Person-Centered International

Jerold D. Bozarth, Ph.D.
The University of Georgia, Professor Emeritus
Person-Center International, President

Have you ever wondered why you believe the things you do? I started to think about why I believe the approach of Carl R. Rogers, Client-Centered/Person-Centered Therapy is a different paradigm from other therapeutic approaches. What I would like to share in this chapter is not only what I believe but a bit about how I have come to believe that this approach is revolutionary and founded upon a different paradigm than other therapeutic approaches. Although the focus of this paper is upon therapy, the revolutionary paradigm is considered to be significant for all interpersonal relationships (Rogers, 1959).

The Different Paradigm

Paradigm refers to a set of beliefs and assumptions that undergird the functional theory. Rogers’ view is different from other therapeutic assumptions including most humanistic views. He assumes a growth hypothesis that is natural and universal which propels individuals towards finding their full potentialities (Bozarth and Brodley, 1991; DeCarvalho; 1991; Rogers, 1959). This is the foundation of the person-centered approach. Moreover, his theory contends that this growth can be promoted by an individual perceiving certain conditions that are experienced by another individual (the therapist) towards her (the client). I will say this in a different way later, but the implicit practicality for therapy is that the individual must be free to follow her own way, in her own direction and at her own pace. It is the therapist/client relationship and the resources of the client that are most important for success.

Some Conclusions

Here are several of my beliefs about Person-Centered Therapy:

    1. The therapist must BE a certain way, congruent, in the momentary relationship to the client while experiencing unconditional positive regard towards and empathic understanding of the client’s frame of reference.
    2. The client must, at least, minimally perceive the two conditions of the therapist’s experience of UPR towards and of EU of her.
    3. The fundamental curative or promotional factor is the client’s perception of the therapist’s experience of unconditional positive regard. It can be no other way in Rogers’ theory.
    4. There are no goals of the person-centered therapist for the client. The only goal of the therapist is for her, to be a certain way.
    5. The primary preparation of the person-centered therapist must be the development of her own unconditional positive self-regard.
    6. The primary condition is the growth hypothesis; i.e., the actualizing tendency.
    7. The necessary and sufficient conditions hypothesized by Rogers are ultimately one condition in unity with the growth hypothesis.
These beliefs will be elaborated upon later. First Realizations:

My first realization of the monumental difference of this theory occurred for me between 1958 and 1963 when I was 25 years old. I started my first professional employment as a Psychiatric Rehabilitation Counselor in a State Mental Hospital. I joined a pilot project intended to help chronic, long term "mental patients" leave the hospital. My academic background included an undergraduate degree with majors in social studies, sociology, speech and psychology with little knowledge about therapy. My responsibility was to develop a psychiatric rehabilitation department and to find ways to help the individuals. At the time, I had not learned the party line of many academicians and clinicians that Rogers’ approach "would not work" with individuals who were in "psychotic" states of dysfunction. In fact, I had not even heard of the "Rogerian" approach at that time. The professional hospital staff often assured me that nothing would help these "psychotic" and "institutionalized" individuals to function outside of the hospital. As it turned out, many of these individuals improved significantly to the point of reasonable self-sufficiency outside of the hospital. My observations of this improvement were buttressed by the hard evidence of reduced recidivism rates, functional employment, independent living, self evaluations and increased quality of life. I did not hear of the work of Carl Rogers until introduced to me by the director of the pilot project who supervised me from another city. Knowing little about what to do, I depended upon the individuals with whom I worked. I listened, cared for and trusted them. My major interest was that of finding what was effective for the individuals with whom I worked. What was the paradigm? The self-direction of the client could be trusted. The clients, who averaged individual hospitalizations of over twenty years, found ways to improve their lot. What was the revolutionary aspect? The relationship and the resources of the client were the primary general treatment factors. There was seldom focus on depth of self exploration or experiencing or any other particular thing. Here are a couple of client scenarios:

