Evaluate the claim that Person-centred Therapy offers the therapist all that he/she will need to treat clients.
In this essay I am going to look at whether person-centred therapy offers the therapist all they will need to treat a client. I am firstly going to focus on a brief history of person-centred therapy, then look at the characteristics and key elements of person-centred therapy. Once I have done this I shall look at criticisms of person-centred therapy from other writers and then go on to form a personal evaluation to whether it is effective or not.
In the field of counselling and psychotherapy there are many different theories which are used to help in the treatment of the client, one of these being person-centred therapy (PCT). There are many thoughts on PCT on whether it is affective or not and a lot of people find it a flawed therapy. Many others though believe it is an effective treatment and is a popular treatment for today.
A brief history of PCT
Dr Carl Roger’s (1902 – 1987) was an influential American psychologist, who was born in Illinois, Chicago. He was the founder of person-centred therapy (PCT), also known as Rogerian psychotherapy amongst other things. Rogers’ interest in the subject came about as a result of working as a psychotherapist for most of his life’. (Chrysalis handout – 2012) He developed this type of therapy in the 1940s and 1950s and was strongly influenced by an Austrian psychoanalyst called Otto Rank (1884-1939). Rogers invited Rank over to do some lectures and from then on was influenced by his post-Freudian models of experimental and relational therapy. This strongly influenced Rogers’ way of thinking and helped to evolve PCT.
Firstly Rogers developed a non-directive therapy which put focus on the client’s thoughts and feelings and meant the therapist was not to direct the client in any way. He then changed the name to person-centred therapy and he realised that the therapist would always guide the client even in the most subtle way and the client would look to the therapist for some sort of guidance. PCT was a ‘therapy focused on creating a reflective space for individuals to actualize their potential’ (www.wikibooks.org)
Carl Rogers believed that all people are fundamentally good. He also believed that people have an actualizing tendency, or a wish to fulfil their potential and become the best people they can be. Rogers would encourage the client to be aware of their own feelings without any direction from the therapist. The therapist’s job would be to actively listen, be non-directive, and be non-judgemental, genuine and non-interpretative (which I will speak about a bit later on).
Another person who believed in self-actualisation was Abraham Maslow (1908-1970). He like Carl Rogers used a humanistic approach in therapy, and developed a ‘Hierarchy of Needs’ (see diagram below). He, like Rogers ‘suggested that a person is constantly motivated to satisfy these needs and, at any one point in time, his behaviour will be directed to satisfying a need’. (Chrysalis handout – 2012).
The humanistic approach went against other theories such as behavioural, psychoanalytical, Cognitive and Integrative.
Maslow, as Rogers’s theory, was based around reaching self-actualization. Maslow ‘saw it as a pyramid of needs with the needs at each level having to be met before the next level can be approached meaningfully’. (Pete Sanders, 1994: 22) At the bottom of the pyramid are our basis needs, such as food, water and shelter. Once the person has this they can then move up to the second stage of the hierarchy, security needs, such as freedom from threat, security. The next level to move up to is love/social needs, which is a sense of belonging, affection and relationships. The next level is esteem, recognition, respect. He believed once all these had been reached you move up to the final stage of self-actualization, which is the fulfilment of personal potential.
As always there are some differences between Maslow’s and Rogers’s theories but the key ideas were in agreement.
Rogers described six conditions for therapeutic change before the client could move towards the changes they wanted in their lives.
The first one is therapist-client psychological contact. This basically means that the must be a relationship between the client and the therapist, where the person’s view of the other is important. The next core condition for therapeutic change is client vulnerability. The client must be anxious or vulnerable, for the client and therapist to stay in the relationship. The third core condition is Therapist Congruence or Genuineness. The therapist must be genuine within the relationship. The fourth condition is Therapist Unconditional Positive Regard (UPR). The therapist accepts the client for what they are and are non-judgemental. The fifth core condition is Therapist Empathetic Understanding.
The therapist must be empathic towards the client rather than sympathetic. ‘Accurate empathy on the part of the therapist helps the client believe the therapist’s unconditional love for them’ (www.wikipedia.org) The last core condition is Client Perception. The client must perceive they are receiving empathy, unconditional positive regard and genuineness from the therapist. The most important factors of any therapy, Rogers’s believed, were the therapist’s attitude towards the client. The therapist must show congruence, unconditional positive regard and empathy at all times. Without these being the main focus of the therapist the treatment was unlikely to be a success.
The therapist must show congruence throughout the therapy. This means that they need to be honest with their client throughout and be genuine towards the client. The therapist needs to be in touch with their own feelings and emotions.
UPR again is extremely important and the therapist must totally accept the client they are trying to help. If they feel they cannot then they should not be working with the client. The therapist must believe the client to be worthy. ‘Seeing someone as worthy does not mean that you have to approve of their behaviour. It simply means that you see them as a human being of equal value’. (Pete Sanders, 1994: 70)
The therapist must show empathy, so basically see the world from the client’s point of view. This means trying to understand the thoughts and feelings of their life and basically stepping into their shoes for the session. The therapist must never mix their own feelings with the clients. The therapist and client may have had similar experiences but they will feel differently about these. No one will ever experience exactly the same feelings; everyone will experience things in a different way.
If the therapist shows all of the above to the client, the client will feel more at ease and comfortable and be able to express their inner feelings, something which they may have struggled to do if the therapist did not do the above. ‘The therapist can then examine any inconsistencies and the appropriate feelings can be explored. Good feelings are encouraged, thereby strengthening the inner-self, negative feelings can then be viewed in a non-threatening manner and more objectively’. (Chrysalis handout – 2012) if a client goes through this process then their self-actualisation will develop and help them to make the changes they require in their lives.
