Rather, Rogers argued that the therapist was there fundamentally in a support role, with the client in his or her own journey toward self-actualization. How then, does the client experience this kind of therapy? For many clients who are experiencing anxiety or self doubt, person-to-person therapy can lead them to discover their own ability to heal themselves. Assuming responsibility for one's own mental health by recognizing the range of life choices that are available is one positive outcome for clients who experience Roger's approach.
Traditional therapy often places the therapist in a professional, diagnostic, medical role. The patient, in this scenario, becomes increasingly convinced that s/he is not able to "get better" without the intervention of an expert. As a result, s/he may become even more despondent and feel less empowered to take control of his life. By contrast, Rogers approach re-situates the therapist and simultaneously empowers the client. This relationship may best be characterized as a way of being. It asks the therapist to be an open participant in the dialogue, and to take responsibility for her own journey as well.
Therapy in Practice
Unlike other forms of therapy, the person-centered approach does not begin with an evaluation session. Rogers was wary of evaluative testing and shied away from asking for a complete medical and psychological history. These tools, he felt, established a sense that the therapist was prepared to diagnose and solve the clients' problems for them. Rather than framing a new therapeutic relationship in the context of assessment and diagnosis, a person-centered therapist will orient a new patient by communicating the core therapeutic values: congruence, unconditional self-regard, and empathy. These values will be communicated through conversation and dialogue, without an overly structured setting.
The therapist will ask questions to help the client communicate his thoughts, and throughout will practice reflective, active listening. Infusing this kind of listening with genuine interest and empathy will naturally create conditions for enhanced conversation. Rogers (1967) reminds his therapists that "it is the realness of the therapist in the relationship that is the most important element," (188). Thus, it is the job of the therapist not to give advice but instead of listen and thereby help the client feel accepted and safe.
Client-centered therapy has been used in individual settings, as a tool in group therapy, in crisis situations, and in chemical dependency. Despite the diversity of these settings, Rogers would have argued that all consist of individual people who can be brought out if provided with a productive environment for communication. Indeed, in recent years his tools have been used in team-building and corporate contexts, in school counseling settings, in classrooms, and in all psychology training programs. After all, "if counselors are lacking in these relationship and communication skills, theyw ill not be effective in carrying out a treatment program for their clients," (Corey, 2009: 179).
Many forms of modern therapy borrow from Carl Rogers' person-oriented approach. For example, art therapy and animal therapy seek to provide a safe and enjoyable context for clients to explore their inner thoughts. The therapist in these approaches, similar to client-centered settings, seeks to create unconditional regard. That is, especially in clients who have difficulty with personal interactions or who suffer from extreme anxiety, art and animals have been shown to create feelings of relaxation and calm. This state, in turn, may help an otherwise "stuck" patient dig into his or her own shell and uncover steps toward greater psychological health. Art and animals do not judge, they do not diagnose, and they do not provide treatment by themselves. But, following Rogers' precepts, modern day art therapists begin with the assumption that "our feelings and emotions are an energy source that can be channeled into the expressive arts to be released and transformed," (Corey, 2009: 181). The extension of client-centered therapy into the world of art merely adds a tool for creating the kind of therapeutic atmosphere that Rogers' promoted.
Thus, "one of the main ways in which person-centered therapy has evolved is the diversity, innovation, and individualization in practice," (Corey, 2009: 177). While still abiding to the core principles, some therapists now practice client-centered therapy with a greater role for therapists to react and even confront their clients. Some integrate client-centered therapy with other approaches, such as cognitive behaviorism. Finally, some have suggested that not all patients are well suited for a client-centered approach; if the model is not one-size-fits-all, then there is room for therapists to interpret the assumptions as they see fit. Adaptability has become a hallmark of Rogers' school of thought. Many practitioners note that the approach is particularly well suited for a globalized world. Cross-cultural communication and diversity in inter-personal relationships can be challenging; person-centered therapy has been applied in these contexts with promising results.
Other forms of modern therapy, such as experiential therapy, accept and use some of the tools described here but reject one of the fundamental assumptions of Rogers' model. Instead of trusting the client to proceed along some innate path toward healing, experiential therapists argue that there is "no built-in force that leads one toward integration and actualization," (Mahrer, 2004: 336). In this view, providing conditions for personal growth isn't enough. The patient needs exposure to new strategies for changing undesirable behaviors.
Similarly, rational emotive behavior therapy echoes doubt about Rogers' description of self-actualization. There is no "real self" waiting to be uncovered. According to rational emotive behavior therapy, clients are biologically diverse with natural strengths and weaknesses. They are influenced not just by some internal barometer but by countless social, environmental, and physical factors. They may hold beliefs that interfere with healing, and they may harbor thinking patterns that make it difficult or impossible to access some sort of inner truth (Ellis, 1998). Still, despite disagreement here about the process toward self-actualization, there is widespread agreement about what a self-actualized person is. Characteristics that are present in these enlightened souls are envisioned similarly across disciplines; how to help clients arrive at those elusive places is much more controversial.
Another line of critique comes from community mental health centers, charged with treating a great number of people who likely do not have health insurance and may suffer from ongoing psychological illness. Many of these therapeutic practitioners feel they don't have the luxury of developing a lasting therapeutic relationship with a client. Similarly, many of these clients seek immediate relief from their symptoms, a need that calls for more rapid diagnosis and treatment. Many of these patients may be good candidates for medication. These shortcomings point out limitations on the applicability of Rogers' theories. Still, and even in the most hectic urban communal health care settings, it is likely that the imprint of the client-centered approach can be felt. Individuals who enter these facilities are likely met by an empathetic ear and may experience unconditional positive regard.
Psychotherapy in general seems to have moved on from Rogers key theory about the client's ability to heal himself. Many therapists are uncomfortable with the idea that the therapist shouldn't offer diagnosis or guidance to the client, that just being there in an emotive relationship will be sufficient. Despite these -- arguably permanent -- disputes, Rogers has had a lasting imprint. Goldfried (2007) explains:
"[Rogers'] emphasis on the importance of the therapy relationship is now routinely accepted as necessary, even if not sufficient for change to occur & #8230; It is currently recognized that therapist acceptance is essential, that nondirective methods can be effective in improving client motivation, and perhaps most important, that the therapist needs to work toward the development of evidence-based interventions," (249).
Perhaps one of the less obvious impacts of Rogers work on the field of psychology is his insistence that therapists themselves be convergent. This is hard! It has led to a consistent feature of therapy programs, where the therapists themselves are often urged to undertake their own programs of personal growth. In this way, the irony of the client-centered approach may be its lasting impact on the personal lives and journeys of therapists.
Carl Rogers' person-centered approach transformed therapy. It shifted the assumptions about people in treatment from being helpless victims of mental disease to being the sole source of self-healing. It shifted the role of a therapist away from a technical expert toward an empathetic partner in a client's journey. It shifted the role of the client away from being a passive participant in diagnosis and treatment toward having an active part to play in uncovering the full self within. It placed new obligations on therapists, and rewrote the thrust of the therapeutic process. Critics have revised some of the more idealistic pieces of Rogers' theories -- especially the notion that self-actualization will happen naturally and only requires the right therapeutic environment -- but his impact on the field has been durable. Unconditional positive regard, empathy and congruence are now consistent features of a therapists approach to treating clients, regardless of which…