Howard had been hospitalized twenty years before I saw him, diagnosed as, Schizophrenic, Paranoid type. He had stabbed several individuals prior to his admittance. He had a grounds pass at the hospital and worked at a paper route in the hospital. He heard about me from other residents and asked his doctor to refer him to me. We talked twice about his thoughts of getting out of the hospital. He decided that this was not the thing for him to do, too threatening! I mostly listened, told him about some of the training and educational possibilities that I could help him with if he did decide to develop out hospital plans. Nearly a year later, he returned to pick up where he left off. He inquired about the possibility of "Barbers School". We talked weekly for several months with him taking the lead. He talked about his daughter, his relationships at the hospital and things most of us might talk about in normal conversations. His consistency with seeking training resulted in him being accepted for funding to attend such a school. There was a wait period before going to school and he decided to seek employment in the community. Although, it was the height of a recession in an industrial community, I supported his wish to seek employment. We talked before and after trips to the city. Most of the staff were quite skeptical about him finding employment when "normal" individuals could not find even part time work. One week later, Howard had three job offers. He accepted one job as a "prep" person shaving individuals before they went to surgery. Later, he went to the school and worked as a barber until his retirement. I always thought that these were interesting jobs for him since he was originally admitted to the hospital for a rampage with a knife that resulted in injuries to a number of people.

Eleanor was referred to me by a ward attendant. She had been diagnosed twenty one years before as, Schizophrenic, Undifferentiated Type. She was on a locked ward in the hospital. The attendant said that she had expressed an interest in getting out of the ward, and he wondered if I could help her in any way. When I arrived, Eleanor was sitting on the floor playing with her feces. I had no idea what to do or say. I introduced myself and told her a little bit about my role in the hospital. She was not responsive except for a wild black toothed smile as she continued to play with her feces. I stayed not knowing what to say or do. Now and then I asked a question or made a statement of some kind. I tried to experience her as best as I could wondering what I could do to be more sure of my contact with her. In desperation, I finally blurted out something like, "Do you think that you might like to go to beauty school?" Maybe I was reminded of her creativity and manual dexterity as she played with her feces. Amazingly, she discarded her activity with the feces and sat in the chair next to me. I told her I would come back next week to check with her again. A short time later, she began to discontinue some of her bizarre behavior. She cleaned herself up over the next months and moved to an open ward. She eventually worked some in the hospital commissary. I do not think that she ever got out of the hospital but the quality of her life increased significantly.

Gerald was a twenty-one year old who was diagnosed as Paranoid when he entered the hospital two years previously. He received permission from his doctor to talk to me about finding a job. He worked on the garbage truck in the hospital but was periodically transferred to a locked ward because of violent behavior towards co-workers. We sat mostly in silence over a half dozen or so sessions. I would say things to him or ask questions every once in awhile. He would answer briefly, "Yes" or "No" when a binary response was possible. I could often "feel" anger exuding from him. I would tell him occasionally that I was sometimes afraid of him. He kept returning. Six months later, I took him to town while he searched for employment. Eventually, he found a job and was discharged from the hospital. Three years later, I received a letter from him which thanked me for helping him and for having faith in him. It was not the end of my information about him though. Over fifteen years later, I was chairing a graduate program in a State University. I was cleaning up old student files that had gathered years before my arrival as I came across Gerald’s name. It had to be him because of his previous residence and other factors. He had been in the military service, honorably discharged and had received his graduate degree in a helping profession. It is still difficult for me to believe that after fifteen years, this coincidence occurred.

What did I learn from my experiences represented by such interactions as the above? Clients who demonstrated varied but clear improvements did not usually focus on their internal experiences; they did not delve into self-exploration, they did not focus on their feelings. They, in fact, talked about anything and everything or nothing. There was no particular technique or way of responding that helped them. I describe myself as offering individuals a nieve trust in their own self determinations, a lack of presumptions in what they should be or do or become, and treating them as equal human beings in their own rights. The great learning for me was that the clients could be depended upon to find their own ways of growing. I learned that I couId depend upon the individual for the best direction for her life. I learned and assimilated a trust for the remarkable resiliency of human beings. In retrospect, I learned the therapeutic potency of the relationship and of trusting the client’s resources for change.

The Quest for a Helping model

I found the model for my approach when I read Rogers’ (1957) hypotheses concerning the necessary and sufficient conditions for therapeutic personality change. The model did not require particular ways of responding, but offered me a guideline for therapists’ relationships with clients. It fit what I had been doing with these chronic, long term, hospitalized individuals. The therapist could do many things, say many things, and behave in multiple ways while holding certain attitudes toward their clients. These attitudes could exist within a context of varied activities. It was a model which provided me with a way to be an instrument for individuals to improve.

