client centered therapy case study

Person-Centered Therapy Case Study: Examples and Analysis

Introduction

Welcome to The Knowledge Nest's in-depth exploration of person-centered therapy case study examples and analysis. We aim to provide you with comprehensive insights into the therapeutic approach, techniques, and outcomes associated with person-centered counseling. Through real-life case scenarios, we demonstrate the effectiveness of this humanistic and client-centered approach in fostering personal growth and facilitating positive change.

Understanding Person-Centered Therapy

Person-centered therapy, also known as client-centered therapy or Rogerian therapy, is a compassionate and empathetic therapeutic approach developed by the influential psychologist Carl Rogers. This person-centered approach recognizes the profound significance of the therapeutic relationship, placing the individual at the center of the therapeutic process.

Unlike traditional approaches that impose solutions or interpretations on clients, person-centered therapy emphasizes the innate human capacity to move towards growth and self-actualization. By providing a supportive and non-judgmental environment, therapists aim to enhance clients' self-awareness, self-acceptance, and self-discovery. This holistic approach has proven to be particularly effective in addressing a wide range of mental health concerns, empowering individuals to overcome challenges and achieve personal well-being.

Case Study Examples

Case study 1: overcoming social anxiety.

In this case study, we explore how person-centered therapy helped Sarah, a young woman struggling with severe social anxiety, regain her confidence and navigate social interactions. Through the establishment of a strong therapeutic alliance, her therapist cultivated a safe space for Sarah to explore her fears, challenge negative self-perceptions, and develop effective coping strategies. Through the person-centered approach, Sarah experienced significant improvements, enabling her to participate more actively in social situations and regain a sense of belonging.

Case Study 2: Healing from Trauma

John, a military veteran suffering from PTSD, found solace and healing through person-centered therapy. This case study delves into the profound transformation John experienced as he worked collaboratively with his therapist to process unresolved trauma. By providing unconditional positive regard, empathetic listening, and genuine empathy, the therapist created an environment where John felt safe to explore his traumatic experiences. With time, he was able to develop healthier coping mechanisms, embrace self-compassion, and rebuild a sense of purpose.

Case Study 3: Enhancing Self-Esteem

In this case study, we examine Lisa's journey towards building self-esteem and self-worth. Through person-centered therapy, her therapist empowered Lisa to identify and challenge deeply ingrained negative self-beliefs that inhibited her personal growth. By offering non-directive support, active listening, and reflective feedback, the therapist enabled Lisa to develop a more positive self-concept, fostering increased self-esteem, and self-empowerment.

Analysis of Person-Centered Therapy

The therapeutic relationship.

Person-centered therapy places profound importance on the therapeutic relationship as the foundation for positive change. The therapist cultivates an atmosphere of trust, respect, and authenticity, enabling the individual to feel heard and valued. By providing unconditional positive regard, therapists create a non-judgmental space where clients can freely explore their thoughts, emotions, and experiences.

Client-Centered Approach

The client-centered approach encourages individuals to take an active role in their therapeutic journey. The therapist acts as a facilitator, guiding clients towards self-discovery and personal growth. By allowing clients to set the agenda and directing the focus of sessions, the person-centered approach acknowledges the unique needs and perspectives of each individual.

Empowering Self-Awareness and Growth

Person-centered therapy seeks to unlock individuals' innate capacity for self-awareness and personal growth. Through empathic understanding, therapists support clients in gaining insight into their emotions, thoughts, and needs. This heightened self-awareness helps individuals develop healthier coping mechanisms, make meaningful choices, and move towards a more fulfilling life.

Person-centered therapy, as exemplified through the case studies presented, offers a powerful and transformative path towards holistic well-being and personal growth. The Knowledge Nest is committed to providing a platform for sharing knowledge, experiences, and resources related to person-centered counseling. Together, we strive to facilitate positive change, empower individuals, and create a more compassionate and understanding society.

Explore more case studies and resources on person-centered therapy at The Knowledge Nest to discover the profound impact of this therapeutic approach.

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Person-Centered Therapy Case Study: Examples and Analysis

By: Tasha Kolesnikova

Person-centered therapy, also known as client-centered therapy or Rogerian therapy, is a form of psychotherapy developed by prominent American psychologist Carl Rogers throughout the 1940s to the 1980s. This type of therapy is a humanistic approach and was seen as revolutionary as most psychotherapies before its emergence was based on behaviorist and psychodynamic approaches. The humanistic approach directly contradicts and contrasts core techniques and models of other approaches that were commonly used at the time.

What Is Person-Centered Therapy?

5 characteristics of the fully functioning person, causes of incongruence, person-centered therapy in practice, person-centered case study, person-centered treatment plan.

Nowadays, the fundamental modalities of person-centered therapy are widely used in modern counseling practices in combination with other techniques and therapies. Rogers is often considered the father of all humanistic schools of therapy, as many new therapies have since stemmed from his work. 

Students can use this article as a resource to help them with an academic essay  about person-centered therapy. 

Person-centered therapy focuses on facilitating  self-actualization .  The therapy is built upon the fundamental ideology that human beings have an innate desire and ability to be the best they can be and live happy, fulfilling lives. An individual must set their own goals, and proceed to approach them in their own way. Once these goals have been met, self-actualization is also achieved and, as a result, they will become a  fully functioning person . 

It also promotes the notion that all individuals have the ability to cope with their problems and possess the potential for change. These abilities are unique to each individual, and therefore, everyone has the power to formulate appropriate solutions to help themselves navigate and manage their lives.

Positive growth can be achieved when an individual has positive regard for themselves and from others. Once optimal levels are reached, the individual will become fully functioning. Under this self-concept, it is believed that every individual has:

• the capacity for self-awareness
• the need for meaning in their life
• the need for balancing freedom and responsibility

The key part of the person-centered approach is to assist individuals in self-discovery and self-acceptance by providing sufficient conditions that help resolve incongruence between themselves and their experiences.

According to Rogers, a fully functioning person has the following five characteristics:

• They are  open to new experiences , both positive and negative. They accept that life can sometimes be painful, but they have healthy abilities to cope and learn from them.
• They are  mindful and focus on present  experiences without preconceptions from previous experiences. They do not dwell on the past or obsess about the future.
• They are  aware of and attentive to facts ,  feelings, and gut reactions . Unity of all three allows them to be true to themselves and thus have the confidence to make the right decisions. If the wrong choice is made, they will be able to accept it and learn from it.
• They are  willing to take risks and be adaptive . They will seize healthy and appropriate opportunities for growth.
• They  have a sense of contentment  and a desire for new challenges and experiences.

Each of these characteristics is achieved through congruence of the self.

An individual tends to struggle with becoming a fully functional person, mostly due to incongruence. Incongruence is usually caused by encountering conditional worth or conditional love at some point, often during childhood.

If love and worth are dependent on meeting specific expectations and withdrawn when these expectations were not met, the individual will suffer from anxiety. This anxiety leads to a feeling of the unified self-being under attack. To relieve this anxiety, the individual will engage in detrimental methods such as denial and defensiveness.

Another cause is frustrated basic impulses that lead to negative feelings and poor social skills.

Individuals receiving person-centered therapy are referred to as clients rather than patients. This is in line with the overall concept that therapy is a shared journey between two people rather than the therapist or counselor treating or giving the advice to solve problems. The client is regarded as the expert of themselves and has all the answers to their own problems required within them.

Sufficient core conditions required for therapeutic change under person-centered therapy are outlined as follows:

• Psychological contact  - a mutually respectful relationship between the counselor and patient must exist, where both parties feel equally important.
• Client incongruence  – the client must experience distress caused by incongruence between their experiences and awareness. They are vulnerable and or anxious.
• Therapist congruence or genuineness  – sometimes referred to as being authentic. The therapist must be aware of their active participation and be deeply involved, becoming congruent with the therapeutic relationship.
• Therapist unconditional positive regard  – the therapist or counselor must have a non-judgmental stance, so the counselor does not impose any conditions of worth.
• Therapist empathy  – the therapist or counselor must effectively and accurately communicate their empathic understanding of the client's frame of reference. Presenting problems from another perspective can also help the client gain a new point of view to solving them.
• Client perception  – the client must perceive and appreciate this empathy and acceptance from their therapist or counselor and develop positive self-regard to a minimal degree.

It is interesting to note that Rogers viewed both approval and disapproval shown towards an individual to be disruptive to therapeutic change. The role of the therapist is to provide a caring and accepting environment conducive to giving clients the freedom to explore areas of their lives in ways they were previously denied or distorted. 

Unlike other therapies, Person-centered therapy does not have many set techniques. This Is because therapy sessions are largely directed by the individual. The counselor's or therapist's job is to create a safe environment that facilitates congruence and form a therapeutic alliance with the individual.

Because of this, a defining technique used during person-centered therapy is  non-directiveness . This is achieved by:

• giving no advice
• asking no questions
• giving no interpretations
• allowing clients to set their own goals

Another technique used during therapy sessions is  active listening . This is achieved by:

• paraphrasing
• summarizing

It was theorized that the client will initially be closed, not open to experiences, and have little to no self-awareness. But once therapy is completed, all these obstacles will be addressed and reversed due to gaining positive self-regard.

There are many advantages in the techniques used during person-centered therapy. However, some concerns have also been raised about the approach:

• Non-directiveness  - idea of non-directiveness has been largely debated. Some have argued that therapy by nature will always be directed in some capacity. Furthermore, bias can never be completely eliminated. Therefore, unconscious or unintentional bias can cause direction.
• Inefficient  – person-centered therapy can take an unnecessarily long time due to the lack of structure and non-directiveness. For fear of intervening with progress, therapists may deliberately withhold solutions or advice from a client, and it may take longer than necessary to reach that solution, if at all.
• Frustration  – being non-direct can understandably cause frustration in some clients who may be seeking advice or opinions.
• Disorder specific  – Rogers originally claimed that Person-centered therapy could treat all mental health disorders, but research has shown this is not the case.

Jane's phenomenological worldview causes her to be incongruent with her true self and what she believed is expected of her. Expectations imposed upon her are unrealistically high, and fear of not meeting those standards has caused her incongruent distress. Subsequently, this has created a condition for her self-worth.

These expectations are a direct result of traumatic stress stemming from culture, religion, and loved ones. In her phenomenological world, she will never be good enough as a daughter, mother, wife, Catholic, or accountant. She feels she constantly lets everyone down and can never gain approval from those whose opinions she cares about.

Trying harder to please and meet everyone's expectations takes her further away from wholeness and true self-worth. She has lost confidence in her ability to make good decisions and constantly seeks outside direction on how she should act. This low self-esteem will hinder any feelings of success and satisfaction.

