PSY 245
CLINICAL PSYCHOLOGY-II
 Assoc. Prof. Dr. BAHAR BAŞTUĞ
 Clinical Psychologist
CARL ROGERS: PERSONCENTERED THEORY AND
THERAPY
Welcome
 This week we’re focusing on person-
centered theory and therapy (PCT).
 This approach was developed by Carl
Rogers.
 The approach is deeply optimistic and
guided by principles of trusting clients and
an actualizing tendency.
Carl Rogers (1902 –1987)
 Freud >>>>pessimist
 Adler & Jung >>>>optimist
 Rogers>>>>superoptimist.
 Rogers developed a distinctive approach:
Listening.
 In his life, he strove to be a genuine and
open person, he strove to be himself.
 Other theorists criticized Rogers being
superoptimist.
LIFE OF ROGERS….
Born in 1902, in Oak Park, Illinois
Biographical Information:
4th of 6 children to a farm family in
Illinois.
His family was rigid fundamentalist
Christians.
Traveled to China, had a significant change of
view. “Rogers appears to have become
Rogers”
Biographical Information: Carl
Rogers
Carl Rogers’s development as a person was
characterized by the following (and more) events:
– He rejected his parents’ conservative religious
ideology.
– He decided to marry his childhood sweetheart.
– He decided to pursue graduate studies at the liberal
Union Theological Seminary in New York City.
– He studied clinical psychology at Columbia
University.
Married in 1924
Rogers’s relationship with his
wife had a powerful affect on
him. Because of his poor
social skills, she was the first
person with whom he ever had
a caring and sharing
relationship.
in 1928
At the time, Columbia
University was
interested in John
Watson’s behaviorism.
Rogers was oriented
more toward the
contemporary scientistpractitioner model. He
was the first person to
tape-record actual
therapy sessions.
Rogers’s first clinical position was at the Adlerianoriented Rochester Child Guidance Center. During
this time, academic psychologists were behavioral,
while clinicians were trained in either
psychoanalytic or neo-analytic theory. Since
Rogers wanted to help people (rather than work in
a laboratory), he was trained in an analytic
approach.
Rogers attended a seminar with Otto Rank
and learned from a social worker, Elizabeth
Davis. Ms. Davis’ way of articulating
clients’ feelings fascinated Rogers.
Rogers adopted the following principles from Otto
Rank:
 Clients have creative powers.
 Therapy should help clients accept their personal
uniqueness and self-reliance.
 The client is the central figure in the therapy
process; the therapist only helps clients access their
powers of self-creation.
 Therapists shouldn’t educate clients.
 Therapist shouldn’t foster dependency with
clients by becoming love objects.
 Therapy works when clients experience the
present within the therapy setting.
Rogers was influenced by the
person of Roosevelt.
Roosevelt was optimistic.
Rogers was influenced by the
philosophy of John Dewey.
Historical Context
 Rogers was influenced by:
– Elizabeth Davis
– President Franklin D. Roosevelt
– John Dewey
– His relationship with his wife
– His clients
Historical Context
 Honoring the Client
– Rogers credited his clients as the greatest
source of his development.
– Natalie Rogers stated: “And so like Carl, I
stayed open to learning from my clients.
They are always our best teachers.”
His daughter, Natalie Rogers, has become a
significant force in integrating dance,
movement, and the arts with personcentered theory and therapy.
Struggles with Psychiatry and Psychology
Rogers developed his client-centered approach to
psychotherapy in a climate openly hostile to his
ideas. He had to fight the behaviorism of academic
psychology as well as the psychoanalysis of the
clinical world.
Rogers had a battle with psychiatry to obtain for
psychologists the right to practice psychotherapy.
Rogers socialized with social workers,
counselors, and teachers. He rebelled
against the traditional class lecture, he
participated in encounter groups.
However, he was elected president of the
American Psychological Association in
1946.
Evolution of Person-Centered
Therapy
Rogers’s practice of person-centered theory
and principles is divided into 4 periods:
1. Nondirective counseling. This period began
in the 1940s and was characterized by
Rogers’s growing aversion to directive,
traditional therapy methods.
Evolution of Person-Centered
Therapy
2.Client-centered therapy. In the
1950s Rogers changed the name of
his approach from nondirective
counseling to client-centered
therapy.
Evolution of Person-Centered
Therapy
3. Becoming a person. During the 1960s,
Rogers focused on self-development.
His work was strongly associated with
the human potential movement. He
published On Becoming a Person and
moved from academia at the University
of Wisconsin to California in 1964.
Person-centered therapy
Evolution of Person-Centered
Therapy
4.Worldwide issues. In the 1970s and 1980s,
Rogers became more interested in worldwide
issues. He began dedicating his work to
improving interracial relations and producing
world peace. He met with Irish Catholics and
Protestants, visited South Africa and the
Soviet Union, and conducted cross-cultural
workshops in Brazil, Dublin, and Hungary.
