Person Centered Therapy

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Person Centered Therapy

• EDCE 655
• Theories Techniques II

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Carl Rogers (1902 1987)

• Born Oak Park, Illinois
• Initially studied theology and was a pastor in
  small church in Vermont
• Became Clinical Educational Psychologist
• Taught at Columbia University
• Liked the work of Otto Rank
• First to systematically analyze therapy via
  recording sessions analyzing transcripts of
  sessions also did a great deal to contribute to
  outcome research
• Received the APA Distinguished Scientific
  Achievement Award for his research in 1956.
• The client knows better to how to proceed than
  the therapist

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Carl Rogers (1902 1987)

• Humanistic Psych.
• Open to change
• Warm close family relations
• Strict Religious standards
• Play discouraged
• Lonely childhood
• Majored in Agriculture to history to religion to
  clinical psych.
• Child Guidance Center Rochester, NY from
  1928-1939
• U. of Wisconsin, U. or Chicago, Ohio State
  University (1939 1963)
• Center for the Studies of the Person - 1968

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Carl Rogers (On Becoming a Person)

• "...In my early professionals years I was asking
  the question How can I treat, or cure, or change
  this person? Now I would phrase the question in
  this way How can I provide a relationship which
  this person may use for his own personal growth?"

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History of Person-Centered Therapy

• Developed by Carl Rogers
• Otto Rank major impact on the development of
  Rogers view on the uniqueness creative
  abilities of the individual
• Elizabeth Davis student of Rank major
  influence on the dev. Of Rogers view of
  responding almost entirely to the feelings being
  expressed
• First works were IDd while Rogers was a
  Professor of Psych. at Ohio State University
• Wrote Counseling and Psychotherapy in the mid-50s
  which helped to articulate his concept on a large
  scale
• Rogers continued his work in the areas of
  Client-Centered Therapy until his death in
  February of 1987

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Rogers Basic System About People

• Trustworthiness
• Ability to understand themselves and solve their
  problems without a counselors direct intervention
• Having the capacity to promote self-directed
  growth in a therapeutic situation
  (client-centered)

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Goals of Person-Centered Therapy

• Intervene on the clients incongruent experiences
• If the client perceives and experiences the
  following, change can occur
• Empathy
• Unconditional Positive Regard
• Congruence
• Implied Therapeutic Conditions of the following
• Psychological contact
• Client anxiety or incongruence
• Openness on the part of the client

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Three Counselor Qualities

• Congruence
• Unconditional Positive Regard
• Empathic Understanding

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6 Conditions in the Counselor / Client
Relationship

• 2 persons are in psychological contact
• The client is experiencing incongruency
• The counselor is congruent or integrated in the
  relationship
• The counselor experiences unconditional positive
  regard or real caring for the client
• The counselor experiences an empathic
  understanding of the clients internal frame of
  reference endeavors to communicate this
  experience to the client
• The communication to the client of the
  counselors empathic understanding and
  unconditional positive regard is to a minimal
  degree achieved.

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Therapeutic Sequence

• The client goes through a process of change that
  include
• Examines problems and takes responsibility for
  action
• Experiences emotions in the immediacy of the
  therapy
• Accepts responsibility of self, formerly denied
• Raises general level of self regard

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Limitations Criticisms

• There is more to the counseling process than
  listening and reflecting
• A full integration of this theory may not be
  applicable to all populations or a variety of
  different diagnoses.

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• 5 I strongly agree with this statement
• I agree, in most respects, with this statement
• I am undecided in my opinion about this statement
• I disagree, in most respects, with this statement
• I strongly disagree with this statement
• _____ 1 At a persons deepest core is a
  socialized, forward-moving being striving to
  become a fully functioning self
• _____ 2 People have the capacity for
  understanding their problems and the resources
  for resolving them
• _____ 3 The basic goal of therapy is to create a
  psychological climate of safety wherein clients
  will not feel threatened and will this be able
  to drop their pretenses and defenses
• _____ 4 The counselors function is rooted not
  primarily in techniques but in his or her ways of
  being and attitudes
• _____ 5 Effective counselors use themselves as
  instruments of change, for they must encounter
  the client on a person-to-person level
• _____ 6 The client uses the therapeutic
  relationship to build new ways of relating to
  others in the outside world
• _____ 7 The client can make progress in therapy
  without the counselors interpretations,
  diagnoses, evaluations, directives
• _____ 8 The relationship between counselor and
  client is the crux of progress in therapy
• _____ 9 the counselors genuineness, accurate
  empathy, unconditional positive regard are
  essential qualities of effective therapy
• _____ 10 When people are free, they will be able
  to find their own way
• _____ 11 Forming a diagnosis and developing a
  case history are not important prerequisites for
  therapy
• _____ 12 It is important that a counselor avoids
  being judgmental about the clients feelings
• _____ 13 Therapeutic change depends on clients
  perceptions, both of their own experience in
  therapy and of the counselors basic attitudes.