She is aware that how she handles situations as it stands is not working but fails to see the situation from another perspective or figure out new solutions.

This is a classic example of a client that may benefit from person-centered therapy. We can understand that although Jane feels these pressures of meeting rejection and disapproval, she still has the potential for self-actualization.

This is evidenced by her independent decisions of marrying a spouse outside her religion and studying accountancy against her family's wishes. The act of seeking therapy confirms her desire for growth and change for a better life.

Jane has risen above adversity on multiple occasions in life. She has achieved academically, personally, and professionally but the lack of caring relationships has distorted her ability to recognize and accept her success and potential. This has deterred her from achieving higher levels of self-actualization. Jane must take new risks to attain the growth she seeks. 

For treatment to be effective, the core conditions must be met. The formulation was as follows:

• Undertaking person-centered therapy, the therapist will provide an optimal therapeutic environment where her actualizing tendencies can flourish.
• Through active listening and empathy, the therapist and Jane will build a trusting therapeutic alliance and further clarify her thoughts and feelings. Being able to work out problems and breaking them down, Jane will no longer view them as insurmountable as she did before.
• Unconditional positive regard will install confidence in Jane as a competent person capable of making decisions and problem solving on her own. By increasing trust in herself, she reduces the control others have over her and will begin to believe in her own self-worth.
• Consistency and genuine rapport between Jane and the counselor will allow her to feel that the ideas and actions developed during sessions are authentic, dependable, and can be replicated outside in the real world.
• Jane's newfound view of the world will lead to her trying out new approaches to problems. She will continue to report back on her progress in integrating these new approaches. She will eventually come to recognize that she is capable of independently achieving success and overcoming failure.
• Jane will continue these practices until she has reached self-actualization and becomes a fully functional person.

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10 Person-Centered Therapy Techniques & Interventions [+PDF]

This term seems redundant now, but when it was first developed, it was a novel idea.

Before the humanistic therapies were introduced in the 1950s, the only real forms of therapy available were behavioral or psychodynamic (McLeod, 2015). These approaches focused on the subconscious or unconscious experience of clients rather than what is “on the surface.”

Many of today’s popular forms of therapy are more client-centered than the psychotherapy of the early 20th century, but there is still a specific form of therapy that is set apart from others due to its focus on the client and aversion to giving the client any type of direction.

“He who knows others is wise; he who knows himself is enlightened.”

So, how does this Lao Tzu quote apply to client-centered therapy? Read on to learn about how knowing one’s self and others is key to the person-centered approach.

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This Article Contains:

What is client-centered therapy a definition, carl rogers: the founder of client-centered therapy, goals of client-centered therapy, how does it work the person-centered perspective, client-centered therapy method and techniques, a take-home message.

Client-Centered Therapy, also known as Client-Centered Counseling or Person-Centered Therapy, was developed in the 1940s and 50s as a response to the less personal, more “clinical” therapy that dominated the field.

It is a non-directive form of talk therapy, meaning that it allows the client to lead the conversation and does not attempt to steer the client in any way. This approach rests on one vital quality: unconditional positive regard . This means that the therapist refrains from judging the client for any reason, providing a source of complete acceptance and support (Cherry, 2017).

There are three key qualities that make for a good client-centered therapist:

• Unconditional Positive Regard : As mentioned above, unconditional positive regard is an important practice for the client-centered therapist. The therapist needs to accept the client for who they are and provide support and care no matter what they are going through.
• Genuineness: A client-centered therapist needs to feel comfortable sharing his or her feelings with the client. Not only will this contribute to a healthy and open relationship between the therapist and client, but it also provides the client with a model of good communication and shows the client that it’s okay to be vulnerable.
• Empathetic Understanding : The client-centered therapist must extend empathy to the client, both to form a positive therapeutic relationship and to act as a sort of mirror, reflecting the client’s thoughts and feelings back to them; this will allow the client to better understand themselves.

Another notable characteristic of person- or client-centered therapy is the use of the term “client” rather than “patient.” Therapists who practice this type of approach see the client and therapist as a team of equal partners rather than an expert and a patient (McLeod, 2015).

Carl Rogers is considered the founder of client-centered therapy, and the godfather of what are now known as “humanistic” therapies, While many psychologists contributed to the movement, Carl Rogers spearheaded the evolution of therapy with his unique approach.

If his approach were to be summed up in a quote, this quote would be a good choice:

“Experience is, for me, the highest authority. The touchstone of validity is my own experience. No other person’s ideas, and none of my own ideas, are as authoritative as my experience. It is to experience that I must return again and again, to discover a closer approximation to truth as it is in the process of becoming in me.”

Carl Rogers

The individual experience of the client is paramount in client-centered therapy.

The Rogerian Approach to Psychotherapy

Rogers’ approach to therapy was a simpler one than the earlier approaches in some ways. Instead of requiring a therapist to dig deep into their patients’ unconscious mind, an inherently subjective process littered with room for error, he based his approach on the idea that perhaps the client’s conscious mind was a better focus.

In Rogers’ own words:

“It is the client who knows what hurts, what directions to go, what problems are crucial, what experiences have been deeply buried. It began to occur to me that unless I had a need to demonstrate my own cleverness and learning, I would do better to rely upon the client for the direction of movement in the process.”

This approach marked a significant shift from the distant, hierarchical relationship between psychiatrist and patient of psychoanalysis and other early forms of therapy. No longer was the standard model of therapy one expert and one layman – now, the model included one expert in the theories and techniques of therapy , and one expert in the experience of the client (the client themselves!).

Rogers believed that every individual was unique and that a one-size-fits-all process would not, in fact, fit all (Kensit, 2000). Instead of considering the client’s own thoughts, wishes, and beliefs as secondary to the therapeutic process, Rogers saw the client’s own experience as the most vital factor in the process.

Most of our current forms of therapy are based on this idea that we take for granted today: the client is a partner in the therapeutic relationship rather than a helpless patient, and their experiences hold the key to personal growth and development as a unique individual.

In addition to this client-focused approach, Rogerian psychotherapy is also distinct from some other therapies in its assumption that every person can benefit from client-centered therapy and transform from a “potentially competent individual” to a fully competent one (McLeod, 2015).

Rogers’ approach views people as fully autonomous individuals who are capable of putting in the effort required to realize their full potential and bring about positive changes in their lives.

“In my early professional years I was asking the question: How can I treat, or cure, or change this person? Now I would phrase the question in this way: How can I provide a relationship which this person may use for his own personal growth?”

Like many current forms of therapy (like narrative therapy or cognitive behavioral therapy , for example), the goals of client-centered therapy depend on the client. Depending on who you ask, who the therapist is, and who the client is, you will likely get a range of different answers – and none of them are wrong!

However, there are a few overarching goals that the humanistic therapies focus on, in general.

These general goals are to (Buhler, 1971):

• Facilitate personal growth and development
• Eliminate or mitigate feelings of distress
• Increase self-esteem and openness to experience
• Enhance the client’s understanding of him- or herself

As it is, these goals span an extremely broad range of sub-goals or objectives, but it is also common for the client to come up with his or her own goals for therapy. Client-centered therapy posits that the therapist cannot set effective goals for the client, due to his or her lack of knowledge of the client. Only the client has enough knowledge of themselves to set effective and desirable goals for therapy.

Other commonly gained benefits include:

• Greater agreement between the client’s idea and actual selves
• Better understanding and awareness
• Decreased defensiveness, insecurity, and guilt
• Greater trust in oneself
• Healthier relationships
• Improvement in self-expression
• Improved mental health overall (Noel, 2018)

Carl Rogers on Person-Centered Therapy video

“When functioning best, the therapist is so much inside the private world of the other that he or she can clarify not only the meanings of which the client is aware but even those just below the level of awareness.”

The quote from Carl Rogers above highlights an important point: the success of this form of therapy rests on the extremely important connection between the client and therapist. If this relationship is not marked by trust, authenticity, and mutual positive feelings, it is unlikely to produce any benefits for either party.

Rogers identified six conditions that are required for success in client-centered therapy:

• The client and counselor are in psychological contact (a relationship).
• The client is emotionally upset, in a state of incongruence.
• The counselor is genuine and aware of their own feelings.
• The counselor has unconditional positive regard for the client.
• The counselor has an empathic understanding of the client and their internal frame of reference and looks to communicate this experience with the client.
• The client recognizes that the counselor has unconditional positive regard for them and an understanding of the difficulties they are facing (Noel, 2018).

When these six conditions are met, there is great potential for positive change.

The way client-centered therapy works is a natural extension of these conditions: the therapist and client discuss the client’s current problems and issues, the therapist practices active listening and empathizes with the client, and the client decides for themselves what is wrong and what can be done to correct it (McLeod, 2015).

It is clear from Rogers’ works that he placed a great deal of value on the firsthand experience of the client, and much less in the “cleverness and learning” or technical expertise of therapists – including himself!

“We think we listen, but very rarely do we listen with real understanding, true empathy. Yet [active] listening, of this very special kind, is one of the most potent forces for change that I know.”

The only technique recognized as effective and applied in client-centered therapy is to listen nonjudgmentally. That’s it!

In fact, many client-centered therapists and psychologists view a therapist’s reliance on “techniques” as a barrier to effective therapy rather than a boon. The Rogerian standpoint is that the use of techniques can have a depersonalizing effect on the therapeutic relationship (McLeod, 2015).

In the words of Carl Rogers:

“When you are in psychological distress and someone really hears you without passing judgement on you, without trying to take responsibility for you, without trying to mold you, it feels damn good!”

While active listening is one of the only and most vital practices in client-centered therapy, there are many tips and suggestions for client-centered therapists to facilitate successful therapy sessions. In context, these tips and suggestions can be considered client-centered therapy’s “techniques.”

Saul McLeod (2015) outlines 10 of these “techniques” for Simply Psychology:

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1. Set clear boundaries

Boundaries are vital for any relationship, but they are especially important for therapeutic relationships. Both the therapist and the client need healthy boundaries to avoid the relationship becoming inappropriate or ineffective, such as ruling out certain topics of discussion.

There are also more practical boundaries that must be set, for example, how long the session will last.

2. Remember – the client knows best

As mentioned earlier, this therapy is founded on the idea that clients know themselves, and are the best sources of knowledge and insight about their problems and potential solutions. Do not lead the client or tell them what is wrong, instead let them tell you what is wrong.

3. Act as a sounding board

Active listening is key, but it’s also useful to reflect what the client is saying back to them. Try to put what they are telling you into your own words. This can help the client clarify their own thoughts and understand their feelings better.

4. Don’t be judgmental

Another vital component of client-centered therapy is to refrain from judgment. Clients are often already struggling with feelings of guilt, low self-worth, and the belief that they are simply not good enough. Let them know you accept them for who they are and that you will not reject them.

