Person-Centered Therapy - Essay Example

Running Head: Counseling Theory Counseling Theory of Word Count= 3709 Counseling Theory Introduction Counseling refers to a broad based theoretical and practical approach in which psychological concepts are used to help individuals suffering from dilemmas. Therapy involves resolving the crisis which individuals face as the objective is usually problem resolution. Communication between the therapist and patient is vital for the success of counseling. It helps to ensure that the therapist have complete knowledge of the problem and can advocate solutions which are appropriate. Strategy in counseling involves examining the primary source of problems which created the crisis in the patients. This paper studies the theories and foundations of person centered therapy, cognitive behavior therapy and psychodynamic therapy. Finally the paper compares and contrasts all therapies. Person centered therapy focuses on ensuring that the client has more decision making ability to resolve his or her problems. Person Centered Therapy The person centered approach therapy has been derived from the conception of humanistic psychology which considers the patients capable and independent with the capacity to solve their problems, realize their potential and change their lives in positive ways. Person Centered Therapy also known as Client Centered Therapy was the idea of a psychologist Carl Rogers during the 1940s (Rogers 23, 1961). The necessary rudiments of Roger’s new approach towards therapy were to achieve personal relations with the patient in order to assist his or to attain the state of consciousness which they can help themselves (Rogers 33, 1980). He did this by approaching the patient in the direction of progression, focusing on the present situation rather than the past. Rogers said that “Organisms by the process of evolution have developed senses which allow us to differentiate between good and bad tastes” (Pg 34, 1980). Another famous psychologist who pioneered the person centered therapy was Abraham Maslow. His theories referred to the relationships between therapist and clients. He also wrote extensively about the relationships which people have with each other. Maslow also contributed to the humanist principles in psychology by creating the hierarchy of needs. Several needs were arranged in a hierarchy according to their abilities. PCT is established on the principle of talking therapy (Bruno 362, 1977). The therapist job is to support the patient and making them express their feelings and listening to what they reveal which will be helpful for the patient to explore and understand their feelings for themselves. According to Bruno, “Therapists using PCT can share several of their emotional processes with the client”(Pg 362, 1977). Although, this approach has been disapproved of by many for its lack of systematic approach, it has confirmed to be immensely successful and popular treatment. Psychologists and counsellors are now using PCT for a variety of social and mental disorders in patients (Barrett 45, 1997). Barett further states that “PCT can be used effectively as compared with other therapies” (Pg 46, 1997). Rogers held the belief that the most important factor that can influence the therapy was not therapist skill or experience but his or her attitude. There are three attitudes which are dependent on the therapist and must be met in order to succeed in person centered therapy: congruence, unconditional positive regard and empathy. Congruence is related to the therapist honesty and sincerity; the motivation to relate to the clients without hiding behind the professional pretense (Barrineau 14, 1996). Barrineau states that “Congruence can help open up the clients as they do not have to fear about the attitude of the therapist” (Pg 15, 1996). Therapists working like this have their feelings available in therapy sessions. They also share expressive reactions with their patients. However, congruence does not mean that therapist themselves reveal their own personal problems to their patients in therapy sessions or shift the concentration of the therapy on themselves rather than working with the patients (Barth 19, 1994). Barth says that “Congruence is one of the important principles of PCT” (Pg 19, 1994). Unconditional positive regard is related to therapist acceptance to the client totally for someone without critical judgment. The therapist has the ability to communicate with this attitude to the client with motivation and eagerness to pay attention without any interruption, judgment or advice. This helps in establishing non threatening context in which the patient feels free to search and share negative feelings without the fear of personal negative response by the therapist. The third important component is empathy. It is the obligation of the therapist to appreciate the patient’s situation from the client’s outlook, presenting a touching understanding and compassion to the client throughout the therapy. The major way of delivering empathy is by demonstrating excellent listening skills (Bozarth 23, 1997). Bozart says “Therapists with listening skills have more chances of gaining the confidence of the clients” (Pg 23, 1997). Self actualization is an important component of person centered therapy as it enlightens the person about how to transform his or her dreams into reality. It creates an awareness by which they enjoy better social relations. Human beings who have a higher concept of self actualization tend to care about others in positive and constructive ways. Carl Rogers explained that negative attitudes can act as hurdles for self actualization. Another concept of PCT is that conditions of worth influence the judgement of an individual. Conditions of worth can include important messages which a person receives from the people which are around a person’s life (Bozarth 33, 1997). Bozart says “Parents and colleagues influence the environment of a human being” (Pg 33, 1997). Self image is affected by the positive or negative conditions of worth which are imposed on a person. A low self image usually refers to the conditions of worth forced on an individual. Another principle of PCT is organismic value in which