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7 Behavior Strands - Rogers Rablen (1958)

• A scale which could be used to measure the stage
  on the process continuum at which a client was
  operating
• 1st Stage Communication about externals
• 2nd Stage Feelings are sometimes described but
  as unowned past objects external to self
• 3rd Stage There is much description of feelings
  and personal meanings which are not now present
• 4th Stage Feelings personal meanings are
  freely described as present objects owned by the
  self
• 5th Stage Many feelings are freely expressed in
  the moment of their occurrence and are thus
  experienced in the immediate present
• 6th Stage Feelings previously denied are now
  experienced both with immediacy and acceptance
• 7th Stage The individual lives comfortably in
  the flowing process of his experiencing

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Modern Rogerian Encounter Skills Pattern (MRESP)

• According to A Ivey (1988) the MRESP primarily
  emphasizes the use of Listening Skills and to
  somewhat lesser degree Influencing Skills
• In the Gloria Interview session Rogers spoke
  29.9 of the time and Gloria spoke 71.1 of the
  time. According to Weinrach (1990) one would have
  expected Rogers, using person-centered approach,
  would have talked far less then a client, which
  was the case in Gloria.
• The counselor using MRESP would be expected to
  make frequent use of the following
• Frequent Common Occasional
• Paraphrase (11/9) Confrontation
  (10/8) Interpretation (36/28)
• Reflection of feelings ((8/6) Encouragers
  (6/5) Advise (6/5)
• Self-disclosure (6/5) Summarization
  (0) Questions (6/4)
• Feedback (5/4)
• Reflection of Meaning (4/3)
• If Rogers performance had been consistent with a
  counselor using a MRESP, Rogers would have used
  the skills in the Reflection of Meaning for more
  frequently. Both the paraphrase and reflection of
  meaning focus on content as opposed to affect.
  Rogers devoted 15 of his time to the combined
  use of these two skills as compared to the 8 he
  devoted to reflection of feeling represents a
  major discrepancy between what would be expected
  and what was found.
• One would have expected Rogers to have made more
  use of encourages, and it is interesting to point
  out no use of summarization

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Genuineness Congruence

• Counselor is real, integrated authentic during
  therapy session
• Inner experience outer expression of counselor
  match
• Openly express feelings and attitudes
• Honest communication is facilitated by expression
  acceptance of both positive and negative
  feelings
• Counselors serve as a model
• Counselors must take responsibility for their
  feelings
• Congruence exists on a continuum

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Unconditional Positive Regard

• Counselors need to communicate a deep genuine
  caring prizing of the clients as a person
• Acceptance of the client must be non-judgmental
  warm
• Counselors caring should be non possessive
• It is not possible for counselors to genuinely
  feel acceptance and unconditional caring at all
  times

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Empathy Accurate Empathic Understanding

• Counselors need to understand clients
  experiences and feelings sensitively and
  accurately as they are expressed during the
  therapy session in the here and now
• Accurate empathy goes beyond recognition of the
  obvious to recognition of the less clearly
  experienced feelings of the clients
• Empathy is a deep subjective understanding of
  the client with the client
• Empathy is a sense of personal identification
  with the clients experience
• Counselors must maintain their seperateness

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Person-Centered Theory The 11 Basic Issues

• 1. Biological /or Social Determinants developed
  around a strong biological core
• 2. Number Weights Assigned to Motivational
  Concepts actualizing tendency is innate
• 3. Psychological /or Reality Environment we
  live in a world with multiple realities
  individual perceptions of reality
• 4. Early /or Continuous Development Critical or
  Significant Life Stages No specific
  developmental stages through which we must pass
• 5. Importance of Role Assigned to Self-Concept
  positive regard from others leads to self regard
  results in a fully functioning individual
• 6. Conscious /or Unconscious Determinants of
  Behavior believes the unconscious represents
  another doorway to self knowledge
• 7. Conditioning /or Freedom to Choose Behavior
  the more we conquer inner fears, the more we
  increase self regard overcome conditions of
  worth
• 8. Explanation of Learning self initiated, self
  directed, self evaluated, self rewarded. Freedom
  to think, feel, act, etc. must be present
• 9. Uniqueness /or Commonality as human beings,
  we all have things in common. As individuals, we
  select, perceive, and process information
  differently
• 10. Importance of Group Membership we need
  strive for positive regard from others. Formal
  groups are important
• 11. Importance of Reward we are interested in
  one kind of reward self-reward, inner
  satisfaction