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5. Don’t make decisions for your clients

Giving advice can be useful, but it can also be risky. In client-centered therapy, it is not seen as helpful or appropriate to give advice to clients. Only the client should be able to make decisions for themselves, and they have full responsibility in that respect.

The therapist’s job is to help clients explore the outcomes of their decisions rather than guide them to any particular decisions.

6. Concentrate on what they are really saying

This is where active listening can be put to use. Sometimes a client will feel uncomfortable opening up at first, or they will have trouble seeing something just below the surface. In these situations, be sure to listen carefully and keep an open mind – the problem they come in with may not be the real problem.

7. Be genuine

As mentioned earlier, the client-centered therapy must be genuine. If the client does not feel their therapist is authentic and genuine, the client will not trust you. In order for the client to share personal details about their own thoughts and feelings, they must feel safe and comfortable with you.

Present yourself as you really are, and share both facts and feelings with the client. Of course, you don’t have to share anything you don’t feel comfortable sharing, but appropriate sharing can help build a healthy therapeutic relationship.

8. Accept negative emotions

This is an important technique for any therapist. To help the client work through their issues and heal, it is vital to let them express their emotions – whether positive or negative. The client may even express anger, disappointment, or irritation with you at one point or another.

Learn to accept their negative emotions and practice not taking it personally. They may need to wrestle with some difficult emotions, and as long as they are not abusing you, it is beneficial to just help them through it.

9. How you speak can be more important than what you say

Your tone of voice can have a huge impact on what the client hears, understands, and applies. Make sure your tone is measured, and make sure it matches your non-judgmental and empathetic approach.

You can also use your voice to highlight opportunities for clients to think, reflect, and improve their understanding; for example, you can use your tone to slow down the conversation at key points, allowing the client to think about where the discussion has led and where s/he would like it to go next.

10. I may not be the best person to help

It is vital that you know yourself as a therapist and are able to recognize your own limits. No therapist is perfect, and no mental health professional can give every single client exactly what they need.

Remember, there is no shame in recognizing that the scope of a specific problem or the type of personality you are working with is out of your wheelhouse. In those cases, don’t beat yourself up about it – just be honest and provide any resources you can to help further the client’s healing and development.

This PDF from the Australian Institute of Professional Counselors also lists some useful techniques for client-centered therapy. Some of them overlap with previously mentioned techniques, but all are helpful!

These techniques include:

• Congruence : This technique involves therapists being genuine and authentic, and ensuring that their facial expressions and body language match their words.
• Unconditional Positive Regard : As described earlier in this piece, unconditional positive regard (UPR) is practice by accepting, respecting, and caring about one’s clients; the therapist should operate from the perspective that clients are doing the best they can in their circumstances and with the skills and knowledge available to them.
• Empathy : It is vital for the therapist to show clients that s/he understands their emotions rather than just feeling sympathy for them.
• Nondirectiveness : A cornerstone of client-centered therapy, non-directiveness refers to the method of allowing the client to drive the therapy session; therapists should refrain from giving advice or planning activities for their sessions.
• Reflection of Feelings : Repeating what the client has shared about his or her feelings; this lets the client know the therapist is listening actively and understanding what the client is saying, as well as giving them an opportunity to further explore their feelings.
• Open Questions : This technique refers to the quintessential “therapist” question – “How does that make you feel?” Of course, that is not the only open question that can be used in client-centered therapy, but it is a good open question that can encourage clients to share and be vulnerable.
• Paraphrasing : Therapists can let clients know that they understand what the clients have told them by repeating what they have said back to them in the therapist’s own words; this can also help the client to clarify their feelings or the nature of their problems.
• Encouragers : These words or phrases, like “uh-huh,” “go on,” and “what else?” are excellent at encouraging the client to continue; these can be especially useful for a client who is shy, introverted, or afraid of opening up and being vulnerable (Garrett & Garrett, 2013).

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We hope this information provides you with a better understanding of client-centered therapy, and that it will encourage you to think of yourself as the master and expert of your own experience. You are the only one who understands your problems, issues, needs, desires, and goals , and it is to you that you must turn to solve these problems and reach these goals.

It is an added responsibility when you understand that you are responsible for how your life unfolds, but it can also be extremely liberating.

We encourage all of you to work on building the trust in yourself and in your knowledge and skills that can take your life from “going through the motions” to living a life that is authentic.

As always please let us know your thoughts in the comments! Have you ever tried client-centered therapy, as either a client or a therapist? What did you think of it? We want to hear from you!

We hope you enjoyed reading this article. Don’t forget to download our three Positive Psychology Exercises for free .

• Buhler, C. (1971). Basic theoretical concepts of humanistic psychology. American Psychologist, 26 (4), 378-386.
• Cherry, K. (2017, June 20). What is client centered therapy? A closer look at Carl Rogers’ person-centered therapy. Verywell Mind . Retrieved from https://www.verywell.com/client centered-therapy-2795999
• Garrett, J. & Garret S. (2013). Person-centered therapy: A guide to counselling therapies. Counselling Connection. Retrieved from http://www.counsellingconnection.com/wp-content/uploads/2013/03/Person-Centred-Therapy.pdf
• Kensit, D. A. (2000). Rogerian theory: A critique of the effectiveness of pure client-centred therapy. Counselling Psychology Quarterly, 13 (4), 345-351.
• McLeod, S. (2015). Person centered therapy. Simply Psychology. Retrieved from https://www.simplypsychology.org/client-centred-therapy.html Person-centered therapy
• Noel, S. (2018). Person-centered therapy (Rogerian Therapy). GoodTherapy . Retrieved from http://www.goodtherapy.org/learn-about-therapy/types/person-centered

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I have loved your article on person centred therapy. I am also a student doing a Bachelors degree in reproductive health and I found this so much useful. It is worth a resource. So madam, my question is, is it right to appropriately ask a client what I think they could do to address their problem after listening to them ? This is because I am not allowed to show any direction to the client although I can carefully give the counselling

I am aware that one of the most important skills of a counsellor is active listening. The client needs to feel that the counsellor is directing their whole attention to what the client is saying. My question is: Is it acceptable that the counsellor takes notes while the client is talking? Thank you in advance for your answer.

Thank you for your question. Note-taking can actually be a sign of active listening. Although the counsellor should not spend the entire session looking down and writing every word, taking short notes is definitely acceptable and will help the counsellor remember important details.

I hope this helps.

-Caroline | Community Manager

Hi there, I’m interested to know if there are ever any instances when intervention is used in the form of a tool with person centered. I From what I’ve read this is not part of person centered, but from watching demonstrations, it feels like the client is sometimes left with an opened can of emotional worms and nowhere to go with those emotions. I’m getting interventions would be used if someone is in serious crisis, suicidal or perhaps reruiring a more structured approach, but I’d hate to keep referring clients if there’s some accepted tools or is it literally just trusting the process? Also, is there any particular publication that has case studies?

You’ll find a great case study example here: https://doi.org/10.1080/14779757.2014.927390

You’re right that a weakness of person-centered therapy is its non-directed nature. In this approach, therapists tend to refrain from recommending particular strategies or techniques, and presumably that includes techniques to manage overwhelming emotions. An underlying axiom of the approach is that clients, by nature, want to grow. Therefore, the therapist need not push and prod them. Instead, the therapist focuses on creating a safe enough space that the client can freely talk about things that have been brewing beneath the surface. This may result in emotional tension that they either need to move through (e.g., processing unprocessed emotions), or perhaps making a difficult change in their life. When you get to this point, it can be helpful to bring in tools from other modalities, such as mindfulness, or different types of support to help the client work through the change they need to make (e.g., assertiveness training, goal-setting).

I hope this helps a little.

– Nicole | Community Manager

I would like to assure readers that Person-Centered therapists do intervene when required by the professional, ethical, and legal standards of their practice. For example, non-directive therapists will intervene when a client threatens to kill their self or another person. Although all therapists are required to intervene in specific circumstances, therapists trained in classical client-centered and the person-centered approach do not consider those interventions to be therapeutic. In practice, a client-centered therapist would only intervene against their client’s wishes after communicating with the client that the intervention is distinctly separate from therapy. It is a common misconception that person-centered and non-directive therapists “refrain from recommending particular strategies or techniques, and presumably that includes techniques to manage overwhelming emotions.” Non-directive therapists have access to all the same clinical and counseling tools (e.g. diagnosis, techniques, exercises, handouts, workbooks, homework assignments, and psycho-education) available to other therapeutic approaches; however, non-directive therapists only offer these tools upon request from the client who will ultimately choose whether or not to use these strategies.

For anyone who is interested in studying classical, non-directive client-centered therapy, I highly recommend reading this book about the theory and practice. The author Barbara T. Brodley was a client-centered therapist, clinical professor of psychology, and researcher that emphasized the value of principled non-directiveness in the person-centered approach. This book is a collection of her most studied papers that continue to guide the development of psychotherapists training in the person-centered approach today.

Brodley, B. T. (2013). Practicing client-centered therapy: Selected writings of Barbara Temaner Brodley. (K. Moon, M. Witty, B. Grant, & B. Rice, Eds.). PCCS Books. https://a.co/d/drnIQ0O

After decades of practice in the field, I totally agree with almost most of the above. Yet, a practical question arises from this practice: How do you keep the client at the center of the conversation with her? Our answer: Before and above everything else – By asking her to ask the questions to be discussed with her. https://www.amazon.com/Signs-Road-Therapy-Conversations-Clients/dp/6200300925/

Thank you for this book recommendation, I’ve been searching high and low for a book that solely accounts for the person-centered approach and nothing more. I’m in my practicum and I’m finding that the person-centered approach feels the most like me, and the best for fostering the therapeutic relationship. I’ve used a lot of CBT techniques with my undergraduate clients but have been met with a great lack of enthusiasm.

I first studied Carl Rogers over 40 years ago when I was working on my MA degree in counseling. I enjoyed your summary article and am glad to see that Rogerian Therapy is still alive and well. I believe that the most important aspect of therapy is not the techniques one uses but the therapeutic relationship.

I’m an on-going masters student in counseling psychology. I found this article a very important piece of information, that client-centered therapy involves allowing the client determines the course and direction of the treatment while the role of the therapist is to support through active listening. I have learn alot, that would help me during practicum

Loving the exchanges! Common sense personalized and shared and heard!

This is a well put article on a Person Centered Theory.

Dr. Nicole,

Thank you very much for putting this together. I have a better understanding of the person-centered theory reading your post.

Can you help explaining Abraham Maslow theory with consent of Guiding and counselling………. The above is mavelous

Hi Kipkorir,

Glad you enjoyed the post. Could you please rephrase your question and I’ll see if I can help. I.e., are you interested in how the principles of Maslow’s theory factor into modern counseling practices, or something different. Let us know!

