The person-centered counseling approach was established in the 1940’s by humanistic psychologist, Carl Rogers. The goal of a person-centered therapy is to create the necessary conditions for clients to engage in meaningful self-exploration of their feelings, beliefs, behavior, and worldview, and to assist clients in their growth process, enabling them to cope with current and future problems. Show A major concept of this approach is that people are generally trustworthy, resourceful, capable of self-understanding and self-direction, able to make constructive changes, and able to live effective and productive lives. Another key concept is that the attitudes and characteristics of the therapist, and the quality of the client-therapist relationship are prime determinants of the outcome of the therapeutic process. Rogers maintains that therapists must have three attributes to create a growth-promoting climate in which individuals can move forward and become capable of becoming their true self: (1) congruence (genuineness or realness), (2) unconditional positive regard (acceptance and caring), and (3) accurate empathic understanding (an ability to deeply grasp the subjective world of another person). 1. CONGRUENCE (GENUINENESS) 2. UNCONDITIONAL POSITIVE REGARD and ACCEPTANCE 3. ACCURATE EMPATHIC UNDERSTANDING If you’ve ever had an experience where you felt like someone just really got you…they completely understood where you were coming from, or could truly relate to the way you felt – that’s accurate empathic understanding. Rogers asserts that empathy helps clients (1) pay attention and value their experiencing; (2) see earlier experiences in new ways; (3) modify their perceptions of themselves, others, and the world; and (4) increase their confidence in making choices and pursuing a course of action. Jeanne Watson (2002) states that 60 years of research has consistently demonstrated that empathy is the most powerful determinant of client progress in therapy. She puts it this way:
References: It’s the essay title just about every person-centred student has to address at some point in their
training: Was Rogers right to claim, as he does in his classic 1957 paper, that the therapist’s (a) congruence, (b) unconditional positive regard, and (c) empathic understanding are necessary and sufficient conditions for therapeutic personality change to occur (along with (d) therapist—client contact, (e) client vulnerability, and
(f) the therapist’s communication of these conditions)? Rogers’s hypotheses were based on the available research of his time, and were an amazingly insightful and succinct reading of it. But over 60 years have elapsed since Rogers put forward his position: Does it still stand up to the evidence? Let’s start with 'necessary’. That means that those first three ‘therapist-provided’ conditions (along with the three ‘relationship’ and ‘client’ conditions) needs to be there for therapeutic personality change to occur. Here, the research suggests a resounding ‘no’. The problem is, it’s evident that therapeutic personality change can happen through a variety of mechanisms where there really isn’t much of a relationship at all. For instance, James Pennebaker has shown that writing about emotional experiences (as with keeping a diary) can be a profoundly therapeutic experience; and there is good evidence that online therapies can be as helpful as face-to-face therapies, often with minimal interpersonal contact. Have you ever watched a film that has had a profound effect on you, or read a book that has moved you to see life in a really different way? If so, it’s really not possible to claim that any kind of relationship factors are necessary conditions for therapeutic personality change. What about ‘sufficient’? Well, yes, the very latest research does show that each of Rogers’s core conditions are associated with positive therapeutic change. But it’s not necessarily the case from that that they are causing the change. It may be, for instance, that clients who improve then start to feel that their therapists are more accepting and empathic. I know, for instance, that if my doctor gives me some good news, I tend to like them more. And what the evidence also shows is that Rogers’s core conditions are just three of many different relationship factors that are associated with positive outcomes. For instance, alignment on the goals of therapy also seems to be important, and then there’s the therapist’s capacity to deal with ruptures in the alliance, and the use of systematic client feedback. All of these factors are closely related to Rogers’s conditions, but it suggests that the ones Rogers identified don’t have some kind of ‘magical significance’: they’re three factors amongst a sea of inter-related relational variables that all, together, are associated with positive outcomes. Add to that is the problem that, for different clients, Rogers’s therapist-provided conditions may be more or less helpful. For instance, research into empathy shows that, for some clients—highly sensitive, suspicious, and poorly motivated—very high levels of empathy may be counter-productive. Certainly, some clients can feel that a therapist is just too positive, or too in their shoes, or too present and full on. And, finally, there’s some very good evidence, both quantitative and qualitative, that clients can really value, and benefit from, ‘non-relational’ interventions, like normalisation through therapist’s expert knowledge, or ‘behavioural activation’. Maybe the relational elements of these therapeutic encounters are sufficient to bring about some degree of change, but to just focus on that would be to ignore what some clients, themselves, are saying matters most. The problem with Rogers’s hypothesis is that, in many ways, they’re not very ‘Rogerian’: in the sense that they assume everyone responds in the same way, without taking into account individual differences. When you say things are ‘necessary and sufficient’, the inference is that this is going to be true for us all, and that doesn’t allow for people to respond to therapies in different ways. That’s why John McLeod and I have been arguing that one way of really embodying person-centred principles is through a pluralisticapproach to therapy: acknowledging the many different ways in which clients can be helped and the individual differences in what works for each of us (see blog on Person-centred therapy: A pluralistic perspective). I’m sure that Rogers, like most of us in the person-centred field, would have wanted to respect those differences; and no doubt his ‘conditions’ were an attempt to speak the language of his times: scientistic, nomothetic (i.e., universal), and absolute. In fact, I remember reading somewhere that he does acknowledge that it probably wasn’t the best way of phrasing things. If he’d said something like ‘congruence, empathy, and unconditional positive regard are incredibly important elements of therapy for many people, much of the time’, he’d have been absolutely spot on. It’s a bit less snappy, but 60 years later he would have still been absolutely spot on with what the evidence is telling us, and that’s an amazing thing. So what would Rogers say now. Reading the evidence, very closely as he did, I’d like to think he’d say something like the following:
What are the 6 necessary and sufficient conditions?These conditions can be expressed in plain English as follows: The counsellor is congruent (genuine). The counsellor experiences unconditional positive regard (UPR) – non-judgmental warmth and acceptance – towards the client. The counsellor feels empathy towards the client.
What do you believe to be the necessary and sufficient conditions for real therapeutic change to occur?'The Necessary and Sufficient Conditions of Therapeutic Personality Change'. Two persons (client and therapist) are in psychological contact.. The client is in a state of incongruence, being vulnerable or anxious.. The therapist is congruent in the relationship.. Are Rogers core conditions necessary and sufficient?Different people are different. So nothing is necessary and sufficient for everyone. But if you want to practice therapy in a safe and effective way, then establishing an empathic, honest, and unconditionally accepting relationship is, for most clients, one of the best things that you can do.
Are the core conditions sufficient?Accordingly, Bozarth (1988) proposes that the core conditions are “not necessarily necessary, but always sufficient.” The second condition identifies incongruence as the state of being that compels the client to seek therapeutic intervention.
|