Discuss Module two

Excerpt from Ch 7

Theory and Practice of Counseling and Psychotherapy, Updated, Tenth Edition

COPYRIGHT © 2021 Cengage Learning

Four Periods of Development of the Approach

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In tracing the major turning points in Rogers’s approach, Zimring and Raskin (1992) and Bozarth, Zimring, and Tausch (2002) have identified four periods of development. In the first period, during the 1940s, Rogers developed what was known as nondirective counseling, which provided a powerful and revolutionary alternative to the directive and interpretive approaches to therapy then being practiced. While he was a professor at Ohio State University, Rogers (1942) published Counseling and Psychotherapy: Newer Concepts in Practice, which described the philosophy and practice of nondirective counseling. Rogers’s theory emphasized the counselor’s creation of a permissive and nondirective climate. When he challenged the basic assumption that “the counselor knows best,” he realized this radical idea would affect the power dynamics and politics of the counseling profession, and indeed it caused a great furor (Elkins, 2009, 2016).

Rogers also challenged the validity of commonly accepted therapeutic procedures such as advice, suggestion, direction, persuasion, teaching, diagnosis, and interpretation. Based on his conviction that diagnostic concepts and procedures were inadequate, prejudicial, and often misused, Rogers omitted them from his approach. Nondirective counselors avoided sharing a great deal about themselves with clients and instead focused mainly on reflecting and clarifying the clients’ verbal communications and intended meanings.

In the second period, during the 1950s, Rogers (1951) renamed his approach client-centered therapy, which reflected his emphasis on the client rather than on nondirective methods. In addition, he started the Counseling Center at the University of Chicago. This period was characterized by a shift from clarification of feelings to a focus on the phenomenological world of the client. Rogers assumed that the best vantage point for understanding how people behave was from their own internal frame of reference. He focused more explicitly on the actualizing tendency as the basic motivational force that leads to client change.

The third period, which began in the late 1950s and extended into the 1970s, addressed the necessary and sufficient conditions of therapy. Rogers (1957) set forth a hypothesis that resulted in three decades of research. A significant publication was On Becoming a Person (C. Rogers, 1961), which addressed the nature of “becoming the self that one truly is,” an idea he borrowed from Kierkegaard. Rogers published this work during the time that he held joint appointments in the departments of psychology and psychiatry at the University of Wisconsin. In this book he described the process of “becoming one’s experience,” which is characterized by an openness to experience, a trust in one’s experience, an internal locus of evaluation, and the willingness to be in process. During the 1950s and 1960s, Rogers and his associates continued to test the underlying hypotheses of the client-centered approach by conducting extensive research on both the process and the outcomes of psychotherapy. He was interested in how people best progress in psychotherapy, and he studied the qualities of the client–therapist relationship as a catalyst leading to personality change.

Rogers and his associates at the University of Chicago conducted research to identify the ingredients in psychotherapy that account for therapeutic change. The client-centered approach emphasized the role of the therapist as a facilitator of growth and honored the inherent power of the client. Research findings consistently supported this approach, confirming that therapeutic change is due to personal and interpersonal factors rather than to specific techniques for curing specific disorders (Elkins, 2016). On the basis of this research, the approach was further refined and expanded (C. Rogers, 1961). For example, client-centered philosophy was applied to education and was called student-centered teaching (C. Rogers & Freiberg, 1994). The approach was also applied to encounter groups (C. Rogers, 1970).

The fourth phase, during the 1980s and the 1990s, was marked by considerable expansion to education, couples and families, industry, groups, conflict resolution, politics, and the search for world peace. Because of Rogers’s ever-widening scope of influence, including his interest in how people obtain, possess, share, or surrender power and control over others and themselves, his theory became known as the person-centered approach. This shift in terms reflected the broadening application of the approach. Although the person-centered approach has been applied mainly to individual and group counseling, important areas of further application include education, family life, leadership and administration, organizational development, health care, cross-cultural and interracial activity, and international relations. During the 1980s Rogers directed his efforts toward applying the person-centered approach to politics, especially to efforts related to the achievement of world peace.

In a comprehensive review of the research on person-centered therapy over a period of 60 years, Bozarth, Zimring, and Tausch (2002) concluded the following:

In the earliest years of the approach, the client rather than the therapist determined the direction and goals of therapy and the therapist’s role was to help the client clarify feelings. This style of nondirective therapy was associated with increased understanding, greater self-exploration, and improved self-concepts.

