Person-Centered Therapy (Client-Centered)
KeywordsTherapeutic Process Empathic Understanding Emotion Focus Therapy Unconditional Positive Regard Experiential Psychotherapist
Person-centered therapy (PCT) is a form of psychotherapy in which the focus is on the subjective experiences of the client and in which the therapeutic relationship is seen as the cornerstone to facilitate change in clients. The angle of incidence is the person as a whole, rather than his problems. Central is the notion of the person’s self-agency, his capacity to take responsibility for his own life.
PCT aims at improving self-esteem and client’s relationships with others, a better trust in one’s inner feelings and experiences as valuable sources of information for making decisions, an increased capacity to experience and express feelings at the moment they occur, and, in line with it, to become more open to new experiences and new ways of thinking about life.
Contrary to problem-centered approaches in psychotherapy, person-centered therapy (formerly denoted as client-centered therapy, see Rogers 1951) starts from the idea that the person is capable to make his own choices in life, and to take responsibilities for his life. Whereas problem-centered approaches (e.g., cognitive-behavioral therapy) see the therapist as an expert who is delivering, or at least suggesting solutions for the client’s problems; in the person-centered approach the client is seen as the expert in knowing his inner world at best himself and in giving meaning to his life. Therefore the focus is not on problems but on the person as a whole. Central in the therapeutic process is the exploration of the client’s inner feelings, resulting in a change of giving meaning towards problematic situations, other people and, especially, to his or her own self. Psychopathology is viewed as a stagnation in the development of the client’s life, in what is called his “actualizing tendency.” With the help of the therapist, who is genuine and respectful to his client, showing empathy with him and his situation, the client is stimulated to explore his inner feelings and to find his own paths in life (again).
Developments in PCT
Two persons are in psychological contact.
The first, whom we shall term the client, is in a state of incongruence, being vulnerable or anxious.
The second person, whom we shall term the therapist is congruent or integrated in the relationship.
The therapist experiences unconditional positive regard for the client.
The therapist experiences an empathic understanding of the client’s internal frame of reference and endeavors to communicate this experience to the client.
The communication to the client of the therapist’s empathic understanding and unconditional positive regard is to a minimal degree achieved.
It may be clear that Rogers’ view on the therapeutic process is first of all a relational one. Eugene Gendlin, a coworker of Rogers, added to this a theory of experiencing (Gendlin 1962), which ultimately evolved into an own branch in person-centered therapy, known as focusing-oriented psychotherapy (Gendlin 1981, 1996). According to Gendlin, the experiential psychotherapist stimulates the client to focus on his inner feelings, whatever comes into his mind at that particular moment. This “focusing” is a structural procedure in which the client silently refers inwardly, trying to suspend intellectual analysis, in order to sense or feel what his experience is saying to him. When words come up and the client attends to them, a felt shift in experienced organization is supposed to occur. This process of bodily sensing is one of repeated steps. The client may not get the answer to his problem(s) all at once. However, over time, focusing leads to greater clarity of what is bothering him and how to react to his problem(s) in a more subtle and differentiated way.
Another and more recent approach in person-centered therapy is introduced by Greenberg et al. (1993), initially called “Process-Experiential Psychotherapy,” and later on “Emotion-Focused Therapy” (EFT; Greenberg 2011). It integrates basic person-centered theory with cognitive psychology and biopsychological theories on emotion, while including psychotherapeutic techniques stemming from Gestalt therapy, like two-chair dialogues. The basic idea is that psychological problems arise because clients are unaware of, or unable to pay attention to their emotions and associated meanings. If clients can get access to these, they will be able to restructure their cognitive beliefs and emotional patterns that have been guiding their dysfunctional reactions. For this, the therapist starts looking for specific “markers” in his dialogue with the client. A marker is some kind of behavior exhibited by the client that signals or marks his struggling with a particular kind of emotional problem or “task.” The therapist then suggests an intervention that will best help the client to explore and resolve that particular emotional processing task. Interventions include evocative unfolding problematic points (i.e., an incident in which the client have said or done something about which he feel self-critical), focusing, two-chair dialogues (when the client exhibit a split between a “want” and a “should”), empty-chair dialogue (in the case of “unfinished business” with another person, such as a former partner or parent), and empathic affirmation at a marker of intense vulnerability. Common to all tasks in emotion focused therapy (EFT) are the steps to be taken: (1) bringing the emotion into awareness, (2) expression of the emotion, (3) regulation of the emotion, (4) transformation of the emotion, (5) corrective experience. This all has to happen in the context of an empathically attuned relationship that facilitates these processes. Research shows that EFT is a validated and efficient form of psychotherapy (Elliott et al. 2013).
Person-centered therapy is a widely used, well-established, and evidence-based form of psychotherapy. Initiated by Carl Rogers in the middle of the past century, it is evolved into different branches of interpersonal and experiential modes of psychotherapy.
Characteristic of all these branches is the emphasis on (a) the person of the client instead of his problems; (b) the relationship between client and therapist, which can be denoted as an equivalent person-to-person encounter in which the therapist is seen as a facilitator of the therapeutic process and the client as the expert on his own needs and inner processes; (c) feelings and emotions, instead of cognitions and behavior; (d) the present, rather than explaining the past or concerns about the future. Characteristic is the open-end structure of the psychotherapy process, too, meaning that PCT stands far from protocolized and time-limited psychological treatments.
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