Person-Centred Therapy: Evaluation and Comparisons

Essay, Pages 15 (3688 words)

Views

1269

Critically evaluate the practical use of person-Centred theory and its limitations as suggested by its critics. How does Person-Centred theory and practice differ from two other models and what ways if any is it similar? Carl Roger’s, the founder of the Person Centered theory came to his vision through his own life journey and relationship with clients as a psychologist. He believed in the potential being realised in all of us under the right core conditions (congruence, unconditional positive regard and empathy) culminating in the actualising tendency: Rogers advocated that there is a tendency within all humans, animals and plants, to move toward completion or fulfilment of potentials, i.

Don't use plagiarized sources. Get your custom essay on

“ Person-Centred Therapy: Evaluation and Comparisons ”

Get custom paper

NEW! smart matching with writer

e., wholeness. Individuals must develop the concept of self and the awareness of their experiences becoming the person’s self perception and the perception of the organismic self (the true-self).

Argument that this is not an argument that can sustain itself....the potato and we are not potato. Roger’s was of the oponion that when there are incongruences between the ideal self and the self concept the more an individual will be fragmented and dysfunctional.

Most of our conditions of worth have been set in place by the conditions and experiences of our upbringing and predominantly by parents or initial carers. Positive self regard is important and brought about by positive regard, a need for love and contact with another person where conditions of worth do not determine a persons self-esteem. If you do this then I will love you, hence you can only be successful if you fulfil other peoples expectations .

The importance of self positive regard means you are freed from others peoples goals and expectations of you. Therefore you are more likely to fulfil your own expectations and become the whole person, a person you wish to be, an existence that should be harmonious and balanced and actualise the organismic self.

‘The counsellor should relate, not as a scientist to an object of study, not as physician expecting to diagnose and cure but as a person to a person.’ The counsellor must feel the client to be a person of unconditional self worth which means the client is valued whatever his feelings, behaviour and condition. When the counsellor is genuine and congruent and not attempting to hide behind a curtain of himself, touching with experiences that are understood in his organismic self , and this will enable the counsellor to fully enter into this relationship regardless of where it may lead. ( Rodgers p.185 2004) As the client becomes aware that he/she is accepted unconditionally the process begins and this exploration is possible because the client becomes less threatened at damaging the old structured self he/she had previously been protecting.

The client may start to experience emotions more fully which creates a congruence in himself that he is these feelings in all their intensity. Hence, he discovers himself more freely and this constructive change will be reflected in the clients newly experiencing self. Critiques of Rogers's person-centred therapy begin with his basic conception of human nature as tending toward the good and the healthy. Some critics of Rogers's theories have difficulty with the concept that therapists can, or should, establish a relationship of unconditional positive regard in the case of dangerously violent persons. There is doubt how parents might put into practice some of these ideas when bringing up children whose behaviour can be difficult and not show any outward appearance of disapproval.

The “organismic valuing process,” sometimes described as an internal monitor of a person's experiences in life that, under favourable circumstances, allows the development of healthy men or women possessing optimum self-esteem and an accurate sense of who they “really are” as well as who they would ideally like to become. The obstacle to this development, according to Rogers, are conditions are those generally inflicted early in childhood in which the individual is denied “unconditional positive regard” and is thereby influenced by either positive or negative “conditions of worth” which instils values and behaviours that are at odds with a person's organismic valuing process. The result of exposure to these conditions of worth is the development of individuals who look to the approval of others for their sense of identity rather than finding it within themselves.

Consequently serious conflicts arise within the personality between its natural organismic valuing process and its perception of conditions of worth that are alien to it. Such conflicts are the source of the vast array of neurotic symptoms and disorders that have been catalogued since the inception of psychology as a professional discipline. In order to cure his patients, whom he called “clients” so as to relate to them in a more equitable manner than did doctors or traditional psychoanalysts, Rogers provided them with the unconditional positive regard they were denied previously by practicing “nondirective” techniques of therapy that avoided communicating to the client the judgmental or interpretive conditions to which they had already been subjected in life and which were only perpetuated in other therapeutic methods, especially psychoanalysis.

A technique of nondirective therapy is “reflection,” , the therapist literally restating, or reflecting back, what the clients have said so that they themselves may become pro-active and insightful in their own rehabilitation, discovering who they are and the type of person they would have become without the conditioning from others. There is the argument here too that it is an impossibility that we can evolve without any sort of conditioning a point critics love to get their teeth into, especially in our modern society. In On Becoming a Person Rogers explains it as this “Unless I had a need to demonstrate my own cleverness and learning, I would do better to rely upon the client for the direction of movement.”

