When to Use Person Centered Therapy for Patients

Person-Centered Therapy (PCT) is a form of counseling based on discussions with the person/patient that allows him to express his subjective view of himself and the world in order to arrive at a more objective/clarified vision. The patient arrives in a state of incongruity and through a series of sessions of PCT is relieved of various levels of incongruity as they are exposed by himself through his own dialoguing with the therapist. The dialogue is primarily centered on the patient, which is why it is called person-centered therapy.

This therapeutic approach is evident in the session between John (patient) and Dr. David J. Cain (therapist) (American Psychological Association, 2012a).

This paper will discuss the approach of PCT by addressing a series of questions regarding the nature of the therapy How does change occur? Change occurs in the patient over a series of interviews with the therapist, as the patient and therapist explore together a range of issues of which the patient overtime becomes aware through the process of talking, reflecting, and discovering underlying themes and patterns within his own life and behavior.

In the case of John, for instance, he enters into therapy aware of a heightened stress level in his own life, which he blames on the man with whom he is living. Yet as the therapist encourages John to talk, it becomes evident to John that he has been a stressful person for some time and may even perhaps be an obsessive compulsive.

Change occurs, for example, as John discovers characteristics about himself that the therapist will help to highlight so that John can decide whether or not these characteristics are negatively or positively impacting his life, and what to do about them (American Psychological Association, 2012b). Why is the relationship key to the process? The relationship is key to the process because without the relationship there is no dialogue, and without the dialogue there is no discovery.

The therapist facilitates the person-centered therapy by motivating the patient to work through his own issues over the course of the interview process. The relationship allows the issues to be unlocked so that the patient can see them anew, sometimes for the first time (Li, Porock, 2014).

The therapy is not relationship-centered because it is not about cultivating relationships as part of a support system; rather the therapy is person-centered -- but even in this approach, the relationship of the therapist and the patient is key to successful therapy because it is the relationship that allows the patient to open up in a manner that allows both individuals to be entirely focused on the patient, which is something that is not always possible in a relationship where two individuals must give and take, as in the case with John and his partner.

The relationship between John and his therapist, on the other hand, is perfect for providing the person-centered approach that John needs to identify elements within himself that are affecting his life (American Psychological Association, 2012b). As Dr. Cain shows in session 1 with John (American Psychological Association, 2012a), the relationship is key because it provides the patient with the empathy he/she needs to open up to himself and respond to the inner questions, ideas and problems that are yelling to get out.

By showing interest in the patient, the patient is able to see that he has something of interest, whereas before he bottles everything up thinking he has nothing to offer or nothing that anyone need to care about. But when the therapist shows empathy to the patient, this is like a get out of jail free card: it gives the patient the opportunity to come out from under his problems and unburden himself for a moment if only by talking about it aloud.

Through this relationship, the patient is also able to see what underlying fears are affecting his other relationships. For example, with John he discovers that his fear of making a ceremonial commitment to his partner is not based on the commitment aspect but rather on the ceremonial aspect: this realization would not have been possible without the therapist's role (American Psychological Association, 2012a).

As the listening and empathic half of the relationship, he fills a gap in John's life which needs to be filled in order to get John to realize things about himself. In short, he needs a good listener. Dr. Cain's second session with John (American Psychological Association, 2012b) shows another aspect of why the relationship is key: Dr.

Cain encourages John to engage his emotions more fully so as to work through them out in the open instead of consistently attempting to repress in order to not deal with them at all. This is the other pivot part of the relationship between the PCT therapist and the client: the therapist assists the patient in dealing with issues of repression by encouraging the patient to emote, to experience the emotions seething below the surface of his being.

This lets the pressure out and lets the patient deflate the stress ball building inside. The same is true for Allyn and Bacon (Person-Centered Child Therapy, 2002), who show how the relationship can even be effective for PCT with children, by using effective body language to convey solidarity, support, and engagement.

What does the relationship look like? The relationship is not nearly as formal as traditional psychotherapy relationships, if only because it more oriented towards the individual's needs and goals, to such an extent that the therapist becomes just a part of a "collaborative process between the person" and the care provider "that results in the development and implementation of an action plan" geared towards allowing the individual to pursue and attain personal objectives (Davidson et al., 2015, p. 82).

In terms of appearance, the relationship can be orchestrated in any manner of ways that facilitate the individual patient, which is why PCT is considered individualized care. The goal of the therapy is not to compel the individual to conform to some objective of the therapist but rather to help the individual patient to identify his or her own goals and reach them through dialogue and strategic questioning that assists the patient in self-discovery and remedy.

