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Wednesday, September 23, 2015

The person centered theory developed by Carl Rogers

The person centered theory developed by Carl Rogers
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is one of the most popular in the fields of psychology, counselling and education. Person-centred theory offered a new way to look at individuals and their development, as well as how people can be helped to change. Fritz Perls is considered the foremost practitioner of gestalt counselling and psychotherapy (Cooper, O'Hara, Schmid & Wyatt, 2007). However, this method was influenced by other gestalt theorists preceding him. The word gestalt is a German term used to define a unique patterning in which parts are integrated into the perception whole. Gestalt psychology is concerned with perception and cognition, whereas gestalt therapy focuses on personality, psychopathology and psychotherapy (Woldt & Toman, 2005). This essay will firstly provide an overview of person-centred and gestalt therapy. Following is a discussion of the similarities and differences between the two theories. Next, is a critique of both theories including strengths and weaknesses of each and finally, a preference of one theory will discussed from both a personal and professional perspective.
The origins of person-centred therapy can be found in reaction to what Carl Rogers, a humanistic theorist, often called 'counsellor-centred therapy', in which the therapist administers tests, asks questions, and suggests courses of action for the client. Rogers's revolutionary approach took on subtle changes as using the term client instead of patient, and it was he who first called his approach 'non-directive counselling', later changing it to person-centred counselling as a means of emphasisng its positive focus on human capacities (Cooper et al, 2007). Therefore, Rogers and other humanists developed a theory based on the power of nurturing relationships that offer respect, acceptance, caring and warmth. It was believed, most likely erroneously, that these conditions were sufficient for change to take place. Although this may sometimes occur, there is often much more help needed to move people toward constructive action (Wilkins, 2010). Consequently, the central hypothesis of the person-centred approach is that individuals have within themselves vast resources for self-understanding and for altering their self-concepts, behaviour and attitude towards others. These resources will become operative in a definable, facilitative, psychological climate. Such a climate is created by a psychotherapist who is empathic, caring and genuine (Parrot, 2003).
Empathy, as practiced in the person-centred approach, refers to a consistent, unflagging appreciation of the experience of the client. It involves a continuous process of checking with the client to see if understanding is complete and accurate. It is carried out in a manner that is personal, natural and free-flowing; it is not a mechanical kind of reflection or mirroring. Caring is characterised by a profound respect for the individuality of the client and by unconditional, non-possessive regard. Genuineness is marked by congruence between what the therapist feels and says, and by the therapist's willingness to relate on a person-to-person basis rather than through a professionally distant role (Mearns, 2007).
This theory believes helping should best take place by focusing on unexpected expressed feelings, clarifying what a person experiences, and helping him or her to feel understood. The goal is to create greater self-awareness and self-responsibility as well as to help people become more congruent and authentic. Rogers and his proponents believed that most helping efforts, whether in education, counselling or any human service, take place in a relationship that is trusting and respectful. Emphasis is placed on the process of learning as well as the outcome. This means that considerable attention is not only directed toward what people are talking about and whether goals are reached, but also how people feel and perceive the experience (Fall, Holden & Marquis, 2010).
The origins of gestalt therapy are found in three Germans whose work Fritz Perls studied: Wertheimer, Koffka and Köhler. Perls saw an individual's perceptions in terms of the gestalt dichotomy of figure-ground and established his theory on that premise. Gestalt therapy is a system of psychotherapy that is philosophically and historically linked with gestalt psychology, field theory, existentialism and phenomenology. Perls, his wife Laura and their collaborator, Paul Goodman, initially developed and described the basic principles of gestalt therapy (Woldt & Toman, 2005). Gestalt therapists focus on contact, conscious awareness and experimentation. There is a consistent emphasis on the present moment, that is, how people are experiencing their bodies, internal reactions and perceptions of others right now at this moment; and the validity and reality of the client's phenomenological awareness and assumes a more direct practical application. It combines features from some of the other therapies, especially with regard to dealing with unfinished business but stresses more active strategies for helping people become more integrated and high functioning. Most of the change that occurs in gestalt therapy result from an I-Thou dialogue between the therapist and client, and gestalt therapists are encouraged to be self-disclosing and candid, both about their personal history and about their feelings in therapy (Hycner & Jacobs, 2003). Role playing is a common strategy employed, in which the client acts out scenarios in an attempt to come to terms with a conflict. Quite a number of other practical helping strategies were developed from this approach, many of which have now become standard operating procedure for any of the helping profession. The techniques of gestalt therapy include focusing exercises, enactment, creative expression, mental experiments, guided fantasy, imagery and body awareness. However, these techniques are relatively insignificant and are only the tools traditionally employed by gestalt therapists. Any mechanism consistent with the theory of gestalt therapy can and will be used in therapy (Capuzzi & Gross, 2007).

