Rainer Sachse
From Client-Centered Psychotherapy to Clarification-Oriented Psychotherapy
Abstract
The following article critically discusses the concept of “classic” Client-Centered
Psychotherapy and draws conclusions from the available outcome and process research that
call for conceptual changes to the therapy. A change of paradigms from a primarily
relationship-oriented psychotherapy to a primarily clarification-oriented psychotherapy is
suggested.
1.
Introduction
Today Client-Centered Psychotherapy (CCP) is no longer a uniform psychotherapy (see
Sachse, 1999): It takes various forms ranging from “non-directive approaches” (see
Biermann-Ratjen et al., 1995, Schmid, 2002) via “process-experiential psychotherapy“ (see
Greenberg et al., 1993) to “objective-oriented psychotherapy“ (see Sachse, 1992, 1996, 2003).
The objective of this study is to show that CCP has developed significantly in the last few
years and that, based on the results of process research, a fundamental change of paradigms is
about to take place, which will lead to a new form of CCP that I would like to call
“Clarification-Oriented Psychotherapy“.
2.
Empirical Evidence and Conclusions
I would like to begin my exposition with some résumés of empirical evidence. On the basis of
these résumés I wish to illustrate the current status of empirically based research, focusing on
the results of process research. And I would like to make clear from what scientifically
supported knowledge base we can - and must - start today, if we want to practice scientifically
based CCP.
I do not wish to deal with the research itself; that would mean going into too much detail.
Rather, I would like to present the conclusions that can be drawn from the available research.
I only wish to cite here the studies on which my conclusions are based, so that any audience
member can verify my conclusions. These studies are: Orlinsky & Howard, 1986; Orlinsky,
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Grawe & Parks, 1994; Grawe, Caspar & Ambühl, 1990a, 1990b; Grawe, Donati & Bernauer,
1994; Greenberg, Elliott & Lietaer, 1994; Elliott, 1996, 2002; Sachse & Elliott, 2002; Sachse,
1992, 1999; Sachse & Takens, 2003.
First of all, I would like to draw some conclusions from the outcome research. These
conclusions are also essential in regard to the consequences they have for the concepts of the
CCP process. The conclusions that I consider to be relevant are the following:
1. In effectiveness studies, classic client-centered (Rogerian-style) psychotherapy has –
without exception - proved only moderately effective. The average effect sizes are about
1.3 (Grawe et al., 1994).
Classic CCP assists clients only moderately in making constructive changes. But changes
in clients are, of necessity, brought about by processes of change initiated through the
therapeutic proposals made by the therapist. If the therapeutic results are only moderate,
then, logically, the processes of change encouraged by the therapist were only moderate,
too. This reason alone is sufficient to think about how therapeutic processes and
interventions should be conceived.
2. Classic CCP has in general proved less effective than Cognitive Therapy. This, too,
shows that Cognitive Therapy produces more effective processes in clients than CCP
does.
3. The effective spectrum of classic CCP is significantly narrower than that of interactional
behavior therapy. The processes of interactional behavior therapy produce far more
changes than can be achieved with classic CCP: So it is possible, in principle, to
encourage a very large number of changes. In this respect, CCP is, however, far from
being optimal. Obviously, CCP fails to optimally exploit the potential of the therapeutic
process. It is imperative that this evidently dysfunctional restriction be overcome.
4. Thus classic CCP is by no means a highly effective form of therapy; it is far from being
“ideal”.
Therefore - if clients are to be given effective help - CCP cannot be preserved as it is.
Preserving the therapy in its classic form is not empirically justified in any way. It must
rather be developed further.
5. Offering clients classic person-centered therapy means offering them a suboptimal
method. The interventions produced, in particular, do not have the quality to initiate
optimal changes.
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Offering that method is not client-centered. It is, at best, ideology-centered or therapistcentered. For this reason alone, it is absolutely essential that CCP be developed further.
6. More directive forms, such as “process-experiential psychotherapy“, show substantially
higher effect sizes - comparable to those of Cognitive Therapy. But then, they also have
totally different concepts of the therapeutic process, which appears to me to be the most
important aspect: They use different and more extensive interventions and therapeutic
strategies.
