Chapter 7 Person Centered Therapy

Empathy

A deep and subjective understanding of the client with the client.

Motivational Interviewing (MI)

A humanistic, client-centered, psychosocial, directive counseling approach that was developed by William R. Miller and Stephen Rollnick in the early 1980s.

Congruence refers to the therapist's

A. genuineness.

Immediacy

Addressing what is going on between the client and therapist right now.

"Third force" in therapy

An alternative to psychoanalytic and behavioral approaches; under this heading are the experiential and relationship-oriented therapies (existential therapy, person-centered therapy, and Gestalt therapy).

Expressive arts therapy

An approach that makes use of various arts—such as movement, drawing, painting, sculpting, music, and improvisation—in a supportive setting for the purpose of growth and healing.

Unconditional positive regard refers to

B. accepting clients as worthy persons.

Person-centered therapy is a form of

B. humanistic therapy.

A limitation of the person-centered approach is a

B. tendency for practitioners to give support without challenging clients sufficiently.

In what stage of change do individuals intend to take action immediately and report some small behavioral changes?

C. preparation

Which statement is most true of person-centered theory?

D. The techniques a therapist uses are less important than are his or her attitudes.

Which technique(s) is (are) most often used in the person-centered approach?

D. active listening and reflection

Accurate empathic understanding refers to the therapist's ability to

D. sense the inner world of the client's subjective experience.

One strength of the person-centered approach is that

D. therapists have the latitude to develop their own counseling style.

Rogers made a contribution to

E. all of the above. -developing the humanistic movement in psychotherapy. -pioneering research in the process and outcomes of therapy. -fostering world peace. -pioneering the encounter-group movement.

Emotion-focused therapy

E. all of the above. -is rooted in a person-centered philosophy. -incorporates aspects of Gestalt therapy into the process. -incorporates aspects of existen- tial therapy into the process.

As a result of experiencing person- centered therapy, it is hypothesized that the client will move toward

E. all of the above. -self-trust. -an internal source of evaluation. -being more open to experience. -a willingness to continue growing.

In person-centered group counseling, the role of the counselor is best described as a

E. facilitator.

Which of the following is considered important in person-centered therapy?

E. none of the above

In person-centered therapy, transference is

E. not an essential or significant factor in the therapy process.

A limitation of this approach is that it is a long-term process.

False

Diagnosis of clients is seen as an important beginning point for therapy.

False

Directive procedures are called for when clients feel that they are "stuck" in therapy.

False

Methods of Natalie Rogers's expressive arts therapy are based on psychoanalytic concepts.

False

Person-centered therapy is best described as a completed and fixed "school," or model, of therapy.

False

Key figure and Major Focus

Founder: Carl Rogers. Key figure: Natalie Rogers. A branch of humanistic psychology that stresses a phenomenological approach, person-centered therapy was originally developed in the 1940s as a reaction against psychoanalytic therapy. Based on a subjective view of human experience, it emphasizes the client's resources for becoming self-aware and for resolving blocks to personal growth. It puts the client, not the therapist, at the center of therapy. Carl Rogers did not present his approach as being fixed and completed; rather, he expected the theory and practice to evolve over time. One way this theory has been expanded is through the work of Natalie Rogers, who has developed person-centered expressive arts therapy, in which the expressive arts are used in self-discovery, healing, and growth.

Emotion-focused therapy

Rooted in a person- centered philosophy, EFT is integrative in that it synthesizes aspects of Gestalt therapy and existential therapy. Strategies used in EFT are aimed at strengthening the self, regulating affect, and creating new meaning.

Therapeutic core conditions

The necessary and sufficient characteristics of the therapeutic relationship for client change to occur. These core conditions include therapist congruence (or genuineness), unconditional positive regard (acceptance and respect), and accurate empathic understanding.

Unconditional positive regard

The nonjudgmental expression of fundamental respect for the person as a human; acceptance of a person's right to his or her feelings.

Hierarchy of needs

We are able to strive toward self-actualization only after these four basic needs are met: physiological, safety, love, and esteem.

