Client Centered Therapy

Definition:
Client-centered therapy, which is also known as person-centered, non-directive, or Rogerian
therapy, is a counseling approach that requires the client to take an active role in his or her
treatment with the therapist being nondirective and supportive. In client-centered therapy, the
client determines the course and direction of treatment, while the therapist clarifies the client's
responses to promote self-understanding.

The goals of client-centered therapy are increased self-esteem and openness to experience.
Client-centered therapists work to help clients lead full lives of self-understanding and reduce
defensiveness, guilt, and insecurity. As well as have more positive and comfortable
relationships with others, and an increased capacity to experience and express their feelings.

History and Background:

Developed in the 1930s by the American psychologist Carl Rogers, client-centered therapy
departed from the typically formal, detached role of the therapist emphasized in psychoanalysis
and other forms of treatment. Rogers believed that therapy should take place in a supportive
environment created by a close personal relationship between client and therapist. Rogers's
introduction of the term "client" rather than "patient" expresses his rejection of the
traditionally hierarchical relationship between therapist and client and his view of them as
equals. In person-centered therapy, the client determines the general direction of therapy,
while the therapist seeks to increase the client's insight and self-understanding through
informal clarifying questions. Beginning in the 1960s, person-centered therapy became
associated with the human potential movement. This movement, dating back to the beginning
of the 1900s, reflected an altered perspective of human nature. Previous psychological theories
viewed human beings as inherently selfish and corrupt. For example, Freud's theory focused on
sexual and aggressive tendencies as the primary forces driving human behaviour. The human
potential movement, by contrast, defined human nature as inherently good. From its
perspective, human behaviour is motivated by a drive to achieve one's fullest potential.

Self-actualization, a term derived from the human potential movement, is an important

concept underlying person-centered therapy. It refers to the tendency of all human beings to
move forward, grow, and reach their fullest potential. When humans move toward self-
actualization, they are also pro-social; that is, they tend to be concerned for others and behave
in honest, dependable, and constructive ways. The concept of self-actualization focuses on
human strengths rather than human deficiencies. According to Rogers, self-actualization can be
blocked by an unhealthy self-concept (negative or unrealistic attitudes about oneself).Rogers
adopted terms such as "person-centered approach" and "way of being" and began to focus on
personal growth and self-actualization. He also pioneered the use of encounter groups,
adapting the sensitivity training (T-group) methods developed by Kurt Lewin (1890-1947) and
other researchers at the National Training Laboratories in the 1950s.While person-centered
therapy is considered one of the major therapeutic approaches, along with psychoanalytic and
cognitive-behavioural therapy, Rogers's influence is felt in schools of therapy other than his
own. The concepts and methods he developed are used in an eclectic fashion by many different
types of counsellors and therapists.

Objectives:
Rogers identified six key factors that stimulate growth within an individual. He suggested that
when these conditions are met, the person will gravitate toward a constructive fulfillment of
potential. According to Rogerian theory, the six factors necessary for growth are:

 Therapist-Client Psychological Contact:

This first condition simply states that a relationship between therapist and client must
exist in order for the client to achieve positive personal change. The following five
factors are characteristics of the therapist-client relationship, and they may vary by
degree.

 Client Incongruence or Vulnerability:

A discrepancy between the client’s self-image and actual experience leaves him or her
vulnerable to fears and anxieties. The client is often unaware of the incongruence.

 Therapist Congruence or Genuineness:

The therapist should be self-aware, genuine, and congruent. This does not imply that
the therapist be a picture of perfection, but that he or she be true to him- or herself
within the therapeutic relationship.

 Therapist Unconditional Positive Regard (UPR): The clients’ experiences, positive or

negative, should be accepted by the therapist without any conditions or judgment. In
this way, the client can share experiences without fear of being judged.
  Therapist Empathy:
The therapist demonstrates empathic understanding of the clients’ experiences and
recognizes emotional experiences without getting emotionally involved.

 Client Perception:
To some degree, the client perceives the therapist’s unconditional positive regard and
empathic understanding. This is communicated through the words and behaviors of the
therapist.

