Client-Centered (also known as person-centered) psychotherapy is a non-directive form therapy based on the ideas of Carl Rogers(1902-1987). Rogers had a scientific and Christian background which influenced his work. His method was different from the traditional model because he moved away from the expert role. By studying psychotherapy sessions (interesting fact: he was one of the first to research his results, the first to record sessions, to publish transcripts of his failures to encourage the study of what goes wrong also the first to do follow-up studies of his results) he believed the efficacy of treatment was mostly to be prescribed to what we now call the nonspecific factors.
He focused on a nondirective, empathic approach that empowers and motivates the client in the therapeutic process. The core belief is that every human being strives for and has the capacity to fulfill his or her own potential. A therapist can guide a patient in this process. Far from being laissez faire, the therapist needs to help actively and empathetically clarify what the patient feels. He identified six necessary and sufficient conditions which are needed to produce personality changes in clients:
Two persons are in psychological contact
The client is in a state of incongruence
The therapist is congruent or integrated in the relationship
The therapist experiences unconditional positive regardfor the client
The therapist experiences an empathic understanding of the client’s internal frame of reference and endeavours 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 perceived by the client
For the therapist this means in short he/she has to develop following conditions (aka the three core conditions):
Congruence
Unconditional positive regard
Empathy
The nondirective approach (meaning: almost only using reflective listening) is now less strictly used and therapist will also give input and use specific interventions. Later developments and adaptions lead to a range of therapies with different emphasis:
Experiential:
Focusing by E. Gendlin
Emotion Focused Therapy by L.N. Rice and L. Geenberg
Interactional/Interpersonal by I.D. Yalom and Kusler
Existential by I.D. Yalom and M. Cooper
Indications
Covers mostly problems of the neurotic range (depression, anxiety or panic) but has been used for all types of disorders. Especially useful for ineffective self-structure organization or perceived discrepancies in self. Can be used at all ages and all levels of intelligence. Passive patients urging the therapist to take control or incapable of managing themselves will not feel helped by this kind of therapy.
Efficacy
There are several RCTs providing evidence for the effectiveness of client-centered psychotherapy in numerous pathologies. But the body of evidence is less extensive and some studies have difficulty withholding under the strict scrutiny of methodology.
Gibbard I, Hanley T. (2008). A five-year evaluation of the effectiveness of person-centred counselling in routine clinical practice in primary care. Counselling and Psychotherapy Research , December 2008; 8(4): 215-222.
Elliott R, Freire B. (2009).Person-centred/experiential therapies are highly effective: summary of the 2008 meta-analysis. British Association for the Person-Centred Approach. 2009
Stiles W.B., Barkha, M., Mellor-Clark, J., Connell, J. (2007). Effectiveness of cognitive-Behavioural, person-centred, and psychodynamic therapies as practiced in UK primary care routine practice: replication in a larger sample. Psychological Medicine.
Training
A recognized psychotherapy training now takes 4 years and includes supervision and undergoing therapy yourself.
Quotes
“The curious paradox is that when I accept myself just as I am, then I can change.” “The good life is a process, not a state of being. It is a direction not a destination.” Carl Rogers
“Emotion is not opposed to reason. Emotions guide and manage thought in fundamental ways and complement the deficiencies of thinking.” Greenberg
Comment from a trainee
“Most useful of this psychotherapy for a trainee is that it really focuses [1] on the basic characteristics you need as a psychotherapist or even psychiatrist to have effective treatment. Without the core conditions as stipulated by Rogers you will not be able to reach a patient through psychotherapy. The client-centered approach strongly trains therapists in the properties needed for a good therapeutic working alliance and a context that makes change possible.” Niel, Belgium, 3th year in training of a cliented-centered therapy
Books:
On Becoming a Person: A Therapist's View of Psychotherapy - Carl Rogers Videos, published online courses
Carl Rogers Counsels an Individual on Hurt and Anger
International associations:
World Association for Person-Centered and Experiential Psychotherapy and Counseling (WAPCEPC)
Network of the European Associations for Person-Centred and Experiential Psychotherapy and Counselling - PCE Europe
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