Client Centered Therapy

Client centered therapy History ● Was developed by Carl Rogers ● Also termed: humanistic, phenomenological person-centered ● Third force in psychology Focused far less on how therapy can affect change in the individual and far more on how the individual can change on their own given the right circumstances that are provided by the therapeutic relationship- known as the third force in psychology Carl Rogers ● Psychoanalytically trained ● Followed client lead instead of assuming expert role ● Influenced by otto ranks nondirective therapy Early Research Therapeutic process ● Predictors of change among people with schizophrenia ● Accurate empathy ● Patients perception Current status ● Association for the development of the person- centered approach (1986) -Interdisciplinary -Meets annually ● Person centered journal Theory of personality ● All humans have an actualizing tendency -Formative tendency ● Reacting as a whole The self Client centered therapy is predicated on this idea that we have a self right Self is considered to be perceptions of characteristic Each person Experience Internal frame of reference Organismic valuing process 19 Basic propositions Themes ● Perception ● Self concept ● Psychological adjustment Perception: We react to the world based on our own perceptions “Reality” Behavior attempts to satisfy needs Understand behavior through the individual Self-concept Center of our own worlds Structure is consistent yet fluid Behavior can be Consistent Inconsistent Psychological adjustment ● Experiences consistent with self ● Understanding of others ● See values as a continuous process Theory of psychotherapy “ client centered therapy in common with other therapeutic approaches aims to enhance the life functioning and self experience of clients. Unlike other therapies however client centered therapy does not use techniques treatment planning for goal setting to achieve these ends -Does Not necessarily use techniques but instead focuses on creating an environment in which the necessary conditions for self actualization and self healing to take place can flourish” Necessary and sufficient conditions for therapy Rogers lays out for us 6 necessary and sufficient conditions for therapy. He tells us that if we can create a therapeutic environment that meets all six of these conditions then we will be successful in creating an environment in which a patient can self actualize(self feel and grow) 1. 2 people are in psychological contact 2. Client is in state of incongruence 3. Therapist is congruent or integrated in the relationship 4. Therapist experiences unconditional positive regard for the client 5. Therapist experiences an empathic understanding of the client 6. Client perceives therapists empathic understanding and unconditional Conditions for therapy: therapist congruence : therapist doesn't deny their feelings Range of characteristics that a therapist can display while still displaying empathy Clip: Demonstrates empathy Wants to know whats going inside of his own internal frame of reference Congruence: shares his experience with will as a way of moving the relationship along Unconditional positive regard: i don't judge who you are as a human i unconditionally accept you value as a human and i want to know who you are Conditions for therapy: client Methods of psychotherapy Non directive; theorist use the skills they have around therapist qualities unconditional positive regard empathy congruence- seeks to bring these in the therapy room to self actualize Respect: respect is being shown to the patient immediately, important for the unconditional positive regard Understanding: seeks to understand the world view of the patient ● ● Recognize implicit feelings Clarify ● Answer questions without -Reassurance -Advise Rogers therapy session Distinctive components ● Necessary and sufficient conditions for change ● Focus on the client's internal frame of reference ● Not focused on changing structure of personality ● Same principles of psychotherapy apply to all people Mechanisms evidence culture Evidence base ● Therapeutic factors ● Extra therapeutic factors ● Core conditions Cultural considerations Within group differences can exceed between group differences Multiple groups Evolving self concept Uniqueness Therapist must Be aware of own biases Challenge bias to achieve true empathic understanding Have openness and appreciate all kinds of differences Review sheet 1. What is the third force in psychology? Emphasis on the idea that a person can change on their own, given the right circumstances provided by the therapeutic relationship. ○ Humanistic movement challenged dominance of psychoanalysis 2. Describe the differences between client-centered and psychoanalytic therapy. Client-centered therapy does not use techniques, treatment planning, or goal setting. Clientcentered therapy also aims to let the client essentially run the session. ■ Client centered therapy is Non-directive, and allows for therapist to follow client’s lead instead of assuming an expert role ■ Also focuses on the present rather than the past (psychoanalytic)\ ■ Psychoanalytic focuses on the therapist as an expert ■ Emphasis