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:
Client Centered counsellors would not say they use techniques – rather they have an approach
of being empathetic, accepting and truly “there” for the client. Having said that the following
skills are central:

 Active and empathic listening

 Reflection of content and feelings
 Genuineness which may include appropriate self-disclosure by counsellor
 Active Listening
 Encouraging Body Language
 Good Tone
 Open Ended and Closed Questions
 Paraphrasing
 Summarizing

Rogers believed that the most important factor in successful therapy was not the therapist's
skill or training, but rather his or her attitude. Three interrelated attitudes on the part of the
therapist are central to the success of person-centered therapy: congruence; unconditional
positive regard; and empathy.

Congruence refers to the therapist's openness and genuineness--the willingness to relate to

clients without hiding behind a professional facade. Therapists who function in this way have all
their feelings available to them in therapy sessions and may share significant emotional
reactions with their clients. Congruence does not mean, however, that therapists disclose their
own personal problems to clients in therapy sessions or shift the focus of therapy to themselves
in any other way.

Unconditional positive regard means that the therapist accepts the client totally for who
he or she is without evaluating or censoring, and without disapproving of particular feelings,
actions, or characteristics. The therapist communicates this attitude to the client by a
willingness to listen without interrupting, judging, or giving advice. This attitude of positive
regard creates a non-threatening context in which the client feels free to explore and share
painful, hostile, defensive, or abnormal feelings without worrying about personal rejection by
the therapist.

The third necessary component of a therapist's attitude is empathy ("accurate empathetic

understanding"). The therapist tries to appreciate the client's situation from the client's point of
view, showing an emotional understanding of and sensitivity to the client's feelings throughout
the therapy session. In other systems of therapy, empathy with the client would be considered
a preliminary step to enabling the therapeutic work to proceed; but in person-centered
therapy, it actually constitutes a major portion of the therapeutic work itself. A primary way of
conveying this empathy is by active listening that shows careful and perceptive attention to
what the client is saying. In addition to standard techniques, such as eye contact, that are
common to any good listener, person-centered therapists employ a special method called
reflection, which consists of paraphrasing and/or summarizing what a client has just said. This
technique shows that the therapist is listening carefully and accurately, and gives clients an
added opportunity to examine their own thoughts and feelings as they hear them repeated by
another person. Generally, clients respond by elaborating further on the thoughts they have
just expressed.

According to Rogers, when these three attitudes (congruence, unconditional positive regard,
and empathy) are conveyed by a therapist, clients can freely express themselves without having
to worry about what the therapist thinks of them. The therapist does not attempt to change the
client's thinking in any way. Even negative expressions are validated as legitimate experiences.
Because of this nondirective approach, clients can explore the issues that are most important to
them--not those considered important by the therapist. Based on the principle of self-
actualization, this undirected, uncensored self-exploration allows clients to eventually
recognize alternative ways of thinking that will promote personal growth. The therapist merely
facilitates self-actualization by providing a climate in which clients can freely engage in focused,
in-depth self-exploration.

Application:
Rogers originally developed person-centered therapy in a children's clinic while he was working
there; however, person-centered therapy was not intended for a specific age group or
subpopulation but has been used to treat a broad range of people. Rogers worked extensively
with people with schizophrenia later in his career. His therapy has also been applied to persons
suffering from depression, anxiety, alcohol disorders, cognitive dysfunction, and personality
disorders. Some therapists argue that person-centered therapy is not effective with non-verbal
or poorly educated individuals; others maintain that it can be successfully adapted to any type
of person. The person-centered approach can be used in individual, group, or family therapy.
With young children, it is frequently employed as play therapy. There are no strict guidelines
regarding the length or frequency of person-centered therapy. Generally, therapists adhere to a
one-hour session once per week. True to the spirit of person-centered therapy, however,
scheduling may be adjusted according to the client's expressed needs. The client also decides
when to terminate therapy. Termination usually occurs when he or she feels able to better
cope with life's difficulties.

Stages of 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).