Roger’s felt that this empowerment by the client gave them the opportunity to attain the highest goal of “getting in touch with themselves. As Freud himself recognised, it is when the client comes to a realisation (interpretation) themselves that they most embrace it. The therapist can help the client to find the insight, but he cannot “give” it to him. This points to the valuable nature of the clients own discovery being of paramount importance in the healing process and not being ‘told’. ( A real high five here for person-centred!)

However there are criticisms to Rogers technique of non-directivity. Most of these critiques have pre-conceived views that it is impossible for anyone to operate from this perspective and some dismiss the fundamental assumptions of the approach (actualising tendency, self-authority and self-directivity of the client).Lietaer’s (1998) work illustrates this, as he puts the client-centred therapist in the role of expert of ‘the process which is part based on Gendlin’s experiencing theory, seeing the therapist as expert. Cain (1986)although a promoter of the person centred theory takes the position which is identified as ‘instrumental non-directivity, in which ‘non-directivity is important as long as it is useful intending the intervention only as a suggestion. Again this is taken up by another ( Khan (1999)who suggests ‘ the therapists authority is endorsed with the rationalization that the client is allowed to agree or disagree, ignore or confirm the therapists input’.

This theory is alien to Rogers since the locus of control is switched to the therapist as intervention is defined as doing something to interfere in order to hinder or alter actions or behaviour. Maria Bowen a close friend and colleague of Roger’s suggested that non-directivity is a myth. In Roger’s interview with ‘JILL’ she considers a number of Rogers responses as interpretive and directive. She also concludes that Rogers seemed to avoid the ‘dark’ side and evaluated 25 of Roger’s therapy interviews to assess the idea that he operated on a positive bias based upon the question, ‘Did Carl Rogers positive of human nature bias his psychotherapy’. Interestingly enough, the findings showed that Rogers tended to veer more towards responding to the negative than to the positive client statements. Non-directivity does not necessarily lie in the particular responses which come from the person of the therapist.

At this point I will look at a more directive module of therapy, Cognitive Behavioural Therapy known as CBT. It originated from Sigmund Freud's pioneering therapeutic approach to individuals who had suffered childhood sexual abuse in 1895, which involved retelling the traumatic event in order to release repressed emotions. This type of therapy involves cognitive and behavioural techniques whereby clients are encouraged and taught ways to change their thought patterns and expectations and relaxation techniques are used. It is often used for phobias, obsessions, eating disorders, stress related ailments and major depression(sometimes in conjunction with drug treatment).There are various techniques that focus on problem solving, such as homework, diary cards and behavioural analysis. Some patients do not respond well to change and feel their suffering and apparent loss of control over their lives were not understood which has more recently led to the introduction of dialectical behavioural therapy.

This is described as an acceptance strategy that acknowledges clients behaviour (e.g. .drinking , drug use, self-harm )was the only way the person could deal with certain emotions. Cognitive therapy uses the power of the mind in influencing behaviour. The basis of the theory proposes that previous experience can damage self image and this can affect attitude emotions and ability to deal with certain issues and life situations. The therapist helps the client to identify, question and change poor mental images of themselves that may help to resolve current negative responses and behaviour, resulting in more positive attitudes and optimistic life view.

Person centred therapy also acknowledges that previous life experiences alter self images resulting in negative responses but allows the client to identify, question these and challenge their particular negative responses and behaviour. This comes back to the premise of non-directivity which ultimately is empowering for the client. CBT states that PCT will not be able to access certain suppressed emotion due to the tremendous trauma the brain has endured in the first place.and not be sufficient getting the patient past denial, getting the patient to discover suppressed emotion, and a therapist must be strong, they must push the patient, they must get them agitated in order to provoke the raw emotion that certain trauma locks away. A PCT environment does not achieve any of these things, and only draws the conclusion of lengthening the CBT treatment itself beyond what should be needed. CBT is an assertive therapy, and must be delivered especially in relation to trauma PTSD.

CBT is often performed from 10 - 12 sessions, though can go for up-to 12 months if the trauma is of a more complex nature. Beyond this time limit it is presumed something is wrong; either the patient isn't working hard enough, or the therapist isn't delivering and pushing the patient to work hard enough.

The real pluses for CBT, is that a majority of the structure can be delivered in a group environment, hence limiting the one-on-one patient / therapist time and achieving greater through put of patients, without disregard for end results. [7] CBT can also be used effectively by changing the delivery to suit children of any age, without losing effective purpose or outcomes. [8] CBT can be delivered online, through Internet Therapy known as Interapy, using a mixture of online tasks and electronic interaction with the therapist. These clear advantages are making it far more popular as the tool of choice with trauma specialists in relation to PTSD.(Post Traumatic Stress Disorder).

