Bohart's client-centered approach to therapeutic change and self-healing

¶ … treating a client as the expert of his experience allow for therapeutic change?

Bohart's views have revolutionized psychotherapy by shifting from a paternalistic medical approach to one that empowers the client. In fact, Bohart suggests that in many cases, psychotherapy is unnecessary. The shift in focus to a client-centered approach allows for a more fruitful and effective therapeutic relationship. Moreover, the bulk of problems are ones that can and should be solved on one's own through the natural support systems the client might have, or the particular coping mechanisms that are culturally or individually relevant to the client. Therapeutic change is achieved by supporting the client's own healing process and serving as catalyst or facilitator. For example, Bohart & Tallman (1999) note that "clients, even children, can provide solutions to their own problems when the therapists assume that the client, not the therapist, is really the expert on the client's problem," (Bohart & Tallman, 1999, "What do we mean by the client as active self-healer?" p. 4). By reminding the client that they are in charge of their own "truth," as Bohart put it in his Palo Alto talk, the client can achieve meaningful therapeutic change because it occurs as a paradigm shift.

Are therapists even needed?

Therapists are facilitators but they may not be necessary in all cases. Self-healing and "self-righting" can and do occur naturally and organically without the need of therapists (Bohart & Tallman, 1999, "Self-healing without a therapist"). After all, psychotherapy is a relatively new technique, but human problems are not. Psychotherapy is also culturally specific. In traditional communities, problems are resolved via talking with members of the social support system, through informal or formal process of group therapy, or through self-guided change. The self-help movement has also catalyzed self-healing. Moreover, Bohart outlines several different types of learning and change that may take place without any therapeutic assistance. One type of change takes place through puzzle solving, and another more powerful type of change involves a paradigm shift. Like second-order change, paradigm shifts can potentially transform the ways the client behaves by changing the way the client perceives herself, her role, and the problem itself. Empirical research substantiates Bohart's claims. Research has consistently revealed that "therapy does not really operate in a medical-like fashion, but more likely works by providing a context that supports and mobilizes clients' self-healing potential," (Bohart & Tallman, 1999, "Research results that may surprise you -- how do we know the client is an active self-healer?" p. 54-55). Therapists may be needed in some situations, but when it is used, the client still needs to take an active role in the process rather than allow the therapist to assume the paternalistic role of controlling the discourse. "Client effort and involvement seems to be the single most important factor in making psychotherapy work," (Bohart & Tallman, 1999, p. 55). The times when therapists are necessary include those times when "natural environment does not provide sufficient support or resources for self-healing" or their ways of coping are "insufficient to deal with the problems they are trying to overcome" (Bohard & Tallman, 1999, p. 87). Of course, persons with serious mental illnesses like schizophrenia may not be capable of self-healing, but Bohart is not speaking about severe issues.