Gestalt therapy and person-centred therapy share common roots and philosophy. Both believe in the potential for human growth, and both believe that growth results from a relationship in which the therapist shows warmth and authenticity (congruence) (Parrot, 2003). Both person-centred and gestalt therapy are phenomenological therapies that work with the subjective awareness of the client. However, gestalt therapy phenomenology is an experimental phenomenology. The client's subjective experience is made clearer by using awareness experiments. These experiments are often similar to behavioural techniques, but they are designed to clarify the client's awareness rather than control his or her behaviour (Corsini, & Wedding, 2005). In addition, both person-centred and gestalt therapy are focused on the "here-and-now", that is, the present problems and issues, as opposed to psychodynamic/psychoanalytic therapy, which explores the client's past (Corey, 2009).
Gestalt therapy has become more like the person-centred approach in two important ways. First, gestalt therapists have become more supportive, compassionate and kind. In addition, it has become clear that the therapist does not have an 'objective' truth that is more accurate than the truth the client experiences (Capuzzi & Gross, 2007). Another key similarity between both therapies is that the process goals of counselling are embedded in the experience of the client and the therapist learning, signifying an 'experiential' approach to counselling (Houston, 2006; Mearns & Thorne, 2007). On the other hand, this similarity denotes another difference. The central focus of the person-centred therapy is the client, whilst the therapist takes a 'back seat' approach to understand and learn about the client as he or she moves towards self-actualisation. The therapist provides the client with support and displays empathy, unconditional positive regard and unbiased or non-judgmental feedback. The therapist guides the client to decide what their goals of therapy are and explore options instead of making suggestions, whilst the therapist maintains their support and understanding. The therapist also reflects back and clarifies their understanding of the client's presenting problem (Mearns & Thorne, 2007). On the contrary, a gestalt therapist will take a much more active approach. In gestalt therapy, the therapist works together with the client in collaboration as they explore and learn about the client. This method presents the assumption that the individual is responsible for their actions and behaviour. By utilising various techniques, a gestalt therapist will assist the client to make the connection between how their behaviour and actions have affected any problems that they are dealing with. This assumes a more confrontational approach and it is the responsibility of the therapist to avoid doing more harm than good as the client comes to terms with these 'confrontations', or risk losing the client at any expense (Houston, 2006).
Gestalt therapy provides an alternative to the non-directive approach of Carl Rogers. A person-centred therapist completely trusts the client's subjective report whereas gestalt therapy uses focused awareness experiments and personal disclosure to help clients enlarge their awareness (Fall et al, 2010). Yet still, both therapies emphasise the importance of not interpreting the client's views as no-one but the client knows themself better. Person-centred but also gestalt therapy value accurate empathy, congruence and genuineness; though gestalt observes body language and brings into awareness somatic responses such as fidgeting or nail biting, giving voice to these actions. Each method focuses on internal causes rather than external and are indicative of great respect for client autonomy (Corsini & Wedding, 2005).
