Client/Person-Centered Therapy – Flashcards

Philosophically grounded in the belief that the individual is an autonomous & sovereign self

is formed by means of reactions to interactions with the environment, especially experiences with others a. External world, like the individual, is constantly changing b. The individual is adapting & interpreting this perception of the external world in such a way to promote personal integration and fit with the environment

for the individual is constructed from phenomenological activity (epistemological/private world) i. "Reality" is the experienced relationship between the external field and internal interpretation; therefore defining our understandings of self and the context ii. Reactions to reality are conceptualized as an organized whole iii. The perceptual process (phenomenology) searches (and offers) meaning and order in understanding(s) of self and the world b. Each person posses her/his own experience, and therefore, needs to be seen in her/his particular context c. Within experiences, all organisms are motivated to move towards one's own unique potential (Actualizing Tendency, i.e., energy force to maximize self-defined potentials which form more complex, differentiated, & integrated life structures throughout the lifespan) i. People naturally follow the road to their own potential (i.e., no negative tendencies) which are directed towards self autonomy and independence ii. All feelings are valid (e.g., anger fits within certain personal contexts) 1. Categories and intensities of emotions are related to personal reality and personal definitions of significance of prompting conditions d. We are the best experts on ourselves e. Have need for positive regard from external forces in nature (other beings) i. Without which we recreate self (actualizing energy) that does not align with the core conditions of self (not nature to self-concept)

a. Defined as the manner that the individual integrates all perceptions into the me, I, my experiences b. Juxtaposed to the Self is the Ideal Self, to the extent that the external influences are out of synch with our actualizing tendency, and we are forced to live with conditions of worth that are out of step with organismic valuing (internal), and receive only conditional positive regard and self-regard--the concept of self that you would like to be (to be valued by others, which is natural) c. This gap between the Self and the Ideal Self -- the "I am" and the "I should" -- is called incongruity. The greater the gap in one's sense of self, the more incongruity which in turn provokes more suffering (incongruity, for Rogers, is the basis for neurosis/psychic distress)

process the individual uses to become aware of consciousness/experiences.

6. Personal values & decisions are formulated through the self-structure; although specific to the individual, there are some generalized models for decisional choice and universal values of humans: a. Values (general) i. People are inherently good ii. People want love iii. People are creative and responsible b. Internal Locus of Evaluation - conscious decisions that you make about what is good/not good for you, based on your own values, etc., not on what others think i. Making decisions based on Conditions of Worth (i.e., messages from others and world that define for us what would make us "worthy") is external locus of evaluation ii. We have tendencies to distort/deny experiences that we see as not bringing us positive regard, that don't satisfy the conditions of worth c. Organismic Valuing Process which helps us to make judgments about what is good for us & not good i. Biologically, psychologically influenced ii. Driven by the actualizing tendency

are generally consistent with the self-structure a. In cases whereupon experiences are brought to the individual outside of her/his self-structure, behaviors are not "owned" by the individual

• Congruence - perceptions of self are harmonious with experiences and relationships o Harmony between real self and ideal self • Open to experience - no distortion or denial is necessary, perception of them is accurate • Have internal locus of evaluation o Under these conditions, the Self is more empathetic & accepting of experiences and others • Accept full responsibility for own actions o Self-directing, works toward positive experiences o Creative & take risks in life o Aware of their impulses o Positive self-concept (unconditional self-regard) • Minimal external conditions of worth o Authenticity in expression of self, including feelings • See life as a process, not as a destination, flexible sense of self • Trust self to follow right path, follows the Organismic Valuing Process • Living in harmony with culture/society (get own needs met and work with society) & living in the present • Moving/growing toward full potential