Later a shift from clarification of feelings to a focus on the client’s lived experiences took place.

As person-centered therapy developed further, research centered on the core conditions assumed to be both necessary and sufficient for successful therapy. The attitude of the therapist—an empathic understanding of the client’s world and the ability to communicate a nonjudgmental stance to the client—along with the therapist’s genuineness were found to be basic to a successful therapy outcome.

The main source of successful psychotherapy is the client. The therapist’s attention to the client’s frame of reference fosters the client’s utilization of inner and outer resources.

Summary

Person-centered therapy is based on a philosophy of human nature that postulates an innate striving for self-actualization. Carl Rogers’s view of human nature is phenomenological; that is, we structure ourselves according to our perceptions of reality. We are motivated to actualize ourselves in the reality that we perceive.

Rogers’s theory rests on the assumption that clients can understand the factors in their lives that are causing them to be distressed. They also have the capacity for self-direction and constructive personal change. Change will occur if a congruent therapist makes psychological contact with a client in a state of anxiety or incongruence. It is essential for the therapist to establish a relationship the client perceives as genuine, accepting, and understanding. Therapeutic counseling is based on an I/Thou, or person-to-person, relationship in the safety and acceptance of which clients drop their defenses and come to accept and integrate aspects that they have denied or distorted. The person-centered approach emphasizes this personal relationship between client and therapist; the therapist’s attitudes are more critical than are knowledge, theory, or techniques employed. In the context of this relationship, clients unleash their growth potential and become more of the person they are capable of becoming. An abundance of research supports the notion that the human elements of psychotherapy (client factors, therapist effects, and the therapeutic alliance) are far more important than models and techniques in the effectiveness and outcomes of therapy (Elkins, 2016).

This approach places primary responsibility for the direction of therapy on the client. In the therapeutic context, individuals have the opportunity to decide for themselves and come to terms with their own personal power. The underlying assumption is that no one knows the client better than the client; in short, the client is viewed as an expert on his or her own life (Cain, 2010). The general goals of therapy are becoming more open to experience, achieving self-trust, developing an internal source of evaluation, and being willing to continue growing. Specific goals are not suggested for clients; rather, clients choose their own values and goals. Current applications of the theory emphasize more active participation by the therapist than was the case earlier. Counselors are now encouraged to be fully involved as persons in the therapeutic relationship. More latitude is allowed for therapists to express their reactions and feelings as they are appropriate to what is occurring in therapy. Person-centered practitioners are willing to be transparent about persistent feelings that exist in their relationships with clients (Watson et al., 2011). It is the therapist’s job to adapt and accommodate in a manner that works best for each client, which means being flexible in the application of methods in the counseling process (Cain, 2010).

Contributions of the Person-Centered Approach

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When Carl Rogers founded nondirective counseling more than 70 years ago, there were very few other therapeutic models. The longevity of this approach is certainly a factor to consider in assessing its influence. Rogers had, and his theory continues to have, a major impact on the field of counseling and psychotherapy. When he introduced his revolutionary ideas in the 1940s, he provided a powerful and radical alternative to psychoanalysis and to the directive approaches then practiced. Rogers was a pioneer in shifting the therapeutic focus from an emphasis on technique and reliance on therapist authority to that of the power of the therapeutic relationship.

As we have seen, Natalie Rogers has made a significant contribution to the application of the person-centered approach by incorporating the expressive arts as a medium to facilitate healing and social change, primarily in a group setting. She has been instrumental in the evolution of the person-centered approach using nonverbal methods to enable individuals to heal and to develop. Many individuals who have difficulty expressing themselves verbally can find new possibilities for self-expression through nonverbal channels and through the expressive arts (N. Rogers, 2011).

Kirschenbaum (2009) contends that the scope and influence of Rogers’s work has continued well beyond his death; the person-centered approach is alive, well, and expanding. Today there is not one version of person-centered therapy, but a number of continuously evolving person-centered psychotherapies (Cain, 2010). Increasingly, person-centered therapists have begun to integrate concepts and methods from other theoretical orientations to the benefit of their clients (Cain, 2016). Although few psychotherapists claim to have an exclusive person-centered theoretical orientation, the philosophy and principles of this approach permeate the practice of most therapists. Most schools of therapy are increasingly recognizing the centrality of the therapeutic relationship as an essential component for therapeutic change.

