The Essence of
Person-Centered Therapy
by
Jerold D. Bozarth,
PhD
The essence of CC/PC therapy is the
therapist’s dedication to going with the
client’s direction, at the client’s pace and in
the client’s unique way of being. (p.59)
And:
It is the full commitment " . . .to trust in the
client’s own way of going about dealing with
his problems and his life." (Brodley, 1988, p.
59)
The following points summarize findings that
contribute to
this conclusion:
First, the Bower study which is a qualitative study of six notable CC/PC
therapists doing therapy. Three listeners independently reviewed an audiotape
of each therapist’s therapy sessions. The therapist and client participants
responded to
questions from
the investigator. The emerging consensual data were the following:
1. Therapists had a wide repertoire of
non-interfering responses. One therapist
responded in a reflective way, with near
intrusive reflective responses; another rarely
commented, and then only in a way to clarify
his uncertainties; another therapist was
described as seductive by the listeners;
another used a Gestalt- type metaphor that
emerged from the client; and another
therapist periodically ‘moaned’ throughout
the session.
2. The clients perceived the therapists as
being helpful; the clients overall directed
themselves in the process of inquiry. At
times, they waited for the therapists to finish
responses before continuing with their own
explorations. In short, the therapists were
experienced as being received by clients as
permissible humans whose specific
responses did not seem to interfere with the
clients’ directions.
3. The listeners perceived the therapists as
disappearing in deference to their clients.
They were experienced as being a ‘shadow
to the client’. Their presence appeared
obvious but there was neither intervention
nor intrusion of the personality of the
therapist (Bower and Bozarth, 1988).
The overriding conclusion was that:
client-centered/person-centered
therapists were experienced (by clients, listeners, and therapists) as
non-interfering individuals who entered the world of the client in such
a manner as to "disappear" into the client’s own process of development
(Bower and Bozarth, 1988).
In brief, the study also suggested that: 1. The attitudinal qualities of
empathy, unconditional positive regard, and congruence (described in various
ways) were the consistent therapist attitudes that existed; 2. The therapists
held a position of total trust in the client’s own direction and way; 3.
The therapists were active and
involved with
a total dedication towards understanding the client’s world; 4. The therapists
had a wide range of response repertoire and personality characteristics
but were intent upon understanding and checking their understandings of
their clients; and 5. The therapists did not attempt to intervene in the
direction, process, or
with the pace
of the clients. The therapists were actively involved and readily
dialogued with
their clients but ‘disappeared’ into
the client’s
process.
Analysis of the
evolution of Carl Rogers as a
therapist
My examination of Carl Rogers’ evolution as a therapist is a qualitative
inquiry to two questions (Bozarth, 1990a). These questions are: 1. Did
Carl Rogers alter his fundamental views of client-centered therapy? and,
2. Did Carl Rogers change his operational functioning as a psychotherapist?
It was my intent to further ask:
What were these
alterations? And, what changes occurred? My basic thought had been that
there was significant alteration of some fundamental views; and that his
functioning as a therapist had changed over the years.
My assessment of Rogers’ comments in the literature, his demonstration
films, and from previous personal communication led me to conclude that
Carl Rogers did not alter his fundamental views of client-centered therapy.
I noted that he was quite consistent in his fundamental views of the importance
of the conditions of empathy and unconditional positive regard that congruent
therapists needed to experience with their clients, and of his dedication
to go with his clients in the direction that the client wanted to go and
in the way the client wished to do it. He became more explicit about the
importance of being ‘genuine’ in the relationship. The importance of genuineness
(which Rogers
periodically interchanged with congruence) as the primary condition to
him was expressed in a dialogue with Wood and in an earlier statement when
he commented that even when the conditions of unconditional positive
regard and empathy
were not experienced by the therapist that genuineness alone may be facilitative
(Rogers, 1967; Rogers and Wood (1984). His more explicit references to
the importance of genuineness in the relationship did not represent any
fundamental change in view. He was always dedicated to and intent on going
with
the client’s
direction, at the client’s pace, and with the client’s unique way of being
(Bozarth, 1990a).