the experiences of human beings are enhanced according to the organism (Bozarth 36, 1997). Bozart states that “Experience plays an important role in enhancing the self image of an organism” (Pg 36, 1997). Experiences are shaped by the organism according to the requirements and perceptions. Those experiences which do not confirm to the requirements and perceptions of the organism are distorted or denied by the human being. Another concept of PCT is the locus of evaluation in which the individual human being lives a world where experiences change daily (Bozarth 38, 1997). The human being reacts according to the conditions and behaviors which are present around him or her. Emotions lead to the direction of goals in human beings as they are understood from their frame of reference. The aims and objectives of person centered therapy are; to assist the patient’s trust and ability to be in the existing situation which helps the client to be more honest without evaluation, to make the client aware of self-worth and confidence, to encourage the client to change, to help them manage their lives (Braaten 67, 1994). Braaten states that “PCT creates confidence and self worth in the patient as compared with other therapies” (Pg 67, 1994). The expected results of person centered therapy are improvement in the self esteem; the client learns to trust his or her inner feelings and experiences as precious sources of knowledge for making decisions; improved capability to learn from past mistakes; decrease in negative feelings such as serving to protect, culpability, shame, insecurity, more positive and comfortable relations with others and willing to think in positive way. Results have shown that person centered therapy assists people to maintain these positive changes over long period of time as compared to those who have treated with other types of therapy (Braaten 87, 1996). This therapy appears to be effective to patients who are in severe depression or are in troubled relationship. However, the person centered therapy does not challenge the clients. It is not useful in psychopathology (Braaten 101, 1996). Braaten says that “PCT can be limited by its unrealistic perceptions of the world” (Pg 101, 1996). CBT During the 1950s and 1960s Albert Ellis and Aaron T developed Cognitive Behavioral Therapy. However, the recent expansion in this field has witnessed the combination of cognitive and behavioral methods to make the cognitive behavioral treatment effective. Emotions play a vital role in this therapy. CBT therapists believe that emotion is the primary function that determines the patient’s feelings and behavior. The therapist is responsible for discarding these negative thoughts and substitutes them with sensible, pragmatic thoughts. The combination of wide range of methods such as relaxation, cognitive reformation, and problem resolution and stress inoculation can be applied in cognitive behavioral therapy (Beck 474, 2005). Beck states “CBT aims to resolve problems by examining the behaviors of patients” (Pg 474, 2005). The aim and objectives of CBT is the regulation of anger through the comprehending and examining of individual aggression, rage patterns and the achievement of skills. CBT has been useful in assisting the patients to control their anger. Research found in a demonstration study of 64 patients, assessed the efficiency of controlling the anger by using anger management therapy that concentrated on cognitive behavioral approach (McGinn 24, 2001). McGinn says that “CBT has been found to be useful in treating anger management” (Pg 24, 2001). The evaluation revealed that a considerable decrease in the participants total experience of intense aggression and significant recovery in cognitive behavioral handling and anger management. Cognitive behavioral therapy was also used in another study in which 55 high anger drivers were subjected to relaxation training (Miller 34, 1999). Miller further states that “CBT helps to calm the behaviors which are associated with anger” (Pg 35, 1999). The outcome of the study was there was significantly lesser risk seeking behaviors. In addition, their positive reactions were also higher. However, it should be kept in mind that CBT is not an instantaneous procedure. The Cognitive methods of psychotherapy have been verified to be one of the most productive and well-organized procedure for a wide range of behavioral problems. In cognitive behavior therapy, the psychotherapist is in direct contact with the patient in order to identify and assess the behavioral problems. The major focus of this method is towards the conflict concerning the association between feelings, thoughts, emotions and outlook. Therapists must ensure that they have adequate knowledge of the patient’s behavior. As soon as this understanding is established, the therapist is successful in the identification of limitless therapy strategies and objectives which are continuously evaluated and examined. Cognitive Psychotherapists work with individuals, families and groups (Egger 1, 2003). Egger says that “CBT therapists can work in single and group settings” (Pg 1, 2003). CBT is concerned with the thought processes of the human beings which are considered as vital for resolving any mental or social disorders in patients. Cognitive Behavioral psychotherapists have the opinion that thoughts are the major factor that directs individual actions and emotions. The most important consideration in Cognitive Behavioral Therapy is the amount of time that will be utilized in the treatment. There are various factors that affect the length of the treatment. The existing state of mind of the patient at the commencement of therapy, the personality of the patient, the affect of the problem on the patient’s social life, the capability of the patient to work and daily performance and the outlook to the therapy are included in the factors that influence the time period of the treatment. Finally CBT is implemented by recognizing the various phases of therapy (Hazell 578, 2003). Hazell says that “By working in phases, CBT ensures better resolution of specific problems” (Pg 578, 2003). When patient experience psychological problems such as aggression, depression, anxiety, they become