Person-Centred Therapy

100 Key Points

Paul Wilkins

• Publisher: Routledge
• Year: 2015
• Print ISBN: 9780415743709
• eBook ISBN: 9781317656555
• Edition: 2
• Topic: Psychology
• Subtopic: History & Theory in Psychology
• Index: Psychology

Person-centred therapy, rooted in the experience and ideas of the eminent psychotherapist Carl Rogers, is widely practised in the UK and throughout the world. It has applications in health and social care, the voluntary sector and is relevant to work with people who are severely mentally and emotionally distressed. As well as being a valuable sourcebook and offering a comprehensive overview, this edition includes updated references and a new section on recent developments and advances.

The book begins with a consideration of the principles and philosophy underpinning person-centred therapy before moving to a comprehensive discussion of the classical theory upon which practice is based. Further areas of discussion include:

The model of the person, including the origins of mental and emotional distress

The process of constructive change

A review of revisions of and additions to person-centred theory

Child development, styles of processing and configurations of self

The quality of presence and working at relational depth

Criticisms of the approach are addressed and rebutted and the application of theory to practice is discussed. The new final section is concerned with advances and developments in theory and practice including:

Counselling for Depression

The Social Dimension to Person-Centred Therapy

Person-Centred Practice with People experiencing Severe and Enduring Distress and at the 'Difficult Edge'

A Review of Research

Throughout the book, attention is drawn to the wider person-centred literature to which it is a valuable key.

Person-Centred Therapy will be of particular use to students, scholars and practitioners of person-centred therapy as well as to anyone who wants to know more about one of the major psychotherapeutic modalities.

Section 1 The underlying epistemology, philosophy and principles of person-centred therapy

1 The person-centred approach is a system of ideas and attitudes in which person-centred therapy is rooted

DOI: 10.4324/9781315765198-1

Although it is sometimes used somewhat imprecisely to refer to a way of doing therapy, the person-centred approach is a global term for the application of the principles derived from the work and ideas of Carl Rogers, his colleagues and successors to many fields of human endeavour. It is one of the most striking things about the method of psychotherapy originating with Carl Rogers – and which has variously been referred to as ‘non-directive therapy’, ‘client-centred therapy’ and ‘person-centred therapy’ – that it, or rather the ideas underpinning it, gave rise to something described as an ‘approach’. This is the person-centred approach of which Wood (1996: 163) pointed out:

[It] is not a psychology, a school, a movement or many other things frequently imagined. It is merely what its name suggests, an approach. It is a psychological posture, a way of being, from which one confronts a situation.

This ‘way of being’ (p. 169) has the following elements:

• a belief in a formative directional tendency;
• a will to help;
• an intention to be effective in one’s objectives;
• a compassion for the individual and respect for his or her autonomy and dignity;
• a flexibility in thought and action;
• an openness to new discoveries;
• ‘an ability to intensely concentrate and clearly grasp the linear, piece by piece appearance of reality as well as perceiving it holistically or all-at-once’: that is to say a capacity for both analysis and synthesis or the perception of gestalts;
• a tolerance for uncertainty or ambiguity.

The ‘person-centred approach’ is not only a way of doing counselling and psychotherapy (between which person-centred therapists do not make a distinction – Point 52) but a way of being in relationship, a relationship which can be with another individual, a group, a nation or even the planet (see Wilkins 2003: 3–5). Although an in-depth consideration of them is outside the scope of this book it is nevertheless pertinent that person-centred theory and practice extends into many other areas of human endeavour. These include education, interpersonal relationships, political, cultural and social change and approaches to research. That the person-centred approach is (for example) concerned with social justice and social change tends to impact on person-centred therapy. Also, the important elements of the approach are the drive for ‘growth’, that is the formative and actualising tendencies (Point 9) and the consideration of people as inherently trustworthy, capable of autonomy and to be deeply respected which has implications for the exercise of power (Point 6). This too goes to the heart of the practice of person-centred therapy. Thus knowledge of the approach as a whole informs person-centred practice. Sanders (in Thorne with Sanders 2013: 99–128) considers the overall influence of Rogers in terms of the wider field to which the person-centred approach has been applied or in which it has influence.