Perhaps Rogers's greatest strength is his unequivocal respect for persons, his insistence on viewing people holistically and as purposeful, and his reliance on his clients. No theorist before Rogers had the confidence to step outside the role of expert and to place trust and responsibility in the hands of clients. But while Rogers is commended for emphasisng the person, therapy students will question how clients can supply accurate self-appraisals (Cooper et al, 2007). Critics say Rogers is naively optimistic but he argues therapists make a mistake when they assume to know what clients are thinking of or why they act in a certain way. However, there are times when even under good circumstances, clients are unable or unwilling to supply the therapist with accurate information for these judgments (Mearns, 2007). In turn, this leads to an even weightier critique of Rogers's basic assumption: that people are basically good and we are the sole masters of our own destiny. Personal wholeness assumes primacy; it becomes a moral imperative, possibly at the expense of appreciation of our responsibilities to others. With the self assuming a positive of importance, Rogers's individualistic and relativistic philosophy can lead to inflated notions of the self (Corsini & Wedding, 2005).

Person-centred therapists offer the same basic conditions to all prospective clients. These conditions do not include psychological tests, history taking or other assessment procedures leading to diagnoses and treatment plans. Diagnostic labels take away from the person of the client; assuming a professional posture takes away from the person of the therapist. The therapist's task is uncluttered by the need to be an expert (Parrot, 2003). Rogers (1946, as cited in Cooper et al, 2007) expressed his belief in the strength of clients and his view of the facilitative role of the therapist,
We have to recognise that if we can provide understanding of the way the client seems to himself at this moment, he can do the rest. The therapist… must concentrate on one purpose only: that of providing deep understanding and acceptance of the attitudes consciously held at this moment by the client as he explores step-by-step into the dangerous areas which he has been denying to consciousness. (p. 226)
A consequence of this position is that the person-centred approach has been used with individuals diagnosed by others as psychotic or mentally challenged, as well as with people simply seeking a personal growth experience. Many practitioners do not agree that it is preferable to dispense with interpretations and rely wholly on genuineness, empathy and unconditional positive regard (Cooper et al, 2007).
Person-centred theory may suffer most from the fact that it seems so simple to learn. The concepts are relatively few, no long lists to remember and there are no specific tactics to recall for each diagnostic problem a client might have. Moreover, person-centred therapy does not place enough emphasis on problem-solving techniques. An integrated practice should incorporate experiential, cognitive learning and process-oriented learning, in which would run counter to person-centred theory (Wilkins, 2010). Success of the therapy depends on practitioners maintaining high trust in the feelings and actions of clients and themselves. A lack of trust often causes practitioners to fall back on safe, passive reflection responses. These are necessary early on but they become increasingly inadequate as the need for a more comprehensive therapeutic relationship develops - a relationship that includes the directness that comes with additional culturally, situationally, and personally relevant feelings and interactions (Mearns, 2007). The few basic concepts in person-centred theory virtually have unlimited complexity because counsellors and therapists must be fully aware of their clients' and their own changing phenomenological world. They must respond to the interactions between these worlds in a way that best fit the genuine nature of their clients and themselves. This is a difficult task that requires an excellent understanding and continuing awareness of oneself and the client (Cooper et al, 2007).
The impetus given to psychotherapy research by the person-centred approach has resulted in substantial evidence demonstrating that changes in personality and behaviour occur when a therapeutic climate is provided. Two frequent results of person-centred therapy are increased self-esteem and greater openness to experience (Mearns & Thorne, 2007). When Carl Rogers began his journey in 1940, psychotherapy was a field dominated by individuals who practiced in a manner that encouraged a view of themselves as experts. Rogers created a way of helping in which the therapist was a facilitator of a process that was directed by the client. More than half a century later, the person-centred approach remains unique in the magnitude of its trust of the client (Capuzzi & Gross, 2007).
Gestalt therapy has pioneered many useful and creative innovations in psychotherapy theory and practice that have been incorporated into the general psychotherapy field. Now gestalt therapy is moving to further elaborate and refine these innovations. Regardless of label, the principle of existential dialogue, the use of direct phenomenological experience for both the client and therapist, the trust of organismic self-regulation, the emphasis on both awareness and experimentation, the paradoxical theory of change, and close attention of contact between therapist and client all form a model of good psychotherapy that will continue to be used by gestalt therapists and others (Woldt & Toman, 2005). Gestalt practice, when true to its principles, is a protest against the reductionism of mere symptom removal and adjustment; it is a protest for a client's right to develop fully enough to be able to make conscious and informed choices that shape his or her life (Fall et al, 2010). Since gestalt therapy is so flexible, creative and direct, it is very adaptable to short-term as well as long-term therapy. The direct contact, focus and experimentation can sometimes result in important insight. This adaptability is an asset in dealing with managed care and related issues of funding mental health issues (Parrot, 2003).
