CLIENT CENTERED

PSYCHOTHERAPY

Mehnaz Mariyam
S4 MSc Psychology
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HISTORY

Client-centered therapy was created in 1940 by Carl Rogers

believing that diagnosis, planning, and interpretation
manipulate the patient to conform to the therapist's ideas.
Originally called "nondirective counselling"
That passive or nondirective therapy was later named client-
centered therapy and was published as such in 1951.
In the 1940s and 1950s client-centered psychotherapy
achieved considerable popularity among psychologists and
other nonmedical workers.
The proper therapeutic relation is seen as egalitarian,
requiring permissiveness and nondirectiveness, unlike the more
formal and authoritarian relation between doctor and patient.
Diagnosis is specifically avoided.
What is required for therapeutic change. Rogers proposed, is
that the therapist be accepting, permissive, and
nonjudgmental, so that he and the client can together explore
the client's phenomenal world and personal meanings.
The force behind therapeutic change is the client's inherent
tendency toward growth or self-actualization.
Client-centered therapy has been reported to be useful for
children and adults, problems of neuroses, situational
problems, speech difficulties, psychosomatic problems (e.g.,
allergies), and to some extent psychosis.
It has been practiced with individuals and groups, and its
principles have been applied in industry, education, child
rearing, and intensive encounter groups.
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Rogers believed that human beings immediately attach

meaning to whatever is perceived, so that perception
becomes reality.
A group of perceptions are organized as the self-concept—
people's perceptions of their own characteristics, their
relationships with others, and the value they place on those
perceptions.
Experiences contradicting the preferred perceptions of that
organization cause anxiety or maladjustment and must be
shut out.
In therapy the structure of the self is relaxed so that the
patient can drop the barrier and admit, "Yes, I do have
those parts of myself that are unacceptable." When this
happens, the previously denied parts are accepted and then
integrated, and the result is a better-functioning person.
The aim of the therapy is to create an interpersonal
environment in which the self-structure can relax and
material can come into consciousness.
The therapist sets the three conditions that foster
relaxation and the personal growth that follows.
The three conditions are Congruence, Unconditional positive
regard and empathetic understanding
When these conditions are met, the client feels released and
understood and is able to accept and integrate, view the
world differently, and continue the process by bringing out
new material.
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Therapist Conditions Required For

Effective Therapy
Rogers places primary emphasis on those attitudes of the
therapist which are the "necessary and sufficient" conditions for
therapeutic change.

Success in therapy depends on the therapist communicating

and the patient perceiving:

(1) the therapist's own congruence:

(2) his unconditional positive regard for the patient, and
(3) his accurate empathic understanding

Therapist's Congruence

Congruence or genuineness is the first and primary requisite,

for nobody can respect others or be empathic unless he is
himself open to experience, free of facade, and self-deceit.
The therapist should be aware of his full experience and
feelings, and able to communicate them openly.
Therapy depends on the readiness of the client to share his
deepest and most intimate feelings.
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Unconditional Positive Regard

The therapist must communicate to the client a deep and

genuine caring for him as a human being, with faith in his
potential.
Making no judgements
There are no conditions on the therapist's acceptance or
warmth. He is as ready to accept negative as positive feeling
from the client.
Rogers came to re alize that grossly immature or regressed
clients may require more conditional regard.
However, with most clients, unconditional positive regard
remains one of the essential require ments of therapy.

Accurate Empathetic Understanding

Progress in therapy requires the therapist to perceive

feelings and experiences sensitively and accurately and to
understand their meanings to the client during the
therapeutic encounters.
Accurate empathic understanding means that the therapist
can sense the client's inner world as if it were his own.
Involves the ability to then communicate this experience to
the client in words and concepts meaningful to him so that
he can gain further awareness of his experience.
In this fashion, the client can recognize where his experience
is incongruous with his self-concept, and work toward
bringing denied feelings into greater congruence with his
self.
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Success of therapy depends on the communication, and

perception, of these therapist attitudes.
Growth in the patient involves, in effect, his incorporation
and utilization of these attitudes as part of himself.
Therapy should, therefore, make him more congruent, be
better able to give others unconditional positive regard, and
be more accurately empathic in viewing himself as others.
These three conditions describe the essence of client-
centered therapy.