As well as the core conditions above, he proposed a comprehensive personality theory. Rogers believed that every human personality had two components, one being self-concept and the other being core self, also known as the organismic self (self-actualization tendency). Rogers’s theory of the concept of self, related to the individuals view or image of themselves, based on life experiences. For example if a child’s first experience is a negative one it is most likely that in adulthood they will have a poor self concept. Self-concept ‘is the part of the human personality that is acquired through experiences, particularly experiences where other people judge us and give us approval on certain conditions’. (Frankland & Sanders, 1995: 81)
The organismic self is there from birth and aims to mature and achieve self-actualization. Self-concept is acquired in early childhood and it is shaped by important people throughout the childhood. ‘Those raised in an environment of unconditional positive regard have the opportunity to fully actualize themselves. Those raised in an environment of conditional positive regard feel worthy only if they match conditions (what Rogers describes as conditions of worth) that have been laid down for them by others’. (www.wikipedia.org)
Conditional positive regard is also known as conditions of worth. As a child we all want positive, loving attention from the important people in our lives. If a child is well behaved the parent is going to show more love to the child and more positive attention, than if the child is wild and unruly. One example of this is that we learn that a condition of the positive love from a parent is not to bite them. If they bite the parent, the parent will tell them off and not be happy with them. The child learns in order to get positive regard, not biting is one of the conditions that needs to be met.
The above example shows that conditions of worth are not always a bad thing but if overused or used inappropriately that is when the problem begins. For example the child only gets positive regard if they get straight A’s in an exam, or if they listen to the ‘right’ music they will fit in with friends. Parents may not realise they give much more love and attention when their child fails and are sad when they are successful. These can all be detrimental to the child and will change the way they perceive the world.
The child will adopt these conditions as their own values thus blocking out the organismic values that comprise who they really are. This will then lead them to live a different life to who they really are. This may mean they live a life that doesn’t satisfy there needs. This is when PCT comes in to help the client, as it tries to expose the client’s true feelings and not the ones that have been learnt and begin to understand what they really want and need. The therapist is there to try and remove these conditions of worth and offer only UPR.
There are many other theories out there as well as the humanistic approach. The first one I will mention is Psychoanalytical therapy, which looks at how the unconscious mind influences our thoughts and feelings and frequently involves looking at early childhood experiences in order to discover how these events shape the person and how they contribute to the present day. This type of therapy is also known as ‘talk therapy’ as it is where the therapist will spend time listening to the client talk about there lives. This approach can be traced back to Sigmund Freud (1856 – 1939) who was the founder of it. There are some elements of this which can be seen in the humanistic approach and Rogers did develop some of his ideas from this.
The next approach is behavioural, which emphasizes the important of thinking in how we feel and what we do and our personality is derived entirely through learning. This approach believes ‘whatever has been learned can be unlearned and modified through application of learning principles. To founders of this type of therapy were J B Watson (1878 – 1958) and B F Skinner (1904 – 1990).
The next approach is cognitive therapy which was developed by Aaron T Beck (1921). Another person who worked on similar ideas from a different perspective was Albert Ellis (1913 – 2007). Ellis believed that behaviour was determined by our belief system, even if they are irrational. ‘Irrational belief systems are leaned, as are emotions reactions to them. New rational beliefs must be learned in place of irrational ones’. (Sanders, 1994: 27)
The last approach I am going to mention is integrative, which is basically taking the most effective parts of all approaches and putting them together. This was founded by Gerard Egan.
The pros and cons of PCT
As with everything there will be pro’s and cons with this type of therapy. I will talk about the pros first.
No other form of therapy will provide as good an environment for unconditional positive regard, empathy and congruence.
It makes the client feel supported and valued no matter what the person has come to see the therapist for.
It places the client at the heart of any process of change and always has the client’s best interests
A very good relationship is built between the client and the therapist.
The client is free to talk about whatever they want to.
The cons of PCT are as follows;
It can be difficult for the therapist to adopt a genuine humanistic approach and offer the core conditions. ‘unconditional positive regard may require much discipline and inner work to be able to practice fully, as all of us have opinions and values which are impossible to suppress or ignore’. (chrysalis handout – 2012)
It is a therapy limited to listening and reflecting. Therapists rarely ask questions, make diagnosis, provide interpretation or advise and no solutions are provided, which might not be suited to all clients.
It focuses totally on nurture and doesn’t consider nature (genetic influences) at all.
It ignores the unconscious mind. Clients may have suppressed feelings which have been buried deep into the unconscious mind and this type of therapy may not be able to bring these to the surface.
The client may go off on a tangent from their presenting issue due to no direction from the therapist.
The therapy is non-directive so the client may make choices which the therapist doesn’t agree with and they may find it hard to say something.
The whole approach is an idea and not research based.
After doing research into PCT, I feel there is a place for it in therapy but should be used alongside other tools rather than being used solely on its own. This type of therapy believes the client will understand the factors that are causing them to be unhappy whereas in reality this is not always the case as clients may have issues hidden in the unconscious mind. The therapist is non-directive so this places all the responsibility for the direction onto the client. This may not be what the client wants. They may require a more directive approach. As a person who has seen a therapist, this type of therapy did not work for me.
I was looking for a more direct approach. It may not be possible for the therapist to always follow the 3 core conditions, unconditional positive regard, empathy and congruence. There maybe many factors which stops the therapist from following these. They may have different values and beliefs than the client. If a client comes in with a specific issue which you have strong beliefs against you could not follow these core conditions.
Each client is individual and whilst this type of therapy may work for one client it may not work for another so I feel that to get the best out of the client and the therapy sessions is to have broad mind and use whichever approach fits best at the time, whether it be one specific approach or snippets of the many different ones.