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Everything to Know About Person-Centered Therapy

How it works, what to expect.

• When to See a Provider

Person-centered therapy, also known as Rogerian therapy, is a client-based form of therapy that empowers the client to take ownership of their mental well-being. It shifts the focus from the mental health professional to the client and allows them to have control of the therapeutic process. Person-centered therapy provides a safe space for clients to become more self-aware and find their own solutions.

Person-centered therapy can be helpful for various types of mental health conditions, such as anxiety, depression, post-traumatic stress disorder (PTSD), and more. 

Read on to learn more about person-centered therapy, techniques, and benefits associated with this form of treatment.

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Defining Person-Centered Therapy

Person-centered therapy, also known as Rogerian therapy, was developed during the 1940s by humanist psychologist Carl Rogers. It is a form of therapy that shifts the focus from the mental health professional to the client, who is empowered to take control of the therapeutic process. Rogers believed that every person, regardless of their mental health struggles, desires and is capable of reaching their full potential.

This therapy practice steers away from the idea that human beings are flawed and require treatment for their problematic behaviors. Instead, it provides clients with the tools and resources they need to understand themselves and what they need to achieve positive change in their lives.

Client vs. Patient

The term "client" is used on purpose in this type of therapy to avoid implying that the person seeking therapy is sick. Using the word client instead helps to empower the person seeking help by emphasizing that they are in control of their life and future and are capable of overcoming any difficulties they face.

In person-centered therapy, the client and the therapist work as a team. The therapist is supportive and avoids the use of judgment, suggestions, or solutions for the client's problems.

Person-centered therapy is a type of non-directive therapy that is empathetically driven toward providing a person with a safe space to talk, self-actualize (realize your full potential), and make positive changes in their life.

Person-centered therapy can help with various types of mental distress including:

• Post-traumatic stress disorder
• Other mood disorders

Person-centered therapy can be utilized one-on-one or in a group setting. There are both inpatient and outpatient programs available.

Your first session will begin much like a meet-and-greet, in which you will get to know one another. Your therapist will want you to talk about what brought you to person-centered therapy and go over how the therapeutic relationship will work if you choose them as your therapy partner.

If you are interested in person-centered therapy, you can contact your healthcare provider for recommendations.

What Techniques Are Involved in Person-Centered Therapy?

There are three main techniques used in person-centered therapy. Each technique is designed to help a person become more aware of their own behaviors in a safe space. When this happens, people are then able to make the necessary changes needed to recover.

Genuineness and Congruence

The genuineness and congruence technique involves the therapist being genuine and harmonious toward their clients. The therapist is open and honest about their thoughts and feelings and, by doing so, teaches their clients the ability to do the same.

This technique also teaches the client self-awareness and knowing how thoughts and feelings affect a person’s experiences.

Clients feel safer when their therapist acts in this way, which in turn builds a trusting relationship between both client and therapist. Trust in the relationship allows clients to be more comfortable opening up in a genuine way.

Unconditional Positive Regard

Unconditional positive regard is total acceptance. This means that the therapist always completely accepts and supports their client when participating in client-centered therapy.

The therapist takes all of their client's feelings and emotions seriously and validates what they are feeling. They also offer reassurance through active listening and positive body language.

How Does Unconditional Positive Regard Help?

When your therapist practices unconditional positive regard, you are likely to feel safe opening up fully, without fearing how they will respond. Research suggests that when a person's experiences and emotions are validated, this type of therapy can be very effective.

Empathetic Understanding

Empathy is the true understanding and sharing of feelings between two people.

In person-centered therapy, the therapist uses empathetic understanding in an effort to get to know who you are, the way your experiences shape your life, and your point of view of the world, yourself, and the people in your life.

The main goal of empathetic understanding is to ensure that the client feels completely understood in everything they say. This is done in a way that gives clients the opportunity to gain insights into themselves that they may not have had prior to beginning therapy.

What Are the Benefits of Person-Centered Therapy?

There are many benefits associated with person-centered therapy including:

• Improved self-awareness
• Improved self-concept (the way you see yourself)
• Greater trust in oneself and one’s own abilities
• Healthier relationships with others based on an improved view and understanding of oneself
• Healthier communication skills
• Improved ability to express opinions and feelings
• Ability to let go of past hurt or mistakes
• Ability to strive for healthy changes that make one's life better

What Are the Potential Limitations of Person-Centered Therapy?

Person-centered therapy has many strengths, but it also has its limitations:

• The lack of structure and interventions may not be effective for everyone, especially people with certain personality disorders or severe mental illnesses, which also may limit someone's ability to self-reflect or relate well to other people.
• While no therapy offers a quick fix, person-centered therapy can be time-consuming. People who want a more goal-oriented and less open-ended approach may not benefit from person-centered therapy.
• The person-centered approach may not work for people who are from cultural or family backgrounds that don't encourage emotional openness.

Things to Consider

To be able to benefit from person-centered therapy, you have to be open to discussing your experiences, both good and bad. Therapists will not direct you in any way, so you must lead the conversation in a way that feels most comfortable to you. You must also establish a relationship with your therapist that feels safe and supportive.

When to See a Healthcare Provider

Mental health issues can be difficult to cope with. Oftentimes, people aren’t sure where to turn or what type of help they need.

If you are dealing with mental health distress, you can contact your primary healthcare provider for assistance. They will likely direct you toward different types of available therapists.

Emergency Assistance for Mental Health Distress

If you are having suicidal thoughts , contact the  National Suicide Prevention Lifeline  at  988  for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911 .

Person-centered therapy, also called client-centered therapy, is a form of psychotherapy that places emphasis on the client over the therapist. It empowers the client to take control of their mental health without judgment and helps improve the client's self-awareness. An open and trusting relationship between client and therapist is key in person-centered therapy.

Frequently Asked Questions

The cost of person-centered therapy will vary significantly depending on factors such as how long you see yourself going, as well as the specific therapist. Your location will also play a role in the cost. In many cases, person-centered therapy is covered by medical insurance.

There are many types of therapy available. The main branches of therapy are psychodynamic, behavioral, cognitive-behavioral, humanistic, and integrative. Person-centered therapy is a form of humanistic therapy.

Erekson DM, Lambert MJ. Client-centered therapy . In: Cautin RL, Lilienfeld SO, eds.  The Encyclopedia of Clinical Psychology . John Wiley & Sons, Inc.; 2015:1-5. doi:10.1002/9781118625392.wbecp073

Allerby K, Goulding A, Ali L, Waern M. Increasing person-centeredness in psychosis inpatient care: staff experiences from the Person-Centered Psychosis Care (PCPC) project . BMC Health Serv Res. 2022 May 3;22(1):596. doi: 10.1186/s12913-022-08008-z

Kim SK, Park M. Effectiveness of person-centered care on people with dementia: a systematic review and meta-analysis . Clin Interv Aging . 2017 Feb 17;12:381-397. doi: 10.2147/CIA.S117637

Barkham M, Saxon D, Hardy GE, Bradburn M, Galloway D, Wickramasekera N, et al. Person-centred experiential therapy versus cognitive behavioural therapy delivered in the English Improving Access to Psychological Therapies service for the treatment of moderate or severe depression (PRaCTICED): a pragmatic, randomised, non-inferiority trial. The Lancet Psychiatry . May 14, 2021. doi:10.1016/S2215-0366(21)00083-3

Farber BA, Suzuki JY, Lynch DA. Positive regard and psychotherapy outcome: A meta-analytic review . Psychotherapy . 2018;55(4):411-423. doi:10.1037/pst0000171

Moon K.A. Rice B.  The nondirective attitude in client-centered practice: A few questions. Person-Centered & Experiential Psychotherapies. 2012;11(4):289-303. doi:10.1080/14779757.2012.740322

Kolden GG, Wang CC, Austin SB, Chang Y, Klein MH. Congruence/genuineness: A meta-analysis. Psychotherapy. 2018;55(4):424-433. doi:10.1037/pst0000162

Elliott R, Bohart AC, Watson JC, Murphy D. Therapist empathy and client outcome: An updated meta-analysis . Psychotherapy . 2018;55(4):399-410. doi:10.1037/pst0000175

Yao L, Kabir R. Person-Centered Therapy (Rogerian Therapy) [Updated 2023 Feb 9]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-.

By Angelica Bottaro Bottaro has a Bachelor of Science in Psychology and an Advanced Diploma in Journalism. She is based in Canada.

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How Client-Centered Therapy Works

• Key Concepts

Effectiveness

Things to consider.

• How to Get Started

Client-centered therapy, also known as person-centered therapy or Rogerian therapy, is a non-directive form of talk therapy where you act as an equal partner in the therapy process while your therapist remains non-directive—they don't pass judgment on your feelings or offer suggestions or solutions.

This approach was developed by humanist  psychologist Carl Rogers during the 1940s and 1950s. Rogers is widely regarded as one of the most influential psychologists of the 20th century . He believed that people are the best expert on their own lives and experiences.

Rogers also suggested that people have a self-actualizing tendency, or a desire to fulfill their potential and become the best that they can be. His form of therapy was intended to allow clients to fulfill that potential by relying on their own strength to change.

Initially, Rogers called his technique "non-directive therapy." Much like psychoanalyst Sigmund Freud , Rogers believed that the therapeutic relationship could lead to insights and lasting changes in clients.

While his goal was to be as non-directive as possible, he eventually realized that therapists guide clients even in subtle ways. He also found that clients often do look to their therapists for some type of guidance or direction.

What Are the Key Concepts of Client-Centered Therapy?

Mental health professionals who utilize this approach strive to create the conditions needed for their clients to change. Client-centered therapy involves a therapeutic environment that is conformable, non-judgmental, and empathetic, which is achieved through three features:

• Genuineness and congruence
• Unconditional positive regard
• Empathetic understanding

By using these three techniques, therapists can help clients grow psychologically, become more self-aware , and change their behavior via self-direction. In this type of environment, a client feels safe and free from judgment.

"Client" vs. "Patient"

Rogers deliberately used the term "client" rather than "patient." He believed that "patient" implied that the individual was sick and seeking a cure from a therapist.

By using "client" instead, Rogers emphasized the importance of the individual in seeking assistance, controlling their destiny, and overcoming their difficulties. This self-direction plays a vital part in client-centered therapy.

Genuineness and Congruence

Client-centered therapists display genuineness and congruence with their clients. This means they always act in accordance with their own thoughts and feelings, allowing themselves to share openly and honestly.

This requires self-awareness and a realistic understanding of how internal experiences, like thoughts and feelings, interact with external experiences. By modeling genuineness and congruence, your therapist can help teach you these important skills.

