive arts to enable individuals to heal.
  • One of the developments associated with the PCT is the emergence ofemotion-focused therapy.
    • EFT is rooted in a person-centred philosophy.
    • ECT is a therapeutic practice informed by an understanding of the role of emotion in psychotherapeutic change. o Emphases the importance of awareness, acceptance and understanding of emotions and the visceral experience of emotion.
    • A premise of ETC is that we can change only when we accept ourselves as we are.