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Doris Leaving Her Husband Child
Doris comes to a community counseling center at
the recommendation of a friend, who expresses
concern that Doris intends to leave her child.
The friend thinks she is confused and needs
professional help. Some Background Data Doris
was born and reared in Arkansas. Her father is a
reformed alcoholic who drank heavily when the
client was a child. Both parents are religious,
and the father is described as a strict
fundamentalist. Doris has a younger brother who
is now an enlisted man in the Army and is
described as the family favorite. Doris says her
parents were stricter with her than with their
son and emphasized the importance of marriage as
well as the womans dependent and inferior role
in that relationship. Doris is a sweet girl who
dropped out of high school in the 10th grade. She
worked as a manicurist in Arkansas until marrying
and moving to Kentucky 3 years ago. She then
worked as a waitress. Her husband says that they
have had no fights or arguments during their
3-year marriage, and the client agrees. 6 months
ago Doris gave birth to a baby boy. There were no
medical complications, and Doris maintains that
she adjusted well to the baby, but she reports
just not being able to feel much of anything
except tired. 2 months ago Doris and her husband
moved to Houston so that he could join an amateur
band. She began working as a cashier at a
drugstore. In the course of her work she began to
have a series of brief sexual affairs with fellow
workers as well as customers. At the same time,
although her husband is happy with the band, he
has not been able to find steady a job. He has
asked her to try to find a second job or take
overtime hours at the drugstore. Doris is
considering leaving her husband and her child,
although she is uncertain how she would continue
to support herself financially. She is also
concerned with what would happen to her son,
because her husband has no means of support. She
insists that she does not want to take the child
with her.
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Doris Leaving Her Husband ChildQUESTIONS FOR
REFLECTION

• Would you be inclined to accept Doris as a
  client? Do you think that you could empathize
  with her situation? Explain.
• What is your attitude about her wanting to leave
  her husband and her child? What are you values on
  this matter, and how would they influence the way
  you would work with her?
• Would you want to see Doris and her husband
  together? Would you want to see him individually?
  See her individually? See them on an individual
  basis and also as a couple? Explain your
  rationale, showing what you would probably focus
  on in each instance.
• Assume that Doris asked you for your advise
  regarding her plan to leave her husband and
  child. What would you say? To what degree do you
  think Doris can function without advice?
• If you accepted Doris as a client, in what ways
  do you think you could be of most help to her?
• Are there feelings about herself and her husband
  that Doris is currently unwilling to accept? How
  would a person-centered approach help with
  acceptance of feelings and with denied parts of
  the self?
• By staying with a person-centered framework, do
  you feel that you could respond to her in a way
  you would like? Do you feel limited by this
  theory in any way? If so, How?
• What are some of the advantages of working with
  Doris within a person-centered framework?

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Don, Who is Sure He Has to Prove Himself
Don, an Air Force officer, comes to see me on the
basis of a referral from a military doctor. He
consulted with the physician because of
continuing heart pains. Even though he is only in
his mid-30s, he has had 2 mild heart attacks.
These resulted in his being hospitalized and
required that he take a sustained period off
work. He is about 30 pounds overweight, has very
high blood pressure, suffers at times from
angina, and develops severe headaches that are of
a chronic nature under stressful conditions. His
physician insisted that, if he was interested in
continuing to live, he would have to learn how to
relax and meet stress in more constructive ways.
Because his physician was convinced that Dons
psychological characteristics and the perpetual
stress he was under called for psychology as well
as medical treatment, he was referred to me.
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Follow-Up You Continue as Dons Counselor

• How do you see Don? What do you see as the major
  themes of his life that need to be focused on and
  explored more fully? How do you personally
  respond to him?
• Assume that I were to refer Don to you for
  continued counseling (in the person-centered
  style). How do you imagine that it would be for
  you to work with him? How might a person such as
  Don relate to you?
• Assume that you will be seeing Don for at least
  six more sessions, what are some specific issues
  that you most want to explore? How might you go
  about doing this with him?
• This approach was characterized by by listening
  and responding to him rather than by my active
  and directive intervention with therapeutic
  procedures and techniques. Do you think you would
  feel comfortable in staying in such a role as
  mine in your work with Don? Why or why not? Are
  there other techniques that you might want to
  introduce?
• Don is driving himself relentlessly, and his body
  is telling him that he will probably kill himself
  if he does not change. Can you think of anything
  you might do or say to him to increase the
  probability that he will pay attention to the
  messages his body is sending him?