“Evaluate the claim that Person Centred Therapy offers the therapist all that he/she will need to treat clients”. Word Count 2,508 During this essay I will present my findings as I view them. I am relatively new to counselling, this hinders my current experience and limits my opinions about therapy and what methodologies are more or less effective when offering therapy to clients.
So, based on text book theories (only at this stage), I will present my findings about client centered therapy and incorporate a number of different methodologies that have assisted me to decipher the answer to this core question, and understanding how affective client centered therapy is as an approach. The research is informative and thought provoking. It certainly raises questions of how clients were viewed and treated in the past, right into the here and now. My task is to explore the above title, possibly uncovering a rather more complex theory than one may first assume.
Initially I explored the world of psychotherapy to provide me with an insight and greater understanding on this subject, also identify the influences and changes that has occurred in a relatively short space of time in this developing area of psychology. As stated by Saunders (2002: pg 14). “From centuries-old ancient philosophies and cultures, through to current ideas in our own white European culture. A summary of the more recent landmarks would go back around 100 years to the work of Sigmund Freud”.
Freud was a physician and the creator of many theories, primarily focussed on psychoanalysis. His work was from clinically derived experiences that were based on feedback from his patients during therapy. This gave birth to the ‘psychodynamic approach’ which stemmed from Freud’s collection of theories. Freud and his colleagues were psychologists who were treating their patients for depression or anxiety related disorders. Although shunned by the medical profession until later in his career, Freud continued to shape and mould psychology as it is recognised today.
Highly influential and extremely passionate professional men introduced their approaches into delivering the different theories/techniques, all of which have influenced and set the tone for the philosophy of psychology today. Definition of psychology, this was derived from the Latin it’s described in two parts, 1. “Psyche” meaning: Breathe, Sprit, Soul. 2. “Ology” meaning: Study of the mind. (Modern Latin, (Oxford dictionary 2000: pg, 652). Psychology emerged from Biology and philosophy, today it is closely linked with other disciplines including sociology, medicine, linguistics and anthropology.
My main focus for study is Carl Rogers’s 1902-1987 (Rogerian approach). Counselling has emerged into a sophisticated therapy, thanks to Rogers’s intention to move towards supporting the client with a non-judgemental, kind and empathetic approach. Rogers developed his theories and debated about the vital skills required when a therapist engages with the client. Rogers not only theorised on mental illness he was also highly influential when developing other areas of therapies which I will explain further on.
Rogers was resolute in his beliefs that the client’s success was based purely on his six core elements all blended together for an effective outcome. As the founder of client centered therapy Rogers was passionate about his ideas. The methodology he used was from a humanistic view and his techniques have made a huge impact into a world of psychology and psychotherapy. In 1942 the term ‘Non-Directive Therapy’ was born but changed nine years later by Rogers who preferred to use the term Client Centered Therapy.
Other leading psychotherapy approaches were introduced from Albert Ellis (1913-2007), an American psychologist who instigated the ‘Cognitive approach’ known as Rational Emotional Behaviour Therapy (REBT) that theorised that as people our thoughts control and depict our feelings it’s a directive therapy that is solution based. Whereas, Gerard Egan, founder of the ‘Integrative approaches’, claims to use whatever technique is appropriate according to the clients issues and is described as ‘middle of the road’ school of thought.
From the beginning it was Rogers’s intention to provide a radical alternative to the then current “psychodynamic and behavioural” approaches. Psychotherapy was a vast unexplored area that was waiting for a new and different alternative which Rogers’s brought about. Psychiatrists are first and foremost medical practitioners who work from an established ‘Medical Model of Mental Illness’ Used by psychiatrists and mental health professionals to describe the full range of human psychological distress and disturbances. and according to Saunders ‘no more than a system of naming things (e. g. the term ‘neurosis’, [Literally meaning an infection of the nerves] is just a list of symptoms it actually explains nothing)”pg106. This was a long established method used when applying a treatment plan in which there was limited flexibility and had deep rooted entrenched guidelines. During the 1960’s Rogers began to use the principles of his approach into other areas such as education, management, group work and resolving conflict.
