Systems of Psychotherapy: A Transtheoretical Analysis Chapter 5. Person- Centered Therapies Chapter 5 Copyright © 2014 Cengage Learning, Inc.

Copyright © 2014 Cengage Learning, Inc. A Sketch of Carl Rogers 1902-1987 Restricted, inexpressive family life. Ph.D. in clinical psychology from Columbia. Founder of psychotherapy research. Evolved from nondirective to client-centered to person-centered. Applied his system to education, politics, and international conflicts. Chapter 5 Copyright © 2014 Cengage Learning, Inc.

Copyright © 2014 Cengage Learning, Inc. Theory of Personality Basic motivating force is actualization. We are born with: actualizing forces that motivate us. valuing processes that regulate us. We create our subjective world. Acquire conditions of worth. Need for unconditional positive regard. Chapter 5 Copyright © 2014 Cengage Learning, Inc.

Theory of Psychopathology More conditional the parents’ love, the more likely pathology. Incongruence between what is experienced and what is person's self-concept. Psychopathology reflects a divided personality due to lack of wholeness. Defensive reactions prevent threatening experiences from coming into awareness. Defenses cause inaccurate perceptions due to distortions and selective omission of information. Chapter 5 Copyright © 2014 Cengage Learning, Inc.

Therapeutic Relationship Necessary and sufficient conditions for personality change Genuineness/congruence Positive regard Accurate empathy Chapter 5 Copyright © 2014 Cengage Learning, Inc.

Therapeutic Processes Goal: Increase congruence between self and experience. Combination of consciousness raising and corrective emotional experience. Therapists control the process of therapy, but not the content. Use facilitative conditions (genuineness, positive regard, empathy). Chapter 5 Copyright © 2014 Cengage Learning, Inc.

Copyright © 2014 Cengage Learning, Inc. Therapeutic Content Intrapersonal Conflicts Anxieties and defenses Self-esteem Responsibility Interpersonal Conflicts Intimacy and sexuality Communication Hostility Control Chapter 5 Copyright © 2014 Cengage Learning, Inc.

Therapeutic Content (cont.) Indivduo-Social Conflicts Adjustment versus transcendence Impulse control Beyond Conflict to Fulfillment Meaning of life Ideal individual Chapter 5 Copyright © 2014 Cengage Learning, Inc.

Practicalities of Person-Centered Therapy (PCT) Psychological testing is rare. Efforts to enhance trainee’s empathy often result in sterile technique. Brief PCT is not common; possibly hundreds of sessions. Typically, sessions are once/week for multiple months. Chapter 5 Copyright © 2014 Cengage Learning, Inc.

A Major Alternative & Extension: Motivational Interviewing (MI) William R. Miller (1947-present) Combines elements of person-centered style and technique. Found therapist empathy (not treatment method) predicted success of therapy for problem drinkers. Research supports MI’s effectiveness. Chapter 5 Copyright © 2014 Cengage Learning, Inc.

Copyright © 2014 Cengage Learning, Inc. Four Principles of MI Express empathy Develop discrepancy Roll with resistance Support self-efficacy Chapter 5 Copyright © 2014 Cengage Learning, Inc.

Copyright © 2014 Cengage Learning, Inc. Four Skills of MI: OARS Open questions Affirmation Reflective listening Summaries Chapter 5 Copyright © 2014 Cengage Learning, Inc.

Effectiveness of Person-Centered Therapies Research on empathy, genuineness and positive regard show: They are valuable contributors to outcome. But are neither necessary nor sufficient. Meta-analyses PCT superior to no treatment and placebo. Allegiance effect in comparing PCT to others systems. Similar treatment outcomes when controlling for investigator allegiance. Smaller effects for children and adolescents. Chapter 5 Copyright © 2014 Cengage Learning, Inc.

Copyright © 2014 Cengage Learning, Inc. Effectiveness of MI More than 200 RCTs. Project MATCH Strongest support in treatment of substance abuse. Particularly effective with ethnic minority and resistant clients. May need to be combined with another evidence-based treatment. Chapter 5 Copyright © 2014 Cengage Learning, Inc.

Criticisms of Person-Centered Therapies From a cognitive-behavioral perspective From a psychoanalytic perspective From a cultural perspective From an integrative perspective Chapter 5 Copyright © 2014 Cengage Learning, Inc.

Future Directions of PCT Methods assimilated by mainstream therapies. Slowly declining in popularity in U.S. Empathy making a comeback. Needs to maintain: Openness to integration with other psychotherapies Active and eclectic methods in era of short-term treatments. Motivational interviewing is on the rise. Chapter 5 Copyright © 2014 Cengage Learning, Inc.

Copyright © 2014 Cengage Learning, Inc. Key Terms actualization actualizing tendency autonomy v. heteronomy allegiance effect client markers conditions of worth counterresistance dissemination and implementation empathy existential living fully functioning person genuineness/congruence incongruence motivational discrepancy motivational interviewing (MI) necessary and sufficient conditions nondirective therapy organismic valuing positive regard/unconditional positive regard process research Project MATCH reflection (of feelings) roll with resistance self-authority self-concept self-regard subception Chapter 5 Copyright © 2014 Cengage Learning, Inc.

Copyright © 2014 Cengage Learning, Inc. Recommended Websites Association for Humanistic Psychology: www.ahpweb.org/ Association for the Development of the Person-Centered Approach: www.adpca.org/ Center for Studies of the Person: www.centerfortheperson.org/ World Association for Person-Centered Psychotherapy: www.pce-world.org/ Motivational Interviewing: www.motivationalinterview.org/ Chapter 5 Copyright © 2014 Cengage Learning, Inc.

Copyright © 2014 Cengage Learning, Inc. Chapter 5 Copyright © 2014 Cengage Learning, Inc.