on therapist skills rather than technical rules Psychoanalytic therapy, on the other hand, uses a variety of techniques to try to "fix" the client. It is also directive; the therapist controls much of the session. ■ Insight in client-centered therapy focuses on client’s internal frame of reference in that moment or instant rather than the past in their unconscious 3. What are the basic assumptions of client-centered therapy? All humans have an actualizing tendency to strive to reach our full potential. ○ All humans have an actualizing tendency ■ Formative tendency- as nature moves towards order, complexity, and interrelatedness it will drive actualizing tendency ■ Innate tendency to strive to reach full potential ○ Reacting as a whole ■ Cannot simply reduce an organism to its parts ■ We are autonomous people and strive for autonomy 4. What three components construct a person's reality? Experience, Through symbolization (becoming aware and conscious of experiences) internal frame of reference, Each person has their own unique vantage point for seeing the world organismic valuing process. ■ We develop for ourselves our own value judgements ■ In order to be a fully functioning person ● Always function through internal frame of reference ● Have to be capable of symbolizing experiences and make decisions about them through this organismic valuing process 5. How does distress occur in the client-centered theory? Distress occurs when we fail to symbolize our experiences (not congruent). When behavior or experiences don’t comply with the patient’s concept of self 6. What is unconditional positive regard? How does it strengthen the therapeutic relationship? Unconditional positive regard is valuing someone as a human being. Showing this regard strengthens the relationship by showing the client that they are always of value. ● Provides setting for client to self-heal and grow and client perceives this and grows to trust the therapist 7. The following concepts embody and affect the client's experience in client-centered therapy. Make sure you understand: a. actualizing tendency actualizing tendency - the tendency for humans to strive to reach our full potential b. reacting as a whole reacting as a whole - we can't simply reduce an organism to just its parts ○ the whole autonomous organism reacts to experience as a whole person c. experience experience - private world of the individual d. internal frame of reference internal frame of reference - an individual's unique vantage point for seeing the world e. organismic valuing process organismic valuing process - we develop our own value judgments ○ making choices based on internalized conditions of worth f. the self: the self - perceptions of the characteristic 'I or me' with the values that we attach to these perceptions ○ each person makes their own reality through experience, internal frame of reference, and organismic valuing process. Organized, consistent, conceptual Gesalt composed of perceptions of the characteristics of the “I” or “me” and perceptions of the relationships of the “I” or “me” with others and various aspects of life altogether with the values attached to these perceptions g. Reality reality - our own perceptions of the world h. Symbolization symbolization - attaching meaning to our experiences ○ becoming aware and conscious of experiences i. adjustment and maladjustment adjustment - positively adapting to things (good coping mechanisms)-allows actualizing tendency maladjustment - negatively adapting to things (harmful coping mechanisms) j. fully functioning person fully functioning person - a person that is actively trying to reach their full potential by symbolizing their experiences k. Self-concept self-concept - how we understand ourselves and our values ○ we are the center of our own world. The structure is consistent yet fluid and behavior can be consistent and inconsistent. Revolves around how a person sees themselves and sees their own behaviors. 8. Similarly, client-centered therapy suggests that therapists should behave in certain ways to facilitate effective therapy. Understand how the following affect therapists in clientcentered therapy: a. Congruence The client must be in a state of incongruence while the therapist is congruent and integrated in the relationship. ■ Basic attitude for therapeutic growth ■ Transparent communication and accurate symbolization of experiences in the internal self-awareness of therapist ■ If therapist is having similar experiences they might share them rather than hide behind mask of professionalism b. Unconditional positive regard the therapist must experience unconditional positive regard for the client. ■ Leave behind prejudice or bias and accept client and everything that comes with them as unique, appropriate, and human c. Empathy The client must perceive the therapist's empathetic understanding and unconditional empathy. 