The first section of this book outlines some of the fundamental aspects of the person-centred approach especially as they relate to the theory and practice of person-centred therapy.

2 Person-centred therapy has been from the outset and remains a radical challenge to the prevailing medical model and the notion of therapist as ‘expert’

DOI: 10.4324/9781315765198-2

Person-centred therapy was originally developed in the 1940s by Carl Rogers and his colleagues. From the outset, Rogers’ intention was to provide a radical alternative to the prevailing psychodynamic and behavioural approaches to psychotherapy and also to psychiatry and the medical model in which all these can be seen as rooted. This was initially called ‘non-directive therapy’ and by 1951 his preferred term was ‘client-centred therapy’. In the 1960s when he began to apply the principles derived from his approach to therapy to other realms of human relationship, the term ‘person-centred approach’ gained currency. This in turn led to the term ‘person-centred counselling/ therapy’ which is currently the preferred term in the UK but which may also be taken to embrace a ‘family’ of related approaches based on client-centred theory (Point 3).

In the various names given to the approach to therapy described by Rogers (1942, 1951, 1959) a radical alternative to (then) current approaches is indicated. In the names alone, Rogers is indicating the centrality of the relationship to the therapeutic endeavour, the focus on the client rather than on theory or technique and the importance of the therapist tracking the experience of clients rather than imposing on them. Furthermore, in his statements of the necessary and sufficient conditions for therapeutic change (1957, 1959) (Point 13), Rogers described six elements about which he (1957: 101) claims that, if they are present, positive change will occur regardless of the orientation of the practitioner ‘whether we are thinking of classical psychoanalysis, or any of its modern offshoots, or Adlerian psychotherapy, or any other’. Thus Rogers was making an integrative statement about psychotherapy, not defining client-centred therapy.

So, a way of reading the statement of the necessary and sufficient conditions is as a challenge to all the elaborate theories and practices of the myriad approaches to therapy. ‘Believe what you want and, providing it doesn’t conflict with the necessary and sufficient conditions, do what you want, but unless the six conditions are present, change will not occur, if they are, constructive change will occur regardless.’ Not only that, Rogers (1957: 101) explicitly states that psychotherapy is not a special kind of relationship – the conditions can be and are met in relationships of many other sorts. Implicitly, these relationships too can be the spur to therapeutic change. Herein lies a radical challenge to psychotherapy and psychiatry. This challenge is about power and how it is exercised (Points 5 and 6).

Person-centred therapy eschews diagnosis (but not necessarily ‘assessment’ – see Wilkins 2005a: 128–145 and Point 32) and the medicalisation of distress. However, there is an argument made by, for example, Sanders (2005: 21) to the effect that ‘counsellors have abdicated the radical position occupied by Client-Centred Therapy (CCT) in the 1950s’. As Sanders (2006a: 33–35) states and explains, ‘distress is not an illness’; he (2007e) explores person-centred alternatives to the medicalisation of distress.

Rather than a ‘disease’ model of mental distress as may be seen as dominating psychiatry or notions of ‘psychosis’ and ‘neurosis’ as may be prevalent in other approaches to psychotherapy, in the contemporary person-centred tradition there are four positions to mental ill-health. These are those based on (Wilkins 2005b: 43):

1. (psychological) contact
2. incongruence
3. styles of processing
4. issues of power.

These conceptualisations challenge not only the medicalised element of the psychiatric and psychotherapeutic professions but also the powerful pharmaceutical industry.

3 The person-centred approach embraces a family of person-centred therapies

DOI: 10.4324/9781315765198-3

The approach(es) to therapy based on person-centred principles are various. They include focusing, experiential psychotherapy, process-experiential psychotherapy and creative and expressive forms too. Even the form originating directly from Carl Rogers and which has variously been referred to as ‘non-directive therapy’, ‘client-centred therapy’ and ‘person-centred therapy’ has shifted and adapted along the way. So just what is it that characterises the person-centred therapies?