7. A further development in theoretical and methodical terms is what I call ”ClarificationOriented Psychotherapy“. That therapy is process-directive and process-oriented.
Clarification-oriented psychotherapy shows effect sizes of 2.3. It is thus as effective as
Cognitive Therapy.
This shows that CCP can effectively be developed further and that it must in fact be
developed further.
8. But further development means change. If the CCP system changes, it will no longer
remain a Rogerian system. If we want to develop the therapy further, we must abandon
the classic form of Client-Centered Therapy.
9. According to studies, the relationship characteristics or relationship variables “empathy”,
“acceptance” and “congruence” correlate on average 0.20 with the therapy success.
This means: Relationship characteristics have only a marginal impact on the success of
the therapy. Thus, “relationship structuring” by the therapist in general practically nontherapy-relevant.
So considering CCP as “relationship therapy” is not empirically justified. That is sheer,
unproven ideology. Thus relationship is not the essential effective variable of CCP.
Relationship structuring by the therapist is probably an important, albeit insufficient
prerequisite for effective therapy.
Relationship is a prerequisite for further constructive work; without it, constructive work
is not possible. But the therapeutic proposal must be much more than an offer of
relationship.
And this means that the therapeutic process in CCP can only in part be seen as an “offer
of relationship”. There is no justification for interpreting all that happens in the
therapeutic process as a “relationship” or a “relationship-structuring process”. It is
obvious that also other, highly relevant things happen, or should happen, during the
therapeutic process that give the client optimum support in his process of change.
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10. In contrast, the quality of the clarification process correlates more than 0.60 with the
therapy success. In CCP, the significant therapeutic effects are produced by clarification
processes.
Thus CCP should be regarded as Clarification-Oriented Psychotherapy rather than
Relationship-Oriented Psychotherapy. Therefore, a large part of the therapeutic process
should be conceptualized as a clarification process: a process, in which clients represent,
restructure and integrate relevant cognitive or affective schemata.
For this reason it is important to look more closely at the role that clarification processes play
in client-centered therapy. I would like to do so based on conclusions drawn from a number of
process studies. The conclusions are:
1. Through their interventions, therapists have a very strong directive effect on their clients’
clarification processes. Whether they want to or not, they act directively, they influence
the client processes. Thus there is no such thing as non-directive therapist behavior.
Empirically, the concept of “non-directive psychotherapy” is plainly and simply
untenable. You may believe this, but you may as well believe that the earth is flat.
Consequently, the concept of “non-directivity” should be eliminated from the process
concepts of CCP.
2. Clients let themselves be extensively guided in their clarification process by therapists.
This means they let themselves be influenced by therapists, they are basically open to
therapeutic intervention.
So clients do want therapists to direct their process, which means that directive therapist
behavior is highly client-centered.
A vital element of the therapeutic process is thus process-directive intervention,
intervention that deliberately steers the clients’ clarification processes.
3. To deepen the clarification process, clients require extensive intervention from the
therapist. They virtually never deepen the process on their own. To be able to start a
constructive clarification process, clients require guidance from the therapist. A selfinitiated deepening of the clarification process practically never happens. This means:
Clients show no actualizing tendency in their own clarification processes.
Should there be such a thing as an “actualizing tendency” - which I doubt there is - it
certainly does not occur in the therapeutic process.
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4. Clients get very easily distracted from the clarification process. They are highly liable to
accept flattening processing proposals; they are thus not immune to influences from the
therapist.
So therapists can act grossly untherapeutically, especially if they are not experts, but just
“good people”.
5. For clients, the deepening process is difficult and challenging.
Clients need to focus fully on that process, in which the therapist-client relationship
evidently becomes a background variable, it must be there, but it must never get into the
focus of the therapeutic work.
6. Clients also require constant directive support from the therapist in maintaining a
deepening process; without that support, the client’s clarification process will flatten.
So therapists need to know exactly when and how they must and can stimulate client
clarification processes.
