Client-Centered Therapy - Case Study Example

 Client-centered therapy was developed by Carl Rogers. The main feature of this type of therapy is that the client controls the pace and progress of the therapeutic process, whereas the therapist has this control in other therapeutic approaches. Self-actualization was the key concept in Rogers’ theory. This concept maintained that people and organisms are constantly moving to enhance and expand themselves. Rogers believed that all people are constantly moving towards self-actualization and, in some cases, the right therapeutic environment is needed to facilitate that process. Rogers described this “actualizing tendency” as the key motivator in all individuals. He believed that the content of this tendency is different for each individual, but is experienced in some way by all individuals. This actualizing tendency is believed to be functioning as long as the person lives, and therefore will very likely change for the individual over time. The actualizing tendency moves the individual away from being controlled and toward self-regulation. Under unfavorable conditions, the tendency remains, although the expression of this tendency may be affected. For example, picture a potato growing in a dark cellar with a tiny source of light. This potato will grow some shoots, but ultimately will not grow to the potential it could have. Bozarth and Brodley (1991) state, “But under the most adverse circumstances, they were striving to become. Life would not give up, even if it could not flourish” (p. 47). This means that although the potato had no real chance of reaching self-actualization, it did not stop its attempt to reach it anyway. Client-centered therapy facilitates the process toward self-actualization in the following way. Much like the potato in the above example, some people find themselves in unfavorable situations which impede on the self-actualizing process. Given the environment that the client-centered therapy aims to achieve, the person may overcome these unfavorable situations which have thus far stunted his self growth, and put him back on the path toward self-actualization. The key feature in helping the client achieve self growth lies in the client-therapist relationship in which the therapist allows the client to realize his potential in a nondirective way. Rogers stated, “Therapy is not a matter of doing something to the individual, or of inducing him to do something about himself. It is instead a matter of freeing him for normal growth and development” (Bozarth & Brodley, 1991, p. 46). Rogers (1946) compiled a list of necessary conditions which the therapist must abide by in order for client-centered therapy to work. First, the therapist must assume that the client is responsible for his own actions, and therefore the therapist will not attempt to take on any of these responsibilities. Next, the therapist must assume that the client is motivated to become “mature, socially adjusted, independent, and productive” (p. 416) and that this motivation will ultimately lead to change. Thirdly, the therapist must create a warm environment which allows the client to express any thoughts and feelings he may have, no matter how absurd, without the fear of being judged. Also, if the therapist sets limits, they must be in reference to behaviors, not attitudes. For example, it may be unacceptable for the client to demand more time at the end of the session, but it is perfectly acceptable for the client to want to do so and voice this desire. Next, the therapist must show the client that he deeply understands the thoughts expressed, and that he genuinely accepts them. Lastly, the therapist must refrain from “questioning, probing, blame, interpretations, advice, suggestion, persuasion, reassurance” (p. 417) or any other behavior which contradicts the genuinely warm and open atmosphere which the therapist strives to provide. Once these necessary conditions are met, Rogers (1946) asserts that the following results will take place. The client will become more aware of his own attitudes and may even become aware of attitudes he did not know previously existed. The client will also come to a better understanding of himself, and will accept himself more readily and completely. With this better understanding of himself, the client will adopt a new, more adaptive goal in replace of his previous maladaptive one. At the same time, the client will behave in a way which is more socially appropriate and which allows for more psychological growth than behavior previously exhibited. Client-centered therapy places trust in the fact that the client knows what’s best for himself. Client-centered therapy asserts that the client knows the areas of concern which he is ready to explore; that the client is the best judge as to the most desirable frequency of interviews; that the client can lead the way more efficiently than the therapist into deeper concerns; that the client will protect himself from panic by ceasing to explore an area which is becoming too painful; that the client can and will uncover all the repressed elements which it is necessary to uncover in order to build a comfortable adjustment; that the client can achieve for himself far truer and more sensitive and accurate insights than can possibly be given to him; that the client is capable of translating these insights into constructive behavior which weigh his own needs and desires realistically against the demands of society; that the client knows when therapy is competed and he is ready to cope with life independently (Rogers, 1946, p. 420). The client-centered therapist allows the client to proceed at therapy at his own pace, deciding what to discuss and what not to, giving the client the control that is usually held by the therapist in other therapeutic approaches. In order for this relationship to work correctly, the therapist must display congruence, unconditional positive regard, and empathic understanding (Brodley, 1987). Congruence refers to the amount of agreement between who one is, who he sees himself as, and who he wishes to be. If there is little discrepancy between these three notions, then there is high congruence. Unconditional positive regard refers to the act of accepting one for who he is completely without judgment. Empathic understanding refers to the ability of the therapist to understand what the client is expressing on the client’s terms. Brodley (1991) gives further advice for the client-centered therapist: In general, try to orient yourself to the client as a whole person who, like yourself, lives, acts, and reacts in a world centered in her/his own perceptions, motives and feelings. The client-centered therapist’s interest is in the client as a whole person, not as a complex of problems or symptoms (p. 4). It is important for the therapist to see the client as a person much like himself, and not defined by his presenting problem. Kahn (1995) mentioned other attitudes and characteristics necessary for the client-centered therapist. The first is being human. This is the notion that the therapist can and should accept the fact that he does not know all the answers and does not need to pretend that he does. The therapist should be viewed by the client as a person, and therefore