9. What is Zimring's new paradigm? What is the difference between objective context and subjective context? Zimring's new paradigm = change an objective to a subjective context. ○ Asserts that humans only become persons through interaction with others and that this process takes place within a certain culture. There is some pathological entity inside that needs to be brought to awareness - until one is able to make the unconscious conscious then maladjustment wil exist An objective context is one in which the world is the focus. A subjective context is one in which the client is the focus. 10. What is the moment of movement? Molecules of change. ○ Experience at a single instant without barriers is capable of being fully experienced ○ Acceptable and capable of being integrated when symbolized ○ Most of therapy tries to prepare people for moment of movement 11. What are the tenets of Feminist Therapies? 1. Personal and political context. 2. Commitment to social change. 3. Value of diverse perspectives. 4. The counseling relationship is egalitarian. 5. A focus on strengths and a reformulated definition of psychological distress. 6. All types of oppression are recognized. ○ Free will ○ Acknowledges partiarchal systems in both society and psychology that tend to discriminate, undermine, and generalize women 1. In developing his theory and clinical practice regarding client-centered therapy, Carl Rogers was heavily influenced by the work of a. Albert Ellis. b. Kurt Goldstein. c. Sigmund Freud. d. Aaron Beck. 2. Which term refers to a state of wholeness and integration? a. Empathy b. Positive regard c. Congruence d. Experiencing 3. Client-centered therapists believe that empathy, unconditional positive regard, and congruence are a. conveyed simply through listening and repeating the patient’s words. b. attitudes consonant with a therapist’s values and beliefs. c. variables the client brings to the therapeutic relationship. d. attributes that can be faked while the therapist is in training. 4. Success in client-centered therapy corresponds with a(n) a. rigid experiential mode. b. dependence on the therapist. c. devaluation of others. d. internal locus of control. 5. Client-centered therapy focuses most heavily on the a. present. b. future. c. past. d. irrational. . A distinctive characteristic of client-centered therapy is the emphasis on the a. human being as a person. b. evolutionary development of emotions. c. therapist’s maintenance of a directive stance. d. earliest recollections of the client. . The client-centered therapist strives to use an approach that is best described as a. medical. b. instrumental. c. directive. d. expressive. . Gendlin’s experiential therapy locates the experiencing process in the a. family. b. society. c. therapist. d. body. 9. What is an ethical claim signifying that human beings should not be used as means to others’ ends? a. Dignity b. Personhood c. Client-centered therapy d. Psychological theories 10. Which of the following represents a similarity between Rogers’s approach and Rankian theory? a. Viewing the individual based on unconscious forces b. Emphasis on transferential relationships c. Allowing the client to be the central figure d. Reliance on interpretation in therapy 11. The event most commonly identified with the birth of client-centered therapy is a. America’s involvement in World War II. b. Maslow’s creation of the hierarchy of needs. c. Rogers’s presentation at the University of Minnesota. d. Rogers’s association with Elizabeth Davis. 12. The University of Wisconsin study of hospitalized schizophrenics showed that treatment outcome correlated highest with the a. therapist’s perception of the therapeutic relationship. b. client’s perception of the therapeutic relationship. c. researcher’s objective ratings of therapeutic process. d. time spent with clients who received the least empathy. 13. According to Rogers, the center of an individual’s world of experience is the a. mother. b. father. c. family. d. individual. 14. In Rogers’s personality theory, behavior is defined as a. the direct result of reinforcement and punishment. b. a goal directed attempt to satisfy an organism's needs. c. a biologically driven process of interacting. d. fulfillment of the drives of the id, ego, and superego. 15. Rogers believed that an organism has one basic tendency and striving, which is a. a drive to seek and maintain pleasurable sensory experiences. b. to actualize, maintain, and enhance the experiencing organism. c. fulfillment of basic needs for personal and species survival. d. an aggressive force the individual must balance with societal needs. 16. For social purposes, reality is defined as a. common perceptions across individuals. b. the private world of individual perceptions. c. uncommon perceptions across individuals. d. public knowledge of an individual’s perceptions. 17. If given a choice, Rogers believed most individuals would chose to be a. dependent. b. sick. c. aggressive. d. Healthy. 18. According to Rogers, psychological maladjustment occurs when an individual a. denies significant sensory and visceral experiences. b. obtains insight regarding current and past experiences. c. relies on internal resources to define self-concept. d. accepts organic experiences into the self-structure. 19. An infant’s ability to evaluate experience in terms of how it maintains or enhances them is known as a. self-concept. b. self-preservation. c. direct organismic valuing. d. distorted symbolization. 