7. A therapist must encourage a client’s explication process in a specific manner in order to
initiate effective clarification. This means, the therapist must make sure that the process
develops slowly, step by step, and - if possible - without omitting any explication stage.
So the therapist’s behavior can be highly constructive - or highly destructive.
To be able to act constructively, therapists need to have a high level of therapeutic knowhow and they must at all times be fully aware of where the clients are in their process.
8. So the therapist has a great effect on the clients’ clarification processes. He should thus be
an expert on the process, who steers the processes deliberately and constructively. He has
great process responsibility in the therapeutic process. He is thus far more than a provider
of room for growth or relationship: Through his active behavior, he significantly
determines the quality of the client processes.
He deliberately influences the client clarification process, which he must do, because the
client needs that support. Otherwise, he would leave the client alone.
Probably the most significant conceptual change required to the CCP process results from
the conclusion, drawn from the available evidence, that therapists practicing CCP need to
be experts - experts have specific knowledge, perform process analysis, make therapeutic
decisions, and produce interventions. And it is probably this change that is the hardest to
accept for the proponents of classic CCP. But I believe that there is no way for us to get
around this conclusion, unless we persistently ignore all empirical data.
The assumption that a therapist should be an expert, however, has far-reaching
consequences and calls for further conceptual changes.
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9. The better the therapist understands the client, the stronger his influence will be on the
client’s clarification process.
Clear therapeutic understanding is the necessary prerequisite for the therapist being able
to make his client constructive proposals in the first place.
10. Understanding the client, however, is not enough. Not only must the therapist understand
what the client means, but he must also make clear to the client how the client must now
work on what question, i.e. he must provide constructive encouragement, which means
the therapist must make processing proposals to the client.
11. Therapeutic intervention can be implemented more easily and used more constructively
by clients, the more effectively the therapist focuses his intervention “on the core”, i.e. on
the central issue that the client is concerned with.
12. The therapist is able to constructively steer the client’s clarification process only if he
understands what the client means and relates as closely as possible to the client.
For this purpose, too, a therapist must have expert knowledge and he must form a model
of the client: He must not only understand what a client says, he must understand what a
client means, and he must understand the client’s schemata, i.e. his “internal reference
system”, i.e. he must form a client model.
13. Therapeutic intervention will in particular have a constructive effect on the client
clarification process, if the intervention
–
is short;
–
contains only one instruction at a time;
–
is clear and comprehensible;
–
expresses directly and explicitly – rather than indirectly and implicitly - what the
therapist means.
14. Therefore, the therapist should be an expert. He needs to be highly competent to
understand what the client means, so that he can constructively direct the client by
producing deliberate, effective interventions. So the therapist must have knowledge and
empathy, he must do the right thing at the right time and he must form a model of the
client and his process.
15. Clients come into therapy with different starting conditions.
16. If clients respond poorly to clarification-oriented intervention from the therapist, it is
necessary to use other therapeutic means to foster the client, such as processing the
processing or complementary relationship structuring. Such measures enhance the clients’
responsiveness to clarification-oriented intervention.
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17. Clients with psychosomatic intestinal diseases (morbus crohn and colitis ulcerosa) show
poorer acceptance of deepening processing proposals and a higher level of avoidance than
axis-I-clients do. In the case of psychosomatic clients, an effective therapeutic approach
consists in adopting a more process-directive attitude and producing a high level of
specific interventions; “classic” CCP approaches are in fact absolutely ineffective.
18. For this reason, therapists must differentially adjust to the clients’ starting conditions;
they must adopt a disorder-specific approach and must certainly not make the same
proposal to all clients.
Thus CCP urgently needs disorder-specific concepts. This is probably the second most
important conclusion that must be drawn from the empirical data: Therapists must act in a
disorder-specific fashion. To do this, they must first identify the disorder - they must
make a diagnosis. To be able to do this, they must have disorder-specific knowledge. And
they must act in a manner that takes account of the particular disorder, which means that
their behavior must be target-oriented, based on knowledge and client processes.
