Person-Centered Therapy Carl Rogers 1902-1987

Biography Child Guidance Clinic- Rochester 1939 Published: The Clinical Treatment of the Problem Child Ohio State University – Professor 1939 1942 Published: Counseling and Psychotherapy Tapes and transcribes therapy sessions to study more objectively therapy process and outcome

Biography U. of Chicago, Professor and Director Counseling Center 1945 U. Wisconsin-Madison 1957 Research with hospitalized psychiatric patients Higher levels of accurate empathy leads to more positive outcomes Client's perception of the relationship is better predictor of outcome than therapist's perception of the relationship Center for Studies of the Person in California 1968

Humanistic Psychology Positive view of humans: Natural potential for growth and to find meaning in life Emphasizes the person's subjective experience Phenomenological approach – exploration method that uses human experience as main source of data

Human Nature: Main Concepts Self-Actualizing Tendency Basic human drive toward growth, completeness, and fulfillment Internal Locus of Evaluation Events that enhance the self actualizing tendency are judged positively and vice-versa.  Need for Positive Regard from Others Feeling accepted by others 

Human Nature: Main Concepts Self-Concept/Self-Regard Learned through the perceptions of regard and acceptance from others Conditions of Worth Expectations or demands from others in order to receive their acceptance These perceptions are internalized and sometimes are out of our awareness

Psychopathology INTERNALIZED CONDITIONS OF WORTH block the natural SELF-ACTUALIZING TENDENCY, creating a state of INCONGRUENCE between what we experience from within (internal locus) and what we believe we should be (conditions of worth) To resolve the conflict, typically we distort or block the experiences from within

Anxiety State of uneasiness or tension that occurs when the discrepancy between what I feel I need to be or do to be accepted and what I really want to do (internal locus of control) threatens to emerge Defense mechanisms are invoked to Distort the "experiencing" from within, Making it easier to conform with external expectations (perceived or real)

Goal of Therapy Facilitate client’s exploration of the parts of themselves that they have denied or distorted, promote the self actualization process Given right therapeutic climate, clients will Become more open to experience Achieve self-trust Develop an internal source of evaluation Be willing to continue growing

Therapy Relationship: Three Conditions Congruence or genuineness Agreement between the feelings and attitudes a therapist is experiencing and his or her professional demeanor (Un)conditional positive regard Non-possessive caring and acceptance of the client Accurate empathic understanding ability to deeply grasp the client's subjective world

Evolution of the Approach Non-Directive Therapy Client Centered Therapy Person Centered Therapy

Interventions Communicating Empathy Attentive/Active listening Openness to the client’s perspective Express understanding & acceptance Techniques Reflection of feeling: explicit and implicit Paraphrasing and synthesizing

Contributions Roger’s Theory Importance of the person of the counselor and of the relationship in the therapeutic process Initiated research in therapy process and outcome by taping sessions and studying the transcription of tapes Research findings provide support for the importance of empathy in therapy outcome (Watson’s 2002 review)

Limitations Therapeutic conditions are necessary but not sufficient Lack of clear goals and structure Lack of challenge to clients Lack of guidance regarding behavioral change

Motivational Interviewing Humanistic, client-centered, psychosocial, directive counseling approach –Willmer & Rollnick 1980’s Initially designed as a brief intervention for problem drinking Promotes a collaborative process that focuses on solutions for behavioral problems – avoids a confrontational style Emphasizes client’s abilities, strengths, resources, and competencies

Motivational Interviewing Goal: reduce ambivalence and increase intrinsic motivation to change Ambivalence -- Reluctance to change - considered normal and expected part of the therapeutic process Reflective listening, empathy, open-ended questions, non-confrontational approach to resistance, support To increase motivation to change, reflect discrepancies between behaviors and values/goals Elicit and reinforce “change talk” --directive aspect

OARS Skills in Motivational Interviewing Open Ended Questions Affirmation Reflective Listening Summary Statements

Stage of Therapy Process Pre-Contemplation Contemplation Preparation No intention of changing Counselor: Nurturing Parent Contemplation Awareness of problem, no commitment to change Counselor: Socratic Teacher Preparation Intend to take action; small changes Counselor: Coach Action Engaged in change process Counselor: Consultant Maintenance Consolidate gains and avoid relapse

Overview Interventions (17 minutes-- OARS 5.4-10.5) https://www.youtube.com/watch?v=s3MCJZ7OGRk Example Depression (14 minutes) https://www.youtube.com/watch?v=3rSt4KIaN8I