Person-centered therapy, aka client-centered therapy, places an emphasis on the client as an expert. Originally founded by psychologist Carl Rogers, it posits that people strive toward a state of self-actualization and therapy can help a client reach self-awareness. A therapist’s job is to offer support rather than form judgment or offer advice. Ultimately, it is the responsibility of the therapist to create the proper surroundings for a client to become a “fully functioning person”.
Focus on the conscience
Person-centered therapy was a major departure from the popular theories of the time, namely psychodynamic and behavior therapy. These therapies focused on human behavior that the client was not consciously aware of. Rogers, on the other hand, thought that people wanted to focus on the aspects of their life that were part of their self-awareness. In other words, the client knows what is bothering them and just needs the appropriate environment to process it.
Why person-centered therapy may not get enough credit
Most current popular therapeutic approaches focus on the actions of the client. Subsequently, numerous self-help resources have been developed for individuals to work on themselves within these orientations. Take cognitive-behavioral therapy (CBT), for instance. There are hundreds of worksheets and exercises that people can use if they wish to practice the CBT orientation. In contrast, person-centered therapy concentrates on what the therapist does to promote a certain environment within the therapeutic milieu. It does not lend itself to specific activities that can be marketed to potential clients. Plus, these therapist techniques tend to be more general, rather than specific acts that can be easily replicated. As a result, person-centered therapy is not discussed as often as a specific treatment modality. But make no mistake. The principles of person-centered therapy have become mainstays of how to conduct psychotherapy. Almost all therapists use at least some client-centered techniques when performing therapy. They just may not realize they are doing it.
Techniques of person-centered therapy
While some may argue that a person-centered therapist does not use techniques as much as they develop a therapeutic atmosphere, there are certain behaviors a therapist must perform to create the optimal environment. Let’s look at some techniques a therapist uses in person-centered therapy.
Unlike most therapies, where a clinician may have an agenda for a particular session, Rogers advocated for a person-centered session where the therapist lets the client lead. It is the client’s journey and it is believed they are experts about their own lives. Thus, the therapist is seen as an equal collaborator, rather than an authority who knows how to guide a person toward self-actualization. This is the reason that Rogers referred to a person in therapy as a client rather than a patient. Although it may be tempting to offer guidance, it is important that the client is taking responsibility for their own life.
Unconditional positive regard
One of the most important aspects of the person-centered therapy technique is that the therapist must exhibit unconditional positive regard for the client. In short, this means that they accept and care for the client as they are. This does not mean that the therapist always has to agree with the client but it does mean that they refrain from judgment. It is essential that the client feels valued by the therapist. You might note that this resembles aspects of positive psychology.
The development of self-concept was key to Rogers. In order to be functioning at an optimal level, he thought that a person must balance their ideal self with how they experience their real self. When that is achieved, they obtain what he termed congruence. He believed congruence was necessary to become a highly functioning person and achieve life goals. It is thought that a client is usually in a state of incongruence when they enter therapy and a major part of their work is to achieve congruence.
To that end, Rogers believed that a therapist must be genuine with clients. He thought that their behavior and thoughts needed to match. In other words, the client should see the client’s authentic self. In order to be effective, a client needs to believe that what a therapist is saying is the truth. This is a major diversion from much of psychodynamic psychology, where therapists were encouraged to hide their true selves from patients. Being genuine allows the therapist and client to build trust and model a healthy relationship. If a therapist is not exhibiting congruence, a client will not be able to achieve a similar state.
It is essential that a therapist exhibit empathy while applying person-centered therapy techniques. Empathy is the ability to put yourself in someone else’s shoes and relate to their experience. It should be noted that empathy is different from sympathy. Empathy is showing understanding for a person while sympathy is feeling bad for them. If a client does not feel understood they will not feel safe with the therapist and will be unable to be genuine and exhibit their true self.
Accept negative emotions
Remaining positive, supportive, and non-judgmental with a client can be difficult. There are times when a client is going to express negative emotions that elicit a reaction. At times a client may even direct negative emotions toward the therapist. A therapist needs to remember that person-centered therapy techniques are based on creating a safe environment for a client where they feel they can share information without negativity and judgment. A therapist needs to learn to not take words personally, especially from a client that is experiencing personal issues.
Active listening is a bit of a misnomer. Yes, you are listening to the client. In fact, truly listening to the client without exhibiting judgment is a fundamental part of person-centered therapy. But, active listening is not just listening. It is listening in such a way as to let the client know that you understand what is being said. Here are some critical aspects of active listening:
Body language - One way to show a client you are paying attention is through body language. You want to maintain eye contact, lean slightly forward, and keep an open style of communication (e.g., arms and legs uncrossed).
