12 Client-Centered Therapy
fundamentals of Client-Centered Counseling
Learning Objectives
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Identify the core conditions of person-centered therapy.
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Explain the therapeutic process of person-centered therapy.
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Describe the benefits and criticisms of person-centered therapy.
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Review the efficacy of person-centered therapy in the treatment of common psychiatric illnesses.
If I can provide a certain type of relationship, the other person will discover within himself [sic] the capacity to use that relationship for growth and change, and personal development will occur. – Carl RogersA good image of Rogerian counseling is of a plant – the counselor provides the growth-promoting climate and the client is then free and able to discover and grow as she / he wants and needs to. Client-centered counseling has gained popularity, specifically in the field of chemical dependency counseling as needs of the client are paramount in determining the best treatment and counseling strategies. Part of client centered counseling is gaining the client’s trust and helping the client to feel comfortable with the counselor. This can be accomplished by creating the counseling relationship with facilitative qualities such as empathy, genuineness, immediacy, warmth, and respect. Ensuring these qualities are present in the initial consult with the client will help create a warm and inviting atmosphere and set the client at ease.
Empathy
We have all experienced times in our lives where we needed another person to understand how we feel, or what we have experienced. This shared human experience can create feelings of empathy, and provide a strong connections among individuals. Within a therapeutic setting, empathy is a powerful tool that a counselor can use to help relate to their client’s thoughts, feelings, and experiences. This relational engagement helps the counselor to understand how their client is experiencing the world around them. For example, a therapist may say, “I hear you saying that you feel powerless in your situation and depressed. This must feel overwhelming and lonely.” This type of relational statement can engage the client and help them to feel more free to offer expressions of how they truly feel, which creates an environment for effective counseling to take place.
Genuineness
Absolutely no one that seeks treatment for a substance use disorder or any other type of disorder, wants to feel like their counselor does not genuinely care for their well-being. It is very important that a counselor is genuine in their desire to help their clients, avoid being false or defensive with their clients, and seek to find common ground and understanding to build a alliance. Genuineness cannot be faked, and it is naturally occurring when real. Sometimes, it can be difficult for a counselor to be genuine, especially if they feel that their client is being dishonest or manipulative. In order to help the client to be more honest and open, it can be useful for the counselor to self-disclose or share with the client personal experiences, feelings, or thoughts. This can help the client feel like they are not being judged and are not alone in their life struggles.
Immediacy
Immediacy involves real feelings in which the counselor is being open, honest, and truly communicating urgency in attending to the clients needs. If the client perceives that the counselor does not take them seriously, or feels like they are an imposition, this can negatively impact the therapeutic relationship.
Warmth
Warmth is similar to genuineness, in that it is a true and real feeling and behavior that is communicated verbally and non verbally from the counselor to the client. It is the counselor telling the client that they value them, are happy they are here, and want to assist and help them in any way that they can. Clients to not want to feel like they are not of value, it is not effective environment for therapy if a client feels like they are not well – received. Think back to a time you were given the cold shoulder by someone. I bet you didn’t really want to talk to them or share feeling or thoughts after that reception.
Respect
Mutual respect between the client and counselor should always be present in each counseling session. Without mutual respect, the therapeutic alliance and treatment will be ineffective. The power dynamic between a counselor and client should be one where each is on equal footing, with the shared goal of helping the client receive the best possible treatment.
the 6 conditions of client-centered therapy session
Rogers (1957) identified six conditions that were necessary and sufficient to facilitate therapeutic change.
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Therapist-client psychological contact: the therapist and client are in psychological contact
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Client incongruence: the client is experiencing a state of incongruence
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Therapist congruence: the therapist is congruent, or genuine, in the relationship
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Therapist unconditional positive regard: the therapist has unconditional positive regard toward the client
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Therapist empathic understanding: the therapist experiences and communicates an empathic understanding of the client’s internal perspective
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Client perception: the client perceives the therapist’s unconditional positive regard and empathic understanding
Indications for treatment
Clinicians may initiate or refer a patient to psychotherapy for reasons not limited to the following:
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Treatment of a psychiatric disorder
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Help with maladaptive thoughts or behaviors
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Support during stressful circumstances or when a chronic problem impairs functioning
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Improve a patient’s ability to make positive behavioral changes, such as healthy lifestyle changes or increasing adherence to medical treatment
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Helping with interpersonal problems
Person-centered therapy can be used in various settings, including individual, group, and family therapy, or as part of play therapy with young children. There are no set guidelines on the length or frequency of person-centered therapy, but it may be used for short-term or long-term treatment. Person-centered therapy may be a good choice for patients who are not suitable for other forms of therapy, such as cognitive-behavioral therapy (CBPT) or psychoanalysis, which require homework assignments and the ability to tolerate high levels of distress that may occur when elucidating unconscious processes (Grover, 2020).
supplemental video
The video below is a role-playing exercise that demonstrates the client-therapist technique of client-centered counseling.
references
Grover S, Avasthi A, Jagiwala M. Clinical Practice Guidelines for Practice of Supportive Psychotherapy. Indian J Psychiatry. 2020 Jan;62(Suppl 2):S173-S182
ROGERS CR. The necessary and sufficient conditions of therapeutic personality change. J Consult Psychol. 1957 Apr;21(2):95-103.
