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Several radically different approaches to therapy can be identified in the profession of counseling and clinical psychology. Smith (1982) reported that the two most influential figures in counseling and clinical psychology were Carl Rogers and Albert Ellis.
Those two approaches are still influential, 35 years later. The approach pioneered by Rogers is still dominant in counseling centers on college campuses. Ellis's therapy was an early form of cognitive-behavioral therapies (CBT), the most widely-practiced form of psychotherapy today.
Rogers and Ellis provide a good way to contrast different styles of counseling, because they are complete opposites. Rogers, often called "the father of counseling psychology, practiced non-directive or person-centered therapy.
Rogers was friendly and loving, and he accepted any perspective a client brought to him. In Rogerian therapy, the client determined his or her own direction of change. Rogers was confident a client would find the right direction in the end.
Ellis, by contrast, offered a prescriptive therapy: he gave definite, sometimes sharply worded, advice. Ellis was willing to be obnoxious to make a point. In therapy, he directly opposed "irrational ideas" in his clients. We will consider the approach of Rogers first, then Ellis.
How were the approaches of Rogers and Ellis "complete opposites"?
Carl Rogers lived from 1902 to 1987. He was particularly influential after World War II and was president of the American Psychological Association twice in the late 1940s. Psychologists were hungering for an alternative to the traditional Freudian views, and Rogers provided a very different perspective.
Rogers never called people who came to him patients. That word implied an involuntary relationship, like a person committed to a mental hospital. For most of his career, Rogers preferred the term client. A client seeks out a helping relationship voluntarily.
Toward the end of his life, Rogers opted for an even less restrictive term. People who came for help were persons. The therapy, previously called client-centered therapy, became known as person-centered therapy.
A counseling psychologist sees people who have problems of living rather than brain diseases or developmental disorders such as discussed in Chapter 12 (Abnormal Psychology). The phrase "problems of living" covers a lot. Here is how Rogers put it in a 1954 lecture.
In my work at the Counseling Center of the University of Chicago, I have the opportunity of working with people who represent a wide variety of personal problems. There is the student concerned about failing in college, the housewife disturbed about her marriage...
...the parent who is distressed by his child's behavior, the popular girl who finds herself accountably overtaken by sharp spells of black depression, the woman who fears that life and love are passing her by, and that her good graduate record is a poor recompense...I could go on and on...
In the end (Rogers believed) people all have the same problem: the problem of figuring out who they really are, then finding the right path, acting according to their better natures. He wrote:
I have however come to believe that in spite of his bewildering horizontal multiplicity, and the layer upon layer of vertical complexity, there is perhaps only one problem....
Below the level of the problem situation about which the individual is complaining–behind the trouble with studies, or wife, or employer, or with his own uncontrollable and bizarre behavior, or with his frightening feelings, lies one central search.
It seems to me that at bottom each person is asking, "Who am I, really? How can I get in touch with this real self, underlying all my surface behavior? How can I become myself?" (Rogers, 1961, p.107)
In what sense is everybody suffering from the same problem, according to Rogers?
Because Rogers believed the core problem was finding one's true self (which sounds trite now but was a new idea in the 1940s) he concluded that a therapist could not direct a client to the correct goal. A client had to find this direction.
Rogers had practical reasons for advocating this approach. It seemed to be what worked, in the actual practice of counseling.
Rogers saw a consistent pattern in cases of successful therapeutic change. He described this progression of events in his book Client-Centered Therapy (1951).
First, Rogers said, clients go through a phase of getting behind the mask. The mask or persona is the face we show the world.
Rogers noticed that a client first coming to a therapist is usually defensive and unnatural, anxious to please or worried about being rejected. The good therapist creates a climate of safety and freedom in which the false fronts start dropping away.
The client may even start to examine them, as if from another person's perspective. That is when real therapeutic change starts to take place.
As clients began to explore change, in therapy, Rogers saw them move toward appreciation of life as a process rather than a thing. Clients become "tolerant of their own complexity." Rogers wrote:
Clients seem to move toward more openly being a process, a fluidity, a changing. They are not disturbed to find they are not the same from day to day, that they do not always hold the same feelings toward a given experience or person, that they are not always consistent. They are in flux, and seem more content to continue in this flowing current. (Rogers, 1951, p.171)
What were trends Rogers saw in successful therapy?
In successful therapy, according to Rogers, clients find openness to all experience, including elements of the personality that might have been hidden before. Like Karen Horney, Rogers had faith that people could handle whatever came up in self-explorations.
Unlike Karen Horney (who retained much of Freud's vocabulary and some of Freud's assumptions) Rogers abandoned all remnants of Freudian theory and stopped using Freudian terminology. The approach Rogers adopted was almost atheoretical, with respect to dynamics or conflicts that might be troubling a person.
To Rogers, the thrust of counseling should be the same in any case. A person in need of help should be provided with a counselor who genuinely listens and cares, in a safe atmosphere, to enable deep introspection and gradual self-directed change.
How Rogerian Therapy Works
The concept of client-centered therapy is simple. The counselor endeavors to understand the client and how the client sees the world. The counselor provides a warm and supportive atmosphere in which the client can do some self-exploration.
Especially in the early days of Rogerian therapy, many client-centered therapists tried to restate what the client was saying, in different words, to make sure the therapist had a clear understanding. No direct advice was given, however.
How does Rogerian therapy proceed?