My assessment of Rogers’ functioning as a therapist by reviewing demonstration
films with Miss Mun, Gloria, and Kathy led me to conclude that Carl Rogers
did not change his operational functioning as a psychotherapist. (Rogers
and
Segal, 1955;
Shostrum, 1964; Rogers, 1975). He did express a slightly wider range of
responses over the twenty year period in the demonstration films; and had
some spontaneous expressions that ‘bubbled up’, especially in the Gloria
film. A
qualitative
evaluation of Rogers’ response sets in the three films indicate Rogers’
primary responses to be empathic understanding responses. The
categories representing
empathic understanding responses were identified as a continue frame representing
‘I am giving you my full attention, please continue’; and a check frame
meaning ‘This is what I understand you to be saying. The
analysis revealed:
100% of the responses in 1955 were check or continue responses (including
empathic under-standing responses); 90% of the responses in 1965 were continue
or check responses (the few declarative responses were
the notable
responses often referred to in the Gloria film); 84% of the responses were
continue or check responses in 1975 (Bozarth, 1990b).
Dr. Brodley’s examination of eight of Rogers’ interviews from the 1940’s
to late 1985 using a comparable evaluation scheme revealed that in
seven of them
91% to 100% of Dr. Rogers’ responses were empathic following responses
(Brodley, 1988). The session consisting of 100% empathic following responses
was the one in late
1985.
Overall it seems accurate to say that Rogers increasingly referred to the
importance of genuineness when working with clients and that ‘realness’
of the therapist was increasingly important in his thinking. He responded
with slightly more varied comments over the twenty-year time span of the
demonstration tapes but his preponderant response efforts were clearly
geared to the understanding of his clients’ worlds -
whether in 1955,
1965, or 1985. Carl Rogers’ fundamental views of
client-centered/person-centered
therapy were not altered. He did not significantly change his operational
functioning as a psychotherapist
(Bozarth, 1990a).
A more holistic viewing of the films and tapes was interpreted as suggesting that Rogers allowed himself to be more expressive over the years. It also seems likely that his varied comments as a therapist over the time period were more client-and situation-specific. It became clearer to me that whatever Rogers said about CC/PC therapy or did as a therapist was within the context of placing his trust in his clients without doing anything to them or ‘being up to something’ as a therapist.
These two examinations, the one of six notable CC/PC therapists and the
other of the evolution of Carl Rogers as a therapist, support Rogers’ explicit
statements about CC/PC therapy; i.e., that the foundation block of the
therapy is the actualizing tendency (Rogers, 1980); that ‘. . . it is the
client who knows what hurts, what directions to go,
what problems
are crucial. It would do better to rely upon the client for the direction
of movement in the process’ (cited in Kirschenbaum, 1979, P.89). He had
a profound and unwavering dedication to trusting the client as his/her
own best authority.
These reviews lead me to conclude with a functional theoretical premise that: The essence of CC/PC therapy is the therapist’s dedication to going with the client’s direction, at the client’s pace, and with the client’s unique way of being.
Implications
of the Essence
of Person-Centered
Therapy (PCT)
The implications of the essence of person-centered therapy is a functional
premise
that precludes
other therapist intentions. The therapist goes with the client - goes at
the client’s pace - goes with the client in his/her own ways of thinking,
of experiencing, of processing. The therapist can not be up to other things,
have other intentions without violating the essence of PCT. To be
up to other things - whatever they might be -
is a ‘yes, but’
reaction to the essence of the approach. It must mean that when the therapist
has intentions of treatment plans, of treatment goals, of interventive
strategies to get the client somewhere or for the client to do a certain
thing, the therapist violates the essence of person-centered therapy.
This holds true if the therapist is trying to move the client through a
certain process, to encourage clients to
experience themselves
in a certain way, to teach clients to be empathic, or to impose other therapeutic
methods on the client. It is a functional premise that includes wide therapist
personality differences, unique ways of doing things, and idiosyncratic
ways of responding as far as they are dedicated to the client’s direction,
the client’s pace, and the client’s unique way of being (Bozarth, 1984).
It is a functional premise that
begets therapists
who ascribe to Rogers’ principles to test the essence of the approach in
a consistent way over time. It is thus that therapists can experience the
potency of allowing individuals to engage in their own empowerment, in
their own
ways without
being violated by the personal observations and theories of their therapists.
Implications of this theoretical stance are integrally related to the concept
of the locus of control. The therapist is promoting a natural individual
and general process in the client by being a certain way; that is, experiencing
certain attitudes toward the client. The client is his/her own best expert
about him/her self and his/her life.
The therapist’s
intent is not to promote feelings or to help the client to become more
independent or ‘to get’ the client anywhere. The goal is not self-actualization,
actualization, independence or to help the client to become a ‘fully functioning’
person. The
only therapist goal is to be a certain way and by being that way a natural
growth process is promoted in the client. The foundation of Person-Centered
Therapy is consistent with the five decades of findings in psychotherapy
outcome research and over ten years of clinical research with impossible
clients’. That is, the person of the
client must
be the master and director for successful outcome.