A study using neuro-imaging in anxiety disorders concluded that CBT physically affects the brain, specifically in the areas of empathy and forgiveness. Neuro-imaging also identified that CBT in combination with prescribed drugs that the two integrated to work collectively together in order to help open specific pathways within the brain helping regulate the dysfunctional neural circuits involved with the regulation of negative emotions and fear extinction. This again may only be temporary and there are no many medications that are being tested (but not always sufficiently) and prescribed that it will take quite a few years before we know the full impact of these substances on the mind body and spirit of the recipients. To use an analog from an article on various modules of counselling he suggests the human heart-mind could be compared to a concrete yard. The concrete represents the barrier, the defence mechanisms, between the conscious and the unconscious The weeds that grow through the cracks are the difficult thoughts. CBT tries to pull up the weeds as soon as they appear.

But the cracks remain and so does the soil beneath, so the weeds keep coming through, naturally. Under pressure more cracks will appear and more weeds – just as for a person under pressure will see their negative thoughts multiply and grow . to block the weeds (and avoid harmful chemical spray: anti-depressants and tranquilisers) you need to tackle the problem at source: where the weeds are coming from, what is going on beneath the concrete. At the deeper levels of the self there are unconscious dynamics that need insight to be resolved .Hence why short term and pharmacology are not necessarily effective in the long term. In contrast to the CBT approach, it is through a basically person-centred approach, already outlined, that the person can be lead in this kind of deep, insight-based work.. No study exists to measure what clinicians claim and know from experience, due to the time based requirements involved on follow-up assessment five, or ten years later.

There are then so many factors within such a time frame that would be insufficient to prove one method over the other clinically, ie. re-exposure to stressors, lifestyle changes, etc. Unfortunately due to these life restrictions, studies are typically only demonstrated for short-term gain vs. clinical experience where patients are monitored over years via feedback. | In the summary of the 2008 meta-analysis by Robert Elliot and Elizabeth Freire (Person-Centred/Experiential Therapies Are Highly Effective) looked at 78 studies where PCE therapies were compared to CBT, including 63 RCT’s (Randomised Clinical Trials). Apparently when all the PCE therapies were analysed they seemed to be slightly less effective than CBT . However when meta-analysis statistically controlled for the theoretical orientation of the researcher, otherwise known as researcher allegiance, the effects disappeared as the research was found to be bias which can be quite common in treatment research.

After this other studies were done and to see if the superiority would decrease in relation to other supportive therapies and PCE therapies. It was found that pure PCT was statically equivalent in effectiveness to CBT, even without doing any control for researcher allegiance. They concluded that important PCE therapists do their own outcome research and ‘not trust watered down versions of what we do’as Roger’s said ‘the facts are friendly’ which is the legitimate version of Person-Centred Therapy. Transpersonal psychology was one of the first self- declared transpersonal academic disciplines to develop in the late 1960’s and 1970’s. It was building upon earlier studies into psychology of religion and mysticism by William James amongst others and from psychodynamic theorists (Jung and Assagioli) and humanistic psychology (Maslov).

It focussed on the exploration of the higher reaches of human nature and experiences often influencing by Eastern religions, philosophies and practices. Transpersonal means ‘beyond’ or ‘through’ the personal, whereby our normal self is transcended resulting in a sense of connection to a larger, more meaningful reality.Transpersonal counselling is varied but are often based on Jungian, Person-Centred, Psychosynthesis, Buddhist, Holotropic principles, to name a few. Important focus’s in transpersonal counselling would be the some of the following: Is there life after death? How can I achieve greater happiness and fulfilment? What is enlightenment? How can I be more creative? Science is also now making headway to show that everything is interconnected in a beneficial mixture of experience.(e.g. Quantum psychiatry, physics and biology: a foetus still carries a cellular record of the agonizing experience and an enormous amount of pent up emotions and physical energies.)

Transpersonal counsellors may used various methods and could appear directive or non directive and may also practice meditation or guided fantasies and other creative pursuits. The processes are varied too ( from spiritiual healing and emergence to kundalini awakenings and mediumship.) For example spiritual emergence may be triggered by trauma, stress, illness, life changing events, immature spiritual practice or drugs. Spiritual emergence is considered to be an spiritual opportunity and transformation but can be very overwhelming and often indistinguishable from psychosis. This is why the understanding of a particular approach is essential because a person with these symptoms could be embraced by the therapist that believes it is a part of spiritual growth and by another therapist possibly put on medication and branded a pschizophrenic. it seems like the essence of transpersonal therapy is the valuing of the wholeness of being and self-realization on all levels and all the experiences that a person has are valuable. Sensitivity to individuals beliefs and practices and major frames of reference are dismissed.