Theory of Personality
The person-centered approach includes a
theory of personality and theory of
psychotherapy. The theory of personality is
complex and difficult to formulate. For this
reason, it gets little attention.
Theory of Personality
• Self theory
• Phenomenology and the valuing of
experience
• Learning and growth potential
• Conditions of worth
Self-Theory
Every person exists within an everchanging world in which he or she is
the center. The self is not a fixed
structure, but a structure in process,
capable of both stability and change.
Self-Theory
The term organism refers to the locus of all
psychological experience. The organism is
the entire realm of an individual’s
experience, while the self is the “me”
portion of the organism.
Rogers’s self has both conscious and
unconscious components.
Self-Theory
The distinction between organism and self
makes it possible that an individual’s self
can be inconsistent with its overall
psychological experience. This discrepancy
is referred to as incongruence.
Self-Theory
In contrast, when the self’s experiences and
perceptions are consistent with the organism’s
total experience, there is congruence.
Congruence between self and organism is
highly desirable; it leads to adjustment,
maturity, and a fully functioning individual.
Phenomenology and the Valuing of
Experience
This theory is basically phenomenological. Personal
experience.
Although both intellectual thinking and feelings are
valued informational sources, experiencing is a
direct way of accurately knowing oneself and the
world.
Phenomenology and the Valuing of
Experience
Person-centered therapy is designed to help
clients be more open to personal experiences.
True learning is best achieved through lived
experience.
Learning and Growth Potential
Rogers believed in the inherent actualizing or
formative tendency in humans. Rogers
believed people have the capacity to learn on
a moment-to-moment basis.
Rogers’ actualizing tendency is similar to
Adler’s striving for superiority.
Conditions of Worth
The main two learned needs are the need for
positive regard and the need for selfregard.
1. The baby begins developing a greater and
greater consciousness of self. Most parents
see this behavior in their children at about
age two, when the child’s favorite words
become “mine!” and “no.”
Conditions of Worth
2. The growing child develops a strong need
for positive regard or approval. This need for
positive regard—to be prized and loved—
becomes so powerful that the child is almost
always looking to caregivers and significant
others for acceptance and approval.
Conditions of Worth
Children begin distinguishing between
approved and disapproved feelings and
actions. They sense and understand the
conditions of worth present in their lives.
Children internalize caregivers’ appraisals.
A young girl loves to play aggresively with
other boys and experiences disapproval from
parents, she concludes:
1. When I play aggresively I’m bad.
(negative self regard)
2. My parents don’t like me (negative regard
from others)
3. I don’t like to play aggresively (denial of a
desirable organismic experience)
Conditions of Worth
Over time, if children continually experience
conditions of worth incongruous with their
organismic values, a conflict may develop
between their conscious, introjected values
and their unconscious genuine values.
Conditions of Worth
When individuals are unaware of true selves
and desires, psychopathology develops. A
discrepancy occurs between real self and
ideal self. It’s known as incongruence.
Conditions of Worth
Individuals are capable of perception without
awareness. This process is subception. In the
case of subception, a person unconsciously
perceives a threatening object or situation.
In sum, it emphasizes several
concepts. It is the theory of self,
experience, striving for maintenance
and enhancement of the self, and
learned needs of positive regard.
Theory of Psychopathology
Psychopathology can be a discrepancy between
the real self and the ideal self.
As humans confront challenges in life they will
misperceive, operate on mistaken beliefs, and
behave inadequately. Dysfunctionality occurs
if we fail to learn from feedback.
Dysfunctionality is a failure to learn and
change.
Theory of Psychopathology
The failure to learn from experience.
Person-centered therapists work so hard to help
clients become open to learning from new
experiences. Rigidity is considered the
antithesis of psychological health. Rigidity
impairs learning.
Theory of Psychopathology
Since every moment is an opportunity for new
learning, avoiding or ignoring these moments
is pathological.
Theory of Psychotherapy
Psychopathology stems from the
individual’s experience of judgment of
the self by significant others.
A nonjudgmental atmosphere will
facilitate psychological health.
Theory of Psychotherapy
The success of person-centered therapy
depends on two fundamental factors:
• The therapist must trust the client.
• The therapist must establish a certain type of
relationship with the client.  So, clients
will be able to begin trusting themselves,
experiencing greater personal development
and psychological health.
Theory of Psychotherapy
It is related to Rogers’s theory of personality. For
constructive personality change, it is necessary for the
following core conditions to exist:
1. Two persons are in psychological contact.
2. The client is in a state of incongruence.
3. The therapist is congruent in the relationship.
Theory of Psychotherapy
4. The therapist experiences unconditional
positive regard.
5. The therapist experiences an empathic
understanding.
6. Communication of unconditional positive
regard and empathic understanding is at
least minimally achieved.