Many years ago all treatments/ therapies were all encased under one label ‘medical treatment’ and in the early years psychotherapy would only be carried out in a ‘clinical environment’ where people were classified as ‘patients’ that need treatment to cure their illness. Counselling on the other hand can be viewed as both medical and educational. Rogers had to use the term ‘counselling’ as a requirement enforced by the American medical profession. The term counselling is deemed suitable to use ‘if not causing medical disturbances but only deep issues in the mind’ (Saunders, (2002) pg107).
Rogers conscientiously and gradually over time merged counselling/psychotherapy cohesively together. It is now virtually impossible to distinguish the differences between the two. The purpose of client centered therapy is to encourage the client to bring about their own self-awareness of their feelings. It is a nurturing process that functions without the counsellor/therapist suggesting or advising how to bring about change. It is not a solution based therapy. The therapist’s role when delivering this approach is to offer a safe and relaxed environment, where the atmosphere creates an aura of empathy, acceptance and no judgements.
As stated by (Saunders 2006) “The unconditional positive regard element of this condition is not the same as ‘liking’ or ‘being nice to’ the client” pg 60. UPR is practised in client centered therapy no matter what the client chooses to disclose. This is achieved by the therapist reflecting and paraphrasing back to the client their inner feelings. The process will encourage positive feelings to facilitate in lifting the clients inner-self in this safe non-threatening environment. The aim is to encourage negativity to rise and bring about self-awareness for the client to explore their reasons for being in treatment.
Carl Rogers assumed that all human beings, if given the right opportunity, are basically good and will strive towards goodness as their main goal. Secondly that the client’s experiences are unique only to themselves, and finally he felt that the client’s internal instincts would guide them into reaching their full potential resulting in self-actualization thus, creating self-healing as a ‘fully functioning individual’. Rogers states in his actualizing theory that “all human beings are drawn towards their natural tendency’, as we are more than just growth and survival”.
Individuals need to understand their value and growth. All humanistic psychologists are focused on the person as a whole, where as the cognitive approach identifies ‘parts of the being’. Cognitive and behavioural approaches focus on irrational beliefs, effect feelings and are responsible for creating the behaviour. Rogers specified that we are instinctive ‘organismic’ individuals with the capacity of self-healing that involves psychological healing. Due to one’s self-doubt and an ingrained belief system (an instilled program since childhood) instils these self-defeating ideas into our psyche.
Thus, creating a belief system of feeling scrutinized and judged. Person centered psychology is more interested in the clients own perception of their distress. We feel as individuals that our own beliefs are accurate and fail to recognize that these thought processes were planted by others (our primary carers and peers), through incidents and learnt behaviour. Client centered therapy is collaborative, it’s a guide to facilitate the client to seek out their own self-realization, which for some will be viewed as an advantage, it offers a free range approach to explore inner feelings, for both therapist and client.
Client centered therapy encourages growth and its aim is in convert immaturity into maturity, this is vital for progress and healing. Rogers approach when implemented correctly should bring about activating the self-healing process he believes is found in each one of us as. Another well-known figure is Maslow who designed ‘A model’ shaped as a pyramid called the ‘Hierarchy of needs’ ‘Humanistic approach’ this is used in many areas of therapy including education and training in the work place.
When Maslow’s basic core conditions are applied in a respectful, non-threatening manner they enable the client to direct the process of their phronesis (through their wisdom). Maslow’s theory consists of a five-step process, starting from the bottom and only raising to the next level by attaining that level of needs. Starting from a person’s basic physiological human need of survival require water, food and shelter. Stepping up again to the next level will accommodate the person’s requirement of personal safety and protection from danger and the emotional need for security.
Raising again up to the third level it covers a person’s social needs that involve the need for acceptance by peers and friendship. Level four covers the need for self-respect and self-esteem. A person requires the emotional need for status and self-confidence, finally reaching the tip of the pyramid, is the need to reach and realise one’s own potential of self-actualisation. As stated in the chrysalis work book (module one: pg9), “Maslow believed that everyone is born with the potential to self-actualise and that, given a good environment, this can be achieved”.
He classified this as reaching a ‘peak experience’ which can be experiencing joy and unimaginable happiness. Rogers stressed the importance of his “six key conditions being both “Necessary and Sufficient” for therapeutic change to take place” as quoted by Saunders, P. (2006:9). The therapist and client have to have a genuine relationship based on a two way psychological connection. Rogers felt that if the client felt the slightest hint that this was not the case the counselling would be flawed from the onset. The client feels vulnerable and anxious and views themselves as needing assistance.