As I pursued higher education, I was trained in therapies that included Adlerian, Psychodynamic, Gestalt, Behaviorism, Cognitive Behaviorism and Vocational Counseling and Guidance. My education in person-centered therapy was informal, self-directed and seldom related to any professional training program. I maintained an abiding interest in the "necessary and sufficient conditions" and in the client-centered approach espoused by Rogers (1957; 1959). I learned during this venture that students seldom had the opportunity to experience the potency of going with the client’s way and direction. All of the other models were "interventive" in one way or another. The other models short circuited the opportunity for the extreme trust of the client.

My quest for a model took a slightly different turn as I started to examine Rogers’ work from a more academic perspective. In the late 1960’s, and 1970’s when I was involved with two immense research projects with the late Charles B. Truax and Kevin Mitchell. These projects (The Arkansas Projects) entailed the examination of the "necessary and sufficient conditions" of highly trained and experienced psychotherapists and, a separate project, of Rehabilitation Counselors in the United States (Mitchell, Bozarth, and Krauft, 1977). My realizations from this research were (1) that there were few therapists or counselors who operated at high levels of these conditions during their sessions. High levels of empathy or unconditional positive regard as measured by the best available instruments seldom existed. The best levels were moderate levels. (2) that clients’ improvement was correlated with the therapist being reasonably real individuals within the relationship. Congruence that was at even moderate levels seemed to be related to multiple client improvements. (3) that the meaning of the Rogerian hypotheses were undertaking a subtle change of meaning. Later, examination of other studies (Mitchell, Bozarth, and Krauft, 1977) confirmed that there were seldom high level condition therapists in the study samples. I was reminded from my earlier experience with working with psychiatric clients as well as others that clients usually moved forward with whatever they find from their therapists if there is a reasonable relationship of "caring", "acceptance" or "unconditionality" perceived. Overall, the research results suggested that client improvement was moderate and that high level therapists’ conditions were a rare phenomenon.

Three Model Direction

Part of my work on the Arkansas research projects involved the development of one of the first training manuals on what has come to be identified as "Human Relations Training" or "Interpersonal Skills Training" models. The work of Carkhuff (1969; 1971) and Truax (cited in Truax and Carkhuff, 1967; and in Truax and Mitchell, 1971) became the forerunner for these models which are now more behaviorized and prominently discussed by Cormier and Cormier (1991) and Egan (1975) as well as others. My discovery while working on the development of the skill models was that this was a distortion of Rogers’ concepts. The concepts were operationally defined for the purpose of research. These operational concepts were then used to develop training programs. What eventually got lost and distorted was the trust stance of the therapist in the client. The skill model deflected the meaning of the conditions as attitudes and set up a model which instructed therapists to "relate, get the client to understand, and then get the client to action", a clear violation of the fundamental trust model of Rogers’ theory. The locus of control was shifted from the client to the therapist. My conclusion at this juncture was (and still is) that there are three models emanating from Rogers’ theory and statements. I identify these models in this way:

The Interpersonal Skills Model (or Human Relations Model), which is problem-centered and therapist driven (Egan, 1975);

The Necessary and Sufficient Conditions Model, which is conditions centered and may be therapist or client driven (Rogers, 1957);

The Person-Centered Model, which is person-centered and client driven (Rogers, 1959).

I concluded that the Interpersonal Skill Model is a distortion of Rogers’ theory even though widely identified as representing the theory. The Necessary and Sufficient Conditions Model was also often viewed as the client/person-centered model and interpreted in ways that misdirected Rogers’ message. The Necessary and Sufficient Conditions Model is considered as the core of all effective therapy by Rogers, regardless of the type of therapy. As such, he emphasizes the communication of the conditions through widely disparate means. Attention to the trust of the client is relegated to less discussion as he focused upon the therapist’s conditions.

The Influence of Groups

I became interested in groups during the time of my work in the State Mental Hospital System. My approach to groups seemed to go against most of the group literature as I depended upon clients for the direction and substance of our activities. Later, it seemed natural for me to become involved in Rogers’ (1970) conceptualization of the "Basic Encounter Group" and later the Large Community Group. From 1974 until now, I have been involved with person-centered groups including activity with The LaJolla Program, Community groups facilitated by Rogers and colleagues, and the Warm Springs, Georgia Person-Centered Workshops which I have coordinated for fifteen years. I learned from these groups to trust individuals and the individuals as a group, to trust myself more, to absorb the happenings, and to say little most of the time. I came to believe that an atmosphere of freedom, a safe place for individuals to struggle, a place for individuals to be accepted as they are were the main ingredients for growth. Empathic understanding and facilitator expertise seem less and less important for personal growth in groups. (Bozarth, 1998, pp. 143-160). If this were true, I pondered the implications for individual therapy and for the theory.