Displaying genuineness and congruence also helps create a secure, trusting relationship between you and your therapist. This trust contributes to a feeling of safety, which may help you engage with therapy more comfortably.

Unconditional Positive Regard

Your therapist will show unconditional positive regard by always accepting you for who you are and displaying support and care no matter what you are facing or experiencing. They may express positive feelings to you or offer reassurance, or they may practice active listening , responsive eye contact, and positive body language to let you know that they're engaged in the session.

By creating a climate of unconditional positive regard, your therapist may help you feel able to express your true emotions without fear of rejection. This is often an affirming experience, and it may set the stage for you to make positive changes.

Empathetic Understanding

Your therapist will also practice empathy during sessions, acting as a mirror of your feelings and thoughts. They will seek to understand you and maintain an awareness and sensitivity to your experience and your point of view.

The goal is to help you build a rapport with your therapist and ensure that you feel fully understood. This may provide you with the environment you need to reflect on your own inner thoughts, perceptions, and emotions, which may offer unique insights you didn't have access to previously.

What Client-Centered Therapy Can Help With

Client-centered therapy may help people who are experiencing:

• Anxiety and psychosis
• Mood disorders
• Negative thoughts related to post-traumatic stress disorder (PTSD)

Benefits of Client-Centered Therapy

Client-centered therapy may improve self-concept, which is your organized set of beliefs and ideas about yourself. Self-concept plays an important role in determining not only how people see themselves, but also how they view and interact with the world around them.

Sometimes, self-concept is congruent with reality. In other cases, self-perceptions are unrealistic or not in tune with what exists in the real world. While most people distort reality to at least a small degree, when self-concept is in conflict with reality, incongruence can result.

For example, imagine a young woman who views herself as uninteresting and a poor conversationalist despite the fact that other people find her fascinating and quite engaging. Because her self-perceptions are not congruent with reality, she may experience poor self-esteem.

What Is the Focus of Client-Centered Therapy?

Through the process of client-centered therapy, you can learn to adjust your self-concept in order to achieve congruence. The techniques used in the client-centered approach are all focused on helping you reach a more realistic view of yourself and the world.

Several studies have shown that the techniques used in client-centered therapy are beneficial.

• Genuineness and congruence appear to lead to better outcomes, especially when they are used in school counseling settings.
• Unconditional positive regard is also effective, particularly at improving overall well-being for people with mood or anxiety disorders.
• Empathetic understanding appears to promote positive outcomes, especially for people experiencing depression and anxiety.

It's not clear if these factors alone are enough to promote lasting change in clients. Outcomes for clients may also depend on their perception of their therapist—if they don't see their therapist as empathetic, for instance, they may not experience positive results from treatment.

For client-centered therapy to be effective, you need to be willing to share your internal experiences with your therapist without their direct guidance or advice. You will act as an equal partner during therapy, often determining the course of your sessions (though your therapist may also ask questions or seek clarification).

While client-centered therapy can help you gain the self-efficacy needed to feel comfortable leading the conversation, this may not be the ideal approach for everyone. Some people may find they prefer therapists who are more directive.

The relationship you and your therapist establish is also an important part of this form of therapy. If you don't feel understood by your therapist or don't feel safe and supported enough to share your thoughts openly, it will be more difficult to make progress.

How to Get Started With Client-Centered Therapy

Client-centered therapy can be delivered individually or as part of group therapy in both outpatient and inpatient settings. If you're looking for a therapist near you, you can ask your primary healthcare provider for recommendations.

During your first session , your therapist will ask about the problems you're facing and your reasons for seeking treatment. They may also go over how the therapy process works and answer any questions you may have, including those about billing and health insurance.

Throughout treatment, your therapist will encourage you to step into an equal role. They may reflect what you say back to you to make sure they understand the thoughts and feelings you're expressing. Overall, you'll be encouraged to explore the issues that are important to you, with your therapist offering support along the way.

Rogers CR. Significant aspects of client-centered therapy . Am Psychol . 1946;1(10):415-22. doi:10.1037/h0060866

Moon KA, Rice B. The nondirective attitude in client-centered practice: A few questions . Person-Centered & Experiential Psychotherapies . 2012;11(4):289-303. doi:10.1080/14779757.2012.740322

Kolden GG, Wang C-C, Austin SB, Chang Y, Klein MH. Congruence/genuineness: A meta-analysis . Psychotherapy . 2018;55(4):424-433. doi:10.1037/pst0000162

Farber BA, Suzuki JY, Lynch DA. Positive regard and psychotherapy outcome: A meta-analytic review . Psychotherapy . 2018;55(4):411-423. doi:10.1037/pst0000171

Elliott R, Bohart AC, Watson JC, Murphy D. Therapist empathy and client outcome: An updated meta-analysis . Psychotherapy . 2018;55(4):399-410. doi:10.1037/pst0000175

Erekson DM, Lambert MJ. Client-centered therapy . In: The Encyclopedia of Clinical Psychology . John Wiley & Sons; 2015:1-5. doi:10.1002/9781118625392.wbecp073

Kim SK, Park M. Effectiveness of person-centered care on people with dementia: a systematic review and meta-analysis . Clin Interv Aging . 2017;12:381-397. doi:10.2147/CIA.S117637

Cuijpers P, Driessen E, Hollon SD, van Oppen P, Barth J, Andersson G. The efficacy of non-directive supportive therapy for adult depression: A meta-analysis . Clin Psychol Rev . 2012;32(4):280-291. doi:10.1016/j.cpr.2012.01.003

McLean CP, Yeh R, Rosenfield D, Foa EB. Changes in negative cognitions mediate PTSD symptom reductions during client-centered therapy and prolonged exposure for adolescents . Behav Res Ther . 2015;68:64-69. doi:10.1016/j.brat.2015.03.008

By Kendra Cherry, MSEd Kendra Cherry, MS, is a psychosocial rehabilitation specialist, psychology educator, and author of the "Everything Psychology Book."

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StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-.

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Person-centered therapy (rogerian therapy).

Lucy Yao ; Rian Kabir .

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Last Update: February 9, 2023 .

• Continuing Education Activity

Person-centered therapy, also referred to as non-directive, client-centered, or Rogerian therapy, was pioneered by Carl Rogers in the early 1940s. This form of psychotherapy is grounded in the idea that people are inherently motivated toward achieving positive psychological functioning. The client is believed to be the expert in their life and leads the general direction of therapy, while the therapist takes a non-directive role. This activity reviews person-centered therapy and highlights the role of the interprofessional team in improving care for patients who undergo person-centered therapy.

• Identify the core conditions of person-centered therapy.
• Explain the therapeutic process of person-centered therapy.
• Describe the benefits and criticisms of person-centered therapy.
• Review the efficacy of person-centered therapy in the treatment of common psychiatric illnesses.
• Introduction

Person-centered therapy, also referred to as non-directive, client-centered, or Rogerian therapy, was pioneered by Carl Rogers in the early 1940s. This form of psychotherapy is grounded in the idea that people are inherently motivated toward achieving positive psychological functioning. The client is believed to be the expert in their life and leads the general direction of therapy, while the therapist takes a non-directive rather than a mechanistic approach.

The therapist's role is to provide a space conducive to uncensored self-exploration. As the client explores their feelings, they will gain a clearer perception of themselves, leading to psychological growth. The therapist attempts to increase the client's self-understanding by reflecting and carefully clarifying questions. Although few therapists today adhere solely to person-centered therapy, its concepts and techniques have been incorporated eclectically into many different types of therapists' practices. [1]

• Issues of Concern

Origins of Person-Centered Therapy

Person-centered therapy, also referred to as non-directive, client-centered, or Rogerian therapy, was pioneered by Carl Rogers in the early 1940s. His ideas were considered radical; they diverged from the dominant behavioral and psychoanalytic theories at the time. Rogers' method emphasizes reflective listening, empathy, and acceptance in therapy rather than the interpretation of behaviors or unconscious drives. [1]

In the 1960s, person-centered therapy became closely tied to the Human Potential Movement, which believed that all individuals have a natural drive toward self-actualization. In this state, one is able to manifest their full potential. According to Rogers, negative self-perceptions can prevent one from realizing self-actualization.

Rogers postulated that a state of incongruence might exist within the client, meaning there is a discrepancy between the client's self-image and the reality of their experience. This incongruence leads to feelings of vulnerability and anxiety. [2]  

Person-centered therapy operates on the humanistic belief that the client is inherently driven toward and has the capacity for growth and self-actualization; it relies on this force for therapeutic change. [3]  The role of the counselor is to provide a nonjudgmental environment conducive to honest self-exploration. The therapist attempts to increase the client's self-understanding by reflecting and carefully clarifying questions without offering advice. The therapist functions under the assumption that the client knows themselves best; thus, viable solutions can only come from them.

Direction from the therapist may reinforce the notion that solutions to one's struggles lie externally. Through client self-exploration and reinforcement of the client's worth, person-centered therapy aims to improve self-esteem, increase trust in one's decision-making, and increase one's ability to cope with the consequences of their decisions. [4]  Rogers did not believe that a psychological diagnosis was necessary for psychotherapy. [2]

The Necessary and Sufficient Conditions

Rogers identified six conditions that were necessary and sufficient to facilitate therapeutic change. [2]

• Therapist-client psychological contact: the therapist and client are in psychological contact
• Client incongruence: the client is experiencing a state of incongruence
• Therapist congruence: the therapist is congruent, or genuine, in the relationship
• Therapist unconditional positive regard: the therapist has unconditional positive regard toward the client
• Therapist empathic understanding: the therapist experiences and communicates an empathic understanding of the client's internal perspective
• Client perception: the client perceives the therapist's unconditional positive regard and empathic understanding

Core Conditions

Rogers defined three attitudes on the therapist's part that are key to the success of person-centered therapy. These core conditions consist of accurate empathy, congruence, and unconditional positive regard. [3] [2]

Accurate Empathy

The therapist engages in active listening, paying careful attention to the client's feelings and thoughts. The therapist conveys an accurate understanding of the patient's private world throughout the therapy session as if it were their own. One helpful technique to express accurate empathy is reflection, which involves paraphrasing and/or summarizing the feeling behind what the client says rather than the content. This also allows clients to process their feelings after hearing them restated by someone else.

The therapist transparently conveys their feelings and thoughts to genuinely relate to the client. Within the client-therapist relationship, the therapist is genuinely himself. The therapist does not hide behind a professional façade or deceive the client. Therapists may share their emotional reactions with their clients but should not share their personal problems with clients or shift the focus to themselves in any way.

