Person centred counselling theory

It was Abraham Maslow who posited the idea of a hierarchy of human needs. This was important in the development of person-centred counselling. Maslow's (1943) hierarchy is based on the idea that there are a number of human needs that must be met so that a person can move towards 'self-actualisation'. Dryden & Mytton (1999) explain that the other figure important in the development of person-centred counselling is Carl Rogers. Rogers was brought up in a strict religious family which isolated him from the normal childhood world and all its distractions.

Early in life he decided to become a Christian minister, but later, at Seminary College, decided to change, and study psychology. Rogers' psychological education was originally a mixture of Freudian psychoanalysis and behaviourism. Rogers' treatment of a pyromaniac was to prove vital for the development of his own technique. Having failed to help a boy using Freudian techniques of analysis, and then subsequently the boy's mother, he simply left the direction of the conversation to the boy's mother and did not interpret it. Rogers found this was a much more successful way of working.

Some of the central tenets of this new type of therapy were first outlined in 1942 (Rogers, 1942). As is clear from the name, the most important aspect of person-centred counselling is that the client is always at the centre of the process, unlike some other forms of counselling where technique is more pronounced. The approach has previously been called 'non-directive' which helps to emphasise that the counsellor is not providing advice, but rather the forum within which the client can explore themselves. Rogers encouraged his fellow therapists to concentrate on the present rather than the past, as well as a closer focus on feelings. Rogers began calling what had been the 'patient' the 'client' to emphasise the fact that the person being treated had to take responsibility for themselves rather than becoming a dependent who had to be treated.

Dryden & Mytton (1999) describes three stages in the historical development of person-centred counselling. The first stage emphasised providing the right atmosphere in which the client could release their emotions. Further, it emphasised the importance of understanding and acceptance on the part of the therapist. In the second stage Rogers concentrated on the attitude of the therapist. Here, he emphasised the idea that the therapist should believe that the client has the means of change within them and this should not be imposed from the outside. The therapist's role was to enter the client's world and to be empathetic and provide support. The third stage was developed through a troublesome therapeutic relationship Rogers had with a client. The client became overly dependent on him and later, having referred the patient to a psychiatrist, discovered deep, unresolved issues within himself. As a result of this experience, Rogers emphasised the importance of the therapist's own feelings. It is only through a real acceptance of the therapist's feelings towards the client that the therapy can proceed effectively. Rogers later called this idea 'congruence' between therapist and client and it represents a genuineness of emotion.

These historical developments in person-centred counselling are placed in their present theoretical arrangement by Dryden & Mytton (1999). Person-centred counselling is a humanistic approach, focussing on the present moment rather than the past. It is fundamentally based on the idea that every living thing has a self-actualising tendency. This is the drive to survive in even the most difficult circumstances. This, Rogers saw, manifested itself throughout the natural world, and human beings are no exception. Rogers explains that this tendency 'maintains and enhances', working towards, but never ultimately achieving, our full potential. Life, for Rogers, is about steady progress towards self-actualisation.

Also fundamental to the person-centred approach is the idea that we all perceive reality in different ways. In other words, the world doesn't look the same to each of us. This is simply because we all have different experiences, which in turn affects our behaviour in different ways. We each filter our senses differently according to our experiences and our way of interacting with the world.

Important in the development of person-centred counselling is the idea of self and it is closely related to the self-actualising tendency discussed above. In the development of self, Rogers does not argue that there are any stages but instead that aspects of personality and self arise through a combination of innate preferences interacting with environment. A child has a basic need to be seen positively - a need for positive regard. Inconsistencies arise when there is a conflict between the inner self and the self-concept. This may arise as others' regard for the growing child and its behaviour is not always congruent with its own inner self. The child can resolve this inconsistency through introjection. This means taking the beliefs and values of others and internalising them so that they become the child's beliefs and values. A mentally healthy person, therefore, manages to balance these conflicts and accept themselves and others unconditionally.