So they do more than making an “offer of relationship” and they do not by any means
offer all clients the same concept. To meet all these requirements, therapists need to be
experts.
From this follows that a disorder-specific approach is impossible for a therapist to adopt
without an expert status. But disorder-specific behavior goes far beyond the therapeutic
concept of classic CCP.
19. How rapidly a therapist can deepen a client’s clarification process and how effectively he
can foster the client thus depends also on the client’s characteristics.
For this reason, therapists also need to have knowledge about the clients’ disorders and
the starting conditions resulting therefrom and about what therapeutic approaches the
clients will respond to.
20. The depth of the clarification process increases continuously as the therapy progresses.
The client achieves the deepest explication level when he is about halfway through the
therapy. Towards the end of the therapy, the depth will slightly decline again.
21. Even in the course of a single session, the explication levels will slowly increase. Clients
do not immediately begin the clarification process, but require a “starting phase”.
22. Experienced therapists control client processes more rigorously and make more proposals
to deepen the processing than inexperienced therapists do. It is for this reason that clients
of experienced therapists show deeper clarification processes than clients of
inexperienced therapists.
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3.
Development
Lines
of
Clarification-Oriented
Psychotherapy
Resulting
from Empirical Evidence
I would now like to derive a number of proposals from the empirical evidence for the further
development of CCP, notably proposals that relate to the process concepts of CCP.
These proposals lead to a change in the fundamental paradigms: While the therapy continues
to be based on the fundamental variables empathy, acceptance and congruence – thus
remaining a client-centered therapy – its core is crystallizing into a clarification-oriented
concept - which has far-reaching consequences for the concept of the therapy.
1. From CCP to Clarification-Oriented Psychotherapy
It is clear that the “basic variables“ ‘empathy’, ‘acceptance’ and ‘congruence’ form an
indispensable foundation for building a trustful therapeutic alliance. These therapeutic
conditions must continue to form the basis of any type of CCP, but they must be just the basis.
And it is clear that a good therapist-client relationship constitutes an indispensable basis for
good clarification-oriented work. The therapist-client relationship is an essential prerequisite
for all therapeutic clarification processes: Without a trustful relationship, there can be no
clarification processes. And it is further clear that relationship structuring as such is an
important therapeutic catalyst for some clients. In fact, a therapeutic relationship alone is
sufficient to trigger constructive changes in some clients. But such clients are certainly not the
majority. However, a relationship offer is, in general, far from being enough. For this reason,
CCP should not be centrally defined as a “relationship therapy“. Rather, the emphasis of the
therapeutic work should be on clarification / explication processes. Clients should be
specifically aided in representing problem-relevant cognitive and affective schemata, in
developing an awareness of these schemata and in making these schemata accessible to
further therapeutic processes. This orientation toward clarification is in my view the central
element and central expertise of CCP. Clarification orientation is highly client-centered,
because it helps the clients in a highly effective manner and because clients expect that sort of
help from therapists.
Moreover, the clarification processes that CCP offers the clients are unique in psychotherapy.
Neither behavior therapy, nor cognitive therapy, nor psychoanalysis offers this form of
structured therapeutic process (see Sachse and Takens, 2003).
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2. Empathic understanding: From „entering a person” to reconstruction
Empathic understanding, as the empirical evidence shows, is a necessary prerequisite for a
therapist to understand the client and for his ability to facilitate the client clarification process.
However, the classic conception of emphatic understanding is not sufficient. A therapist
cannot „enter the client” directly, unless he is telepathic, which only few therapists are, I
understand. On a psychological level, “understanding“ is rather a highly complex
reconstruction process, which therapists perform based on their knowledge and their client
models. The concept of ”phenomenological understanding” is absolutely untenable from a
psychological point of view. This concept is a philosophical concept, but by no means a
psychological concept. It leads to a highly naïve and false understanding of the relevant
processes: The assumption that behavioral processes are phenomenological processes is in
stark contrast to all the empirical evidence relating to psychology of language. This concept
should therefore be definitely abandoned. The processes of understanding should rather be
approached from a psychology-of-language perspective. Here it must be made clear
–
that understanding is a process that is always aided by a person’s own knowledge;
–
that, for this reason, there can be no unbiased, a priori valid understanding;
–
that understanding is only a hypothesis;
–
that understanding is a complex, fragile process of reconstructing what the client means;
–
that a therapist can by no means be capable of understanding all clients.