Rogerian therapy appears simpler than it is. Rogers (1946) quoted a beginning therapist who complained about the "illusion of simplicity." It all seems so easy, until a beginning therapist tries to do it. Then he or she is likely to find out how difficult it is not to interrupt, interpret, take charge, or dominate the therapy proceedings with advice.
What are common misconceptions of Rogerian therapy?
Misconceptions of Rogerian therapy are common. One misconception is that the counselor is supposed to adopt a passive, laissez faire attitude: just stay out of the client's way and let things evolve. Rogers said that comes across to the client as uncaring, even rejecting.
The passive, anything goes attitude fails to convey unconditional positive regard for the client. Rogers felt that was essential to a good counselor/
Clients are likely to leave the counselor who takes a laissez faire attitude "disappointed in their failure to receive help and disgusted with the counselor for having nothing to offer," said Rogers. People who report negative experiences with Rogerian therapy often describe this hands-off approach.
One parent stopped taking her child to counseling because the therapist simply provided finger paints and sat back and watched. It was a fiasco from the parent's point of view. Passivity on the part of the therapist was not what Rogers recommended.
A second misconception is that the counselor should clarify the client's thoughts. The client says something confused or muddy, and the therapist comes back with a clear restatement of it, bringing everything into focus.
That is partly descriptive of what takes place in therapy, Rogers said, but it is too intellectualistic, not sufficiently warm and empathetic. The client is likely to feel put-down, as if he or she is being diagnosed. The counselor is constantly demonstrating, "I know better."
According to Rogers, the emphasis of therapy should not be on the counselor's brilliance in making interpretations. It should be on the client's unique world-view and process of self-discovery.
To better understand the client, the therapist may try to restate what the client is saying, so that the client can correct and clarify the therapist's understanding. Gendlin (1988) described it this way:
Rogers eliminated all interpretation. Instead, he checked his understanding out loud, trying to grasp exactly what the patient wished to convey. When he did that, he discovered something: The patient would usually correct the first attempt.
The second would be closer, but even so, the patient might refine it. Rogers would take in each correction until the patient indicated, "Yes, that's how it is. That's what I feel."
Then there would be a characteristic silence. During such a silence, after something is fully received, the next thing comes in the client. Very often it is–something deeper.
Rogers discovered that a self-propelled process arises from inside. When each thing is received utterly as intended, it makes new space inside. Then the steps go deeper and deeper. (p.127)
How does a client get to "something deeper" in Gendlin's description?
Rogers assumed a client had the capacity to deal with any material that came up and would use those insights to grow and improve. Rogers called this the self-actualization hypothesis. Rogers wrote:
...The counselor chooses to act consistently upon the hypothesis that the individual has a sufficient capacity to deal constructively with all those aspects of his life that can potentially come into conscious awareness. (Rogers, 1951, p.22)
What is the self-actualization hypothesis? What is the counselor's role?
In Rogers view, a successful counselor provided the type of relationship that allowed this growth to take place.
If I can provide a certain type of relationship, the other person will discover within himself the capacity to use that relationship for growth, and change and personal development will occur. (Rogers, 1951, p.33)
The beneficial counselor was warm, but not cloying; understanding but not judgmental; supportive but not pushy. The rest happened automatically. People told their story and learned from it if they felt understood, not rejected. Rogers wrote:
In the emotional warmth of the relationship with the therapist, the client begins to experience a feeling of safety as he finds that whatever attitude he expresses is understood in almost the same way that he perceives it, and is accepted. He then is able to explore... (Rogers, 1951, p. 41)
How was change in the personality achieved, according to Rogers?
Rogers believed that self-exploration, conducted honestly, leads ultimately to a restructuring of self. If the ego is not confronted or stressed, it participates in its own exploration, its own healing growth.
The changes produced are not experienced as something alien, forced on a person. Instead, changes in the person's self-perspective feel like joyful self-discovery.
This process of discovery turns out to be relatively easy, once started. It is a process of letting go of barriers and defenses, rather than forcing something to happen.
In what way is the change "easy" and how does the client's statement relate to this?
Rogers quoted a successful client:
You know, it seems as if all the energy that went into holding the arbitrary pattern together was quite unnecessary–a waste. You think you have to make the pattern yourself; but there are so many pieces, and it's so hard to see where they fit.
Sometimes you put them in the wrong place, and the more pieces mis-fitted, the more effort it takes to hold them in place, until at last you are so tired that even...awful confusion is better than holding on any longer.
Then you discover that left to themselves the jumbled pieces fall quite naturally into their own places, and a living pattern emerges without any effort at all on your part. Your job is to discover it, and in the course of that, you will find yourself and your own place. (Rogers, 1951, p.43)
It is precisely the acceptance of one's true feelings that gets one past them, in Rogerian theory. Once barriers and defenses are let down and formerly-suppressed thoughts and feelings are confronted.
The client discovers that letting go of a harmful behavior pattern or personality facade is nothing to be feared. In fact, it is easy, and it sets the stage for positive growth.
Gendlin, E. T. (1988). Carl Rogers. American Psychologist, 43, 127-128.
Rogers, C. (1946) Significant aspects of client-centered therapy. American Psychologist, 1, 415-422.
Rogers, C. (1951) Client-Centered Therapy: Its Current Practice, Implications, and Theory. Boston: Houghton-Mifflin.
Rogers, C. (1961) On Becoming a Person: A Therapist's View of Psychotherapy. Boston: Houghton-Mifflin.
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