Humanistic/Existential As left to the medical model as possible About self-actualization Open ended therapy Not about reducing depression/anxiety, getting rid of anything wrong/pathology but about being the best you can be Created in the 40’s by Rodgers in reaction to psychoanalysis Rodgers originally was working with psychotic individuals Purely patient focused and guided by the patient, up to the patient what the patient needs, patient sets the goals of treatment and the duration of the sessions Client at the center of the treatment and not the therapist About listening to patient, validating them, and supporting them What is curative is the patient being an environment with unconditional positive regardwarmth, acceptance- then self-actualization will take place Rodgers was one of the first to do outcome research in therapy Part of what is called the 3rd force in psychology (which includes humanism and existentialism) Both humanism and existentialism focus on the experience of the patient Emphasis of concept of freedom, values, autonomy, purpose, and meaning Individuals have the potential to self-actualize and find meaning Like an acorn, can grow in the proper conditions Person seen as striving for full functioning Have the resources for self-growth and insight Focus on the capacity to encounter reality and solve life’s problems on their own without the help of a professional Focus on the here and now Mental health is the congruence between what the person is and wants to be Phenomenological world of client is central (client’s reality) Way of being is a shared journey Called the non-directive approach at first, focused on the development in the 40s on the nondirective environment, challenges idea that therapist knows best, no diagnosis, suggestion, diagnostic procedures are prejudicial and misused. Changed to “client-centered” with the emphasis shifting to the client as the center instead of the non-directiveness Best way to understand patient is by their own frame of reference Focus in 50’s on actualizing tendency and motivating patient for change Empathy, acceptance and congruence from the therapist are necessary for change Congruence= what the therapist is saying, and feeling are consistent, related to honesty, therapist modeling truthfulness that they want patient to achieve in their life 60’s- emphasis shifted again to self-actualizing potential of the patient, and patient trusting their own experience (extension of congruence), patient having an internal locus of evaluation and moving away from conditions of worth, Rodgers started outcomes research to test his theory that focused on the process as well as the outcome of therapy Rodgers interested in how people best learn in psychotherapy Rodgers studied qualities of patient client relationship and how it impacted change 4th period in 70-80’s- conflict resolution SELF As a result of interaction of the environment the self is formed. Self is formed out of evaluative experiences. Self is consistent but fluid pattern of “I” or “Me” Different values person has is related to perception of themselves Experiences are either symbolized to the self or ignored because they don’t fit with the selfconcept Behaviors that are adopted typically consistent with idea of self Inconsistent experiences are perceived as a threat and self-structure becomes more rigid in response to that threat Incongruence= split between how the individual sees themselves and the real self -When there is a disparity is can lead to anxiety, depression, etc. -Goal of therapy is to decrease the split so they can self actualize Organismic Valuing Process- in infancy if improves self state its good, and if not its bad Later child is provided of provisions of others which are the conditions of worth. This may contradict their own values which is where the problems occur Defenses: Denial and Distortion RogerianSelf-Actualized- Openness to experience, trust in self, internal source/locus of evaluation, willingness to continue growing Developing reintegration in the patient- from external standards to internal standards Overcome rigidity and discrepancy between self and real self Six conditions necessary for personality/psychological change to occur: 1) two people in psychological contact 2) client experiencing incongruity 3) therapist experiences unconditional pos regard and real caring and acceptance of client 4) empathic understanding of client 5) recognize internal frame of reference and communicate this back to the patient 6) communication to client of empathic understanding and unconditional pos. regard (make sure that this is minimally achieved that the patient reports back to you that they’re experiencing this) Therapist characteristics and quality of therapist patient relationship Willing to be real with patient Qualities of therapist: genuineness, non-possessive warmth, accurate empathy, unconditional acceptance and respect of client Congruence- therapy is genuine and inner experience matches external experience Caring is unconditional acceptance without stipulations Main task of therapist is to understand client’s experience Therapist to understand client’s feelings as their own without getting lost in them Techniques: No specific techniques in Rogerian therapy Focus on therapeutic relationship Does not use diagnosis or history taking Positive and optimistic view of human nature Relationship centered rather than technique centered Focus on therapists attitude and therapeutic context Limited efficacy with non-verbal clients Dependent on therapist’s ability to bring themselves to the interpersonal interaction Exploration stage: Goals: get to know patient, establish rapport (trumps information gathering) Interventions- attending and listening, restatement, open questions and reflection of feelings Attending and listeningTo develop trusting relationship: establish rapport, try to understand client’s internal experience, respect and interest in patient, focus client on inner experience Facilitation emotional expression- nonverbal communication, encourage focus on what feeling in the moment Learning about client- don’t assume pts. experience is the same as anyone else Follow the lead that client provides- client knows self best Difficulties/Mistakes: inadequate listening, getting too involved with own thoughts, being judgmental, asking too many closed questions (y/n)- can result in client feeling they don’t have anything better to say closes them down, talking too much, giving too much advice, trying to be buddies with patient, not allowing for silence (examine own fears about silence), discouraging the intense expression of affect (explore difficulties with tolerating intense affect)