A brief history on the development of a ‘radical’ approach
The person-centred approach was developed by the psychologist, Dr Carl Rogers from 1940 onwards. Prior to this, the dominant form of therapy was psychoanalytic psychotherapy (Feltham, 2013), an approach developed by Sigmund Freud in the 1890’s which focused largely on interpretation and analysis of past events in a client’s life (Yakeley, 2013). During Rogers’ doctoral research in educational and clinical psychology, he completed his fellowship in New York at The Institute for Child Guidance where “the ethos of eclectic Freudianism countered the objective, measurement-oriented emphasis” (Barrett-Lennard, 2013, p.34) of his previous studies. Rogers himself, initially identified as a therapist of the analytical persuasion by virtue of his educational background but became increasingly disenchanted with this approach during his time at the child study department in Rochester during the late 1920’s (Thorne, 2013). Rogers gradually became aware of the limitations of this approach partly, when he began counselling a mother who had initially presented with concerns over her son’s behaviour. His failed therapeutic attempts at analysing their situation resulted in the mother requesting individual counselling during which she passionately confided a plethora of personal problems. Rogers (cited in Hergenhahn & Henley, 2014, p.555) highlights this encounter as:
one of a number which helped me to experience . . . that it is the client who knows what hurts, what direction to go, what problems are crucial, what experiences have been deeply buried. It began to occur to me that unless I had a need to demonstrate my own cleverness and learning I would do better to rely upon the client for the direction of movement in the process.
Rogers reluctance to persist with the practice of psychoanalytical therapy was the impetus for the genesis of the person-centred approach. The events which followed are characterised as both revisionist and progressive in the domain of psychotherapy. Rogers formulated and refined a new modality of psychotherapy, so radical and revolutionary that it has been described as “the first major alternative to psychoanalysis” by Hergenhahn & Henley (2014, p.555) amongst others across the fields of psychology and psychotherapy, such as Webb (2018) and Malim & Birch (1998).
Zimring & Raskin (1992, cited in Tudor et al., 2004) summarise four key stages throughout Rogers’ life which define the progression of the approach. The first phase begins with Rogers’ second book Counselling and Psychotherapy: Newer concepts in practice (1942) and marks Rogers’ departure from the prevailing medical model of therapist as expert in determining ‘patient’ problems and diagnoses. Kirschenbaum (2004, p.117) describes the text as “a book that challenged the field of psychotherapy to its core” and remarks, along with Cornelius-White & Ciesielski (2016) on Rogers’ use of ‘client’ as opposed to ‘patient’ as provoking a radical change in popular, medical discourse. Further radical developments during this period, include Rogers’ first transcriptions of a series of eight counselling sessions ‘The case of Herbert Bryan’ Sanders (2012). Both Kirschenbaum (2004) & Sanders (2012) reference the inclusion of these transcripts in Rogers’ second book as an unprecedented contribution to the study of psychotherapy not only in his use of credible analysis alongside the transcripts but also his use of recording technology. Tudor & Worrall (2006) make particular reference to Roger’s methods of research as being ‘radical’ but also emphasise the fact that the roots of his ‘ideas’ were not contemporary in nature.
It is important to acknowledge, that whilst Rogers is credited with popularising the person-centred approach, this evolving paradigm derives significant themes from the key philosophical spheres of humanism, phenomenology and existentialism (Casemore, 2011) & (Tudor et al, 2004). Tudor (2018), Bozarth (2016) & Barrett-Lennard (2013) all comment on the influence of Jessie Taft, Frederick Allen & Virginia Robinson on Rogers’ development of client-centred therapy. Whilst we consider Rogers to be the innovator of this radical paradigm, Tudor (2018) remarks that he was heavily influenced by the work of Otto Rank through his relationship with Taft. Tudor (2018, pp.46-47) elaborates on the significance of Rank’s impact on Rogers’ work by highlighting obvious parallels between Rank’s focus on understanding the client’s world in the ‘here and now’ and Rogers’ theories on self-actualisation and non-directive therapy generally. However, Rogers was indeed innovative in his approach to blending these various philosophies and ideas and utilising them “as the basis for a new and radical form of psychotherapy” Tudor & Worrall (2006).
Rogers contributed to key progressions in medical and psychological discourse by centring the client as expert over the therapist in their understanding of their own experiencing. Natiello (2016) and Cornelius-White & Ciesielski (2016) refer to the far-reaching, positive consequences of this on not only therapists but psychologists, social workers, doctors, teachers and parents. Cornelius-White & Ciesielski (2016) frame Rogers’ propagation of the term ‘client’ over ‘patient’ as a “powerful symbol . . . a humanisation of both therapist and client, a de-stigmatising of psychotherapy.” The emergence of ‘non-directive’ therapy is the key focus of this first period. Rogers began to understand the importance of the therapist responding to emotion over content, showing an appreciation of the client’s feelings and holding faith in the client’s ability to self-direct through growth and actualisation.