The therapist communicate
congruence,
unconditional positive regard,
and empathic understanding to the client.
Congruence
is defined as authenticity or transparency. The
congruent therapist is real, open, and honest.
«The more that the therapist can be genuine in
the relationship, the more helpful it will be.»
Therapists should acknowledge and express
both positive and negative feelings within the
context of the therapy relationship.
How would you describe congruence?
Unconditional Positive Regard
Acceptance, respect, or prizing
Valuing the client as a separate person or organism
whose thoughts, feelings, beliefs, and entire being
are openly accepted, without any conditions. If the
therapist can accept clients completely, the clients
can begin exploring who they really are and what
they really want. By accepting clients, therapists
lead clients to begin accepting themselves.
Unconditional Positive Regard
This acceptance should extend to the momentto-moment changes and inconsistencies
manifested by clients during sessions.
Unconditional Positive Regard
At one moment the clients may identify only
feelings of love and kindness toward
someone, and at the next they may rage
about the same person. To the personcentered therapist, both love and rage are
important, valid, and equally worthy of
attention. By simply listening and reflecting
back both feelings, the therapist allows
clients to accept what’s been expressed.
Unconditional Positive Regard
How would you describe
unconditional positive
regard?
Accurate Empathy or Empathic
Understanding
Accurate Empathy or Empathic
Understanding
 Noticing your clients’ feelings.
 Entering into the client’s world, seeing and
experiencing what client sees and
experiences.
 Rogers shifts from using a second-person
pronoun (“When he left, you felt betrayed
and alone”) to using a first-person pronoun
(“he just up and left, and I felt betrayed and
alone”). This pronoun shift is referred to as
walking within.
 Kızılderili Atasözü
“komşun hakkında hüküm vermeden
önce iki ay onun makosenleriyle yürü.”
Empathy
has been most widely discussed and researched.
Empathy is a prerequisite for therapy and a
necessary condition.
Empathy is a multidimensional concept. Three
components are commonly discussed in the
literature:
Subjective empathy involves to identify with a
client and imagine and experience what it is
like to be a patient.
Interpersonal empathy occurs when you
attempt the phenomenological experiencing
of a client from an extended perspective.
Objective empathy involves using the
observational data to understand the client.
THE PRACTICE OF PERSONCENTERED THERAPY
two different types of person-centered
therapists:
1. The Classical person-centered therapist is
highly nondirective, does not use
assessment procedures, and does not
establish any specific goals for clients.
2. The contemporary person-centered
therapist is a more active and directive
therapist.
The Practice of PCT:
A Way of Being With Clients
 Assessment Issues and Procedures
– Classical person-centered therapists don’t
employ standardized assessment or diagnostic
procedures.
– Contemporary person-centered approaches
sometimes employ assessment procedures.
The Practice of PCT:
A Way of Being With Clients
 The Therapist’s Opening Statement
– Clients can take the lead in
determining what to talk about.
– Example: “Anything you’d like to
tell me about yourself that will help
me to know you better, I’d be very
glad to hear.” (Rogers, 1963)
Experiencing and Expressing Congruence
– This can be tricky.
– How do you think therapists should
experience and express congruence?
Experiencing and Expressing Congruence
The basic question is: If I am to be congruent,
do I need to tell the client about my every
thought and feeling?
The answer is “No.” That’s not to say that
therapists should be too cautious about selfdisclosing to clients.
The main aim of this openness is
communicating helpful information to
clients.
A certain amount of censoring is necessary.
To use techniques in therapy is appropriate,
but only when the techniques come up
spontaneously, not when they’re
preplanned.
Experiencing and Expressing
Unconditional Positive Regard
• This is also tricky.
• It involves accepting clients as they are
and avoiding judgments.
• Is this possible?
• How do you think you could
experience and express unconditional
positive regard?
Experiencing and Expressing
Unconditional Positive Regard
Everyone is human and judges others.
The problem is how to best express positive
regard. Would it be appropriate to say, “I
accept you completely and totally as the
person you are” or “I prize and value your
total being”?
Experiencing and Expressing
Unconditional Positive Regard
Most therapists get themselves in trouble if they directly
express unconditional positive regard to clients, for two
reasons:
1.Expressing too much positive regard can be overwhelming
to clients. Clients may react by wanting to break down
therapy boundaries. Upon hearing such positive, loving
statements they naturally seek more closeness, a friendship or
romantic relationship. Some clients may react to direct
expressions of affection with fear. These clients may try to
expand the boundary between themselves and the therapist.
Experiencing and Expressing
Unconditional Positive Regard
2. Saying “I care about you” or “I won’t judge you”
can be viewed as unrealistic, especially if the
therapist hasn’t spent much time with the client
and doesn’t really know the client well.