Indwelling the Theory

The theory is a different paradigm! The theory is revolutionary! Why? It is a different paradigm because of the radical trust in the client and in the notion of the growth hypothesis. It is revolutionary because it flies in the face of other treatment assumptions. Notably, the assumption of most mental health treatment models is, one way or another, the specificity assumption (Bozarth, 1998, pp. 163-173). That is, there is the assumption that there are certain treatments for particular disabilities. There is a focus on the problem of the client. The person-centered assumptions are that the healing is natural in the client and that nature is promoted by the therapist/client relationship and by the discovery of the client’s own resources. Client problems will be solved as the client’s growth tendency is promoted. Clients find their own ways of dealing with the problems. As I examined the theory over and over, I acquired more clarity on the nature of this revolutionary paradigm. Again, I will share this briefly through my own historical perspective.

A Reconceptualization

of the Necessary and Sufficient Conditions

Something continued to pique me about Rogers’ great hypotheses concerning "The necessary and sufficient conditions". It struck me that the conditions of congruence, unconditional positive regard, and empathic understanding of the client’s frame of reference were often discussed as separate rather than as having the high interrelationship communicated by the statement itself. Further, there was something a bit incomplete in the hypothesis statement when Rogers’ theory of pathology is considered. My (Bozarth, 1998, pp. 43-50). reconceptualization of the necessary and sufficient conditions for therapeutic personality change entails (a) genuineness (or congruency) being viewed as a therapist state of readiness that enables the therapist to better experience the client with empathic understanding of the client’s internal frame of reference and to experience unconditional positive regard (UPR) towards the client; (b) Empathic understanding (EU) of the client’s frame of reference being viewed as the action state of the therapist in which the client’s world is accepted as he or she is experiencing it at any given moment. This is the most optimal way for the client to perceive the therapist’s experience of unconditional positive regard towards her; and (c) Unconditional positive regard is viewed as the primary change agent in which the client’s needs for positive regard and positive self regard being met. This results in congruence between his or her organismic experience and self concept along with promotion of the actualizing tendency. The fundamental curative or promotional factor is the client’s perception of the therapist’s experience of unconditional positive regard. It can be no other way in Rogers’ theory! Individuals become disturbed or incongruent because of the introjection of conditional self values garnered from parents and society. Numerous authors realize this point which is included in writings by Brodley (1993), Lietaer (1984),, Mearns (1994), Thorne (1991) and Van Belle (1980) to name several. The relationship of the pathological etiology has not been explicitly considered in relation to the necessary and sufficient conditions. It is the client’s perception of the therapist’s experience of unconditional positive regard that allows the client to experience unconditional positive self regard; thus becoming whole again and to open their organismic experiences without distortion or conditionality.

Interrelationship of the Conditions

I (Bozarth, 1997; 1998, pp. 51-67) discovered while writing about empathy that Rogers’ empathic understanding of the person’s frame of reference and unconditionality are integrally intertwined even to the point of being one condition. The client must perceive both of these conditions as experienced by the therapist towards the client. This is clear in both of his formal conditions statements of 1957 and 1959. Rogers rarely discussed empathy without making references to "acceptance", "unconditional positive regard" (UPR) or similar terms. Empathy (EU) was seldom discussed as a separate quality by him. In addition, consideration of precise definitions of each of these conditions suggest high integration. That is, the therapist accepts each momentary experience of the client (UPR) and accepts each momentary perception and experience of the individual’s world (EU). Likewise, the overlap of congruence with UPR and EU is also present in a way that suggests that they are functionally one condition.

