Person-Centered Psychotherapy
Overview
Person-Centered Psychotherapy, also called Rogerian Therapy and client-centered therapy, was developed by American psychologist Carl Rogers in the mid 1900s, further building upon humanistic psychology. Rogers’ goal was to develop a theory that would focus on the client's unstated and underlying feelings, rather than their overt expressions, in an attempt to further understand the client. In order to do this, Rogers extensively researched personality development to understand how people perceive themselves and their world around them. With the understanding that emotions are almost directly linked to one’s feelings of identity, Rogers wanted to focus on understanding the client in front of him beyond the words that they are overtly saying. Thus Rogers’ research on personality development came to the understanding that, “Each individual has their own private world. And to understand this individual, we must enter this private world and seek to comprehend the individual from their internal frame of reference.”[1]
Another significant portion of Rogers’ theory is the understanding that Person-Centered Psychotherapy relies on the healthy relationship between therapist and client. This is generally referred to as the “therapeutic relationship”. With this understanding, “The counselor seeks to gently enter the client’s subjective world, to understand this client from the client’s internal frame of reference, and to provide an experience in which the person is accepted and cared about without conditions of worth.”[2] Throughout Person-Centered Psychotherapy, the therapist is astutely attuned to how the client is reacting, taking a non-directive role throughout the session, and allowing the client (who is believed to be the expert of their own life) to lead the session.[3]
Description
Since a fundamental part of Person-Centered Psychotherapy is the therapeutic relationship between therapist and client, Rogers believed the following conditions would foster a healthy relationship between therapist and client, and that they would be “necessary and sufficient” for constructive change to occur within therapy:[4]
Two persons are in psychological contact.
The client is in a state of incongruence, being vulnerable or anxious.
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.
In addition to these necessary conditions to promote therapeutic change, Rogers believed in three core conditions to drive success in therapy:
Empathy: The therapist can achieve this by actively listening and engaging with the client, showing they are developing an understanding for their client’s private world. Furthermore, Rogers stated, “When functioning best, the therapist is so much inside the private world of the other that he or she can clarify not only the meanings of which the client is aware but even those just below the level of awareness.”[5]
Congruence: Agreement, harmony or compatibility promotes a therapist actively showing their internal feelings and thoughts, creating a genuine, yet still professional, relationship with their client.
Unconditional Positive Regard: A therapist displays unconditional positive regard by showing their client that they are accepted unconditionally. Thus, the therapist refrains from signaling judgment, approval, or disapproval, which “may allow the client to drop their natural defenses, allowing them to freely express their feelings and direct their self-exploration as they see fit.”[6]
Rogers viewed these relationship conditions as essential factors to achieve because he found that as clients receive empathy, positive regard, and congruence from their therapist, they become more empathetic, positive regarding, and congruent with themselves.[7]
Techniques/General Practices
Within Person-Centered Psychotherapy, the following techniques and practices are generally employed:
“Following” responses rather than “leading” responses to allow the client to speak freely.
Paraphrasing allows therapists to summarize what a client has said and restate it back to them, allowing the client to process their emotions after hearing their statements repeated back to them.
Reflection occurs when the therapist simply restates what the client has said, while heavily focusing on the emotions behind their statement, in an effort to further increase their client’s self-understanding. Furthermore, the therapist does this without offering their own advice, because the therapist believes that each client knows themselves best - thus they are the only ones that can create solutions for their problems.[8]
While other techniques may be used during person-centered therapy, they must adhere to the values and philosophy of those practicing Person-Centered Psychotherapy.
Efficacy
Gelso & Williams (2022) note that Person-Centered Psychotherapy can be very effective, especially when the “necessary and sufficient” and three core conditions are present to a high degree.[9] In a study conducted by Ghafoori et al. in 2019 regarding PTSD, researchers found that Person-Centered Therapy was significantly associated with the most therapy sessions completed and only a 41.75% dropout rate - the lowest compared to cognitive-behavioral therapy (CBT) and eclectic treatments.[10] Furthermore, Elliot and Freire conducted a meta-analysis in 1994, which has been replicated in 1996, 2001, 2004, and 2008 in which they have found congruent results that support Person-Centered and experiential therapies as statistically equivalent to CBT therapies in terms of effectiveness. They’ve also found that clients that receive Person-Centered and experiential therapies show large positive gains compared to those who do not receive therapy.[11] While Person-Centered Psychotherapy can be very effective, the non-directive nature of this therapy may be less effective for some clients compared to other modalities. In these cases, clients may need a more aggressive or direct approach than Person-Centered Psychotherapy can offer (e.g., CBT or Gestalt).
If you are interested in exploring Person-Centered Psychotherapy, please reach out to a licensed mental health professional (e.g., a psychotherapist, psychologist or psychiatrist) for guidance and support.
Contributed by: Kendall Hewitt
Editor: Jennifer (Ghahari) Smith, Ph.D.
references
1 Gelso, Charles J. & Williams, Elizabeth Nutt. (2022). Counseling Psychology (Fourth Edition, pages 320-325). American Psychological Association.
2 Ibid.
3 Yao, L. & Kabir, R. (2023 February 9). Person-Centered Therapy (Rogerian Therapy). National Library of Medicine. https://www.ncbi.nlm.nih.gov/books/NBK589708/
4 Eager, Elisabeth. (2010). Summary and Evaluation of Carl Rogers’ Necessary and Sufficient Conditions of Therapeutic Personality Change (Vol. 17, No. 1-2, page 1). The Person-Centered Journal.
5 Bozarth, J. D. (n.d.). Person-Centered Approach. New York Person-Centered Resource Center. Retrieved August 25, 2023, from http://www.nypcrc.org/approach
6 Yao & Kabir (2023)
7 Gelso & Williams (2022)
8 Yao & Kabir (2023)
9 Gelso & Williams (2022)
10 Ghafoori, B., Wolf, M. G., Nylund-Gibson, K., & Felix, E. D. (2019). A naturalistic study exploring mental health outcomes following trauma-focused treatment among diverse survivors of crime and violence (245, 617–625). Journal of affective disorders. https://doi.org/10.1016/j.jad.2018.11.060
11 Cooper, M., Watson, J., & Hölldampf, D. (2015). Review of Person-Centered and Experiential Therapies Work: A Review of the Research on Counseling, Psychotherapy, and Related Practices (Vol. 22, No. 1-2, pages 2-3). The Person-Centered Journal.