the therapist should express himself openly and genuinely. Also, the therapist should be humble. He should not assume that he “knows” more about the client’s situation that the client himself does. These essential attitudes require the therapist to know himself and his feelings well. The therapist cannot allow himself to be preoccupied with any preconceived notions about the client, or give in to any existing prejudices that he may have. At the same time, the therapist can and should refer a client to another therapist if he believes that these problems cannot be overlooked. The therapist may also realize that he is becoming annoyed or frustrated or bored with a client from time to time, and he must learn to keep these feelings in check. Warner gives two possible explanations for such negative feelings. The first is that the process of empathic understanding has broken down; the therapist does not understand the client and is therefore becoming increasingly frustrated. The second explanation is that the therapist himself has unresolved issues which the client is somehow bringing to the surface and instead of dealing with these issues, he becomes frustrated with the client and the empathic process is impeded. In either instance, the therapist must hone his empathic understanding skills. Brodley (1991) gives a list of guidelines for empathic understanding. The therapist should listen to what the client is telling him, and express a tentative understanding of what has been said. The therapist should avoid trying to come to a deeper understanding of what the client has expressed. At the same time, the therapist must remember to try and see things through the client’s eyes in order to fully understand what the client is expressing. If the therapist does not understand what is being said, he should not hesitate to ask to clarification. Rogers (1946) offers an account given by a young minister who had employed client-centered therapy in his own line of work: Because the client-centered, nondirective counseling approach has been rather carefully defined and clearly illustrated, it gives the illusion of simplicity. The technique seems deceptively easy to master. Then you begin to practice. A word is wrong here and there. You don’t quite reflect feeling, but reflect content instead. It is difficult to handle questions; you are tempted to interpret (p. 421). This minister is voicing concerns that virtually all client-centered therapists encounter, particularly when beginning to practice. While it may seem so simple to just listen and not offer any advice, it is almost contrary to human nature. All of one’s life, when someone comes to him with a problem, he tries his best to give a possible solution, but the client-centered therapist must turn this urge off. The minister then goes on to say, Only gradually does it dawn that if the technique is true it demands a feeling of warmth. You begin to feel that the attitude is the thing. Every little word is not so important if you have the correct accepting and permissive attitude toward the client. So you bear down on permissiveness and acceptance (Rogers, 1946, p. 421). The minister is expressing what most therapists indeed must find out on their own. It is not enough to “act” accepting and permissive. It is not enough for the therapist to just say that he is accepting of the client. In order for client-centered therapy to work, the therapist must truly accept the client completely and be the embodiment of this acceptance and permissiveness. Then, and only then, will the therapeutic environment be the warm and open atmosphere it is truly meant to be. The minister continues, But you still have those troublesome questions from the client. He simply doesn’t know the next step. He asks you to give him a hint, some possibilities, after all you are expected to know something, else why is he here! Then you begin to wonder. The technique is good, but … does it go far enough! Does it really work on clients? Is it right to leave a person helpless, when you might show him the way out? (Rogers, 1946, p. 421). Once again, these are concerns raised by most client-centered therapists from time to time. It is natural for the therapist to feel like he has thrown the client overboard and refuses to give him a life jacket. It is easy for the therapist to believe that he is in fact doing to exact opposite of helping the client by refusing to provide guidance and interpretations. But, when the therapist continues with this process he begins to see changes in the client which prove that the lack of guidance and interpretations has indeed helped. The minister then recognizes that knowledge of self is crucial for the therapist: For here is demanded of you what no other person can do or point out – and that is to rigorously scrutinize yourself and your attitudes towards others. Do you believe that all people truly have a creative potential in them? That each person is a unique individual and that he alone can work out his own individuality? Or do you really believe that some persons are of ‘negative value’ and others are weak and must be led and taught by ‘wiser,’ ‘stronger’ people? (Rogers, 1946, p. 421). The therapist must constantly be aware of his perceptions of people in general. The therapist must truly believe that all people have the potential for greatness, given the proper environment, or the process can never work. The minister finishes by mentioning exactly how demanding the client-centered therapists’ job is: Instead of demanding less of the counselor’s personality in the situation, client-centered counseling in some ways demands more. It demands discipline, not restraint. It calls for the utmost sensitivity, appreciative awareness…It demands that the counselor put all he has of these precious qualities into the situation, but in a disciplined, refined manner …When genuine acceptance and permissiveness are your tools it requires nothing less than the whole complete personality. And to grow oneself is the most demanding of all (Rogers, 1946, p. 421). This account outlines the difficult role that the therapist must play. While positive regard and empathic understanding seem like easy concepts to master, they often take years to develop fully. Much like the client, the therapist is always moving toward self-actualization, and the more he learns about himself, the more he grows, and the better he becomes as a therapist. Reference List Bozarth, J. D. & Brodley, B. T. 1991, ‘Actualisation: A functional concept in client-centered therapy’, Handbook of Self-Actualisation, vol. 6, no. 5, pp. 45-60. Brodley, B. T. 1987, ‘A client-centered psychotherapy practice’, Available at: http://world.std.com/~mbr2/cct.practice.html Brodley, B. T. 1991, ‘Instructions for beginning to practice client-centered therapy’, Available at: http://world.std.com/~mbr2/cct.beginning.practise.html Kahn, E. 1995, ‘Effecting a collaboration between Roger’s client-centered therapy and Kohut’s self psychology’, The Person-Centered Journal, vol. 2., no. 1, pp. 44-53. Rogers, C. R. 1946, ‘Significant aspects of client-centered therapy’, American Psychologist, vol. 1, pp. 415-422. Warner, M. S. ‘Fragile process’, Available at: http://www.focusingresources.com/articles/fragileprocess.html Read More