Learning and Being in Person-Centred Counselling (third edition)

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Most of the ways of behaving that are adopted by the organism are those that are consistent with the concept of self. Unlike other therapies, the client is responsible for improving his or her life, not the therapist. This is a deliberate change from psychoanalysis and behavioral therapies, where the patient is diagnosed and treated by a doctor. Rogers believed that every person could achieve their goal. This means that the person is in touch with the here and now, his or her subjective experiences and feelings, continually growing and changing.

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]

Stage 3

Rogers, C. (1959). A theory of therapy, personality and interpersonal relationships as developed in the client-centered framework. In (ed.) S. Koch, Psychology: A study of a science. Vol. 3: Formulations of the person and the social context. New York: McGraw Hill. According to Rogers, people could only self-actualize if they had a positive view of themselves (positive self-regard). This can only happen if they have unconditional positive regard from others – if they feel that they are valued and respected without reservation by those around them (especially their parents when they were children).

Under certain conditions, involving primarily complete absence of any threat to the self-structure, experiences which are inconsistent with it may be perceived, and examined, and the structure of self revised to assimilate and include such experiences. When we are in a relationship where we feel safe, understood and accepted for who we are, we can look at some of the things that don’t fit in with our picture of ourselves and, if necessary change our picture to fit our experience more accurately. Or we can accept the occasional differences between our pictures of ourselves and our experience without becoming anxious. However, unlike a flower, the potential of the individual human is unique, and we are meant to develop in different ways according to our personality. Rogers believed that people are inherently good and creative. 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]Individuals were living life on other people’s terms – and were withholding, muting or pushing down their own organismic valuing process. The people they wanted to be, were being pushed away by themselves to please others. This means that self-actualization occurs when a person’s “ideal self” (i.e., who they would like to be) is congruent with their actual behavior (self-image). The goal is not to validate or condone these behaviors, but to create a safe space for the client to express themselves and navigate toward healthier behavior patterns.

Hence the child is not loved for the person he or she is, but on condition that he or she behaves only in ways approved by the parent(s). They become destructive only when a poor self-concept or external constraints override the valuing process. Carl Rogers believed that for a person to achieve self-actualization, they must be in a state of congruence.

Stage 2

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. People who are able to self-actualize are more likely to have received unconditional positive regard from others, especially their parents, in childhood. 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]