Unfortunately most of us are not so completely balanced and well-developed and problems do occur in this balancing process. One imbalance which Rogers often saw was that the need for positive self-regard was often so strong that it outweighed what he called 'organismic needs'. It is these organismic needs that automatically tell us what is good for us so that we can obtain the things that we need. This means that if there is a serious conflict then we will tend to distort or deny what is actually happening to us. Dryden & Mytton (1999) quote the example given by Rogers (1951) of an adolescent boy brought up by over-controlling parents. While he loves his parents, he is also extremely resentful of the control they exert over him. To resolve this conflict the boy may disown the anger, or misattribute it to a different cause. While this is effective in removing the immediate discomfort, it serves to maintain psychological inner conflict.

The process by which counselling takes place is very important in the person-centred approach. There should be no suggestion that the therapist is taking the upper hand and, in any way has privileged information about the client. Rogers (1961) found when the necessary conditions were set up, the change that was required in the client happened automatically.

Empirical investigations into outcomes have been limited within person-centred counselling as those involved in the approach are not generally predisposed to scientific evaluation. The notable exception is that research carried out by Rogers himself in the development of his therapeutic process.

One of the major advantages of the person-centred approach that has been backed up in the research literature is its concentration on the therapeutic relationship. Research, for example, that has looked at the common versus specific factors that are important in outcomes for psychotherapeutic interventions has found that client-therapist relationship is extremely important. Strupp (1996) has estimated from research that 85% of the outcome variability from different types of psychotherapies can be explained by common factors. These common factors are largely the same ones espoused by Rogers (1951).

Practical criticisms of the person-centred approach have tended to concentrate on the fact that it doesn't provide particular approaches for particular needs. Person-centred counselling is considered to be good for more low-level or basic problems, but is perhaps not suited for more serious mental disturbances. For example, it is less likely that those suffering from severe psychosis will be able to benefit from this type of counselling. Its fundamental assumption is that a person entering counselling needs to be motivated to change. It is questionable whether this will be the case for the more seriously disturbed client. The other line of criticism is more centred on its philosophy. Because of the vague nature of its central tenets it is very difficult to test, and some critics have argued that its central ideas of self-actualisation are impossibly optimistic views of human nature.

Gestalt therapy is based on some of the principles of Gestalt psychology, which has at its core the idea that something, like, for example, the human mind, should be considered as a whole rather than broken down into its component parts. Like person-centred counselling, gestalt therapy is also a humanistic approach. It is also similar in that its genesis was in the reaction against the authoritarian version of psychotherapy that had been created by Freud. It aims to put the client and therapist on similar footing and concentrates on the client's view of the world, particularly their view as it is at that very moment. 

The two names most associated with gestalt therapy are Fritz and Laura Perls. Fall, Holden & Marquis (2004) explain that the self, in gestalt therapy, is seen as relational, the person does not exist outside their relationships with other people. Gestalt therapy is often associated with practical experiments, such as the empty chair technique in which the client is asked to have a conversation with a person imagined to be in an empty chair. While gestalt has many things in common with person-centred counselling, it concentrates more on the experiential aspect - so that experiments may form a part of the counselling process. It is also much more active in nature than person-centred counselling and in this sense can provide a useful adjunct to a person-centred approach, especially since many of its basic tenets are similar.

Transactional analysis was developed by Eric Berne and concentrates on analysing the dysfunctional social interactions that people have with each other, characterising these as 'games' (Berne, 2001). Berne took Freud's ideas of the ego, superego and id and turned it into a tripartite structure with adult, parent and child, theorising that in our everyday life we move from one 'ego-state' to another. This theory, like the two mentioned previously has, at its base, the idea that we have a number of needs that have to be satisfied. A person is considered happy or well-adjusted if they can satisfy these needs without interference with other people's needs. Change is addressed in transactional analysis by creating a contract between the client and therapist - like the other therapies discussed motivation for change is seen to be centred within the client, and the client is seen to understand what is best for them. Transactional analysis in counselling is usually focussed more tightly on solving particular problems and, in this, can be contrasted from person-centred counselling which does not focus on problems. Ideas and techniques from transactional analysis, however, do lend themselves to incorporation in an integrative approach.

All of the therapeutic techniques require a thorough understanding of the theory and practice before they can be used. In any type of therapy there are usually powerful emotions at work and these need to be dealt with in the right way to help the client grow. But, like any situation, it is only through some kind of engagement with these issues and the associated dangers, that progress can be made.
 

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