Thus, According to Rogers (1961), the following six

conditions are necessary and sufficient for personality
changes to occur:
1. Two persons are in psychological contact.
2. The first, whom we shall term the client, is in a state of
incongruence, being vulnerable or anxious.
3. The second person, whom we shall term the therapist, is
congruent or integrated in the relationship.
4. The therapist experiences unconditional positive regard for
the client.
5. The therapist experiences an empathic understanding of the
client’s internal frame of reference and endeavors to
communicate this experience to the client.
6. The communication to the client of the therapist’s empathic
understanding and unconditional positive regard is to a
minimal degree achieved.
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Goals of Client centered therapy

Rogers (1961) described the characteristics of the person

who is moving in the direction of becoming increas-ingly
actualized: (1) an openness to experience, (2) a trust in
one’s organism, (3) an internal locus of evaluation, and (4)
the willingness to be a process. These characteristics
constitute the basic goals of client-centered therapy.
Openness to experience entails seeing reality without dis-
torting it to fit a preconceived self-structure. The opposite
of defensiveness, openness to experience implies becoming
more aware of reality as it exists outside one self.
One goal of therapy is to help clients establish a sense of
trust in themselves. Often, in the initial stages of therapy,
cli-ents trust themselves and their own decisions very little.
They typically seek advice and answers out side themselves
for they basically do not trust their own capacities to direct
their own lives. As clients become more open to their
experiences, their sense of trust in self begins to emerge.
Internal locus of evalu-ation means looking more to oneself
for the answers to the problems of existence. Instead of
looking outside oneself for validation of personhood, one
increasingly pays attention to one’s own center. One
substitutes self-approval for the universal approval of
others.
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Indications for Psychotherapy

The general indications for therapy are when clients feel

that their organized self-structures are no longer effective
in meeting their needs in the reality situation or when they
perceive discrepancies in themselves or see that their
behavior is out of control.
Client-centered approach has been used with 2-year-olds
and adults of 65, with people who have mild adjustment
problems and disorders diagnosed as psychotic, and with
persons of all social classes and levels of intelligence.
Client - centered therapy can be used in various settings,
including individual, group, and family therapy, or as part of
play therapy with young children.
There are no set guidelines on the length or frequency of
Client-centered therapy, but it may be used for short-term
or long-term treatment.
Client centered therapy may be a good choice for patients
who are not suitable for other forms of therapy, such as
cognitive-behavioral therapy (CBT) or psychoanalysis, which
require homework assignments and the ability to tolerate
high levels of distress that may occur when elucidating
unconscious processes.
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Ethical issues, Reasearch and Evaluation

Practitioners of client-centered psychotherapy did not

believe that diagnosis was particularly useful and did not
follow the medical model of illness. That a warm and
genuine relationship is sufficient to dissolve resistances that
are dynamically motivated and tenaciously held is another
tenet open to question.
Reflecting what the client feels without interpreting where
it comes from or the purposes it may serve is uninformative
and could drive the client to action as a further defense.
Rogers admitted as much when he noted that the method is
frequently unsuccessful with clients who feel incapable of
managing themselves and who insist that the therapist take
over; a different approach interprets the client's insistence
and resentment, rather than just reflecting them.
Similarly, reflection in the face of other intense
transferences seems to be less effective than a focus on the
fantasies that lend force to the transference.

In its contributions to psychotherapy research, client-

centered therapy has been outstanding .
Rogers and his followers were the first to record and review
transcripts of sessions, the first to document the process of
treatment, and the first to do follow-up studies of results.
They developed such innovations as the Q-sort and scales to
objectify the Rorschach test.
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Rogers and his colleague were able to document that client-
centered therapy is effective.

Limitations of Client centered psychotherapy

One limitation of the approach is the way some practitioners

become “client centered” and lose a sense of their own
personhood and uniqueness. Paradoxically, the counselor
may focus on the client to such an extent that he or she
diminishes the value of his or her own power as a person and
thus loses the impact and influence of his or her personality
on the client.
Thus one must be cautioned that this approach is something
more than merely a listening and reflecting technique.
It is based on a set of attitudes that the therapist brings to
the relationship, and, more than any other quality, the
therapist’s genuineness determines the power of the
therapeutic relationship.
 References

Korchin, S.J. Modern Clinical Psychology. Delhi: CBS. Publishers

and Distributors.
 Kalpan H.et al. (eds) (1980) Comprehensive Text Book of
Psychiatry. London: Williams and Wilk