The relationship does not look like a traditional relationship, either, because it is completely focused on the individual: therefore, it is a special relationship in which the therapist provides a focus for the patient, provides listening, empathy and light in terms of situating themes within a specific context important to the patient. The therapist's role is to provide "engagement" with the patient (Andrus, 2014, p. 20).

Why is Person Centered therapy less popular today? PCT is less popular today because other methods have shown to be effective in counseling, such as the relationship-centered approach, which is based on the idea of cultivating a network of relationships so as to build a support structure that can assist the patient in stabilizing his or her life. Other therapies adopt a behavioral approach which concentrate on providing the patient with a behavior-based concept-framework that can support the patient's needs.

The PCT approach, however, is geared towards allowing the patient to discover on his or her own what the underlying issues are, with some prompting from the therapist whose main role is to engage the patient, ask questions, and stir up ideas within the patient as he or she reflects on his or her own life. The approach is much more subjective in the sense that it focuses on the subjective experience of the patient and explores the possible meanings of this experience.

However, such an approach is only successful so long as the patient is willing to be engaged, that is, so long as the patient has a desire to talk things out, to open up, and to allow the therapist to play the significant role of confidante in the relationship. In fact, confidante is likely too strong a word, because in reality the patient is confiding in him or herself.

This approach reduces, in a sense, the therapist to a minor but important role -- which is another reason the therapy is less popular today. Still, the popularity of PCT is not completely at a low, as some studies suggest that a return to this approach may be in the rise as its qualities become more apparent to researchers (Greenberg, 2004).

What fits for you as a therapist? PCT fits me as a therapist because I believe that it is important for the patient to talk through issues and to arrive at their identification through his or her own thought processes with minimal intrusion from the therapist. However, it is also important for the therapist to engage the patient and to raise questions and highlight areas that might be helpful for the patient to probe and this is something I enjoy doing.

The dialogue between therapist and patient is like a process of discovery that is spontaneous but focused and instinctive: it helps the patient to realize on his own how he has developed, why, and what he can do about it. My role as a therapist is to assist him or her in tapping the potential that exists within the person to have an epiphany.

Behavioral approaches in general fit me as a therapist as well because I realize that there are many ways to reach a client and it is not always important that an epiphany moment occur. Positive change can be effected and reinforced through a series of sessions in which positive behavior is identified and negative behavior identified too and a strategy implemented that assists the client in moving away from the negative behavior and towards the positive behavior.

It is not always advantageous or immediately helpful to focus primarily on a psychological course of action designed to help the client to figure out for himself what the underlying issue is. Behavioral approaches can assist the client in overcoming the issues without ever really having to uncover them and bring them to the fore.

By overcoming them through positive courses of behavior, a goal is reached that enables the client to participate more fully and effectively in life and thus the underlying issues themselves can disappear and fade away, left behind as the client makes a new transition into a different mode of being. Motivational Interviewing: How is this helpful? Motivational interviewing is helpful because it can effect "client change talk" which has an impact on the client's behavior (Miller, Rose, 2009, p. 531).

This method of interviewing is especially helpful because it provides the support that the patient can need in order to work through issues within himself, whereas otherwise he would not receive in the necessary motivation.

The motivation itself is not overwhelming or forceful and in a sense the client provides most of it just by showing up and committing to the therapy, but the therapist must also commit to bringing a desire to see the client transform for the better and that is where motivational interviewing can come into practice and be a game changer. I have used motivational interviewing in the past and found it to be an effective strategy because of the positivity that it encourages and the behavioral emphasis that it provides.

In most cases, the patient is aware that something is wrong and wants to figure out what it is but lacks the support to complete the process. Motivational interviewing is a good approach because it keeps the client on the right path and provides that missing support. It helps the client also to discover what is wrong or missing and to set about changing the behavior or acknowledging the faults, etc., that have contributed to his issues in the past.

What makes it work is its focus on the patient is its establishment of a link "between client change talk and subsequent behavior change" (Miller, Rose, 2009, p. 531). This link acts as a bridge between the talking/thinking aloud and the doing that follows. The motivational viewing gives the patient access to the awareness of the "other side" of himself that can be reached, the more positive, successful side, and allows the client to understand that it is entirely possible to get there.

What makes it not work at times is when the demographic does not suit the exchange or interviewing. Motivational interviewing, in other words, is not a method that works for everyone. Some personalities or individuals with differentials do not find the strategy to be as effective for them. For example, the study by Miller and Rose (2009) showed that the positive effects of motivational interviewing were "doubled when the recipients were predominantly from minority populations, compared with White non-Hispanic-Americans" (p. 529). This result indicates that motivational interviewing.