Self-actualization, originally introduced by the for the motive to realize one's full potential, is an important concept underlying person-centred therapy. It refers to the tendency of all human beings to move forward, grow, and reach their fullest potential. When humans move toward self-actualization, they tend to be concerned for others and behave in honest, dependable, and constructive ways. The concept of self-actualization focuses on human strengths rather than human deficiencies. Both Rogers and Maslow believed in a person’s potential to reach self-actualisation. Maslow however referred to the “psychology of being” and that self-actualisation was an end in itself at the top of the hierarchy of needs whereas Rogers considered the “psychology of becoming”- the process of being able to take charge of your life and become the person you want to be - a continuous process.
As we have seen above Carl Rogers’ theory of Person-Centred Therapy included the concept of Self-Actualization, which in turn implied that a biological internal force that develops capacities and talents to the fullest. Rogers’ understanding was that for a person to be truly helped, the important healing factor is the relationship itself. He believed that the most significant element in successful therapy was not the therapist's skills or training, but rather his or her attitude.
There are three interrelated attitudes on the part of the therapist which are central to the success of the Person-Centred Therapy: congruence, unconditional positive regard and empathy. Congruence refers to the therapist's openness and genuineness—the willingness to relate to clients without hiding behind a professional facade. Therapists who function in this way have all their feelings available to them in therapy sessions and may share significant emotional reactions with their clients. However, congruence does not mean that therapists disclose their own personal problems to clients in therapy sessions or shift the focus of therapy to themselves in any other way.
Unconditional positive regard (UPR) means that the therapist accepts the client totally for who she or he is without evaluating or censoring, and without disapproving of any particular feelings, actions, or characteristics. The therapist communicates this attitude to the client by a willingness to listen without interrupting, judging, or giving advice. This attitude of positive regard creates a non-threatening context in which the client feels free to explore and share painful, hostile, defensive, or even abnormal feelings without worrying about personal rejection by the therapist.
The third necessary component of a therapist’s attitude is empathy. The therapist tries to appreciate the client's situation from the client’s point of view, showing an emotional understanding of the client's feelings throughout the whole therapy session. In other type of therapies, empathy with the client would be considered a preliminary step to enabling the therapeutic work to proceed; but in Person-Centred Therapy, it actually constitutes a major portion of the therapeutic work itself.
The therapist puts into practise this empathy by active listening that shows careful and perceptive attention to what the client is saying. In addition to standard techniques, such as eye contact, that are common to any good listener, person-centred therapists employ a special method called reflection, which consists of paraphrasing and/or summarizing what a client has just said. This technique shows that the therapist is listening carefully and accurately, and gives the clients an added opportunity to examine their own thoughts and feelings as they hear them repeated by another person. Generally, clients respond well to this technique and they go further on the thoughts they have just expressed.
According to Rogers, when these three attitudes (congruence, unconditional positive regard, and empathy) are practised by a therapist, clients can freely express themselves without having to worry about what the therapist thinks of them. The therapist does not attempt to change the client’s thinking in any way. Even negative expressions are accepted as appropriate experiences. Because of this non-directive approach, clients can find out which problems are important to them and explore these issues – not those ones considered important by the therapist.
Based on the principle of self-actualization, this undirected, uncensored self-exploration allows clients to recognize alternative ways of thinking that will promote personal growth. The therapist merely facilitates self-actualization by providing a climate in which clients can freely engage in focused, in-depth self-exploration.
Carl Rogers described six therapeutic conditions:
Therapist-Client Psychological Contact: a relationship between client and therapist must exist, and it must be a relationship in which each person’s perception of the other is important.
Client incongruence or Vulnerability: that incongruence exists between the client’s experience and awareness. Furthermore, the client is vulnerable to anxiety which motivates them to stay in the relationship.
Therapist Congruence or Genuineness: the therapist is congruent within the therapeutic relationship. The therapist is deeply involved him or herself – they are not "acting" – and they can draw on their own experiences (self-disclosure) to facilitate the relationship.
Therapist Unconditional Positive Regard (UPR): the therapist accepts the client unconditionally, without judgment, disapproval or approval. This facilitates increased self-regard in the client, as they can begin to become aware of experiences in which their view of self-worth was distorted by others.
Therapist Empathic understanding: the therapist experiences an empathic understanding of the client’s internal frame of reference. Accurate empathy on the part of the therapist helps the client believe the therapist's unconditional love for them.
Client Perception: the client perceives, to at least a minimal degree, the therapist's UPR and empathic understanding. Wikipedia
Rogers declared that these conditions are both necessary and sufficient. “By necessary he meant that helpful change will only happen if all three conditions are present. If one is missing change will either not happen or if it does happen, it may not be helpful.” First Steps in Counselling
By sufficient Rogers meant that if all these conditions are present, helpful change will occur regardless of any other conditions being met. According to Sanders the core conditions have to be experienced by the client before they are of any use.
