Understanding selective mutism
For therapists wondering, “What is person-centered therapy?” this article addresses that question and covers key elements—including the benefits and criticisms—of person-centered therapy.
Any of us who practice psychotherapy know that there is no shortage of modality options to be trained in and work from.
This number is increasing all the time in our profession.
Many of the therapists I work with or supervise consider themselves integrative—combining
techniques, theories, and interventions from multiple schools of thought.
And yet, person-centered therapy, an enduring and influential approach, initially developed over 70 years ago by Carl Rogers, and continues to shape how most therapists conceptualize the therapeutic relationship and nature of therapy.
So, let’s take a deeper dive into Carl Rogers’ world and understand the roots of person-centered therapy, its key concepts, distinctions from other approaches, and maybe even some ways to utilize it in your own practice, regardless of your current primary modality.
Understanding the evolution of terms
First, I’d like to clarify some language and give some historical context to present-day person-centered therapy.
Humanistic therapy
This is an umbrella term that incorporates several therapeutic modalities (including person-centered therapy, gestalt therapy, existential therapy, and others). The common thread is that they all focus on the client as an individual and have a focus on client growth. Not all humanistic therapies would be called Rogerian, though many humanistic therapies share elements with Rogers’ approach.
Rogerian therapy
Named after Carl Rogers, Rogerian therapy is considered to be one of the first times that humanistic psychology approaches were applied in a clinical psychotherapy setting.
Client-centered therapy
This is the term that Carl Rogers initially used to describe his therapeutic theory. He referred to the individuals he saw as clients rather than patients as a way to move away from language that suggested illness, as well as to shift the perspective of the power differential. Additionally, as Rogers developed through his career, he became increasingly less formal and more relational.
Person-centered therapy
As his theory continued to expand, Rogers himself switched from using “client-centered therapy” to “person-centered therapy” to further move toward language that supports individual autonomy and a holistic perspective. The term person-centered therapy often goes beyond psychotherapy and can be seen as a philosophy that many mental health, educational, and even medical organizations utilize. This is the term that is most widely used in the present day.
It is important to note that while Rogerian therapy, client-centered therapy, and person-centered therapy are all often used interchangeably, the terms represent an evolution of language.
Additionally, while the actual therapeutic practices are the same, this linguistic evolution marks the continued reduction of the therapeutic power-differential and an increasingly inclusive, humanistic stance.
For the rest of this article, I will be using person-centered therapy to speak further about this modality.
What is person-centered therapy?
Person-centered therapy is a non-directive therapeutic modality that empowers clients to recognize that they are the experts in their own lives. The person-centered approach emphasizes the importance of a warm, empathetic therapeutic relationship, with the therapist adopting a non-judgmental stance.
While it might be surprising to those of us trained in the past 50-plus years, at the time it was developed (in the 1940s-1950s), person-centered therapy was revolutionary.
Along with some of the work by other noted humanistic therapists in the first half of the twentieth century (in particular, existential and gestalt theorists), person-centered therapy marked a significant shift away from more directive approaches.
These humanistic approaches, while distinct, all place focus more on the here and now rather than the past, and stress the importance of the therapist’s attunement to each individual client.
Key elements of person-centered therapy
To better answer the question of “What is person-centered therapy?” let’s explore the essential elements of the person-centered approach.
In addition to the focus on the client being the expert of their own experience, core components of person-centered therapy include:
Unconditional positive regard
According to the APA Dictionary of Psychology, unconditional positive regard is: “an attitude of caring, acceptance, and prizing that others express toward an individual irrespective of their behavior and without regard to the others’ personal standards.”
Carl Rogers believed that a therapist using unconditional positive regard toward their client creates an environment which promotes growth, self-awareness, and improved self-worth. Beyond that, Rogers proposed that healthy human development requires unconditional positive regard and referred to it as a “universal human need.”
Congruence
Simply put, congruence is a match between who a person is and what they display to others.
This is at the core of Carl Rogers’ approach in two ways.
First, he believed that the therapist presenting authentically was paramount to the therapeutic process. According to Rogers, this stance is essential for therapeutic effectiveness and sets an example for clients to embrace their own authenticity.
Second, congruence, a sense of internal consistency of self with reality, is a desired outcome of person-centered therapy.
Empathy
Empathy is at the heart of person-centered therapy and refers to the therapist’s ability to understand the emotional experience of the client as if they were experiencing it themselves, while still retaining therapeutic boundaries.
Another way to think of this is the therapist’s attunement to the emotions and needs of each individual client.
How does person-centered therapy treatment work?