The therapist needs to be balanced and healthy minded about their own residing issues and have dealt with their own issues during their training. As Rogers’s states, it is vital that the therapist “can accurately be himself in the relationship”. A fundamental requirement of Client centered therapy specifies that the therapist actually feels a genuine regard towards the client. Rogers terms this as an ‘unconditional positive regard’ (UPR) an empathetic approach. The therapist needs to be authentic, transparent and a willingness to be open with self-disclosure.
Rogers specifies that the client must be completely listened to without any interruption from the therapist, who should demonstrate that they have fully understood with a genuine regard to support the client. To support the number of approaches, Chrysalis designed ‘A Model’ (TIME) an acronym Temporal, Interventional, Multi- model, Empathy. This effective tool offers guidance when selecting an appropriate approach to be practiced accordingly with the formatted structure as a set of rules in which to be guided by. This is a profoundly simple tool that has been designed as a multi-model (it fits all).
The TIME model’s function is to mix and match the client’s issue/s, personality and suitability by selecting the appropriate treatment plan. Temporal meaning time, Interventional involves using other holistic therapies to run alongside these approached , which may assist with the cognitive side of the person for example using hypnotherapy by communicating with the subconscious, where positive suggestions and affirmations may be placed to replace the negative beliefs that are blocking/hindering progress. The client may relax enough to allow their own phronesis (practical instinctive wisdom) to appear.
Multi Model is combining or selecting the different approaches from a variety of therapeutic sources. Chrysalis encourages the therapist to explore all approaches and form a comprehensive treatment plan that is tailored to an individual. The last area to discuss is empathy, all therapy is empathetic, and it would be impossible to implement without it. As suggested in Saunders primer (2006) “… being empathetic is to perceive the internal frame of reference of another with accuracy, and with the emotional components and meanings…”pg 66.
Empathy and communication is therefore essential. Disadvantages for some clients, if offering client centered therapy could be bring about discontentment, as it involves a long duration of time, (from the client’s perspective) they may not wish to attend numerous sessions, they may be unable to remain focused, affecting their motivation and stop attending. Client centered therapy may place too much pressure on the client if they themselves require direction and solutions to their predicament. Results are hard to gage thus, questioning its impact as a structured ystem. Client centered therapy may be seen as far too simple and the whole approach could be misunderstood thus, affecting its effectiveness. I like the feel of client centred therapy, for me it offers a kind, gentle and dignified treatment. The client may develop from this approach, however I can only surmise that as client centered therapy permits self-exploration, holistically healing the individual; it will not be suitable for all clients, as the question suggests but it is certainly suitable for dealing with the here and now and promotes self development.
These modern times have seen a shift in emphasis with the medical approaches. The public are open to embrace different holistic therapies. Today the opportunities for people to try out new ideas and concepts are more readily available than ever before. Psychotherapy and counselling has flourished into a general acceptance. Some General practitioners promote counselling as a way forward rather than the patients only being offered powerful invasive drugs viewed with caution and some considered as highly addictive and not addressing the root of the client’s issue/s.
I am in no doubt that through time and as this course progresses my perspective will change for the better. I have already started to question how I converse with people on a one to one level. Questioning my ability to actually actively listen and observe my approach towards empathy & being non-judgemental. Feedback in class and group work will further contribute to these interpersonal skills in order to become a competent therapist.
How I can/will deal with total honesty towards a client, under whatever circumstances, regardless of the client’s issue/s are certainly challenging tasks ahead of me. I am looking forward to practising the models and theories available. I understand that not every model or approach is suitable to every client and experience will help in my development for the good of the client. I am appreciative and thrilled to be living in today’s times, where opportunity and options are the norm for the majority of people.
Today as a culture we not only require change but we encourage progress in the holistic world of therapies. REFERENCES: Rogers, C. (1951). Client Centered Therapy. UK: Constable & Robinson Ltd publisher. Sanders, P. (2002). First Steps in Counselling. A Students’ companion for basic introductory courses Third edition, UK: Ross-on-Wye, Saunders, P. Franklin, A. Wilkins, P. (2009). Next Steps in Counselling Practise. Second edition, UK: Ross-on-Wye, PCCS Books. Saunders, P (2006). The Person-Centered Counselling Primer. UK: Ross-on-Wye, PCCS Books.