Psychology_Person_Centered_Theory

The Emergence of Person Centered Counseling: Person centered counseling emerged in a time that Psychoanalysis along with Behavioral Therapy dominated the current times. In the United States it was a time when Social concerns and people's thinking were changing. The answer was to be a more Humanistic oriented type of theory that focused more on the client (Cappuzzi & Gross, 2007). Carl Rogers was the founding father of Person Centered Counseling. In the 1940's Rogers was working with children's issues in New York. A speech that he gave at the University of Minnesota titled "New concepts in psychotherapy" in 1940 marked the beginning of a new type of Therapy (McLeod, 2009). As with other types of Therapy Theory PCT has its own unique set of principles and guide lines that make it what it is. These broadly are respect, equality, and authenticity directed towards the client. It was also coined as "Non-directed" therapy whereby the client was not directed toward any kind of specific behavior (Cherry, Unknown). The therapist would show the client "unconditional positive regard" and create an atmosphere where there was no judgment and genuineness between both therapist and client. This establishment of an intensely personal relationship would hopefully allow the client to trust the therapist thereby opening up themself and allowing for a genuine introspection and eventual change in their thoughts and behavior. It was the job of the therapist to facilitate this relationship by the actions of total genuineness and caring about the client (Rogers, 1961). The Therapist in this relationship is very much a type of guide if you will helping the client to find his way to the inner self, (self-actualization) all the while the therapist also looking within his inner self to promote the caring relationship as much as possible. (Cappuzzi & Gross, 2007) I personally would describe this as a sort of an intricate dance of emotions ebbing and flowing. It is a warm sincere approach to counseling and psychotherapy. PCT received criticism for its "non-directed approach” which will be discussed later in more detail. In 1945 Rogers became the head of the University of Chicago Counseling Center. He was also a professor of Psychology there. At this time many WWII veterans were returning home from battle with many different psychological issues. At the current time the main therapy being used was psychoanalysis which firstly was very expensive and also lacked the needed amount of trained therapists. This led to the training of counselors in Rogers Person Centered Therapy. This also marked the beginning of the era of the "counselor" in the United States (Cappuzzi & Gross, 2007). There was no shortage of critics to Rogers PCT therapy mainly due to the "non- directive" underpins of the theory. The argument was that after developing a personal relationship with the client it was impossible or unlikely not to have some sort of impact on their behavior, thereby having to be directing them in some way (Ellis, 2001). That issue of directedness or non-directedness is trivial if the closeness of the relationship had some positive impact on client behavior. Also not to mention that the" non- directed “quote was somewhat taken out of context and Rogers made statement to the fact that the "attitude" of the therapist should be non-directed (non-directed attitude) (Rogers, 1961) Differentiations of Person Centered Counseling: Person Centered Counseling as the name implies focuses the therapy on the client. It is "non-directed" meaning that direction regarding change or Behavior is not conveyed by the counselor. The key in Person Centered Therapy is establishing an authentic and unique relationship between the therapist and the client. Other theories, even those which regard the client therapist relationship as helpful do not consider it to be as important a factor as PCT. One example is REBT. This is a form of therapy that has both cognitive and behavioral aspects but does not hold the client therapist relationship as a major factor in therapy (Ellis, 2001). REBT can be quite a bit more confrontational as compared to PCT which considers the relationship with the client to be the cornerstone of the therapeutic value (Rogers, 1961). Traditional Behavioral therapy concentrates on the behavioral problem without regards to how the problem came to manifest itself. Cognitive therapy assists in getting a person to change destructive habits of thinking. "Think right, feel right ". PCT is all about allowing the person to direct the therapy how they see fit. The therapist is there to help and support authentically. PCT works on the person in their entirety. For example Psychoanalysis makes a distinction between the conscious and the unconscious. CBT (Cognitive Behavioral Therapy) makes differentiation between the thoughts and feelings. Approaches to client interaction: It is important at the outset of therapy to establish guidelines between the client and therapist as to how the therapy will be conducted. A solid foundation and understanding of what is expected of one another will help to alleviate disappointment and enable both counselor and client to focus on the task at hand. It is a good idea for the counselor to even have a written guideline that can be given to the client to lessen the chance of future misunderstandings. All scenarios of the client counselor relationship cannot be covered but a solid foundational understanding that is carefully written and explained mitigates possible problems. A good counselor must have a number of skills at his or her disposal to be effective. Here are some that I believe are quite important. * Listening Skills: This is a trait that requires practice and conscious thought. It takes work to become a good listener. A lot of what a person is saying can tell you a wealth of information about how they are feeling if you are attuned to what is actually being said. There are a lot of times underlying meanings to things that people convey in conversation. This is one of the most important skills that help to make an effective counselor. * Authenticity: This is a trait that is very important in Person centered counseling. It is important that the client feels that you are genuinely concerned for them and helps lead them to the path of self-actualization. * Professionalism: This is an area where clear boundaries are established between counselor and client. It is of the utmost importance that the counselor does not let his position as counselor lead to any inappropriate level that can harm the client or the therapeutic relationship. There are different schools of thoughts on how personal one should let the client therapist relationship get. As a rule the therapist should obey the outlines set forth by his governing body that he is a member of. In lieu of that common sense can also be used. * Respect: Show the client that you respect him or her as a person and value their input in the process. Allow them to make decisions and collaborate as to how and in which direction the therapeutic process should go. * Non Judgmental: The client should know that whatever is divulged to the counselor they will not be judged for it. In this scenario it may take time for trust building before the client feels comfortable enough to divulge certain information or feelings. In 1994 Jessie Wright and Denise Davis wrote an article describing the importance of the client therapist relationship in Cognitive Behavioral Therapy (Wright & Davis, 1994). They interviewed two dozen outpatients that were seen for a variety of mood disorders and asked about their expectations regarding therapy. In conclusion some empirical evidence of client expectations was garnered. It was found that the client therapist relationship was essential for client satisfaction and that the therapist needed to be sensitive to both general and idiosyncratic needs of the client for a good therapeutic outcome. Goals and Targets in Counseling: At the onset of counseling after hearing what is bothering the client it is imperative to understand what the client wishes the outcome of therapy to be. From that point depending on the particular problem we can establish a plan as to how to assist in this outcome. We want to help and facilitate the client to the desired outcome without giving any hard advice. We suggest possible courses of action that may be taken to obtain the desired outcome but allow the client to make the ultimate decisions on how to proceed. After identifying the problem the client is asked to imagine or ask himself questions about what he wants, and needs. He can be asked to imagine what a bright future looks like for him. Imagination for a better future can assist the client in looking past their current situation and seeing actual hope for a better more fulfilling life. After identifying what they want they are more apt to see the current problem in a better light. After realizing what is wanted and needed we can assist the client in setting realistic goals. These goals should be in line with clearing up what brought them to therapy in the first place. The goals should be challenging yet sustainable and the client should realize that this is hard work. Lastly we should assist the client in gathering enough incentive to stick with the goals and plans. After leaving the therapists office and reentering the busy day to day normalcy of life it is easy to forget about the target goals that were set forth. We should work with the client to sustain their motivation for change. This can be done by a constant reminder of the happiness and fulfillment that will come from change within themselves (Egan, 2007). Objectives of person centered counseling: The objective of person centered counseling is to guide the client to “self-actualization”. It is agreed upon that the client is the expert on their problem and the counselor takes on a role of facilitator and supporter also going on the journey with the client. The client directs the therapy and the counselor follows. While he is doing this he shows true respect, care and genuineness which in turn is felt as being very tangible to the client. The client feeling the honest non-judgmental support of the counselor feels even freer to delve within themselves and to see their problems clearer whereby working out a solution. This guides them to self-actualization (Capuzzi & Gross, 2005). Comparisons between counselling approaches to therapy: I will talk about three mainstream theories in regards to therapy. ; Psychodynamic, Behavioral (Cognitive Behavioral) and Humanistic. We will talk about all three and point out some key differences between each. Most theories in psychology have three dimensions that involve how a client thinks, feels, or acts. The most emphasis that is put on one or more of these aspects usually determines which of the approaches are being used (Capuzzi & Gross, 2005). Psychodynamic Approach: The psychodynamic approach today though having its roots in Sigmund Freud’s Psychotherapy is a bit more contemporary. The psychodynamic approach uses past experiences to explain why a client is unbalanced in the present. The Psychodynamic theory believes that the unconscious still controls parts of our behavior. It is the job of the therapist to bring out the unconscious and seek to learn of past experiences of the client that may be causing upset in the present. This is mainly done through a process called transference. Transference occurs when the client unbeknownst to them through therapy relive feelings or emotions from the past and focus them on the therapist. There is also a technique known as free writing where the client is encouraged to write whatever comes into their head which can reveal some unconscious thoughts the client may be having. CBT (Cognitive Behavioral Therapy) CBT has roots in behavioral therapy which was made widely popular by one of its main players B.F. Skinner. REBT (Rational Emotive Behavioral Therapy) a widely popular form of CBT was founded by Albert Ellis (Ellis, 2001). This form of CBT as others concentrates on the thought process of the client. Broadly the motto of CBT is “Think Right Feel Right” (Branch & Willson, 2010). In the REBT approach it is the job of the therapist to show the client the irrational thought process that is disturbing them. This even means at times being a bit confrontational in regards to therapy (Ellis, 2001). Homework can also be assigned which can assist the client in overcoming certain types of phobias. The type of homework assigned is widely dependent on the severity of the condition the client is facing. Person Centered Therapy: Person centered therapy as it implies focuses on the person as a whole. The therapist remains present in the relationship showing genuineness, empathy, and unconditional positive regard. (Rogers, 1961) This guides the client to a level of personal growth known as self-actualization. The therapist is a supporter and a facilitator however the client is in charge of the direction in which the therapy goes. The above description of theories is not meant to be complete or exhaustive as its purpose is to point out differences and similarities in the approaches to therapy which will be discussed now. The differences in theses mainstream therapies are as follows: Psychodynamic Theory relies on two main factors: It works on reliving past experience from the unconscious to bring out past problems (mainly from childhood) that are causing the client to be upset in the present. It also deals with the conflicts between the “ID” and the “ego/super ego” that are causing the client to repress hidden desires which in turn is causing turmoil in their life. CBT works on the clients thinking in the present that is causing them to be upset. It tries to get the client to think correctly and in turn they will feel better. How you think is how you feel. The psychodynamic way of thinking is that much of your behavior comes from the unconscious which you have no real knowledge or control over it. Person centered theory focuses on the client as a whole being that with help and guidance can gain personal growth and self-actualization. This in turn will automatically show the client within self how they know they need to think and behave. The “work” of getting better is directed by the client. The client is non-directed. Person centered therapy believes the individual has control over his actions and behavior and can change that behavior (Cappuzzi & Gross, 2007). Similarities between approaches: Though it seems these approaches are entirely different we can find some similarities. Both Psychodynamic and person centered theories speak of problems from childhood. PCT states that the client probably did not receive Unconditional positive regard as a child. It states that the acceptance received as a child was probably conditional based on their behavior which after a time caused incongruence in the person. Receiving unconditional positive regard from the therapist could assist in bringing them back to growth and congruence within themselves. REBT can consist of homework assignments that can assist with certain types of phobic behavior depending on the anxiety level of clients. Psychodynamic can also assign homework such as free writing exercises in attempts to bring out unknown things from the subconscious. Also REBT acknowledged the usefulness of the client therapist relationship in PCT even though Albert Ellis did not see it as essential as PCT does (Ellis, 2001). Relating different approaches to counseling contexts: Some goals of different theories as it relates to counseling objectives are as follows: Psychodynamic Theory: Seeks to bring out unconscious feelings and desires that the client is not aware of. In this theory it is believed that most behavior is derived from and shaped by early childhood relationships. The efficacy of this theory relies on the counselor’s ability to accurately interpret the transference, past relationships, and possibly dreams of the client bringing the subconscious into the conscious thereby allowing the client to then see what has been disturbing them allowing then a change. Person centered Theory: Seeks to show the client genuineness, unconditional positive regard, and a non-judgmental attitude. These attributes are said to have been missing from childhood where acceptance was conditional on behavior. This caused incongruence and manifested itself in adulthood in negative fashion. After receiving these attributes from the therapist the client is eventually able to by him or herself find answers to what is upsetting them. The therapist is there throughout as a supporting participant. CBT (Cognitive Behavioral Therapy): Seeks for the most part to show the client how their mal-adaptive thinking patterns are causing them distress. This type of therapy emphasizes that the way that we think causes the distress in our lives. Therefore exercises and dialogue are undertaken that enhance a better way of thinking about current problems. A behavioral aspect is also present as in CBT negative thoughts beget negative actions. A client can be assigned homework or activities regarding behavior to help them cope with their mal adaptive issues. An example of this could be having a client don an outrageous outfit and ride the train for four stops. An exercise like this would show the client that this type of activity would not be nearly as bad as they would think it would be in their mind. These types of activities would of course be based on the degree of anxiety that the client has regarding their phobia (Wright & Davis, 1994). Constructive Theory: This is theory that states that an individual’s mal adaptive view of their reality is what is causing their upset. Through dialogue and collaboration with the therapist a plan is made to reshape the client’s reality. This theory relies on the power of language, information processing, and cybernetics (The science of communication and automatic control systems) in bringing about behavioral change. Adaptation of theories and concepts: A mistake that one could make as a counselor is having one set approach to counseling without being flexible enough to effectively meet the needs of the client. There are some Clinical Psychologists or perhaps even counselors who do advertise and subscribe to one theory. For example: Psychodynamic, REBT, Person Centered Theory just to name a few. Within some of these theories there are even spinoffs and it can at times get a bit confusing. As a counselor it is important to have a solid foundational knowledge about theories however a counselor must be flexible enough to be able to meet the needs of the client. A good example of a theory that has undergone major changes is Psychoanalysis. It no longer has its ideas embedded in infantile sexuality but retains the thought of inner turmoil stemming from usually early childhood relationships gone wrong. It also relies on transference which was an original idea from Sigmund Freud’s theory. Another major change is the therapist’s attitude toward the client. It is a much warmer relationship than the “blank screen theory” which has the therapist being an emotionless blank screen for transference (Egan, 2007). Straight behavioral therapy though possibly still practiced by some has been changed and revamped into Cognitive Behavioral Therapy. Along with behavioral techniques the client works on their thought process and thinking to enhance a better outcome from therapy. It’s a two pronged approach and is a preferred theory for many therapists. It is interesting to note that Person Centered Therapy made popular by Carl Rogers has some underpinnings is Psychoanalysis. Rogers believed that the incongruence that occurred in clients stemmed from not receiving the unconditional positive regard as a child. To sum it all up there have been some studies done regarding the Efficacy of different theories and psychotherapy itself. The actual studies show that the Efficacy of actual Psychotherapy had very little to do with the theory that was being used with the client (Smith, Glass, & Miller, 1980). Other factors such as “Common Therapeutic Factors” ranked highest as the factor that produced the most success from therapy. Therapeutic factors were described as: Client motivation, degree of client disturbance, motivation, client’s ability to relate to others, strength of ego, psychological mindedness, ability to identify a single problem to work on in counseling, and sources of help and support in the client’s environment. Second on the list was client therapist relationship. Coming in last was theory used in therapy (Lambert, 1992). So what does this tell us' Do we abandon theory' Theory gives us guidance and knowledge and is a platform and foundation that we can always to refer to. Instead we should be more flexible and possibly adopt an eclectic stance regarding theory taking what works best for us and the client and fine tuning as we go along, all the while maintaining our pre agreed upon goals and boundaries set forth at the outset of the therapy. Works Cited Branch, R., & Willson, R. (2010). Cognitive Behavioural Therapy For Dummies. West Sussex: John Wiley & Sons Ltd. Cappuzzi, D., & Gross, D. (2007). Couseling and Psychotherapy Theories and Interventions. New Jersey: Pearson Education. Capuzzi, D., & Gross, D. R. (2005). Introduction to the Counseling Profession. Boston: Pearson Education Inc. Cherry, K. (Unknown). Client-Centered Therapy. Retrieved June 7, 2012, from About.com Psychology: http://psychology.about.com/od/typesofpsychotherapy/a/client-centered-therapy.htm Egan, G. (2007). The Skilled Helper. Belmont: Thompson Brooks/Cole. Ellis, A. P. (2001). Overcoming Destructive Beliefs, Feelings, and Behaviors: New Directions for Rational Emotive Behavior Therapy. New York: Prometheus Books. Lambert, M. (1992). Implications of outcome research for psychotherapy integration. In J. Norcross, & Goldstein, Handbook of Psychotherapy integration (pp. 94-129). New York: Basic Books. McLeod, J. (2009). An Introduction to Counselling. Berkshire: Open University Press. Rogers, C. P. (1961). On Becoming a Person. United Kingdom: Constable & Compamy Ltd. Smith, M., Glass, G., & Miller, T. (1980). The benefits of psychotherapy. Baltimore: John Hopkins University Press. Wright, J., & Davis, D. (1994). The therapeutic relationship in Cognitive Behavioural Therapy. Patients perceptions and therapist responses.