Emphasis on Research

One of Carl Rogers’s contributions to the field of psychotherapy was his willingness to state his concepts as testable hypotheses and to submit them to research. He literally opened the field to research. He was truly a pioneer in his insistence on subjecting the transcripts of therapy sessions to critical examination and applying research technology to counselor–client dialogues. According to Cain (2010), an enormous body of research, conducted over a period of 70 years, supports the effectiveness of the person-centered approach. This research is ongoing in many parts of the world and continues to expand and refine our understanding of what constitutes effective psychotherapy. Cain (2010) concludes, “person centered therapy is as vital and effective as it has ever been and continues to develop in ways that will make it increasingly so in the years to come” (p. 169). Murphy and Joseph (2016) predict: “For the future, we envisage a person-centered experiential therapy that offers a flexible, effective, and evidence-based therapy that is widely available” (p. 210).

Even his critics give Rogers credit for having conducted and inspired others to conduct extensive studies of counseling process and outcome. Rogers presented a challenge to psychology to design new models of scientific investigation capable of dealing with the inner, subjective experiences of the person. His theories of therapy and personality change have had a tremendous heuristic effect, and though much controversy surrounds this approach, his work has challenged practitioners and theoreticians to examine their own therapeutic styles and beliefs.

Limitations and Criticisms of the Person-Centered Approach

Although I applaud person-centered therapists for their willingness to subject their hypotheses and procedures to empirical scrutiny, some researchers have been critical of the methodological errors contained in some of these studies. Accusations of scientific shortcomings involve using control subjects who are not candidates for therapy, failing to use an untreated control group, failing to account for placebo effects, reliance on self-reports as a major way to assess the outcomes of therapy, and using inappropriate statistical procedures. In all fairness, these accusations apply to the research on many other therapeutic approaches as well.

There is a similar limitation shared by both the person-centered and existential (experiential) approaches. Neither of these therapeutic modalities emphasizes the role of techniques aimed at bringing about change in clients’ behavior. Proponents of psychotherapy manuals, or manualized treatment methods for specific disorders, find serious limitations in the experiential approaches due to their lack of attention to proven techniques and strategies. Those who call for accountability as defined by evidence-based practices within the field of mental health also are quite critical of the experiential approaches.

I do not believe manualized treatment methods can be considered the gold standard in psychotherapy, however. There is good research demonstrating that techniques account for only 15% of client outcome (see Duncan et al., 2010), whereas contextual factors have powerful effects on what happens in therapy (Elkins, 2009, 2012, 2016). Research points to relational and client factors as the main predictors of effective therapy. Furthermore, the evaluation of evidence-based practices has been broadened to include best available research; the expertise of the clinician; and client characteristics, culture, and preferences (see Norcross et al., 2017).

A potential limitation of the person-centered approach is that some students-in-training and practitioners with this orientation may have a tendency to be very supportive of clients without being challenging. Out of their misunderstanding of the basic concepts of the approach, some have limited the range of their responses and counseling styles mainly to reflections and empathic listening. Although there is value in accurately and deeply hearing a client and in reflecting and communicating understanding, counseling entails more than this. I believe that the therapeutic core conditions are necessary for therapy to succeed, yet I do not see them as being sufficient conditions for change for all clients at all times. From my perspective, these basic attitudes are the foundation on which counselors must then build the skills of therapeutic intervention. Motivational interviewing rests on the therapeutic core conditions, for example, but MI employs a range of strategies that enables clients to develop action plans leading to change.

A related challenge for counselors using this approach is to truly support clients in finding their own way. Counselors sometimes experience difficulty in allowing clients to decide their own specific goals in therapy. It is easy to give lip service to the concept of clients’ finding their own way, but it takes considerable respect for clients and faith on the therapist’s part to encourage clients to listen to themselves and follow their own directions, particularly when they make choices that are not what the therapist hoped for.

More than any other quality, the therapist’s genuineness determines the power of the therapeutic relationship. If therapists submerge their unique identity and style in a passive and nondirective manner, they are not likely to affect clients in powerful ways. Therapist authenticity and congruence are so vital to this approach that those who practice within this framework must feel natural in doing so and must find a way to express their own reactions to clients. If not, a real possibility is that person-centered therapy will be reduced to a bland, safe, and ineffectual approach.