Sanders (2004: 155) listed the primary and secondary principles of person-centred psychotherapy; the former are ‘required’ for person-centred practitioners and define the broad family that is the person-centred approach, the latter ‘permitted’ in the sense that they bring practice closer to the classic client-centred approach as it was defined in the 1940s and 1950s. Adapted as characteristics of the approach, these are as follows.

Primary principles

• The actualising tendency has primacy. It is required to believe that the process of change and growth is motivated by the actualising tendency and an error to act otherwise.
• Constructive, growthful relationships are underpinned by the active, attentive inclusion of the ‘necessary and sufficient’ conditions established by Rogers (1957).
• The non-directive attitude has primacy. It is mistaken to direct the content of experience either explicitly or implicitly.

Secondary principles

• There is a right to autonomy and self-determination. It is a mistake to violate the internal locus of control of another/others.
• A ‘non-expert’ attitude underpins relationships with others. It is a mistake to imply expertise in the direction of content and substance of the life of another. In this sense at least ‘equality’ is fundamental.
• The non-directive attitude and intention have primacy in that it is a mistake to wrest control of the change process from the actualising tendency in any way whatsoever.
• The therapeutic conditions proposed by Rogers (1957) are sufficient to enable encounter. It is a mistake to include other conditions, methods or techniques.
• Holism – it is a mistake to respond to only a part of the organism.

Although Sanders presented his principles in terms of the relationship between therapist and client, if it is to be person-centred, at least the primary principles apply to any relationship between individuals, an individual and a group, society or nation, groups of all kinds and individuals and groups and ecologies of all levels.

Sanders (2007a: 107–122) revisits the ‘family’ of person-centred and experiential therapies, explaining how the core values are seen by different authors (pp. 108–111), and characterising different approaches to:

• person-centred/client-centred therapy emphasising the centrality of the actualising tendency, the necessary and sufficient conditions and principled non-directivity (pp. 111–114);
• experiential therapies including focusing-oriented and process-experiential psychotherapies in which experiencing is at the core and the therapist is an expert process facilitator/director (pp. 114–117);
• pre-therapy – not a therapeutic approach as such but a system of techniques to come before therapy per se with clients for whom ‘contact’ is problematic (pp. 117–118).

The ‘tribes of the person-centred nation’ are explored more fully in Sanders (2012).

4 There is a philosophical basis to person-centred therapy

DOI: 10.4324/9781315765198-4

The person-centred approach can be considered as rooted in one or more of a number of philosophical or epistemological paradigms. It is not possible to point to one of these major paradigms and to say categorically ‘the person-centred approach belongs there’. Thus, the person-centred approach is not ‘humanistic’ (which may be considered as of the Romantic paradigm) even though it has been assigned as such and has some characteristics in common with humanistic approaches. For example (drawing on Spinelli 1994: 256–260), that person-centred therapy is ‘humanistic’ implies that the following are emphasised:

• the client’s current experience rather than past causes which may ‘explain’ that experience;
• the totality of the client rather than a particular ‘problem’;
• the client’s personal understanding and interpretation of their experience rather than the therapist’s;
• the client’s freedom and ability to choose how to ‘be’;
• an egalitarian relationship between the client and the therapist;
• the therapeutic relationship as intrinsically healing and/or growth-inspiring;
• integration of self-concept and the ‘self’ per se;
• the client’s inherent actualising tendency and innately positive nature;
• the client’s core, unitary self as a source for individual development.

However, it seems that the principles of client-centred therapy were established before those of humanistic psychology (see Merry 1998: 96–103) and possibly contributed to the development of that line of thought rather than being derived from it. Also, person-centred theory is an organism...

Table of contents

• Cover Page
• Half Title Page
• Frontmatter Page
• Title Page
• Copyright Page
• Contents
• Preface
• Preface to the second edition
• Section 1 The underlying epistemology, philosophy and principles of person-centred therapy
• Section 2 Classical person-centred theory
• Section 3 Revisions, reconsiderations and advances in person-centred theory
• Section 4 Criticisms of person-centred therapy – and rebuttals
• Section 5 Person-centred practice
• Section 6 Person-centred theory and practice when working with reactions to life events
• Section 7 Newer developments, advances and understandings: expanding person-centred therapy for the twenty-first century
• References