The Integration Statement

It became clearer that Rogers’ 1957 statement concerning the necessary and sufficient conditions was not about Client-Centered Therapy (Bozarth, 1998, 103-109; Stubbs and Bozarth, 1996). This is a fact widely ignored by most scholars even though Rogers is very pointed that the conditions are NOT just about Client-Centered/Person-Centered Therapy. Stubbs and Bozarth (1996) dubbed Rogers (1957) statement as the "Integrative Statement". Barrett-Lennard (1998) refers the shifting phenomenon of inquiry as "Conditions Therapy Theory). The conditions in this statement have to do with all kinds of therapies and with interpersonal relations in general. The implications of this fact suggest to me that we need to re-frame some of our previous thinking. For example, I (Bozarth, 1983) concluded in a previous review of research in the United States that there were few studies of Client-Centered Therapy per se. Studies usually entail a "method" of therapy seldom using Client-Centered Therapists. The studies often focused on "skills" of the therapist rather than the attitudes. The realization that Rogers’ statement is an integration statement suggests that most of the research has been directed towards the conditions cited by Rogers and not towards the stance of person-centeredness. This proves to be a somewhat complicated research problem. To some extent, it provides a rationale for the discovery of Mitchell, Krauft and myself which concluded that Rogers’ hypotheses had not been adequately tested; that the numerous research findings of the 1960’s were actually weak studies. It also sheds some light on the much maligned Wisconsin study with people diagnosed as psychotic (Rogers, Gendlin, Keisler and Truax, 1967). The therapists were not particularly wedded to the client-centered approach. They found that they could not apply a particular response model which several called, "Client-Centered Communication". The study, at the fundamental level , was an examination of the extent to which the therapists were able to hold the core attitudes towards the clients. Like most of the studies which followed this project, the core conditions became "skills" rather than the attitudinal conditions of CC/PC therapy. My personal experience with long term hospitalized "psychotic" clients creates some questions for me of the extent of trust that was offered to the clients in this project. Whatever the case, the research direction became misdirected.

The Research

Numerous research studies were directed toward the basic

attitudinal qualities hypothesized by Rogers in 1957 (See Truax and Mitchell, 1971). Research reviews suggested that these studies were not as strong as initially reported (Bergin and Lambert, 1978; Mitchell et al., 1977). This led to a shift of research focus and to an unsubstantiated conclusion that the conditions hypothesized by Rogers were necessary but NOT sufficient. A later qualitative analysis (Stubbs & Bozarth, 1994) revealed more clearly that prominent conclusions about the research findings were predicated upon rather murky evidence. This was especially true concerning the statement that Rogers’ hypotheses were NOT sufficient. There was not one valid study which supported this assertion. This was also true for the conclusion that there is adequate documentation for the assumption of specific treatments for particular dysfunctions. It turns out that these findings blends with a significant direction of psychotherapy outcome research. In a recent review of psychotherapy outcome research, I (Bozarth, 1998) offer the following summary:

The conclusion is clear: There is not a research foundation for the underlying assumption of specific treatments for specific dysfunctions. The specificity myth is replete. I repeat Stubbs and my previous comment that the direction of the research continues to prove "' . . . 'significantly insignificant to help' and often obscures what is most significantly helpful" (Stubbs & Bozarth, 1994, p.117). The most clear research evidence is that effective psychotherapy results from the resources of the client (extratherapeutic variables) and from the person to person relationship of the therapist and client. The specificity and systematizing of these variables remain somewhat murky although they do include Rogers' hypothesized variables of the attitudinal qualities. The research on relationship reviewed by Sexton and Whiston (1994) supports the conclusion " . . . that there are significant individual differences among and within clients over time and that these individual differences account for the majority of the variance in counseling outcome (Martin, 1990)" (p. 58). The data increasingly points to "the active client" and the individuality of the client as the core of successful therapy. (Bozarth, 1998, p. 173) The most clear conclusion from five decades of psychotherapy outcome research is that the variance accounting for success is associated with the therapist/client relationship and the resources of the client (extratherapeutic variables). It is estimated that thirty per cent of successful therapy is related to the former, the therapist/client relationship, and that forty per cent of successful therapy is related to the extratherapeutic variables of the client (the internal and external resources of the client). Technique accounts for only fifteen percent of the success variance, and another fifteen percent is accounted for by placebo effect. The outcome research was cast in the form of a therapeutic model by Duncan and Moynihan (1994) in a way which, seemingly unrealized by them, is a near complete parallel with the person-centered model.