Classic understanding concepts in CCP are unpsychological, naïve and empirically wrong and
should therefore be urgently revised.
But this leads to significantly different conclusions about the clients’ process and thus to new
concepts of therapist behavior and thus to new concepts of the therapeutic process.
3. From non-directivity to process-directivity
Clients, on their own, have massive problems clarifying relevant schemata. They get
entangled in dysfunctional processes, avoid dealing with negative schemata, etc. So therapists
must offer clients specific help. They must produce interventions and apply strategies in order
–
to internalize the client’s perspective;
–
to activate schemata;
–
to channel the client’s attention;
–
to develop questions;
–
to work on the representation of the schema.
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For this reason, therapists must make specific processing proposals, which must be derived
from their understanding of the client. The therapists are thus process-directive, they make
specific proposals as to what the client should do next or what he should not do to avoid
slipping back into dysfunctional processing patterns. If therapists let the clients “go” or just
follow them, no constructive clarification process will take place. Nowhere is an actualizing
tendency less apparent than in the therapeutic process. If the therapist makes no proposals, he
leaves the client alone, lets him down, deprives him of potential encouragement and is thus
extremely poorly client-centered. The ideological postulates of CCP are a matter of total
indifference to clients. What clients want is optimum help, the best available therapy, but not
purest theory. Clients do not want religion, they want professionalism. And they are entitled
to it.
4. From “mere understanding” to confrontation
Clients are highly ambivalent about clarification processes. From this follows that clients tend
to use avoidance strategies in order not to deal with negative content. Clients with
psychosomatic diseases even tend to employ avoidance strategies so extensively that
processing content becomes virtually impossible. Therefore, therapists should deal
specifically with avoidance strategies: They should confront clients with this problem and
encourage them to actively explore the reasons for their avoidance tendency. This approach,
too, is highly process-directive. Here, therapists make proposals, but do not in any manner
force the clients to embark on this process. But the therapist directs the client’s attention, he
takes on his part of the process responsibility and does not simply let the process run. If the
therapist fails to do this, the client could just as well talk to the parking meter.
5. From the “purity of the teachings“ to the integration of effective methods
Clarification processes are the basis for the further processing of schemata. So clarification
processes are necessary - though sometimes insufficient - methods for changing schemata.
Clarification alone sometimes does not lead to a change in schemata. If this is so, the therapist
must again make proposals to the client that help him, otherwise the therapist would let him
down again. Clients must be encouraged to
–
verify schemata;
–
associate schemata with other schemata and resources;
–
test schemata systematically;
–
develop alternative assumptions.
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For this purpose, Cognitive Therapy provides good therapeutic strategies. These strategies
should be integrated in effective CCP. This means that the arsenal of CCP methods should be
supplemented with other effective methods. Here it is irrelevant whether or not these
strategies fit the classic ideology. What I believe client-centered therapy must do is offer
clients the most effective methods, rather than the purest ideology. Ideology has never helped
anybody (except the ideologists, maybe).
6. From the homogeneity myth to disorder specificity
It is evident from the entire research literature that different disorders function differently
from a psychological perspective. So clients with different disorders come into therapy with
different starting conditions, thus they need different therapeutic offers. In this case, clientcentered therapy means that:
–
therapists have knowledge of different disorders;
–
the method allows the therapist to develop strategies and interventions that are
specifically geared to the starting conditions and objectives of the specific client.
CCP can no longer hold fast to the homogeneity myth; it is a Stone Age myth that is totally
untenable in view of the available empirical data. But disorder specificity implies also that
diagnosis is needed as part of CCP. Diagnosis makes sure that therapists adopt the best
possible client-centered approach! In this case, diagnosis permits to identify at the earliest
possible stage what a client needs and to what he will respond. The therapist can thus use the
information to act in the best possible client-centered manner. Rejecting diagnosis in CCP is
highly unreasonable: Each piece of information that helps the therapist to adjust to his client,
is useful, regardless of what source it may come from.