Experiencing and Expressing
Unconditional Positive Regard
If it’s inappropriate to directly express
unconditional positive regard to clients,
how can therapists communicate this
important message?
1.by keeping appointments, and by listening
sensitively.
2.by allowing clients freedom to discuss
themselves in their natural manner.
Experiencing and Expressing
Unconditional Positive Regard
3.by demonstrating that you hear and
remember specific parts of a client’s story.
4.by responding with empathy to clients’
emotional pain and intellectual conflicts.
5.clinical experience and research both
indicate that clients are sensitive to an
interviewer’s intentions. By making an
effort to accept and respect your clients.
Experiencing and Expressing
Empathic Understanding
Person-centered therapists do not believe it’s
possible for one individual to directly know
and experience another individual’s
feelings. As with unconditional positive
regard, what appears important regarding
empathy is not that therapists perfectly
experience and express empathy, but that
they try their best to do so.
Experiencing and Expressing Empathic
Understanding
– Entering and becoming at home in the client’s
personal perceptual world.
– Being sensitive from moment to moment with
the client’s changing meanings and emotions.
– Temporarily living, and moving in the client’s
life.
– Sensing deep meanings, but not uncovering
feelings that are too far out of awareness.
Entering and Becoming at Home in the Client’s
Private Perceptual World
Entering the client’s private world requires
preparation. You need to be open to feeling
what the client feels and willing to ask the
empathy question:
“How would I feel if I were _____ and saying
these things?”
The procedures employed to enter the client’s
world include reflection of feelings,
empathic exploration, and clarification.
Being Sensitive from Moment to Moment with
the Client’s Changing Meanings and
Emotions
Moment-to-moment sensitivity requires
focused attention to your client’s changing
way of being. In his emotion-focused
therapy, Greenberg recommends focusing
on meaning associated with the client’s
verbalizations.
Temporarily Living, and Moving in the
Client’s Life
To reside in another person’s life is serious
business. Rogers says to do this
temporarily.
Your goal is to have one foot inside the world
of the client and one foot planted in your
own world.
Temporarily Living, and Moving in the
Client’s Life
Martin Buber, existantialist, referred to this
sort of relationship experience as an I-Thou
relationship, and he emphasized that it’s
impossible to constantly maintain such a
relationship.
Sensing Deep Meanings, but not Uncovering
Feelings That Are Too Far out of Awareness
Rogers talked about working on the edge of
his clients’ consciousness. As a personcentered therapist moving about within your
client’s world, if you have an impulse to tell
a client about something outside of his or
her awareness, it’s best to hold your tongue.
Your main job is to follow the client’s lead,
not to walk your own path.
PCT has been integrated with other therapies.
These include:
– Motivational interviewing
– Emotion-focused therapy
– Nondirective play therapy
Motivational Interviewing
was developed by William R. Miller. In his work
with problem drinkers, Miller discovered that
structured behavioral treatments were no more
effective than an encouragement-based control
group. He concluded that reflective listening and
empathy were crucial in producing positive
treatment effects with problem drinkers, and
began his development of motivational
interviewing.
MI builds on person-centered principles by adding
more focused therapeutic targets and specific
client goals.
Focusing on Client Ambivalence (primary target of
MI)
Their four central principles of MI flow from their
conceptualization of Rogers’s approach.
According to these principles, it is the therapist’s
job to
• Use reflective listening skills to express empathy
for the client’s message.
Motivational Interviewing
• Notice and develop the theme of discrepancy
between the client’s deep values and current
behavior.
• Meet client resistance with reflection rather than
confrontation.
• Enhance client self-efficacy by focusing on
optimism, confidence that change is possible, and
small interventions that are likely to be successful.
Cultural and Gender Considerations
 Empowering of all persons, including
women.
 Designed to address the needs and interests
of unique clients.
 Too indirect for some cultures, but actually
could be too direct (focusing on self and
emotions) in other cases.
Evidence-Based Status
• Rogers was the first to record his sessions.
• Rogers studied client-centered relationship
variables in the treatment of 16 hospitalized
schizophrenics. The patients made little progress in
PCT. But, patients who rated their therapists as
higher empathy, warmth and genuineness had
shorter hospital stays than patients who rated their
therapists as less degree of empathy, warmth and
genuineness.
Evidence-Based Status II
 Recent research on the effectiveness of PCT
has yielded small, but positive results.
– PCT is consistently more effective than no
treatment.
– It is more effective than placebo treatment.
– It is less effective than structured cognitive and
behavioral treatments.
Concluding Comments
It may be that at least in some cases, the
person of the therapist and the attitudes of the
therapist holds are more important than
specific problems or techniques.
from Lao-tse :
 If I keep from meddling with people,
they take care of themselves,
 If I keep from commanding people, they
behave themselves,
 If I keep from preaching at people, they
improve themselves,
 If I keep from imposing on people, they
become themselves.