Key Concepts

A key concept is that clients have the resourcefulness for positive movement. The client has the capacity for resolving life's problems effectively without interpretation and direction from an expert therapist. This approach emphasizes fully experiencing the present moment, learning to accept oneself, and deciding on ways to change. More than the therapist or technique, it is the client who makes therapy work. What clients value most is being understood and accepted, which results in the creation of a safe place to explore feelings, thoughts, behaviors, and experiences. This approach views mental health as a congruence between what one wants to become and what one actually is.

Positive psychology

A movement that has come into prominence, which shares many concepts on the healthy side of human existence with the humanistic approach.

Humanistic psychology

A movement, often referred to as the "third force," that emphasizes freedom, choice, values, growth, self-actualization, becoming, spontaneity, creativity, play, humor, peak experiences, and psychological health.

Limitations

A possible danger is the therapist who, by merely reflecting content, brings little of his or her personhood into the therapeutic relationship. The core conditions are centered more in the therapist's attitudes and values than in the therapist's skills. Without a person- centered attitude or way of being, mere application of skills is not likely to be effective. The approach has limited use with nonverbal clients, and it tends to discount the significance of the past. Some of the main limitations are due not to the theory itself, but to some counselors' misunderstanding of the basic concepts and to their dogmatic practical applications. For those who value accountability within the framework of evidence-based practice, this approach is limited due to the lack of attention on using empirically proven techniques for specific problems.

The MI spirit

It is essential that therapists function within the spirit of MI, rather than simply applying the strategies of the approach. The attitudes and skills in MI are based on a person- centered philosophy.

Strengths

One of the first therapies to break from traditional psychoanalysis, person-centered therapy stresses the active role and responsibility of the client. It is a positive and optimistic view and calls attention to the need to account for a person's inner and subjective experiences. It makes the therapeutic process relationship-centered rather than technique- centered. It focuses on the crucial role of the therapist's attitudes. The model has generated a great deal of clinical research into both the process and the outcomes of therapy, which in turn has led to refining the tentative hypotheses.

Stages of change

People are assumed to progress through a series of five identifiable stages of motivation and readiness to change in the counseling process. They include the precontemplation stage, the contemplation stage, the preparation stage, the action stage, and the maintenance stage.

Presence

The ability to "be with" someone fully in the present moment; being engaged and absorbed in the relationship with the client.

Accurate emphatic understanding

The act of perceiving accurately the internal frame of refer- ence of another; the ability to grasp the person's subjective world without losing one's own identity.

Philosophy and Basic Assumptions

The approach is grounded on a positive view of humanity that sees the person as innately striving toward becoming fully functioning. The basic assumption is that it is the therapist's attitudes and belief in the inner resources of the client that create the therapeutic climate for growth. By participating in the therapeutic relationship, clients' self-healing capacities are activated and they become empowered. Clients actualize their potential for growth, wholeness, spontaneity, and inner-directedness. It is not the therapist who primarily brings about change, but the client. The main source of successful psychotherapy is the client. The therapist's attention to the client's frame of reference fosters the client's utilization of inner and outer resources.

Self-actualization

The central theme of the work of Abraham Maslow. His theory of self- actualization is postulated on a hierarchy of needs as a source of motivation.

Congruence

The state in which self-experiences are accurately symbolized in the self-concept. As applied to the therapist, congruence is matching one's inner experiencing with external expressions; congruence is a quality of realness or genuineness of the therapist.

A major contribution of this approach has been the willingness of Rogers to state his formulations as testable hypotheses and submit to research.

True

Motivational interviewing is deliberately directive and is aimed at reducing client ambivalence about change and increasing intrinsic motivation.

True

Motivational interviewing rests on the therapeutic core conditions; however, it offers a range of strategies that enable clients to develop action plans leading to change

True

Natalie Rogers expanded on her father's theory of creativity using the expressive arts to enhance personal growth for individuals and groups

True

The person-centered approach to group counseling is based on the assumption that the group members have the resourcefulness for positive movement without the facilitator of the group assuming an active and directive role.

True