target of demoralization. Demoralization is responsible for affecting the person’s ability to work properly and also stops him or her from responding to the problem as it should be. The second stage of the therapy revolves around the diversion of the patient’s concentration towards the symptoms of the crisis. Rehabilitation is the stage which focuses to replace the negative feelings of the patient with the help of positive constructive thoughts (Weisz 62, 2001). Weisz says that “Rehabilitation provides an environment where negative feelings can be countered” (Pg 62, 2001). Therapists are responsible for teaching the patients to implement new and progressive methods to manage hard situations such as problematical relations, unfriendly work environment, etc. Psychodynamic theory Psychodynamic theory studies about human behavior in the light of psychology. It studies the links between the functional parts of the body and the conscious. It aims to provide a study of the various parts of the mind and psyche which are influenced by mental and emotional forces. Sigmund Freud was the pioneer of psychodynamics as he referred to the emotional changes which a human being experiences. Currently the therapy focuses on the specific responses of the mind and body towards images, textures and sounds (Alonso, 2006). Alonso also states that “Psychodynamic therapy can help resolve several mental problems” (Pg 23, 2006). It studies the mind and body states by examining the physiological responses. Psychodynamic therapy consists of transference in which the patient transfers his or her emotional thoughts, sensibilities, attention and tactics which are used to protect the human being from danger to the therapist. Transference assists patients in helping to resist conflicts and opposition from mutually exclusive desires or tendencies. The client becomes aware of the feelings and behaviors which are present inside the conscious into current relationships. The patient by the process of transference uses responsive mechanisms to counter any negative emotional behavior by focusing on current relationships. Another aspect of psychodynamic therapy is that of counter transference in which the therapist uses involuntary and voluntary behavior, thoughts and feelings towards the patient. This is beneficial for the therapist as it enables him or her to understand the feelings, thoughts and behavior of the client. The therapist aims to deeply inspect the patient’s problem by observing the emotional state of the patient. He or she also desires to perceive the extent of pain present in the patient and the tolerance level of the patient. Interpretations by the therapist are used to create a sense of self awareness in the patient. Rutan says that “psychodynamic therapy is a part of psychoanalysis which observes the defense mechanisms that are present in human beings” (Pg 34, 2007). Defense mechanisms might be negative or positive depending on the personality of the individual or their usage. These mechanisms help human beings cope with loss, grief, anger, stress and internal conflicts. They assist the individual to respond to the problems of the world. Rutan says that “common defensive mechanisms can include denial which is the refusal to accept a harsh reality” (Pg 45, 2008). Another form of defensive mechanism is that of rationalization in which the mind justifies any action by hiding the real motives. Rutan says that “reaction formation is a defensive mechanism which converts negative impulses into an impulse which is acceptable by the standards of society” (Pg 87, 2008). Person Centered v. Cognitive Behavioral Therapy Person centered therapy has been derived from the theory of humanistic psychology that concentrates on the skill of the patient to work out their crisis, realize their ability and bring changes in their lives in a constructive way. Carl Rogers focused on the humanistic perception and maintaining beneficial relations with the patients to promote self confidence, realism and actualization in their life (Brems 45, 1994). Brem says that “Humanistic principles were introduced by Carl Rogers in psychology” (Pg 45, 1994). Cognitive Behavioral Therapy is based on the conception that concentrates on the skill of the therapist to detect the illogical, negative thoughts of the patient that result in unnecessary negative emotions and disposing these thoughts, restoring sensible, positive thoughts. Albert Ellis concentrated on discovering the negative thoughts of his patients and then replacing them with positive ones (Corey 21, 2001). Corey says that “CBT focuses on positive behavior as helping counter undesirable behavior” (Pg 21, 2001). Initially, the person centered approach was concentrated on the patient being in control of the therapy which guided the patient to build up a better understanding of self, self exploration and enhanced self concepts. At present, the person centered approach concentrates on the patient to establish a good understanding of the self in the settings that allows him or her to solve his or her own problems without the direct involvement of the therapist. However, in Cognitive Behavioral Therapy, the therapist directly deals with the patient in order to detect and evaluate the behavioral crisis faced by him or her. The main emphasis of this method is towards the clash in connection with the relation between thoughts, opinion, and way of thinking, sentiments, feelings and attitude (Back 664, 2007). The therapist is reliant on the patient for the patient’s behavioral crisis. As soon as this understanding is successfully established, the therapist can without any difficulty discover boundless therapy strategies and goals which are constantly evaluated and investigated. Cognitive therapists work with individual patients, families and in groups. There are about six conditions in order to succeed in person centered therapy. These conditions include the relation between the client and the therapist, the present state of mind of the client, the therapist concern regarding the patient and the problem, unconditional positive regard, compassionate understanding, good communication between the therapist and the patient (Brems 45, 1994). Brem says that “PCT