The Growth Hypothesis: Extrapolation

The results of the outcome research on psychotherapy persuaded me to re-examine the fundamental notion of the growth hypothesis (Bozarth, 1998, pp. 27-33; Bozarth & Brodley, 1991). The suggestion that seventy per cent of the variance of success is related to the therapist/client relationship and to the resources of the client suggests to me that the cornerstone of successful therapy has more to do with clients than with therapists. Thus, I decided to look again at the foundation block of the Person-Centered Approach in the search for clarity. Clearly, Rogers’ foundation block is the actualizing tendency of the individual. Rogers (1980) also discussed a more general assumption which he identified as the "Formative Tendency". Van Belle (1990) offers a succinct summary of these assumptions:

For Rogers everything that exists, including human beings, is taken up into this total evolutionary process of becoming. This growth process has its own ends in view and its own organizational principle within itself. It is a syntropic force, it has morphological properties. It forms and reforms itself dynamically (Rogers, 1980). Individuals, as microcosms of this total process, each uniquely have the capacity to form themselves or to actualize their potentials but they have this capacity only insofar as they are open to themselves, thus only insofar as they function as the "organisms" or growth principles that they are (Van Belle, 1985). Here we have the one and only condition that Rogers posits for growth to occur. (p. 49-50) My view is that the research findings can be explained by this hypothesis. It became more apparent to me that this assumption is also one that helps with understanding some of Rogers’ comments later in his life. Rogers refers to times when his therapy relationship " . . . transcends itself and becomes a part of something larger . . . "

(Rogers, 1980, p. 129). As Rogers (1980) stated in a personal paper first written in 1974:

we are wiser than our intellects . . . that our organisms as a whole have a wisdom and purposiveness which goes well beyond our conscious thought . . . I think men and women, individually and collectively are inwardly and organismically rejecting the view of one single culture-approved reality. I believe they are moving inevitably toward the acceptance of millions of separate, challenging exciting informative individual perceptions of reality. I regard it as possible that this view-- like the sudden and separate discovery of the principles of quantum mechanics by scientists in different countries-- may begin to come into effective existence in many parts of the world at once. If so, we would be living in a totally new universe, different from any in history. Is it conceivable that such a change can come about? (pp. 106-107) Rogers’ revolutionary paradigm has implications beyond that of therapy. The extrapolation suggests that the paradigm could take on new and more radical assumptions. It reflects possibilities that go beyond the realms of current thinking.

A Reframing of the Revolutionary Position

If we look at Rogers’ theoretical position in a different frame, the paradigmatic position may become more clear. It can be simply stated:

The person-centered therapist must be a certain way in the relationship! This way entails that of experiencing unconditionality (UPR) towards the client. When the client perceives the therapist as being this way, a natural, constructive healing force is promoted in the client. It took me forty years of clinical work, indwelling of theory, involvement with research projects and varied types of inquiry to absorb what I had learned from the people I worked with in the State Mental Hospital in 1958 to 1963. Here is a recapitulation of my conclusions related to the above statement: 1. The therapist must BE a certain way, congruent, in the momentary relationship to the client while experiencing unconditional positive regard towards and empathic understanding of the client’s frame of reference. The therapist must be congruent, "a real person" (not holding a façade). The therapist must EXPERIENCE unconditional positive regard towards the client. Experience refers to, in this case, the therapist’s active and personal living through of unconditionality towards the client. The word "experiences" is important in that it is more indicative of the nature of the conditions being part of the character of the therapist in the relationship. The attention is on the therapist’s experience towards the client rather than on communication to the client. Likewise, the therapist must experience empathic understanding of the client’s frame of reference. The therapist must to some extent experience what the individual’s life is like for the individual "as if’ the therapist were that individual. These are great demands for the person-centered therapist that call more for therapist’s development, especially of unconditional positive self regard, rather than for skills, techniques and ways to do therapy.

2. The client must, at least, minimally perceive the two conditions of the therapist’s experience of UPR towards and of EU of her. When the therapist experiences these two conditions, I assume that they are communicated in the interactions between the two individuals. (It should be noted that in his 1959 theory statement, Rogers does not indicate that the therapist must communicate these attitudes as stated in the 1957 statement).

3. The fundamental curative or promotional factor is the client’s perception of the therapist’s experience of unconditional positive regard. It can be no other way in Rogers’ theory. The reason individuals have difficulty is because of the introjection of conditional self regard from significant others and society. The corrective factor is the development of unconditional self regard through being received with unconditional positive regard by the therapist.