Unconditional Positive Regard

The therapist creates a warm environment that conveys to clients that they are accepted unconditionally. The therapist does not signal judgment, approval, or disapproval, no matter how unconventional the client's views may be. This may allow the client to drop their natural defenses, allowing them to freely express their feelings and direct their self-exploration as they see fit.

Critics have contended that the principles of person-centered therapy are too vague. Some argue that person-centered therapy is ineffective for clients who have difficulty talking about themselves or have a mental illness that alters their perceptions of reality. There is a lack of controlled research on the efficacy of person-centered therapy, and no objective data suggests its efficacy was due to its distinctive features. [1]  People have asserted that the unique qualities of client-centered therapy are not effective, and the effective aspects are not unique but characteristic of all good therapy. [5]

• Clinical Significance

Indications for Psychotherapy

Clinicians may initiate or refer a patient to psychotherapy for reasons not limited to the following:

• Treatment of a psychiatric disorder
• Help with maladaptive thoughts or behaviors
• Support during stressful circumstances or when a chronic problem impairs functioning
• Improve a patient's ability to make positive behavioral changes, such as healthy lifestyle changes or increasing adherence to medical treatment
• 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. [6]

Person-centered therapy relies on the client's active participation and may not be appropriate for individuals who lack motivation or insight into their emotions and behaviors.

To examine the efficacy of person-centered therapy in the treatment of various psychiatric conditions, this article will include recent studies using any form of non-directive counseling based on Rogerian principles, including person-centered therapy/client-centered therapy (PCT/CCT), non-directive supportive therapy (NDST), and supportive counseling/therapy (SC/ST).

Important limitations exist as NDST is not a popular focus of most researchers in the field. It is often only included as a control for nonspecific therapeutic conditions, and therapists may not have administered optimal treatments. Consequently, the researcher's allegiance to a specific therapy could skew results. [7] [8]  Additionally, given the inherent vagueness of this type of therapy, there could be differences in how NDST/SC/ST was defined and implemented.

There is evidence in the literature to support the efficacy of non-directive therapy as a treatment for depression. Three meta-analyses conducted within the past decade concluded that ST/NDST is an effective therapy for adult depression but may be less effective than other forms of therapy. [7]  [Level 1] 

Importantly, the authors mention that researcher bias may have played a role in the superiority of the other psychotherapies. After controlling for researcher allegiance, the differences in efficacy between non-directive therapy and other psychotherapies disappeared. This was true for all three meta-analyses. One study also notes no significant difference in effect sizes of non-directive supportive therapy versus full person-centered therapy. However, this was only based on two studies. [7]

A 2021 randomized, non-inferiority trial comparing person-centered therapy with CBT as a therapeutic intervention for depression found that person-centered therapy was not inferior to CBT at six months; however, person-centered therapy may be inferior to CBT at 12 months. The authors suggest that there needs to be continued investment in person-centered therapy to improve short-term outcomes. [9]  [Level 1]

In adults with depression over the age of 50, one meta-analysis found non-directive counseling to be effective, with effects maintained for at least six months. However, non-directive counseling was less effective than CBT and problem-solving therapy. [10]  [Level 1]

A 48-week randomized control trial compared nonspecific supportive psychotherapy with cognitive behavioral analysis system of psychotherapy (CBASP) in patients with chronic depression that were unmedicated (n=268). Both groups demonstrated a reduction in depressive symptoms. Patients who received nonspecific supportive psychotherapy had a lower response rate than patients who received CBASP. [11]  [Level 1]

However, there were fewer severe adverse events with nonspecific supportive psychotherapy. [12]  [Level 1] Follow-up two years posttreatment found the benefits of the two treatments were comparable on multiple measures, including the number of asymptomatic weeks. [13]  [Level 1]

Bipolar disorder

One randomized controlled trial (n=76) compared ST/SC to CBT in treating bipolar disorders and observed no difference in relapse rates. [14]  [Level 2]

Non-directive psychotherapy may be comparable to CBT and other forms of psychotherapy in treating generalized anxiety disorder in older adults. [15]

Post-Traumatic Stress Disorder (PTSD)

In the treatment of PTSD, non-directive therapy may be an effective treatment. [16]  Person-centered therapy may be comparable to evidence-based treatments for PTSD, with fewer dropouts. [17]  Trauma treatment research consistently shows lower dropout rates with person-centered therapy compared to other types of treatment. PCT may be a reasonable option in settings without the resources to provide the high levels of training required in other therapeutic modalities for PTSD.

Despite mixed evidence of its efficacy compared to other forms of psychotherapy, person-centered therapy is consistently recommended as a viable option, given the rising demand for psychological therapy. [9]  The literature suggests an important role for PCT in low-resource communities where the training and supervision of more technical psychotherapies may be less readily available, and access to mental healthcare is limited. [17] [18]

• Enhancing Healthcare Team Outcomes

It is estimated that 1 in 5 adults living in the United Kingdom and the United States suffer from mental illness. [19]  Most patients receive treatment for a nonpsychotic psychiatric disorder in a primary care setting. In recent years, mental health care in children and adolescents has increased more rapidly compared with adult mental health care. Again, most of this mental health care has been provided by non-psychiatrist providers. [20]  

In response to this rising need, there have been recent efforts to integrate behavioral health and primary care—an interprofessional care strategy will result in the best outcomes. The Collaborative Care Model employs a team-based approach emphasizing collaboration between different providers and has demonstrated improvement in depression outcomes compared to the usual care that persists for at least 24 months. [21]  [Level 1]

Compared to other forms of psychotherapy, person-centered therapy has the advantage of being more readily available and more easily implemented in other healthcare roles. [11]  Rogers himself stated that professional psychological knowledge is not required of the therapist; the qualities of the therapist and their experiential training are more important than intellectual training. [2]  

In a small randomized controlled trial comparing various psychotherapeutic interventions of PTSD in a low-resource setting, all participants experienced symptom reduction regardless of the intervention. Importantly, nurses felt that supportive counseling was the most transferable to their respective work environments. [18]  [Level 2] Another pragmatic trial (n = 228) found that non-directive counseling provided by public health nurses is an efficacious treatment for post-partum depression. [22]  [Level 3] 

Non-directive supportive counseling has a broader application beyond behavioral health. Healthcare providers can employ these principles to help patients make informed decisions about their physical health; however, more research is necessary to assess the impact of this approach on healthcare outcomes. [23]  [Level 1]

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Disclosure: Lucy Yao declares no relevant financial relationships with ineligible companies.

Disclosure: Rian Kabir declares no relevant financial relationships with ineligible companies.

This book is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) ( http://creativecommons.org/licenses/by-nc-nd/4.0/ ), which permits others to distribute the work, provided that the article is not altered or used commercially. You are not required to obtain permission to distribute this article, provided that you credit the author and journal.

• Cite this Page Yao L, Kabir R. Person-Centered Therapy (Rogerian Therapy) [Updated 2023 Feb 9]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-.

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• Data mining techniques in psychotherapy: applications for studying therapeutic alliance. [Sci Rep. 2023] Data mining techniques in psychotherapy: applications for studying therapeutic alliance. Mosavi NS, Ribeiro E, Sampaio A, Santos MF. Sci Rep. 2023 Sep 29; 13(1):16409. Epub 2023 Sep 29.
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A Case Demonstrating Person Centred Therapy

Author: Jane Barry

Michael has made an appointment to see his School Counsellor. He is due to finish school this year and is undecided about what direction he should take once he leaves school. Michael is a high achiever and his parents want him to make the most of his opportunity to enter University and study Law or Medicine. Whilst Michael is interested in Medicine, he feels that his interests at the moment are directed towards working and travelling abroad. He wants to discuss his preferences with the School Counsellor and to talk about the pressure he has been experiencing.

For ease of writing, the Professional Counsellor is abbreviated to “C”.

Essential Case Information

“C” has known Michael for the last 18 months and has developed a rapport with him. Michael and his parents have visited “C” a few times to discuss Michael’s career options and the subjects that would benefit him the most. From these meetings, “C” has ascertained the following information. Michael’s parents would like him to achieve a high OP score and are encouraging him to pursue science and maths subjects to allow him access to University to study Law or Medicine. Michael’s father is a Barrister and would like to see his son follow on in his professional footsteps. Michael’s mother wishes for Michael to have a professional career, but she has also encouraged his interest in arts, history and travel.

Both parents have contributed considerable time and energy into Michael’s education and Michael is very grateful for their support. As he has a very close relationship with his parents, Michael feels a great deal of pressure to follow the goals that they have set for him. Whilst he would like to follow a career in Medicine, he is not sure that he has the life experience to make such an important decision. After the last meeting, Michael confided to “C” that he did not want to go into university straight after school. If he could have his own way, he would prefer to take some time off from study and travel for a while. He has a close group of friends who are interested in welfare work. Together they have plans to travel and work voluntarily. These dreams with his friends seem exciting and challenging to him and would allow him some time to come to a decision about his career.

Michael has talked to his parents about travelling, particularly to his mother. She is understanding of his need to see the world and to experience a different side to life, however she is also concerned that he is still very young and inexperienced. She would prefer to see him enter University first and travel when he gets a little older. Michael’s father is also concerned about Michael’s preferred directions. He fears that if Michael doesn’t undertake University at this age, he may spend his life wandering around the world, without any substantial training to fall back on. Michael’s older sister (Theresa) has dropped out of her studies and has spent the last 5 years travelling. Michael’s father does not want to see his son follow the same direction as his sister. He has offered to finance his son’s further education if he enters university directly after school.

“C” has previously administered a Personality Need Type Profile for Michael, and has found him to have moderate type C/D needs. After some discussion with Michael, “C” believes that he has fairly high need gratification through his school work and home life, however the disagreement with his parents has been causing him some discomfort, particularly because of his security needs.

Session Content

“C” has decided to use a person-centred approach with Michael. “C” believes that Michael has the resources to come to his own decision about his life. Because of the rapport that already exists between “C” and Michael, “C” suspects that Michael may look to him to acknowledge his right to choose his own path. Because of “C’s” respect for both Michael and his parents, “C” believes that a person centred approach would be of benefit, to ensure that the responsibility for the decision remains with Michael.

When Michael arrives, “C” begins the session by making him comfortable and asking some questions about his sports interests. Both “C” and Michael are interested in touch football, and it is a topic that they have discussed in some detail in the past. As this conversation draws to a close, “C” asks Michael about his reasons for making the appointment.

As Michael explains the difficult decision he has to make, “C” pays close attention to Michael’s body language and his description of feelings. “C” attempts to make Michael feel listened to by making eye contact with him and by sitting forwards, in a more active listening position.