7. From a “good person” to an expert
If you consider how specifically and how effectively a therapist must foster a client in order to
stimulate genuinely constructive processes and how badly a therapist can harm the client
process by unfavorable intervention, it is clear that the therapist must be an expert. In CCP,
the therapist should be a true, genuine person: But this aspect concerns the relationship
element of the therapy. As far as the clarification element is concerned, the therapist must
additionally be an expert on the process. The therapist must
–
make the right processing proposals at the right times;
–
decide between strategies;
–
choose objectives;
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–
take decisions based on indications, etc.
To be able to do all that, a therapist must have knowledge of
–
psychic disorders;
–
therapy objectives;
–
therapeutic strategies and interventions.
A therapist must make decisions, understand, and plan strategies. A therapist must also be
able to act strategically on a long-term basis, anticipate the effects of interventions, and “look
over wide spaces”, form models, etc. This means: To be able to act effectively and to foster
clients, a therapist must be an expert and act as an expert. As an expert, the therapist must
assume his part of the process responsibility during the therapy. Being there only as a person
is an easy task for the therapist, which requires no knowledge, no expertise and only a
minimum of processing; but then it also gives the client only a minimum of support. It is thus
rather a homeopathic therapy, which is far from providing therapeutic benefits. Therapists
who proceed in this manner offer their clients at best 5% of what helps therapeutically. So,
overwhelmingly, therapists do not offer what is effective. Can this really be called responsible
therapist behavior?
8. From the naïve attitude to the client model
For this reason, therapists - using their knowledge - should constantly process information
about the clients and form a model - a model of
–
what problems the client has;
–
what objectives can be pursued;
–
how the client structures his relationship with the therapist;
–
how the client processes his problems;
–
how the client could be fostered in the best possible manner.
Therapists form models, whether they want to or not; but the models should not be formed
arbitrarily, but in a systematic and disciplined manner and they should be based on
psychological knowledge. The models that therapists form provide the basis
–
for the therapist’s understanding, they are thus not in contrast to, but form the foundation
of, empathic understanding;
–
for therapeutic decisions;
–
for developing interventions and strategies.
Without a model, deliberate therapeutic behavior is not possible.
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9. From following to negotiating
In the therapeutic process, the client is the expert on content, while the therapist is the expert
on the process. The client determines what is to be processed, what he wants to achieve and to
change, etc. The therapist makes clear what objectives are achievable, what the client should
process and change, if (and only if!) he wants to achieve specific objectives. In the therapeutic
process, these two experts must negotiate; they must establish a consensus, a compromise. In
this process, the therapist makes clear what is feasible and what needs to be done in order to
reach specific aims: The therapist is the expert on developing solutions and processing
content. The client determines whether or not he wants to accept and implement the
therapist’s proposal. If he rejects the proposal, the therapist has to accept that: Each client has
a right to his problems. As for content, the therapist establishes no rules; he does not tell the
client what is good and right or how the client should decide. The therapist does not brand
thoughts as “irrational”. The client alone can know what resolutions he can make and stick to.
But the therapist can say whether the client can achieve his aim by following a specific course
or whether he will get stuck in certain types of processing.
10. From ideology to psychology
Rogers attempted to base his system on contemporary psychology. But that was 50 years ago;
the assumptions underlying the Rogerian theory are now hopelessly obsolete. If you want to
base CCP on psychology today, you have to fundamentally change many Rogerian concepts,
such as:
–
actualizing tendency,
–
experience,
–
attitudes,
–
non-directivity,
–
the assumption that attitudes will lead to changes, and many more.
If you fail to do that, you will lose touch with psychology. And then you will no longer
practice Psychological Psychotherapy. And that is the other way of gambling away the
scientific base of CCP: If you are no longer centered on the underlying science, you will no
longer practice a scientifically oriented process. But science moves on: Therefore, CCP must
move on, too, so that it will not “miss the boat”.