4.There are no goals of the person-centered therapist for the client. The only goal of the therapist is for her, to be a certain way. There is not a goal of experiencing, or of depth of self-exploration or of self-actualization. There is no particular process or behaviors or direction that any person is expected to follow. Others have assumed from Rogers’ writings that there are certain goals such as experiencing or self-actualization. This appears to come from Rogers’ speculations that certain processes and behaviors are apt to occur with the client if the therapist’s experience of the conditions are perceived. The error of this misunderstanding is that Rogers’ speculations are interpreted as instructions rather than predictions that are apt to occur. The intent then becomes to make them occur and/or to pursue these predictions as goals. This was clear to me in my early relationships with chronic, long term "psychotic" clients who mostly talked about the realities or fantasies of their lives. This becomes clear theoretically if we think of the foundation of the theory; that is, that there is a natural, constructive process within each individual. This natural process is promoted when the individual perceives the experiencing of unconditional positive regard towards her. Rogers was actually clear about this in several of specific statements. His goal was to be a certain way himself. He then trusted that the client would accelerate her constructive growth.

5. The primary preparation of person-centered therapist must be the development of her own unconditional positive self-regard. This becomes clearer in Rogers’ (1959) theoretical statement concerning the family. This statement is a shorter version of his theory of therapy. He states:

The theoretical implications would include these:

1. The greater the degree of unconditional positive regard which the parent experiences toward the child:

a.The fewer the conditions of worth in the child.

b.The more the child will be able to live in terms of a continuing organismic valuing process.

c. The higher the level of psychological adjustment of the child.

2. The parent experiences such unconditional positive regard only to the extent that he experiences unconditional self-regard.

3. To the extent that he experiences unconditional self-regard, the parent will be congruent in the relationship.

a, This implies genuineness or congruence in the expression of his own feelings (positive or negative). 4. To the extent that these conditions exist, the parent will realistically and empathically understand the child’s internal frame of reference and experience an unconditional positive regard for him.

5. To the extent that conditions 1 through 4 exist, the theory of the process and outcomes of therapy and the theory of the process and outcomes of an improving

relationship apply. (p. 253)
This statement permits us to better understand the importance that Rogers accords to UPR in his theory. It IS the parent’s (or therapist’s) experience of unconditional positive regard towards the child (or client) that (1) creates fewer conditions of worth, (2) promotes the organismic valuing process, and (3) promotes psychological adjustment in the child. Moreover, the parent (therapist) must have unconditional self-regard to be congruent in the relationship and, hence, to be able to experience unconditional positive regard and empathic understanding of the child’s frame of reference. This statement succinctly describes the condition of UPR as the curative attitude not only for the client but also for holding oneself congruent as the therapist. It is dependent upon the therapist (substituting for the term, parent) having unconditional positive self regard. Rogers’ revolutionary paradigm has numerous implications.

Some Implications

A couple of the implications of the person-centered paradigm are noted in the following discussion.


The fundamental assumption of the person-centered approach is also the basic ethical premise for person-centered practitioners. The manifestation of the assumption is that the practitioner is dedicated to the self-authority and self-determination of the client. As such, the principle suggests new interpretations and even different statements concerning ethical standards. Such revision does not suggest fewer ethical restraints, rather it suggests stronger ethical principles and more attention to the nature and substance of professional relationships.

Psychotherapy is the search for and integration of one’s own biologically intrinsic and authentic values. Psychotherapy, for Rogers (1961), like Maslow (1970), was a process of recovery of "specieshood" or of "healthy animality," of self-discovery, and of integration leading toward greater authenticity of being and spontaneous expressiveness. This assumption is significantly different from underlying assumptions of most ethical standard statements. Most ethical assumptions in therapy are embedded in psychoanalytic theory. The assumptions are: (1) that therapist must be controlled in their behavior with clients; that is, they can not be trusted; (2) that the client is helpless in the relationship with the therapist (and that feelings are transference towards the therapist); (3) that the therapist is more powerful than the client and can easily coerce the client. It is not my purpose here to argue ethical virtues of a different assumptive base. Rather, the implications of the growth assumption for ethical behavior is examined.

The job of the person-centered therapist is to be a certain way and that way involves maximal experiencing of self-regard of the therapist. It is assumed that this promotes the positive growth of the individual. The difference between the client and therapist is not therapist expertise but the therapist’s congruence (in the face of client incongruence) in the relationship. It is the therapist’s dedication and intent of experiencing the client in certain ways; i.e., with unconditionally and "as if" the therapist were the client. The abiding person-centered ethic is to operate from these attitudinal qualities. This is the way the person-centered therapist strives to "be". Person-centered ethics are predicated on attitudinal qualities of the therapist. When the therapist is this way, the therapist can be trusted to act in accord with the positive growth directions of the client.