The second key period in the development of person-centred theory brought further radical developments. Rogers’ “formidable and revolutionary” book Client-Centred Therapy: Its current practice, implications and theory was published in 1951 (Sanders, 2012, p.4). The text not only detailed the key principles for therapy but also for education, group and play therapy and also set out the nineteen propositions, importance of the actualising tendency and ideas about enabling clients to self-direct. Cornelius-White & Ciesielski (2016, p.16) remark on the radical shift of focusing on therapist attitudes as opposed to techniques and also on empathic acceptance of the client as being a “radical practice” and also a key proponent in pushing the field of psychotherapy to a “social justice empowerment position.” During this period, Eugene Gendlin, initially a student of Rogers and later a colleague commented on client-centred therapy being offered at the ‘Counseling Center’ as having “put Rogers ahead of the country . . . In 1945, blacks, women, gay people and others found help because these therapists knew that every client had to teach them a new world” (Rogers & Russell, 2002, cited in Kirschenbaum, 2007, p.164). Gendlin (1988) further described Rogers’ new form of therapy as “a war against monolithic authority” (cited in Hergenhahn & Henley, 2014, p.555).
Whilst at The University of Chicago, Rogers launched the first ever programme of research into psychotherapy, an undertaking not yet attempted by other theorists (Sanders, 2012) & (Cornelius-White & Ciesielski, 2016). Rogers’ further works in 1957 & 1959 set out the framework for the client-centred approach and also the ‘necessary and sufficient’ conditions. As a subsequence of his 1957 & 1959 papers more radical developments ensued. ‘Common factors’ theory was introduced to assess therapist performance offering “unique insight to understanding current person-centred therapy research and practice” (Cornelius-White & Ciesielski, 2016, p.17). Sanders (2012) comments that Rogers’ unique and radical positioning of client as expert caused controversy and disapproval within the field. However, his “nothing less than revolutionary” (Sanders 2012, p.6) approach served to unmask, demystify and expose the characteristics of the therapeutic relationship that led to positive changes in personality.
The years which followed included the publication of Rogers’ On becoming a person. He focused on refining his ideas regarding the concept of ‘being’ but there were no radical additions to the existing paradigm (Sanders, 2012). Following the failures and successes of the ‘Wisconsin Project’ during which Rogers’ worked closely with Eugene Gendlin, ‘focusing-oriented therapy’ would emerge. From this point onwards, various schools would materialise in both contemporary person-centred and process-experiential theory and practice.
It has been around eighty years since Carl Rogers began to formulate his ideas and even now critics question the efficacy of the approach and whether the revolution is a failed one. Markowitsch (2018) questions how far Roger’s “silent revolution” has progressed and whether even now, his notion of the therapist as the instrument of therapeutic change is too radical for some. Finke (2018, p.19) considers whether the mission to centre clients creates conflicting dichotomies with therapist functions. He poses the question “how radical can it be?” if too little focus is given to psychopathology and relevant diagnoses and asks whether therapeutic techniques can be justified in a person-centred approach. Whilst Glahn (2018) insists there is no evidence for exactly how the actualising tendency is to be accessed other than the use of the core conditions and argues there is no available mode of “treatment” for extinguishing obstacles to accessing it.
Wide ranging contemporary analysis of classical client-centred therapy continues to this day. New and exciting critiques of Roger’s theories are essential in positioning the person-centred approach as relevant and effective. However, the more radical and far-reaching developments at this stage come in the form of the growing tribes of person-centred psychotherapy (Warner, 2000). Nevertheless, these newer schools of thought represent some significant paradigm shifts most notably in relation to the levels of directiveness which are acceptable for them to be regarded as part of the tribe. It has been argued that it is “levels of interventiveness’ that distinguish the tribes (Warner, 2000, pp.31-33) or “primary and secondary principles” (Sanders, 2012, pp. 238-239). Both of these concepts appear to regard levels of non-directiveness as defining characteristics of the tribes.
For example, the sensitive process work of the experiential approach, categorised as a “Level 3” (Warner, 2000, p.31-33) enables clients to find the words to articulate the deeper meanings, felt senses and experiences within them with more of an individualistic approach. Whilst the encounter-oriented approach, categorised as “Level 2” (Warner, 2000, p.31-33) seeks to unify the three core conditions in order to offer a deep connectedness to the client. It explores not only the experiencing of the client but also the therapist in relation to the client, a less individualistic approach. Experiential therapy has grown from Gendlin’s (1962, 1974) theories on focusing, whilst encounter-oriented therapy, also known as ‘relational depth’ was developed by Mearns and Cooper (2005) and further refined by Knox, Murphy, Wiggins and Cooper (2013). Experiential and encounter-oriented therapy are just two examples of these ‘tribes.’
Pete Sanders book ‘The Tribes of the Person-Centred Nation’ (2012) articulates the evolution of the person-centred approach, providing a rich and diverse appreciation of the many other contributions such as ‘emotion-focused therapy’ and ‘existentially informed person-centred therapy.’ As Merry (2012) comments of person-centred therapy “with it’s emphasis on the qualities of the relationship between client and therapist, and its rejection of diagnostic assessment and labelling, it remains as radical today as it was in the 1940’s.”
Lisa Major PG Dip MNCS (Accred) Person-Centred Experiential Counsellor & Psychotherapist
www.sentiopsychotherapypractice.co.uk
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