Client-centred Therapy

I have been told that my approach is person, or client-centred. To some extent this has to be true in the sense that any effective therapist has to demonstrate client-centredness to the person in front of them.

That said, I am not convinced that I am person-centred in the traditional understanding of the ‘person-centred school’. This perspective can be tracked back to the work of Carl Rogers (assuming you do not want to travel back to the Greeks!). You can find a summary account of Rogers’ life and work at:

https://en.wikipedia.org/wiki/Carl_Rogers

The reason why I am reluctant to accept a person-centred label is that I may adopt an humanistic stance in my work, but that’s a rather vague phrase. I am less convinced about the contributions made by the core conditions that emerged from Rogers’ clear and incisive writing. When I say this, I am referring not only to his three core conditions that are well-known, but also the three less well publicised conditions laid down in his texts.

My understanding of the six conditions, in brief, is:

1. that a relationship between client and therapist must exist and that each person’s perception of the other is important.

2. that incongruence exists between the client’s experience and awareness. This is a normal human condition, but one that motivates clients to seek to change.

3. the therapist needs to be congruent within the therapeutic relationship. That means the therapist is not “acting”. They can draw on their own experiences to facilitate the relationship. Traditional therapies were doubtful about therapists’ sharing their own experiences so Rogers was breaking ground here in the mid-20th century.

4.the therapist accepts the client unconditionally, that is, 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.

5. the therapist seeks to experience an empathic understanding of the client’s inner world (or internal frame of reference, as it is termed). The therapist’s accurate empathy helps the client see the therapist’s unconditional regard for them.

6. The client perceives, at least to a minimal degree, that their therapist’s unconditional positive regard and empathic understanding is present.

These conditions have been labelled “necessary and sufficient” for effective therapy. For myself, I regard them as a global basis for working towards being an effective therapist – they are, indeed, necessary but the six conditions are not sufficient.

Why do I think is this? The six core conditions minimise the therapist’s knowledge and understanding. In my experience, clients do expect their therapists to have some skills and to be active in using them. They do not expect knowledge and understanding to be withheld from them in the name of ‘unconditionality’ simply because they have not asked for it. It is difficult for any of us to ask for what we want if we do not know what to ask for!!

Furthermore, the six core conditions do not allow for any incongruence between the therapist’s experience and awareness. In the ‘safe experimental’ method, a therapist will experience small defeats and small victories, as will the client. All need to be identified, discussed and explored in therapy, between sessions and in the process of clinical supervision. Why? It is not reasonable to expect clients to undertake a process if I, as a therapist, am unwilling to do the same thing. It is not simply a question of settling a ‘good example’: it is demonstrating by example.

On one final point, I would say that self-regard in a client is increased not simply by gaining insights into their own current self-worth. They will also be enabled here when their therapist identifies how their own self-worth is distorted by self and others.

I am used to person-centred people saying these three issues I have listed are addressed by the condition of ‘congruence’ within the therapeutic relationship. This gives the impression that the therapist is given permission to speak their mind – discouraged to put on a professional veneer. Would that this were so. What I have observed, in training and in practice, is that modern therapists can swap the ‘professional face’ of older therapists with a reluctance to commit ask questions or offer an opinion.

The truth be told: there is a time for “acting” when being a therapist. If a client appears to say something important, I can mark it with a verbal or a non-verbal response. The latter are often powerful but require a conscious response from me – to a degree that is ‘acting’; that is, not responding with my first impulse. Some of what emerges from Neuro-linguistic Programming (NLP) demonstrates there is an OK side to ‘acting’.

In my view, the person-centred tradition lost the spirit of Rogers’ attitude or a set of ethics. Over time, training and trainers became wedded to the ideas behind the core conditions. in time, ‘person-centredness’ lost its flexibility and became a ‘school’ – a rather ossified tradition.

In doing so, the school became less motivated to follow the client’s own journey. A person-centred therapist is likely to be enraged by this statement. I can appreciate that most therapists want to walk alongside a client on their journey into a changed future; one that is shaped by that client. It is easy to say those words, and easy to stop demonstrating the difficult actions required to keep two people in a negotiated focus.