“As you know, Mum and Dad are really keen for me to go to University next year, but I really don’t like the idea. I’m not looking forward to more years of study yet,” Michael explained. “I’m getting to the point where I don’t want to do any more study after this year, I’d rather hang out with Paul and Mica. Their parents don’t put the same pressures on them to study and they don’t mind if they travel after leaving school. Compared to them, I feel like I’m wrapped up in cotton wool.”

“C” paraphrased Michael’s comments, focussing on his feelings, “so your feeling that you haven’t got as much freedom as your friends do.” “Well, yeah,” replied Michael, “I’ve always gone along with what Mum and Dad wanted, and so I’ve never had any reason to really disagree with them, and I’ve always kinda wanted what they wanted anyway. But now I don’t. Sure it will be great to go to University one day, it’s not like I’m going to be like my sister and never come home, but Dad is really paranoid about it.”

“C” responded, “It sounds like you’ve got some plans of your own, that are different to your sister’s and your fathers, is that right?”

“Definitely,” Michael said with emphasis. “Definitely,” “C” replied, “you said that with a lot of conviction!” “Yeah,” Michael replied, “you know, I’ve got some really good ideas of where I want to go and what I could do with my life.” “That’s great,” responded “C”, “I’d really like to hear about them.”

As Michael describes his plans for the future, “C” listened carefully and felt proud of the goals Michael was setting himself. “C” appreciated the strength of character that Michael demonstrated, for someone of such a young age. “C” felt that Michael had both the conviction and determination to create meaningful goals for himself and to carry them through.

Michael felt excited and elated to talk about his plans so candidly with someone. He felt that “C” had a deep appreciation of his needs, which inspired confidence in himself and the goals that he dreamed about. Michael was surprised and heartened by the depth of his convictions and the strength of his belief in his goals. Having someone listen to him so intently made him feel special and worthwhile. He genuinely felt that his world was an exciting and challenging place to be.

“C” expressed some of his thoughts to Michael, so as to further convey his genuine concern for Michael. “You certainly seem to have some very clear goals for yourself. From what I know of you, you’re a very determined young man and you’ve achieved very well at the subjects that you’ve taken on. I am sure that you can achieve all of your goals if you keep your determination. It takes a lot of maturity, and a certain type of person to be able to identify your goals so clearly. I can imagine that it must be frustrating to experience some obstacles to reaching your dreams.”

“Yes…I’m not sure what to do about that,” replied Michael. “I know that my parents mean well and are worried for me, but, I think that I want them to support me in other ways now.” “How is their support of value to you,” inquired “C”.

“Probably more valuable than what I realise! You know, they’ve done a lot for me. I’ve always been into a lot of things and they seemed to have sensed that and tried to give me lots of opportunities. In some ways we’re a well suited family, you know? They want a son who achieves well, and I just want to achieve. Up until this point, we’ve mostly agreed about what I achieve at. My sister is different though, she is happier to just accept life as it comes along and she never used to like Dad pressuring her to do stuff. They used to argue a lot and sometimes I think she saw going overseas as a way to escape and be herself.”

“Dad was pretty upset when she went, I think he took it personally. I know he would just go crazy if he thought that I was going to do the same thing. I just wonder if I can ever get him to see that the decisions Theresa made and the ones I want to make have got nothing to do with him. I really don’t want him to think that I’m ungrateful or doing it to spite him.”

“C” reflected, “it sounds like your pretty grateful to your father and that you respect him. It also sounds like you are trying to find some ways to tell him about your plans, whilst still respecting him.”

“Yeah, though I’m still afraid that he won’t agree to my plans,” replied Michael.

“C” responded, focussing on his feelings, “can you tell me more about your fears?” “Well,” Michael replied, “I don’t know, I guess I fear that he’ll back off and not offer me any more chances to go to University.”

“How would you feel if that happened,” inquired “C”. “Really let down, and angry too. I mean, he’s got to let me make my own life now. I’m not just a kid any more,” Michael responded, frowning.

“C” reflected Michael’s meaning back to him. “You’re feeling angry about your lack of freedom and you want your father not to treat you like a kid any more. You want to go to University some day, but you’d like to have a break from study and travel with your friends. You’re afraid that your father will not accept your decisions and you will lose respect for each other. Does this sound right to you?”

Yeah, Michael sighed, “so what am I supposed to do? Why won’t Dad give me some credit for my own sense? Does he think that I’m going to be a kid for the rest of my life? I deserve to make my own plans,” complained Michael.

“C” nodded and responded, “they’re all important questions Michael, what do you think some of the answers might be?” “I don’t know,” replied Michael, “I thought that you could help me out there.” “Hmm,” said “C”, “that’s a tough one. I can see why you’re having such difficulty in making a decision. On the one hand, you’ve got some very exciting plans of your own that you want to fulfil. On the other hand, your trying to consider the plans that your parents are offering you, to get a tertiary education. I’m also wondering how you’ll make a decision.”

“Ultimately, I’d like to do both,” said Michael. “C” nodded and remained silent for a period. Michael also sat silently, thinking to himself. After a period, Michael replied, “I think I need to think about it some more. I need to talk to my parents some more too. I’ve been a bit afraid to talk about it directly, in case they definitely say ‘no’. I was thinking that I have to put in my selection for university soon, so perhaps I could apply for Medicine, but then defer for a year. It might be easier for Dad to accept, if I did this. What do you think about that?”

“C” replied, “discussing some of your options with your parents is a good idea. Perhaps you might think about how you would approach them. How might you feel if they still did not accept your proposals?”

“I’d feel let down and angry. I think I’d want to leave home if that happened. I wouldn’t want to make a scene, but I do want to live my own life. I think that I would have to leave.”

“C” replied, “that is a serious move, leaving home. Your goals must be very important to you indeed.”

“They are!” Michael exclaimed.

“C” probed further into Michael’s feelings about the choices he wanted to make. In particular he asked Michael about approaching his parents to discuss his goals. “C” focussed in on what Michael would say to his parents to let them know the seriousness of his intentions. “C” also asked Michael to consider how his parents might react to his news. From this, Michael developed some strategies for himself to use when telling his parents of his intentions.

In summary, “C” expressed his appreciation of Michael’s world and experiences. “C” validated Michael’s feelings and goals and complemented Michael on his mature strategies to explain his goals to his parents. Michael’s decisions included setting a time with his parents to discuss his goals, to suit everyone. He thought that they might go out for dinner one evening, to mark it as an important event. Michael would ask his parents to think about their goals for him and discuss these over dinner. In this way Michael would be allowing for his parents to contribute to his plans and hopefully influence them to listen to and respect his own ideas.

As a finishing point “C” asked Michael how he had felt about the session in general. Michael had appreciated the opportunity to talk about his issues and goals so completely to someone. He said he felt clearer about the direction he wanted to take in his life and was beginning to consider how to explain his goals to his parents. He thought that “C” had really appreciated him for who he was and it made him feel more mature in himself. He had hoped that “C” would have offered him some more direct advice about what to do, but understood that it was his own responsibility to decide.

End of Session

Some points to consider with Person Centred Therapy are as follows:

This therapy focuses on the quality of the client / counsellor relationship . It assumes that clients are basically trustworthy and have the inner resources to find solutions to their own problems. It is a less directive therapy on the counsellor’s behalf, meaning that clients are free to set their own goals and create the conditions that will allow themselves to explore their needs and behaviours.

Therapists themselves contribute to the client’s growth by providing a warm, positive, trusting, and open relationship with the client . The three important qualities the counsellor should possess are congruence (genuineness), unconditional positive regard (acceptance and caring) and accurate empathetic understanding (ability to deeply grasp the world of another person).

There are no fixed techniques that apply to Person Centred Therapy, rather there are a set of principles for counsellors to be guided by. Some of these are as follows:

• The client is experiencing a discrepancy between the way they perceive themselves, the ideal picture of themselves and the reality of their situation. They may feel helpless and unable to make a decision, or direct their own life.
• Whilst the client may look to the counsellor for direction, the emphasis will be upon the client to take responsibility for their own decisions and to learn to use the therapeutic relationship to increase their self-understanding.
• The therapist should attempt to understand the client’s world through listening, empathising, respecting and accepting them; and in doing so, the counsellor will be integrating themself into the relationship with the client.
• The therapist should try to experience genuine care and acceptance of their client, otherwise, the client may feel that the counsellor is feigning interest and will not fully disclose their feelings.
• As clients experience the therapist listening to them and accepting them, they learn how to accept themselves. As they find the counsellor caring for them, they start to experience themselves as worthwhile and valuable. When they experience realness from the counsellor, the client is encouraged to shed their pretences with themselves and others.

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Specialties

Client-Centered Therapy

What is client-centered theory and therapy.

Client-centered theory was originated by Carl Rogers more than five decades ago, at a time when the humanistic approach to psychology was evolving and clearly differentiated from the more analytical styles of that period.

• Client-centered theory is hypothesized on the belief that all beings have innate means to grow and change beyond their perceived limitations of “self” (e.g., attitude, behavior, and self-concept) toward greater positive personal development when facilitated through consistent and reliable relationships in therapy (Cepeda & Davenport, 2006; Rogers, 1957, 1961).
• Client-centered therapy is a nondirective approach where the role of the therapist is not to offer direct advice for change or make any other type of suggestion that is usually found in the behavioral therapies but to use self-awareness in relationship to the client, focusing on the here and now of the presenting disparity, and provide a safe environment in which the client is capable of achieving self-actualization.

The client-centered therapist shows respect in recognizing that the client is the expert, inherently capable of resolving their challenges in order to live a more complete and satisfying life (Cepeda & Davenport, 2006; Green, 2006).

Client-centered theory and therapy are not based on stages of development or steps of actions to take sequentially with the client; rather, they rely solely on the stance of the therapist to genuinely possess three key humanistic characteristics:

• Unconditional positive regard

Furthermore, these three attitudes are manifested by the therapist and accessed during counseling sessions with the client, who is often experiencing a sense of incongruence, vulnerability, and anxiety.

It is essential to the theory of client-centered work that the client perceives and recognizes to some extent these therapeutic attitudes (Bozarth & Brodley, 1991). Table X-1 offers a more detailed explanation of each of the three elements that are central to the therapist’s behavior as client-centered.

In 1957, Carl Rogers hypothesized six conditions as “necessary and sufficient” to promote what he called constructive personality change in the individual (p. 241).

It is also suggested that as long the therapist is able to interrelate the three salient qualities discussed earlier (congruence, empathy, and unconditional positive regard), then at a minimum the client will experience positive growth (Snodgrass, 2007; Snyder, 2002).

Table X-2 represents the key principles of client-centred theory.

In addition to Rogers’ explanation of the client-centered approach in the helping profession, there have been many others who built on this original hypothesis by expanding its application.