Multicultural Diversity

There have been numerous critiques of Rogers’ theory in relation to cultural values and, as well, to gender perceptual stances. The position is often taken that Rogers’ values were middle class American values and emerged from the U.S. culture which values such traits as independence, individual resourcefulness and materialistic accomplishments. I consider this a flawed argument that fails to consider the essence of the theory as an organismic, natural and universal theory. The theoretical assumption applies to all human species and indeed, to all living organisms (and even beyond: See Rogers, 1980). The qualities of the biological core are intrinsic to the human nature of each individual. Denial and unawareness of the core lead to psychological illness. Evil is a product of social conditioning and reaction to introjected values of conditional love according to Rogers. The more one becomes what one truly is, the less evil one finds within. The more one permits evil feelings to surface the less potent and burdensome they become (DeCarvalho, 1991). Moreover, the more one actualizes, the more one is able to interface with the environment and others even when at odds with strictures of the norm group. The latter point concerning societal adjustment, although not necessarily societal agreement, with particular societal norms for individuals at higher levels in the actualizing process is important in order to understanding part of Rogers’ position (1980). When the theory is cast in a way that is considered inappropriate in particular instances, it is always cast in the format of the way individuals have learned to "do" Client-Centered Therapy. Elsewhere, I (Bozarth, 1998, 97-101). have argued that focusing on how to do person-centered therapy is one of the more inhibiting factors to the creation of the freeing environment for the individual. As such, the arguments that CCT can not apply to certain other cultures are predicated upon this way of "doing" therapy. The foundational premise of a universal and natural force is ignored as the basic premise.

Societal Impact

Rogers (1956) discussed the societal implications of his theory in his early books about therapy. It was, however, in the early 1960’s that his primary efforts went in this direction. Rogers (1977) wrote a book concerning the meaning of his theory for society. He believed that the most notable influence of his theory on society was related to power and control in relationships. He described the societal influence of his approach in the following way: "Most notably it has altered the thinking about power and control in relationships between persons . . . " (p. xii). Rogers’ summarizes the thrust of his approach numerous times in his book on personal power. One of these quotes is an appropriate to communicate the overall idea. He states:

A person-centered approach, when utilized to encourage the growth and development of the psychotic, the troubled, or the normal individual, revolutionizes the customary behaviors of members of the helping professions. It illustrates many things: (1) A sensitive person, trying to be of help, becomes more person-centered, no matter what orientation she starts from, because she finds that approach more effective. (2) When you are focused on the person, diagnostic labels become largely irrelevant. (3) The traditional medical model in psychotherapy is discovered to be largely in opposition to person-centeredness. (4) It is found that those who can create an effective person-centered relationship do not necessarily come from the professionally trained group. (5) The more this person-centered approach is implemented and put into practice, the more it is found to challenge hierarchical models of "treatment" and hierarchical methods of organization. (6) The very effectiveness of this unified person-centered approach constitutes a threat to professionals, administrators, and others, and steps are taken’ consciously and unconsciously- to destroy it. It is too revolutionary. (p. 28) Rogers reminds us of the theoretical basis of these key principles. He notes: "From the perspective of politics. Power, and control, person-centered therapy is based on a premise which at first seemed risky and uncertain: a view of man as at core a trustworthy organism" (p. 7). Rogers’ revolutionary proposition founded upon the growth hypothesis faces us with different ways of thinking, and practicing and being. Person-Centered Therapy and the Person-Centered Approach is a revolutionary paradigm.



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This chapter is a revised version of the paper:

Bozarth, J. D. (1998, July). Person-Centered Therapy: A Revolutionary Paradigm, presented at the annual meeting of the Seventh International Forum on the Person-Centered Approach. Johannasburg, South Africa.

Parts of this chapter are reproduced with permission from PCCS BOOKS publishing company in the book:

Bozarth, J. D. (1998). Person-Centered Therapy: A Revolutionary Paradigm. Ross-on Wye: PCCS Books.

This chapter,, Forty years of dialogue with the person-centered approach, is scheduled to be published in an edited book by Douglas Bower. Book title and publisher may be identified through this web site at a later date.

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