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Introduction

Person-centred therapy, also known as person-centred psychotherapy, person-centred counselling, client-centred therapy and Rogerian psychotherapy, is a form of psychotherapy developed by psychologist Carl Rogers beginning in the 1940s and extending into the 1980s. Person-centred therapy seeks to facilitate a client’s self-actualising tendency, “an inbuilt proclivity toward growth and fulfilment”, via acceptance (unconditional positive regard), therapist congruence (genuineness), and empathic understanding.

It is one of the most influential and fundamental modalities of treatment in modern psychological practice, and is applied almost universally in modern psychotherapy. However, it is rarely used on its own; typically it is combined with other forms of therapy.

Background

Person-centred therapy, now considered a founding work in the humanistic school of psychotherapies, began with Carl Rogers, and is recognised as one of the major psychotherapy “schools” (theoretical orientations),[clarification needed] along with psychodynamic psychotherapy, psychoanalysis, classical Adlerian psychology, cognitive behavioural therapy, existential therapy, and others.

Rogers affirmed individual personal experience as the basis and standard for living and therapeutic effect. This emphasis contrasts with the dispassionate position which may be intended in other therapies, particularly the behavioural therapies. Living in the present rather than the past or future, with organismic trust, naturalistic faith in one’s own thoughts and the accuracy in one’s feelings, and a responsible acknowledgment of one’s freedom, with a view toward participating fully in our world, contributing to other peoples’ lives, are hallmarks of Rogers’ person-centred therapy. Rogers also claimed that the therapeutic process is essentially the accomplishments made by the client. The client having already progressed further along in their growth and maturation development, only progresses further with the aid of a psychologically favoured environment.

Although client-centred therapy has been criticised by behaviourists for lacking structure and by psychoanalysts for actually providing a conditional relationship, it has been shown to be an effective treatment.

What is Required for Therapeutic Change?

Rogers (1957; 1959) stated that there are six necessary and sufficient conditions required for therapeutic change:

1. 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.
2. Client incongruence: that in-congruence exists between the client’s experience and awareness.
3. Therapist congruence, or genuineness: the therapist is congruent within the therapeutic relationship. The therapist is deeply involved – they are not ‘acting’ – and they can draw on their own experiences (self-disclosure) to facilitate the relationship.
4. Therapist unconditional positive regard: 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 or denied.
5. 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 regard for them.
6. Client perception: that the client perceives, to at least a minimal degree, the therapist’s unconditional positive regard and empathic understanding.

Core Conditions

It is believed that the most important factor in successful therapy is the relational climate created by the therapist’s attitude to their client. The therapist’s attitude is defined by the three conditions focused on the therapist, which are often called the core conditions (3, 4, and 5 of the above six conditions):

1. Congruence: the willingness to transparently relate to clients without hiding behind a professional or personal façade.
2. Unconditional positive regard: the therapist offers an acceptance and prizing for their client for who he or she is without conveying disapproving feelings, actions or characteristics and demonstrating a willingness to attentively listen without interruption, judgement or giving advice.
3. Empathy: the therapist communicates their desire to understand and appreciate their client’s perspective.

Processes

Rogers believed that a therapist who embodies the three critical and reflexive attitudes (the three core conditions) will help liberate their client to more confidently express their true feelings without fear of judgement. To achieve this, the client-centred therapist carefully avoids directly challenging their client’s way of communicating themselves in the session in order to enable a deeper exploration of the issues most intimate to them and free from external referencing. Rogers was not prescriptive in telling his clients what to do, but believed that the answers to the clients’ questions were within the client and not the therapist. Accordingly, the therapists’ role was to create a facilitative, empathic environment wherein the client could discover the answers for him or herself.