A positive contribution of gestalt therapy is the emphasis on the clients' inherent wholeness and capacity for self-awareness; helping clients use focused awareness of their own to free up energy for health and growth. In gestalt therapy, any activity that contributes to clients' awareness of self, others and their experience of the larger world is considered useful. An appealing feature of gestalt therapy is its holistic nature (Hycner & Jacobs, 2003). Another is the application of dialogue in counselling relationship. Dialogue provides contact between the client and therapist and is used to engage clients rather than manipulate or control them. There has also been emphasis on the therapeutic process instead of relying solely on techniques (Houston, 2006). During the 1960s gestalt therapy was known for its treatment of individuals who were primarily constricted, anxious and/or depressed, in conflict with themselves and with serious pathology. Although gestalt therapy was and still is quite effective with this population, its effectiveness and safety is not limited to such individuals. In fact, gestalt therapy may well be the treatment of choice for some personality disorders, e.g. borderline personality disorder (Capuzzi & Gross, 2007).
Similar to person-centred, gestalt therapy isn't without its limitations either. A novice counsellor or therapist might be inclined to use such gestalt techniques as empty chair, figure-ground, locating feelings, etc. without sufficient practitioner training. The techniques may be of little value to the client (Houston, 2006). In addition, the intense emotional responses that some gestalt experiments evoke can be harmful to the client if misused or abused by an inexperienced therapist. Perls' here-and-now orientation could limit the freedom that a therapist might like to use in exploring the history of an issue, problem or concern more fully (Corsini & Wedding, 2005). According to Yontef (1993, as cited in Woldt & Toman, 2005), some practitioners believe the client's cognitive process is important, yet many gestaltists tend to deemphasise cognition and focus more on feeling. Furthermore, Perls' work is seen as a collection of various theories like Freud and Jung, yet Perls seldomly credits them for their contributions. Despite these limitations, in the 1960s when Fritz Perls prophesied that gestalt therapy would come into its own during the coming decade and become a significant force in psychotherapy during the 1970s. His prophecy was more than fulfilled (Fall et al, 2010).
Person-centred and gestalt therapy are both highly effective and popular in their own unique way. However, as a novice counsellor, the choice of preference would be the person-centred therapy. As person-centred therapy doesn't have any specific techniques, from a professional perspective it would be easier to practice than gestalt therapy. To attempt to use some of the gestalt therapy techniques such as empty chair or dream works may be more damaging to the client instead of being useful if the counsellor has inadequate training (Houston, 2006). Although empathy, unconditional positive regard and congruence are not necessarily easy to demonstrate whilst working with a client, for a novice counsellor it would be more effective for the client and would also build on the counsellor's confidence. Unlike gestalt therapy, focusing on the client's thought process would be important during the change process. As we are the master of our own destiny, from a personal perspective, as the client travels through their journey they are in control of their situation while the counsellor joins them but as a facilitator of the change process therefore, can move forward on their own towards self-actualisation (Cooper, 2007).
Person-centred therapy and gestalt therapy are both unique and influential methods in the field of psychotherapy and have been for more than the last half of the century. After analysing each method, it can be seen that they share some common similarities including their belief in a client's potential for growth and the qualities of the therapist. There are also some differences between the two therapies such as their change process and intervention methods. Through critical analysis, like the many other methods of psychotherapy, person-centred therapy and gestalt therapy each have their own strengths and flaws. Based on these findings and with each method providing a good case, as a therapist the preferred choice of therapy is the person-centred therapy. Both therapeutic methods are still extensively used by practitioners and soughted by individuals (Corsini & Wedding, 2007).

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