20. The conceptual development of a concept of self is a. a process completed by adulthood. b. unrelated to relationships with others. c. absolutely indefinable operationally. d. a fluid, changing process. 21. The process by which an individual becomes aware of an experience is known as a. symbolization. b. reality. c. actualization. d. experience. 22. In ambiguous situations, individuals tend to symbolize experiences in a manner consistent with a. social reality. b. parental attitudes. c. self-concept. d. a therapist. 23. Fully functioning individuals capable of experiencing complete emotions rely on a. external sources of evaluation. b. pleasure sustaining impulses. c. organismic valuing processes. d. biological instincts and drives. 24. Understanding another individual by “living” in their internal frame of reference is a. knowledge. b. empathy. c. congruence. d. reality. 25. Rogers’s ethical vision of the person is expressed in scientific language by his axiomatic concept of a. organismic valuing process. b. reparative therapy. c. client-centered therapy. d. actualizing tendency. 26. In the first interview, a person-centered therapist will a. gather historical information. b. go where the client goes. c. develop a treatment plan. d. complete a diagnostic formulation. 27. When asked for advice, a person-centered therapist would most likely a. facilitate the patient’s personal decision-making. b. provide an opinion based on empathic knowledge. c. focus on the transferential nature of the interaction. d. assign homework that would allow self-discovery. 28. For a “moment of movement,” each statement is true EXCEPT which of the following? a. The experience has the quality of being unacceptable. b. It is an experience without barriers or inhibitions. c. For the first time it is being experienced completely. d. It is not a thought, but an experience at that instant. 29. A successful person-centered therapy outcome would be defined by a. objective assessments indicating progress. b. alleviation of symptoms representing a diagnostic label. c. a therapist’s perception that the client improved. d. the client’s evaluation that therapy was beneficial. 30. In person-centered therapy, termination is decided by a. symptom reduction. b. the therapist. c. the client. d. behavior change. 31. Zimring underscores the importance of how humans become persons within the context of their a. own psyche. b. culture. c. family. d. psychic distress. 32. If a child were raised by critical parents and unable to verbalize their own thoughts and feelings, Zimring’s paradigm would suggest degradation of the a. subjective context. b. family context. c. objective context. d. everyday world. 33. A client-centered therapist would likely view the diagnostic process as a. crucial to treatment planning. b. a colossal waste of time. c. vital to establishing empathy. d. enhancing the client’s locus of control. 34. The conclusion drawn from meta-analyses and large-scale studies that all major psychotherapies yield comparable effect sizes is referred to as the a. Dodo Bird effect. b. common factors research. c. Zimring’s paradigm. d. client-driven model. 35. In Lambert’s meta-analytical review evaluating client-centered therapy, the outcome variable accounting for the most variance in treatment progress was a. core conditions. b. therapeutic techniques. c. placebo factors. d. client variables. 36. Client-centered therapy was developed by ___________. ANSWER: Carl Rogers 37. Carl Rogers believed that all humans had _______ tendency, which he saw as a part of the _______ tendency of the world. ANSWER: actualizing; formative 38. For Carl Rogers, _______, _______, and _______ were the three basic requirements to create a therapeutic environment. ANSWER: empathy; unconditional positive regard; congruence (genuineness) 39. When a therapist is able to maintain an unaltered attitude about a patient, regardless of the patient’s comments or choices, this is referred to as _______. ANSWER: unconditional positive regard 40. In addition to the basic requirements of the therapeutic environment for the therapist, Rogers believed that the client must focus on _______, _______, and _______. ANSWER: self-concept; locus-of-evaluation; experiencing 41. For Rogers, ______________________ is the state of wholeness and integration within the experience of the person, and the hallmark of psychological adjustment. ANSWER: congruence 42. The ongoing process in which individuals freely rely on the evidence of their own sense for making value judgments is referred to as the _______. ANSWER: organismic valuing process 43. When a client is able to experience something without barriers, this is termed as __________. ANSWER: involvement of movement 44. Carl Rogers would view neurosis as the result of incongruence between the _________ and the _________. ANSWER: real self; ideal self 45. The ethical commitment to the egalitarian nature of therapy is not an expression of orthodoxy but rather is a _________________ that guides our course without dictating the route. moral compass According to Rogers, the center of an individual's world of experience is the… Individual ANSWER: