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Cognitive Behavioral Therapy

5 Distinctive Characteristics of Person-Centered Therapy

"This type of therapy is not a preparation for change; it is change."

There is a great deal of confusion today about "person-centered therapy." Today, the term "person-centered" is ubiquitous and largely assumed to be a mere foundational principle on which to construct a clinical methodology, rather than a radical therapeutic ethic.

Carl Rogers, the once-great torchbearer of a new, more humanistic psychological treatment, clarified early on a few of the important distinctions setting person-centered therapies apart from many other psychotherapies, distinctions which have, by and large, persisted for nearly a century.

1. A goal of psychological integration.

Rogers clarified that person-centered therapy "Aims directly toward the greater independence and integration of the individual rather than hoping that such results will accrue if the counselor assists in solving the problem.”

kevin turcios/Unsplash
Source: kevin turcios/Unsplash

It’s not enough to help people change. The goal is to turn clients into their own therapists. Person-centered therapies help clients move from being out of touch with emotions and more rigidly organized to being increasingly open, fluid, and flexible, which Rogers called “being in process.”

In 1942, Rogers wrote, "The individual and not the problem is the focus. The aim is not to solve one particular problem, but to assist the individual to grow [to] cope with the present problem and with later problems in a better-integrated fashion...more independent, more responsible, less confused, better-organized ways."

2. Emphasis on emotions.

Even Don Meichenbaum (2017), one of the pioneers of cognitive behavioral therapy, said, “People don’t have pathology because of distorted thoughts. That is a simplistic and inaccurate understanding of human functioning.” Emotions are at least as great a marker of health as thoughts. Therapeutically, emotions may be more pliable and consequential in initiating transformative change.

Rogers (1942), also wrote on emotion: "Knowledge is ineffective because it is blocked by the emotional satisfactions which the individual achieves through his present maladjustments. The boy who steals knows that it is wrong and inadvisable. The parent who nags and condemns and rejects knows that such behavior is unfortunate in other parents. The student who cuts class is intellectually aware of the reasons against doing so. The student who gets low grades in spite of good ability frequently fails because of the emotional satisfactions of one sort and another which that failure brings to him."

Still, emoting, thinking, feeling, and behaving are not discrete. We are complexly woven beings. Increasing awareness of any aspect of our patterns of living provides opportunities to intervene upon near-automatic chain links of emoting, thinking, feeling, and behaving. Are emotions any more fundamental or responsible or important? No. Yet person-centered therapies theorize that emotions are a therapeutic key.

3. Concerned with a whole, complex person.

Person-centered therapies are not only focused on emotion but on what a person does with their emotions. Therapeutic engagement must focus on cycles if it is to clarify the human ecology—“You did what? And then you felt what? And then you thought what? And then you did what?”

Priscilla Du Preez/Unsplash
Source: Priscilla Du Preez/Unsplash

Life's web of feedback loops is sufficiently complex to confound linear causality. Thinking affects perception, states of mind affect thinking, emotional experiences affect thinking, and behavior influences emotional experiences and thoughts.

Rogers believed that favorable conditions promote healthy growth and told of how, when he was a boy, a basement bin of potatoes several feet below a small window would grow pale white sprouts so unlike the healthy green shoots sent up when planted in the soil in spring. This story highlighted the tendency of living things toward growth, whatever the conditions.

4. Focus in the here and now.

There is almost never a need to ask “why” questions or engage in comprehensive history-taking.

Rogers wrote, "The significant emotional patterns of the individual, those which serve a purpose in his psychological economy, those which he needs to consider seriously, show up just as well in his present adjustment, and even in the counseling hour, as they do in his past history. For purposes of research, for understanding of the genetics of human behavior, past history is very important. For therapy to take place, it is not necessarily important."

5. Therapeutic relationship as healing.

The therapeutic relationship is the fundamental stuff of therapy. Therapeutic alliance is the most important aspect of therapeutic relationship. This alliance includes not only the affective bond but mutual trust, which hinges on genuine care. Therapists must be genuinely curious if alliance is to form and the relationship is to become healing.

Priscilla Du Preez/Unsplash
Source: Priscilla Du Preez/Unsplash

Rogers wrote, "The therapeutic contact is itself a growth experience. Here the individual learns to understand himself, to make significant independent choices, to relate successfully to another person in a more adult fashion... This type of therapy is not a preparation for change, it is change."

This was Rogers' vision in the early 1940's at The Ohio State University. After that, things evolved. He led groundbreaking therapy research at the University of Chicago and formulated "six conditions that bring about client change" (1957). He described a process in which clients move from being more out of touch with their emotions and more rigidly organized to being increasingly open and flexible, the "being in process."

Anne Nygård/Unsplash
Source: Anne Nygård/Unsplash

And then the person-centered school, so to speak, split in the early 1960s. Carl Rogers left academia, went to California, got involved in the Encounter Group Movement, and stopped doing research. Some who had worked with him in Ohio and Chicago stayed back with the original formulation—empathy, genuineness, and congruence. They have become what we call today the "classical" or "relational" person-centered therapists.

Others dug deeper into helping clients be more open to their emotions and new experiences. They became "experiential" therapists—like Eugene Gendlin, who developed "focusing," helping clients look into their body to understand where and how they feel; another group—Les Greenberg, Laura Rice, and Robert Elliott—developed the "process-experiential" approach, known to most now as "emotion-focused therapy." Bill Miller and Stephen Rollnick were significantly influenced by Rogers in developing "motivational interviewing." Even well beyond person-centered and experiential therapies, it would be short-sighted to underestimate Rogers' influence.

References

Meichenbaum, D. (2017, December 15). Why some psychotherapists are more effective [Conference presentation]. The Evolution of Psychotherapy 2017, Anaheim, CA, United States.

Rogers, C. R. (1942). Counseling and psychotherapy: Newer concepts in practice. Cambridge, MA: The Riverside Press.

Rogers, C. R. (1957). The necessary and sufficient conditions of therapeutic personality change. Journal of Consulting Psychology, Vol. 21, pp. 95-103.

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