creates a better mode of communications between the therapist and client” (Pg 45, 1994). The relation between the client and the therapist must be of trust and where the therapist supports him or her in expressing their feelings and emotions. The therapist has to be sincere with the client and has to understand them as they reveal to them what they see from their point of view. The core concept of CBT on the other hand is to assist the patients to recognize and evaluate disrupting cognitions which assists them to challenge and alter feelings, thoughts and behaviors related to extremely distressing experiences (Baker 367, 2005). Baker says that “CBT involves countering depressing experiences” (Pg 367, 2005). Other CBT constituents include educating the patients about post traumatic stress disorder, exposing them to distressing material and challenging and changing their negative thoughts. Person centered therapy was developed by Carl Rogers which was not intended for any particular age group. Person centered therapy can be applied to people who are suffering from anxiety, aggression, alcoholics, personality disorders, etc. However, some therapists argue that it cannot be used with individuals who don’t have a strong education background. Studies have proven the usefulness of cognitive behavioral therapy for wide range of problems, which includes many disorders such as mood, anxiety, personality, eating, psychotic, etc. CBT has been shown effective as antidepressant medication for people who are in severe depression. CBT is also used for Bipolar Disorder and concentrates on psycho-education in relation to the disorder and understanding cues and activates relapse. Person Centered Therapy vs Psychodynamic Therapy Psychodynamic therapy in contrast to PCT was initially used to study the meaning of the words spoken by patients. It aimed to bring the unconscious thoughts of the human being into the conscious to resolve conflict and mental disorders. Compared with PCT, it involves more frequent sessions (Alonso, 2006). Alonso says that “Psychodynamic therapy helps resolve issues by giving more time to the client” (Pg 26, 2006). Psychodynamic theory looks at the behavioural problems of an individual and their ability to survive in the environment. Psychodynamic therapy in contrat to PCT can comprise of group therapy in which clients interact with each other. This helps create a form of social identification for people suffering from similar mental disorders. PCT on the other hand focuses on the special relationships between therapists and clients. PCT highlights the importance of individual human beings as therapists promote ways for the client to enhance their self image. Individuals are part of the treatment as they find their own ways to achieve growth. Psychodynamic therapy is helpful in the treatment of psychological problems and disorders like anxiety and depression. Despite significant improvement for many people, this therapy does not work for everyone. As compared with PCT, this therapy has sessions which are conducted once a week. Sometimes clients which are in need of urgent assistance are allowed to attend sesssion twice or thrice a week. Also in psychodynamic therapy, the client and the therapist have eye to eye contact as they sit in front of each other. Therapists also talk extensively as compared with person centered therapists. Psychodynamic therapy as compared with PCT focuses on the unconscious feelings, behaviors and thoughts of individuals which can assist the therapist in resolving the psychological problems of the patient. Unlike PCT, where the therapist encourages the client to become close, the psychodynamic therapist does not give advice or become friendly with the client. The psychodynamic therapist must assist the client in understanding the involuntary processes which drive some of his or her negative emotions and behavior. Psychodynamic therapy encourages a distance or neutrality between the therapist and client in order to prevent any personal desires from harming the therapuetic process. Psychological interventions and lack of training There are inherent risks if psychological interventions are not accompanied by proper training. Inexperienced PCT therapists might not lead the path for the client to find the solution for their treatment. A therapist who is not active might not solve the client’s problems using PCT. There is also the danger of simplicity when recognizing the possible problems of clients. Some mental disorders cannot be solved by simple listening and caring. It requires behavioural and psychodynamic interventions to cure these problems. The client might not be adequately prepared to face the challenges of the real world by using PCT. Conclusion Person Centered Therapy is a useful technique which is used by mental health professionals to resolve a number of social and mental disorders. This therapy focuses on giving the client more decision making ability in resolving the problem. The client is considered an essential part of treatment. The therapist in person centered therapy makes the client aware of their problems and helps to resolve them. Cognitive behavior therapy on the other hand uses learning processes to overcome specific problems. This therapy believes that behaviors are acquired by human beings from the environment. This therapy believes that abnormal behavior can be countered by improving learning skills of the clients. References Alonso A, Rutan JS. Object relations theory and its impact on psychodynamic group therapy. American Journal of Psychiatry. 2006 Bruno, Frank J. (1977). Client-Centered Counseling: Becoming a Person. In Human Adjustment and Personal Growth: Seven Pathways, pp. 362-370. John Wiley & Sons. Rogers, Carl (1961). On Becoming a Person Rogers, Carl (1980). A Way of Being. Boston: Houghton Mifflin Barrett Lennard, G. T. (1997). The span of Carl Rogers helping system: Journey and substance. London: Sage. Barrineau, P. (1996). A reexamination of the role of dreams (from a person-centered perspective): Practical implications for mental health counselors. Journal of Mental Health Counseling, 18(1), 3-15. Barth, R., & Sanford, R. (1994). 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