One such contributor to this approach is Robert Carkhuff, who elaborated on the three core conditions by adding confrontation, immediacy, and concreteness, also noted as “facilitative conditions deemed essential for effective counseling” (Horan, 1977).

In this realm, these qualities or conditions parallel Rogers’s core conditions in the following way:

• Concreteness in empathetic understanding is about “being specific”
• Immediacy with congruence refers to “what goes on between us right now”
• Confrontation is seen as useful in “all three of Rogers’ conditions” (Brazier, 1996) as “telling it like it is” (Carkhuff, 1971, as cited in Horan, 1977).

Carhuff’s emergences in the client-centered approach are often seen as more active and direct than the original precepts and are recognized as qualities that further aid the helping process of the client.

The effectiveness of client-centered therapy is primarily dependent on the relationship between the client and therapist, whereby the therapist is completely aware of him- or herself in relationship to the client and the client is able to communicate unexpressed feelings and emotions that have caused confusion with his or her notion of self.

Ultimately, clients are able to experience on their own accord that they are loved and valued, which allows them to realize their fullest potential through self-actualization.

The Client-Centered Perspective Applied to Social Work

The conditions of client-centered theory match the fundamental values and skills of social work. The two have a historically organic relationship based on the shared belief and respect for the individual’s worth and dignity, autonomy, self-determination, and ability to improve whatever conditions exist through empowerment of the individual, group, or community.

The core skills used by social workers in purposeful relationships include empathy, respect (unconditional positive regard), and authenticity (congruence), which are also noted as the key elements/attitudes to the client centered approach (da Silva, 2005; Rooney, & Larsen, 2001).

The following case is presented to illustrate the use of the client-centered approach in social work.

In reviewing this case, we can see that the stance of the therapist was to establish a trusting relationship with the client using the three key characteristics of a client-centered approach. Throughout this relationship the social worker

• shows unconditional positive regard for the client by being warm, and nonjudgmental of the client’s presenting conflict;
• demonstrates empathy by being able to communicate an understanding through accurate reflection of the client’s feelings; and
• remains congruent even with expressing her own experience of Liz as lovable.

Through verbalizing unexpressed emotions, Liz succeeded in reconciling her feelings of despair over the role of caregiver versus her need to be loved and was able to fully realize her potential for happiness and achieve a greater and more fully integrated sense of self.

The Larger Perspective

Social workers can use client-centered practice in a multitude of settings, including family and couples counseling, group therapy, and the larger context of community work. In each of these settings, the therapist uses the three key skills to address each individual or member and his or her unique needs and concerns, ultimately facilitating an ideal scene from the present scene.

If there were a code of conduct for client-centered therapy it might read something like this.

Client-centered therapy does not diagnose, judge, assess, solve, or otherwise profess to know what is “wrong” with the individual.

Client-centered therapy focuses on the uniqueness of the individual by respecting, nurturing, loving, and fostering the fragmented aspects of the client’s notion of self while the therapist demonstrates and maintains an integrated sense of wholeness.

Client-centered therapy can be viewed as a significant precursor to other effective therapies that are intentionally directive, problem-solving, or behavior-changing in their focus. At a minimum, the client-centered approach is seen as significant in assisting the client to feel understood, loved, and fully integrated through establishing a safe, trusting, and reliable rapport with the therapist.

•  Cognitive-Behavioral Therapy (CBT) Opens in new window
• Barrett-Lennard, G. T. (1998). Carl Rogers’ helping system: Journey and substance. Thousand Oaks, CA: Sage.
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Counselling Case Study: Working with Grief

Maggie is a 35 year old woman who came for counselling six months after the break up of her nine year marriage to Michael, the father of her two children, Josh aged 6 and Joseph aged 12 months. Currently both children are in Maggie’s sole care. Maggie has been referred to counselling by her General Practitioner whom she has been seeing for a number of minor physical ailments and early signs of depression.

For ease of writing the Professional Counsellor is abbreviated to “C”.

Maggie and Michael met at university when they were studying business computing. After graduating they were employed in separate companies and dated for a number of years before finally getting married. They both continued working until the birth of their first child Josh, when Maggie took a year off before returning to work part time. Michael continued in full time work and received a number of promotions over his years of continuous employment.

Maggie continued working part time until the birth of their second child Joseph, when she again took a year off to care for both children at home. She was about to return to work when Michael came home one night and said he was leaving her for a woman he had met at work. Two weeks later Michael moved out of the family home. He has not contacted Maggie or the children since. Maggie has not felt well enough to return to work and is now in danger of losing her position with the company.

Application of Person-Centered Counselling

The counsellor applying this approach is primarily concerned with communicating empathy and unconditional positive regard to the client. This includes the application of micro skills such as active listening, reflection of feeling and meaning and summaries in the context of a genuine interaction between the counsellor and the client. The counsellor’s role is specifically ‘non expert’ supporting the client to recognise personal strengths and to find answers that are congruent with her/his own values and beliefs.

Preparation

C’s preparation of the counselling room included placing chairs in face-to-face mode, checking the position of curtains to minimise glare, and placing a box of tissues within easy reach of the client’s chair. C also spent a couple of quiet moments clearing her mind of prevailing thoughts from the previous client in order to give Maggie her full attention.

Session Details

Upon Maggie’s arrival, C introduced herself and spent some time developing rapport in an attempt to make her feel welcome and at ease. This was done by asking Maggie to be seated and making general conversation about the weather, and about how Maggie’s day had been so far.

C formally began the session by asking Maggie whether she had received the counselling agency’s letter sent to confirm her appointment details and a brochure containing information about the counselling service including fees, hours of opening, qualifications of staff and map location. Maggie confirmed she had received the leaflet and said that it had been very useful and informative.

C then asked if Maggie had any questions not covered in the information brochure. Maggie replied in the negative and C proceeded to ask Maggie what had brought her to counselling.

Maintaining good eye contact and an open posture, C waited for Maggie to start speaking. After about 20 seconds of silence during which Maggie looked down at the floor, she finally spoke through tears. “My husband left me for another woman six months ago and I just don’t seem to be able to get on with my life.”

C observed Maggie’s emotional reaction and decided that Maggie would be best supported by a person centered approach which would allow her to voice her feelings surrounding the loss of her marital relationship.

C responded with a paraphrase and reflection of feeling “You sound devastated by the loss of your marriage Maggie.”

Maggie replied “Yes I am, but it was six months ago, I should be getting on with my life by now. That’s what my family and friends are saying anyway. But I still miss Michael so terribly and the boys cry for him every night at bedtime.”

C: “So, am I right in saying that you and the boys are still heartbroken yet friends and family think you should be over it by now?”

Maggie: “Yes, that’s about it. Maybe I should be over him by now. What do you think?”

C: “Let me ask you Maggie. Do you think six months is long enough to mourn the loss of a long-term intimate relationship?”

Maggie: “No I don’t.”

C: “And you’re the only one who knows how it feels to have lost your relationship with Michael, Maggie.”

Maggie nodded and continued telling the story of her life in the past six months, pausing occasionally to wipe her reddened eyes with a tissue from the box nearby. Maggie described the physical and emotional upheaval as she struggled to cope with looking after the children on limited income. She also voiced her fears and uncertainty about her own and her children’s future.

C continued to stay focused on Maggie emotionally and to use encouragers and reflections of feelings to confirm and validate her feelings.

After one of many silences, during which C had remained silent but attentive, Maggie looked up without speaking. C decided that this was an opportune time to summarize some of the issues Maggie had raised so far and said “Maggie, you’ve described a huge upheaval in your life in the past six months that has meant reorganising your life in many ways. You’ve taken on the sole responsibility for two children, managing the house and finances and at the same time dealing with the emotional loss of your marriage. That sounds like an awful lot to deal with at once.”

Maggie: “Yes, I suppose it is when you put it all together. It didn’t seem so daunting when Michael was there to help.”

Thereafter, through continued bouts of tears Maggie described her childhood dream of being married with children and the emptiness she now felt having lost that dream so suddenly. She also voiced feelings of anger and self-recrimination for not being able to cope with her new circumstances as a sole parent.

Through the use of open questions, paraphrases and reflections, C was able to explore with Maggie her feelings of anger and also clarified the meaning of what being a ‘good mother’ meant to her. Maggie talked about memories of her own mother who did not work outside the home and was always waiting for her when she returned home from school.

Further exploration through paraphrases and reflections highlighted the significant differences in parenting lifestyles of the past and today, with many parents now assuming the onerous task of undertaking responsibilities of homemaking, parenting and external work.

Maggie then said ” Yes, I suppose being a mother has changed a lot since my Mum’s time.”

C: “That’s for sure Maggie.”

Maggie then went on to describe how much she missed working outside the home and having a career. C reflected Maggie’s feelings (expressed explicitly verbally and implicitly though non verbal signals such as frowns, smiles and wistful glances at the ceiling) and used open questions to explore what Maggie liked about her work including her strengths and capabilities.

Maggie: “You know, maybe I could negotiate to return to work part time for a while until I can get my life organised a bit better? I have a few friends who might be able to help me out with picking the boys up from childcare if I need to work late occasionally.”

C (smiling): “So you think working part time with some childcare support from friends might be the way to go Maggie?”

Maggie: “Yes, I think I’ll put the idea to my boss on Monday.”

From then on, Maggie’s talk slowed and she assumed a more relaxed posture sitting back in her chair. C asked if there was anything else she’d like to talk about today. Looking at her watch Maggie replied that she would need to get going to pick up the boys up from the childcare centre. She also said she would like to come back again the following week.

C replied that she was most welcome to come back anytime and wished her luck as she left looking tired, but definitely more relaxed.

Session Summary

In this session, Maggie, given the freedom to voice her emotional pain in an atmosphere of empathy, genuineness and unconditional positive regard was able to acknowledge that the expectations she was placing on herself were unrealistic and was able to begin to consider other ways of managing her new life.

The use of the Person Centered Approach to counselling in this initial session was well suited to a client such as Maggie who was able to articulate and explore her feelings associated with the loss of her marriage and future uncertainty.

The key concepts of Person Centred Therapy applied in this session were:

• The creation of a non-directive and growth-promoting climate wherein the client feels nurtured and respected.
• A congruent and empathic approach by the counsellor that emphasises and promotes self worth and empowerment encouraging clients to find answers that are congruent with her own values and beliefs.

Author: Liz Jeffrey

Related Case Studies: A Case of Grief and Loss , A Case of Grief Using an Eclectic Approach , A Case of Acceptance and Letting Go

• March 5, 2007
• Case Study , depression , Person-centred
• Case Studies , Clinical Mental Health , Relationship & Families

Comments: 3

A very well presented case study/ counselling session. thank you

Well organized and well written. Thank you.

That was a great way to do this. I love how the c got her to open up more and made her more comfortable.

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