With the three key components of unconditional positive regard, congruence, and empathy in mind, let’s consider what person-centered therapy treatment actually looks like and how it works.
The role of the therapist in person-centered therapy
In client-centered psychotherapy, the therapist serves as a facilitator of the session instead of the expert with the answers. The therapist is non-directive and provides a non-judgmental space that maximizes the client’s ability for insight and growth.
Through active and reflective listening skills and an attuned presence, the therapist supports the client in accessing self-awareness. This can promote a deeper understanding of the client’s own feelings and experiences.
The client’s role in person-centered therapy
The client is seen as the expert in the room and is encouraged to be an active participant in their own healing.
The person-centered approach positions the client as the leader of the sessions, choosing the focus of each session, goals, and direction. In this respect, clients take responsibility for their own growth and progress.
The therapeutic process in person-centered therapy
Building mutual trust and therapeutic rapport is essential to person-centered therapy. This is created through the presence of both the therapist and client rather than by utilizing concrete interventions.
Focus is placed on exploration and expression of feelings, thoughts, and behaviors within a non-judgmental space.
The aim of therapy is self-discovery and increased self-understanding as facilitated through the therapeutic connection.
Person-centered therapy interventions and techniques
Unlike many evidence-based practices, person-centered therapy is light on concrete interventions. The techniques used in person-centered therapy are often considered “soft skills,” such as validation of feelings, reflective listening, and summarizing.
The theory is grounded in the belief that the therapeutic alliance is the primary intervention. As a result, the client experience will be unique to each individual based on their own experiences, worldview, and desired outcomes.
Benefits of person-centered therapy
With a focus on individual autonomy, belief in resilience, and capacity for growth, person-centered therapy is a modality that is applicable to a wide range of presenting issues, including, but not limited to: anxiety, depression, self-esteem, and relational concerns.
This therapeutic style truly values a non-judgmental stance, which can reduce the sense of isolation and shame that a client feels and create an environment for emotional vulnerability and expression.
Person-centered therapy can also easily be integrated with many other therapeutic modalities and interventions.
Research supports that the therapeutic alliance and relationship are correlated with positive therapeutic outcomes, more so than the specific modality or interventions used by the therapist.
Additionally, person-centered therapy does not require a great deal of advanced specialized training and does not rely on high-fidelity adherence to manuals or protocols.
Criticisms of person-centered therapy
Person-centered therapy is often criticized for a lack of structure and concrete interventions. One might ask, “How is it different from talking to a supportive friend or family member?”
The person-centered approach relies heavily on the therapist’s skills of self-awareness, consistent attunement, and insight to assess their own ability to present in a non-judgmental, positive way with a wide range of clients.
Using person-centered techniques as a sole modality will likely not be most effective for clients who are not voluntarily attending therapy, are in a high crisis state, experiencing severe substance use, or who have complex trauma histories. These presenting concerns may be supported by some of the principles of person-centered therapy when paired with more structured and concrete interventions and strategies.
Person-centered therapy tends to rely too heavily on the assumption that all clients in therapy will be self-aware or have the skillset to change their own circumstances. Depending on where a client is in their change journey, a therapist relying solely on a person-centered approach might feel stuck quickly.
The focus on autonomy, individuality, and self-determination may not resonate with clients from backgrounds that are more collectivist and group-focused.
Conclusion
Whether you consider yourself a full-fledged Rogerian or find person-centered therapy to be too warm and fuzzy for your temperament, you cannot deny the impact person-centered therapy has had on the way we conceptualize therapy in modern times.
You should now feel confident in responding if a colleague or client asks “What is person-centered therapy?”
Person-centered therapy techniques have had a wide-reaching impact, not only in psychotherapy, but in education, parenting, and even the workplace.
During a time when there is a great amount of political and social unrest in the world, I invite you to consider how you might incorporate some of these concepts in your practice and beyond.
Sources
● Rogers, C. On Becoming a Person: A Therapist’s View of Psychotherapy. (1961) Boston: Houghton Mifflin.
● Bozarth, J. D. Person-Centered Therapy: A Revolutionary Paradigm. (2010). New York: Springer Publishing.
● Cain, D. J. Person-Centered Psychotherapies. Theories of Psychotherapy Series. (2010) Washington, DC: American Psychological Association.
● Greenberg, L. S., & Watson, J. C. Person-Centered and Experiential Therapies: A Handbook. (2006) New York: Wiley.
● Schmid, P. F. The Person-Centered Approach: A Contemporary Perspective. (2014) London: Routledge.
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