Reflection -Another part of active listening is verbally responding to what is being said. In many therapies, the therapist is trying to interpret what the client means and see it through their own lens. In person-centered therapy, you do not try and change the meaning but rather simply reflect the client in an effort to further understanding.
Paraphrase - It is quite easy to misunderstand a client’s meaning. The goal in active listening is to clarify what is being said so you know you are hearing what they want you to hear. One way of doing this is to paraphrase their comments to ensure you are understanding their meaning.
Tone - Your tone of voice is an important consideration in person-centered therapy. Your tone should remain even and supportive. Large inflections may be interpreted by the client as a judgment or a lack of empathy.
Open-ended questions - When you ask a client a question you have a choice: direct them toward a certain answer or leave it open-ended. In person-centered psychotherapy, open-ended questions are superior. They are not leading, allowing the client to remain in control of their session. In addition, open-ended questions tend to elicit more information.
Affirmations - Affirmations can be both verbal and non-verbal. “I appreciate what you are telling me” is an example of a verbal affirmation. Even a small phrase like “go on” tells a client you are interested in what they have to say. A non-verbal affirmation can be something as simple as a head nod.
Is person-centered therapy effective?
One criticism of client-centered therapy is that it is vague and difficult to operationalize, therefore making it hard to adequately test its effectiveness. However, the concepts behind the theory have been more readily examined, leading to the following research conclusions:
- One of the crucial aspects of person-centered therapy is the relationship between the client and the therapist. It is a more egalitarian approach aimed at making the therapeutic relationship more cooperative rather than authoritative. Feelings of collaboration between client and therapist have been linked to improved therapeutic outcomes.
- Another pillar of the person-centered approach is the positive regard the therapist has for the client. For most of the 20th century, therapists were specifically trained to not engage interpersonally with clients. However, many aspects of therapist interpersonal involvement are related to therapy improvement. For instance, in a meta-analysis, therapist positive regard was significantly linked with positive treatment results.
- The concept of congruence is a basic tenet of client-centered therapy but has since been adapted for use in CBT. The idea of helping a client match their real self with their ideal self is very similar to a client learning to think realistically about themselves or their environment. This is especially important for those clients that may suffer from mood disorders or other difficulties that result from a poor self-image. Just as we find that realistic thinking helps clients that undergo CBT, congruence has been associated with clinical improvement in psychotherapy.
- Therapist empathy is not exclusive to person-centered therapy, but it is a hallmark of the genre. At the time of its emergence, a therapist showing empathy was groundbreaking. On the face of it, however, it makes perfect sense that therapist empathy would make a client feel better understood. Not surprisingly, therapist empathy is a moderately strong indicator of positive treatment outcomes.
Resources for person-centered therapy
Because client-centered therapy encompasses techniques that are geared more for the therapist than the client, it does not possess the activities and worksheets that you find for other therapeutic approaches. However, numerous resources still exist to educate yourself about person-centered therapy:
- You can find readings, videos, and interviews about person-centered therapy concepts on psychotherapy.net. Some of these discuss client-centered therapy in general but also how to adapt it to work with children, adolescents, and minorities. It even has resources that talk about how to use it with art therapy. You will have to pay for these resources but you can earn continuing education credits for some.
- One of the most helpful activities to learn about a particular therapy is to watch someone conducting a psychotherapy session. That is why many psychotherapy training programs use one-way mirrors and videotaping to watch particular sessions. Want to see an example of a therapist actually conducting person-centered therapy? You can find it here.
- Counseling connection has a brief yet comprehensive guide to client centered therapy. It includes its history, applications, as well as potential strengths and weaknesses.
- Although it can be difficult to find worksheets and activities involving person-centered therapy, Pinterest—as usual—has several. Most of these are educational, presenting information in an easy-to-digest manner.
- There are a few professional organizations dedicated to all things person-centered therapy. One of the most well-established is The Association for the Development of the Person-Centered Approach (ADPCA). Having contact with members of a professional organization presents a wealth of information. Further, the ADPCA has its own journal and conducts an annual professional conference.
Person-centered therapy was ahead of its time. The focus on the therapist-client relationship, including empathy and positive regard for the client, set the stage for the birth of other schools of thought (e.g., positive psychology and interpersonal psychology) and a change toward a more egalitarian therapeutic technique. It is especially useful with clients that may be hesitant to engage in psychotherapy or have highly sensitive problems. What’s more, the fundamentals of the technique are associated with improved therapeutic outcomes. So, if you are interested in the benefits of a more collaborative therapeutic relationship, then person-centered therapy may be right for you.
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