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11. From confession to profession
CC therapists should define themselves as experts on the process who make a scientifically
based proposal for change to their clients, a therapeutic offer that helps clients solve their
problems as effectively as possible. In this process, therapists are professionals: They do not
live an ideology, but they offer their clients professional help. Ideology does not matter, nor
does “dogma”. What matters is what therapists actually do. And the ethics of psychotherapy
demand that they offer their clients a highly optimized psychotherapy.
12. The end of self-deception
CCP should give up the still significant level of self-deception; which means that it should
revise assumptions that have clearly been proved to be false, such as:
–
The therapy is based on an actualizing tendency.
–
The therapy is non-directive.
–
The therapy is optimally effective.
–
Empathy, acceptance and congruence are necessary and adequate therapy conditions.
You may still believe all that, but you may as well believe that the earth is flat. Insistence on
antiquated assumptions has led, and will continue to lead, to a situation where CCP is not
taken seriously at academic level. Representatives of classic CCP sometimes criticize the
“reformers” for not being willing to embrace the process and preferring directive methods.
Maybe the reformers regard the classic approach as obsolete, restrictive, boring, non-dynamic,
inflexible and ineffective. You do not have to be very competent to practice classic CCP; you
don’t even need to be a psychologist. Maybe that is a little meager for psychotherapy.
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4.
A Scientific System or a Sect?
If you practice CCP today, you can choose whether to advocate a scientifically supported,
psychology-based and empirically founded, developing concept or a classic, unchangeable,
highly ideological system that persistently ignores empirical evidence and is developing into a
sect. I believe that you have the choice between a scientific system and a sect.
As holding fast to conventional ideologies has a central impact on what therapists actually do
in the therapeutic process and how they actually structure the therapeutic process, I would like
to criticize classic CCP for no longer being state of the art.
From a scientific point of view, you should give up numerous Rogerian concepts, such as:
–
actualizing tendency,
–
non-directivity,
–
CCP as a relationship offer,
–
homogeneity myth,
–
rejection of diagnosis,
–
rejection of therapist expert status,
–
rejection of client model forming,
–
the assumption that basic attitudes of therapists alone can bring about constructive
changes in clients.
But if you stick to all these concepts, you must be prepared to hear from others that
–
you are disregarding empirical evidence;
–
you are ignoring theory-forming in psychology;
–
you can no longer claim to represent a psychological, scientific form of therapy.
If you hold fast to theoretically obsolete, empirically falsified assumptions, you are clearly
outside the scope of science, because doubting, searching for empirical evidence and further
development are the core elements of scientific research. If you no longer allow change to
happen, you are building a Chinese Wall against progress. And then you will find yourself in
the realm of religion, trapped in a sect. What a sect tries to do is:
–
to preserve a system to the largest possible extent, to shut it off from all change;
–
to keep the teachings as pure as possible and to defend them;
–
to brand any deviation as “false”, “impure” and “inadequate”;
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–
to cherish the founder’s writings;
–
to subject the founder’s writings to an exegesis and debate about what he may have meant
by certain statements;
–
to persistently ignore all alternatives and confuting data;
–
to define the system as optimal, perfect and not in need of revision, thus ignoring
substantial counter-evidence.
In my opinion, some concepts of CCP meet fully this definition of a “sect”. Of course, you
can form a sect and believe all that; but then, I think, you can no longer claim with impunity
that what you are doing is based on science, because that is sheer nonsense. And a systematic
deception.
And: Then the focus is no longer on helping the clients as effectively as possible; the client
has degenerated into a marginal figure. Thus the system is by no means client-centered; it is
highly ideology-centered. You no longer reflect on how you can help the client or what the
client wants (certainly not ideology!), but you reflect on what Rogers thought.
I would like to dissociate myself clearly and unambiguously from this development into a sect
and do not even wish to be placed anywhere near it. For this reason, I no longer wish to call
my approach CCP, but Clarification-Oriented Psychotherapy.
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