Hence why Rogers and the transpersonal are similar in their embracing of the persons frame of reference. Another consideration may be atheist may object to seeing a transpersonal therapist and a religious or spiritual person may feel the need to be seen by therapist with similar spiritual beliefs. When religious belief systems can often be such major identity issues for clients it is important not to be dismissive as some therapeutic disciplines can be. Jesus, Mohammed, Buddha, Ramakrishna were diagnosed more recently as schizophrenic psychotics, hysterics or epileptics .and the famous psychoanalyst Franz Alexander described Buddhist meditation as ‘artificial catatonia’, which I personally find quite offensive! .Transpersonal combines the awakening of personal awareness and intuition (non-rational knowing)with the body's ability to heal itself through compassionate self support.

Some transpersonal experiences are ‘deep connection and love with other people, a sense of sacredness, euphoria, memories of previous life/lives , creative inspirations, out of body and death/birth experiences. I think that Person centred approach is also geered for creating a journey for personal awareness and intuition with the congruent nature of the discipline and the conditions that are at the core of Roger’s goal of the harmonious self.Techniques may be taught and supported explicitly in the therapy session and, at times shifts in consciousness may be cultivated to allow the individual to develop immediate insight and inspiration that may not be available through more conventional means. This may provide clients with a skill they can practice on their own. Rogers speaks of something similar as he feels ‘‘all in one piece’ as he ‘settles into’ a holistic mode of perception. Losing awareness of his surroundings and even the sense of time, he demonstrates that he is experiencing , by definition, an altered state of consciousness’ ( Ludwig 1967)

He states himself ‘he was able to be more aware , not less, aware than at other times. He states that he ‘never felt as whole or as much a person’ than he did in his therapeutic interviews. In 1961 he commented that ‘when there is this complete unity, singleness, fullness of experiencing in the relationship, then it acquires the ‘out –of-this-world’ quality which therapists have remarked upon, a sort of trance like feeling in the relationship from which both the client and he emerge at the end of the hour, as if from a deep well or tunnel. He spoke of his inner spirit reaching out and touching the inner spirit of the other and the relationship transcending itself, becoming part of something larger where he found profound growth, healing and energy were present.(Rogers p.202)

Transpersonal experiences of psychological death, rebirth and oneness, with other people, with nature and the entire universe and the cosmic consciousness can reduce the level of aggression, increase compassion and tolerance and ultimately lead to high ecological awareness, an optimal strategy to lead a fulfilling life and a productive contribution to the collective well-being. This sounds very much like the fully-functioning person Rogers speaks of, the creative and free being that becomes that potential in its fullness in the cosmic picture.Rogers had a definite relationship with transpersonal ideologies although he did not become a transpersonal psychologist he seemed congenial to it, especially in his role in the humanistic psychology, his visits to mediums and attempts to explain his own mediumistic experiences in psychotherapy in the new age language. He was curious and experimental with the transpersonal but he remained a client centred psychotherapist.

CONCLUSION FOR THEORY ESSAY

Moreover, Rogers's work continues to serve as a foundation for the counseling profession (Capuzzi & Gross, 2001; Gibson & Mitchell, 1999; Gladding, 2000; Nugent, 2000). It also plays a major part in the practice of the vast number of counselors, clinical psychologists, and psychotherapists who describe their practice as "eclectic" or "integrative," including the client-centered approach as a major component in their repertoire (Aspy, Aspy, Russel, & Wedel, 2000; Bergin & Garfield, 1994; Sharf, 2000). But Rogers's influence extends beyond the field of psychology, just as the career of the man did during his lifetime. While some of Rogers's critics felt that his theory was superficial (DeMott 1979), overly optimistic, and underestimated the capacity for human evil (May, 1982), the simplicity of his message and his unyielding belief in the strength and power of human potential is carried on in humanistic and transpersonal fields today (Sharf, 2000; Cowley, 1993).

At best, Rogers's detractors claim, his ideas may be applied only among a limited range of clients, specifically those suffering from the milder forms of neurosis, acknowledging that while person-centred therapy may prove no more effective than any other method, it has yet to demonstrate that it is harmful in any way. Despite such criticisms, Rogers's theory of personality and his therapeutic methodology continue to gain adherents and have become among the most widely influential trends in the history of psychology. And Finally, ‘This new world will be more human and humane. It will explore and develop the richness and capacities of the human mind and spirit. It will produce individuals who are more integrated and whole. It will be a world that prizes the individual person—the greatest of our resources.’ (Rogers, 1980, p. 356)