How Client-Centered Therapy Works

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Client-centered therapy, also known as person-centered therapy or Rogerian therapy, is a non-directive form of talk therapy where you act as an equal partner in the therapy process while your therapist remains non-directive—they don't pass judgment on your feelings or offer suggestions or solutions.

This approach was developed by humanist psychologist Carl Rogers during the 1940s and 1950s. Rogers is widely regarded as one of the most influential psychologists of the 20th century. He believed that people are the best expert on their own lives and experiences.

Rogers also suggested that people have a self-actualizing tendency, or a desire to fulfill their potential and become the best that they can be. His form of therapy was intended to allow clients to fulfill that potential by relying on their own strength to change.

Initially, Rogers called his technique "non-directive therapy." Much like psychoanalyst Sigmund Freud, Rogers believed that the therapeutic relationship could lead to insights and lasting changes in clients.

While his goal was to be as non-directive as possible, he eventually realized that therapists guide clients even in subtle ways. He also found that clients often do look to their therapists for some type of guidance or direction.

What Are the Key Concepts of Client-Centered Therapy?

Mental health professionals who utilize this approach strive to create the conditions needed for their clients to change. Client-centered therapy involves a therapeutic environment that is conformable, non-judgmental, and empathetic, which is achieved through three features:

• Genuineness and congruence
• Unconditional positive regard
• Empathetic understanding

By using these three techniques, therapists can help clients grow psychologically, become more self-aware, and change their behavior via self-direction. In this type of environment, a client feels safe and free from judgment.

"Client" vs. "Patient"

Rogers deliberately used the term "client" rather than "patient." He believed that "patient" implied that the individual was sick and seeking a cure from a therapist.

By using "client" instead, Rogers emphasized the importance of the individual in seeking assistance, controlling their destiny, and overcoming their difficulties. This self-direction plays a vital part in client-centered therapy.

Genuineness and Congruence

Client-centered therapists display genuineness and congruence with their clients. This means they always act in accordance with their own thoughts and feelings, allowing themselves to share openly and honestly.

This requires self-awareness and a realistic understanding of how internal experiences, like thoughts and feelings, interact with external experiences. By modeling genuineness and congruence, your therapist can help teach you these important skills.

Displaying genuineness and congruence also helps create a secure, trusting relationship between you and your therapist. This trust contributes to a feeling of safety, which may help you engage with therapy more comfortably.

Unconditional Positive Regard

Your therapist will show unconditional positive regard by always accepting you for who you are and displaying support and care no matter what you are facing or experiencing. They may express positive feelings to you or offer reassurance, or they may practice active listening, responsive eye contact, and positive body language to let you know that they're engaged in the session.

By creating a climate of unconditional positive regard, your therapist may help you feel able to express your true emotions without fear of rejection. This is often an affirming experience, and it may set the stage for you to make positive changes.

Empathetic Understanding

Your therapist will also practice empathy during sessions, acting as a mirror of your feelings and thoughts. They will seek to understand you and maintain an awareness and sensitivity to your experience and your point of view.

The goal is to help you build a rapport with your therapist and ensure that you feel fully understood. This may provide you with the environment you need to reflect on your own inner thoughts, perceptions, and emotions, which may offer unique insights you didn't have access to previously.

What Client-Centered Therapy Can Help With

Client-centered therapy may help people who are experiencing:

• Anxiety and psychosis
• Dementia
• Depression
• Mood disorders
• Negative thoughts related to post-traumatic stress disorder (PTSD)

Benefits of Client-Centered Therapy

Client-centered therapy may improve self-concept, which is your organized set of beliefs and ideas about yourself. Self-concept plays an important role in determining not only how people see themselves, but also how they view and interact with the world around them.

Sometimes, self-concept is congruent with reality. In other cases, self-perceptions are unrealistic or not in tune with what exists in the real world. While most people distort reality to at least a small degree, when self-concept is in conflict with reality, incongruence can result.

For example, imagine a young woman who views herself as uninteresting and a poor conversationalist despite the fact that other people find her fascinating and quite engaging. Because her self-perceptions are not congruent with reality, she may experience poor self-esteem.

What Is the Focus of Client-Centered Therapy?

Through the process of client-centered therapy, you can learn to adjust your self-concept in order to achieve congruence. The techniques used in the client-centered approach are all focused on helping you reach a more realistic view of yourself and the world.

Effectiveness

Several studies have shown that the techniques used in client-centered therapy are beneficial.

• Genuineness and congruence appear to lead to better outcomes, especially when they are used in school counseling settings.
• Unconditional positive regard is also effective, particularly at improving overall well-being for people with mood or anxiety disorders.
• Empathetic understanding appears to promote positive outcomes, especially for people experiencing depression and anxiety.

It's not clear if these factors alone are enough to promote lasting change in clients. Outcomes for clients may also depend on their perception of their therapist—if they don't see their therapist as empathetic, for instance, they may not experience positive results from treatment.

Things to Consider

For client-centered therapy to be effective, you need to be willing to share your internal experiences with your therapist without their direct guidance or advice. You will act as an equal partner during therapy, often determining the course of your sessions (though your therapist may also ask questions or seek clarification).

While client-centered therapy can help you gain the self-efficacy needed to feel comfortable leading the conversation, this may not be the ideal approach for everyone. Some people may find they prefer therapists who are more directive.

The relationship you and your therapist establish is also an important part of this form of therapy. If you don't feel understood by your therapist or don't feel safe and supported enough to share your thoughts openly, it will be more difficult to make progress.

How to Get Started With Client-Centered Therapy

Client-centered therapy can be delivered individually or as part of group therapy in both outpatient and inpatient settings. If you're looking for a therapist near you, you can ask your primary healthcare provider for recommendations.

During your first session, your therapist will ask about the problems you're facing and your reasons for seeking treatment. They may also go over how the therapy process works and answer any questions you may have, including those about billing and health insurance.

Throughout treatment, your therapist will encourage you to step into an equal role. They may reflect what you say back to you to make sure they understand the thoughts and feelings you're expressing. Overall, you'll be encouraged to explore the issues that are important to you, with your therapist offering support along the way.

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By Kendra Cherry, MSEd
Kendra Cherry, MS, is a psychosocial rehabilitation specialist, psychology educator, and author of the "Everything Psychology Book."

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