ClientCentered Therapy

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Chapter 13 Treatment of Psychological Disorders
client’s experience of this relationship that brings beneficial changes. (Notice that
this assumption is shared with object relations and some other forms of brief
psychodynamic therapy.)
4. Clients must remain responsible for choosing how they will think and behave.
Of the many humanistically oriented treatments in use today, the most influential are
client-centered therapy, developed by Carl Rogers, and Gestalt therapy, developed by
Frederick and Laura Perls (Cain & Seeman, 2002; Patterson, 2000; Woldt & Toman, 2005).
Client-Centered Therapy
Carl Rogers was trained in psychodynamic therapy methods during the 1930s, but he
soon began to question their value. He especially disliked being a detached expert whose
task is to “figure out” the client. Eventually convinced that a less formal approach would
be more effective, Rogers allowed his clients to decide what to talk about and when,
without direction, judgment, or interpretation by the therapist. This approach, now
called client-centered therapy or person-centered therapy, relies on the creation
of a relationship that reflects three intertwined therapist attitudes: unconditional positive regard, empathy, and congruence.
Unconditional Positive Regard The attitude Rogers called unconditional positive regard consists of treating the client as a valued person, no matter what. This
attitude is communicated through the therapist’s willingness to listen without interrupting and to accept what is said without evaluating it. The therapist doesn’t have to
approve of everything the client says, but must accept it as reflecting that client’s view
of the world. Because Rogerian therapists trust clients to solve their own problems, they
rarely give advice (Merry & Brodley, 2002). Doing so, said Rogers, would send clients
an unspoken message that they are incompetent, making them less confident and more
dependent on help.
client-centered therapy (personcentered therapy) A type of therapy
in which the client decides what to talk
about and when, without direction,
judgment, or interpretation from the
therapist.
unconditional positive regard In
client-centered therapy, the therapist’s
attitude that expresses caring for and
acceptance of the client as a valued
person.
empathy
In client-centered therapy,
the therapist’s attempt to appreciate
how the world looks from the client’s
point of view.
reflection Restating or paraphrasing
what the client has said.
congruence In client-centered therapy, a consistency between the way
therapists feel and the way they act
toward clients.
Empathy In addition, the client-centered therapist tries to see the world as the client
sees it. In other words, the therapist tries to develop empathy, an emotional understanding of what the client might be thinking and feeling. Client-centered therapists convey empathy by showing that they are actively listening to the client. Like other skillful
interviewers, they make eye contact with the client, nod in recognition as the client
speaks, and give other signs of careful attention. They also use reflection, a paraphrased
summary of the client’s words that emphasizes the feelings and meanings that appear
to go along with them. Reflection confirms what the client has said while also expressing
the therapist’s interest and helping the client to be aware of the thoughts and feelings
expressed. Here is an example:
Client: This has been such a bad day. I’ve felt ready to cry any minute, and I’m not
even sure what’s wrong!
Therapist: You really do feel so bad. The tears just seem to well up inside, and I wonder if it is a little scary to not even know why you feel this way.
Notice that in rephrasing the client’s statements, the therapist reflected back not only
the obvious feelings of sadness but also the fear in the client’s voice. Most clients
respond to empathic reflection by elaborating on their feelings. This client went on to
say, “It is scary, because I don’t like to feel in the dark about myself. I have always prided
myself on being in control.”
Empathic listening tends to be so effective in promoting self-understanding and
awareness that it is used across a wide range of therapies (Corsini & Wedding, 2001).
Even beyond the realm of therapy, people who are thought of as easy to talk to are usually “good listeners” who reflect back the important messages they hear from others.
Rogerian therapists also try to convey congruence (sometimes called
genuineness) by acting in ways that are consistent with their feelings during therapy.
Congruence