Rogers originally developed Person-Centred Therapy in a children’s clinic while he was working there; nevertheless, PCT was not intended for a specific age group or population but has been used to treat a broad range of people. Rogers` therapy has also been applied to persons suffering from depression, anxiety, alcohol disorders, cognitive dysfunction, schizophrenia and other . Some therapists argue that PCT is not effective with poorly educated individuals or people who have problems to express themselves; others sustain that it can be successfully adapted to any type of person. PCT could be very effective in and with young children (employed as ).
The expected results of PCT include improved self-esteem, being able to make decisions, trust in one’s inner feelings and experiences, ability to learn from mistakes instead of repeating them; reduced guilt-feeling and insecurity, decreased defensiveness, more positive relationships with others; an increased capacity to express feelings and openness to new experiences and new and more optimistic ways of thinking about life.
Studies of humanistic therapies in general and PCT in particular indicate that people who have been treated with these approaches maintain stable changes over longer periods of time and that they change substantially compared to untreated persons. Humanistic therapies (Gestalt-therapy, , depth therapy, holistic health, etc.) seem to be particularly effective with clients suffering from depression or with relationship issues. PCT appears to be slightly less effective than other forms of humanistic therapy in which therapists offer more advice to clients and suggest topics to explore. According to Professor Michael King there is no difference in therapeutic effectiveness between PCT and CBT (Cognitive Behavioural Therapy), but both PCT and CBT obtained significantly better results than “usual general practitioner care” at a four month follow-up. First Steps in Counselling pg130
PCT has been criticized by behaviourists for lacking structure and by psychoanalysts for actually providing a conditional relationship. In PCT there is no emphasis placed on boundaries. Therefore, the client could lead the conversation to areas not considered appropriate for counselling.
A frequent criticism of PCT is that it is not effective or even dangerous to apply with serious mental problems (severe forms of psychosis): “Critics of Rogers’s theories maintain serious doubts that therapists can, or should, establish a relationship of unconditional positive regard in the case of dangerously violent persons.”enotes.com
PCT has also been criticised for the vagueness of its principles, its antipathy to diagnosis, and its emphasis on the client’s self-evaluation as the way to judge the outcome of therapy. According to Dr. Michael Miller “Client-Centred Therapy may work less well with people who find it difficult to talk about themselves or have a mental illness that distorts their perceptions of reality”. Harvard Mental Health Letter
Quite a few factors may affect the success of PCT. The skills of the therapist are very important. Generally, clients tend to overlook occasional therapist’s mistakes or failures if an adequate relationship with good rapport has been established, but if the therapist constantly fails to demonstrate one or all of the core conditions (unconditional positive regard, congruence, or empathy) cannot effectively use this type of therapy. Even though the therapist is naturally an emphatic, respectful and understanding, accepting and genuine person, if the client does not perceive these qualities the therapy could not be successful: “just as important as you having or ‘being’ these qualities is the transmitting of them and the receiving of them by the client”. First Steps in Counselling
Another issue is the client’s comfort level with non-directive approach. Some studies have suggested that certain clients may get annoyed, bored or even frustrated with a Rogerian style of therapeutic interaction. Thirdly, when the client is in doubt with the therapy for example she/he was forced by family or friends to go to therapy, she/he may not work well together with the therapist, especially with non-directive approach.
While person-centred therapy is considered one of the major therapeutic approaches, along with psychoanalytic and , Rogers’s influence is felt in schools of therapy other than his own. The concepts and methods he developed are used by many different types of counsellors and therapists.
Conclusion:
I believe that Person-Centred Therapy offers the therapist many great tools to treat the client successfully, but at the same time I think that this approach on its own will not suit all clients but will work extremely well in combination with other types of therapy. “Clients who have a strong urge in the direction of exploring themselves and their feelings and who value personal responsibility may be particularly attracted to the person-centred approach. Those who would like a counsellor to offer them extensive advice, to diagnose their problems, or to analyse their psyches will probably find the person-centred approach less helpful. Clients who would like to address specific psychological habits or patterns of thinking may find some variation in the helpfulness of the person-centred approach, as the individual therapeutic styles of person-centred counsellors vary widely, and some will feel more able than others to engage directly with these types of concerns.” Dr Greg Mulhauser
Resources:
Wikipedia-internet:
Counsellingresources.com written by Dr Greg Mulhauser
Harvard Mental Health Letters website
First Steps in Counselling Pete Sanders
Next Steps in Counselling Practice Pete Sanders, Alan Frankland and Paul Wilkins
Carl R Rogers Client Centered Therapy
Abraham H Maslow Toward a Psychology of being
Denise Kensit : Rogerian Theory: A Critique of the Effectiveness of Pure Client-Centred Therapy.
Edwin Kahn: A Critique of Nondirectivity in the Person-Centered Approach.