• Perceptual distortion - reinterpreting the situation so that it appears less threatening (i.e., not symbolized accurately, lack of congruence) o Creation of psychological tension b/c of the disintegration of how one understands the self and these presenting experiences from the external world/others o Perceived threat to the self-structure o Manifests in forms of defenses, denial, poor self-regard, does not accept responsibility, does not trust self, not creative, doesn't take risks, subception (failure to fully perceive experiences), lives in the past, disorganized thinking and decision making, anxious and protective self concept, & not open to new experiences • Have external locus of evaluation, concerned with what others think, & doesn't value Organismic Valuing Process • Self-structure is damaged b/c not aware of who self really is because of looking at self based on external conditions of worth • Actualizing and self-actualizing tendencies become divorced from one another

• In therapy, a congruent therapist who provides unconditional positive regard and empathetic understanding will stimulate client change (given the client perceives and receives these messages) • Move from incongruence to congruence, eliminate/diminish Conditions of Worth • Awareness and acceptance of all of one's experience o Loosening up stuck feelings o Becoming aware of aspects of self that are denied or distorted (masks) • Able to know one's real Self (versus reliance on the Ideal Self) • In touch with the natural Organismic Valuing Process, using an internal locus of evaluation • Able to communicate authentically (removing mask[s]) • Moving toward full potential • Identifying and working through resistance • 7 stages of change • Corrective emotional experience - being in a relationship with someone who fully accepts you -> increased self-acceptance -> move toward actualization

• Necessary and sufficient are the three qualities; if embodied (by counselor) and experienced (by client), then the client will improve, even if no other special "techniques" are used. If the therapist does not show these three qualities, the client's improvement will be minimal, no matter how many or what "techniques" are used; they are as follows: o Congruence - genuineness, honesty with the client (by counselor) o Unconditional positive regard - Counselor shows complete acceptance and caring for client, prizing o Empathy - able to experience the client's world as if you are the client o Less developed 4th condition - transcendence, connected with client • Process of psychotherapy: o Therapeutic relationship and each session is initiated with the client defining the terms and topics o Note: Rogers originally called therapy non-directive, because he felt that the therapist should not lead the client, but rather be there for the client while the client directs the progress of the therapy. As he became more experienced, he realized that as "non-directive" as he was, he still influenced his client. The goal is to facilitate & not guide direction, content, etc. • Selected techniques (although not a technique driven theory): o Reflection is the mirroring of emotional communication: If the client says "I feel like shit!" the therapist may reflect this back to the client by saying something like "So, life's getting you down, hey?" By doing this, the therapist is communicating to the client that he or she is indeed listening and cares enough to understand o Paraphrasing verbalizations, paraphrasing nonverbal messages, self-disclosure, expressing emotions • Applications: Individual counseling, play therapy, group counseling, classroom teaching, etc.

• Too much emphasis on individual, very little attention to culture, family, and their effects on people's lives and behaviors • Sees only the positive - rose-colored glasses • Individual must change, the unhealthy environment not asked to change • Does not attend to how social structures can oppress people • May be inappropriate for person in crisis or for someone with moderate to severe mental illness • Self-disclosure may not be culturally accepted • No diagnosis or assessment • Can we truly be unconditional in our regard for others? • No cognitive or behavioral change processes—core conditions are seen as necessary and sufficient • Concepts can be difficult to measure o Ambiguous or inconclusive research support

Once again we come across a counseling theory that doesn't give us much information by way of technique, it is more framework for how to view the client, their innate abilities, and being with that client as they approach self-actualization and reach their full potential. Understanding of this theory is paramount, however, because of the importance it places on the relationship between the counselor and client. Wampold (2001) cites that 1% of change in counseling emits from a particular technique, but the vast majority positive outcomes are attributed to the relationship formed between the client and counselor.

1. What is the concept of this technique? By facilitating a warm, open, nonjudgmental relationship, clients can feel trust, congruence, and empowerment within the session, paving the way for further self-actualization. 2. How does it relate to the theory? Rogers believed that a person is comes equipped with the necessary psychological tools to handle their own problems. Furthermore, Walker (1956, also on pg. 173 in text) compares Rogers' understanding of the human psyche to that of the philosopher Rousseau: "every man comes from the hand of his Maker a perfect being, this pristine splendor is corrupted...by an imperfect society". Of course, Rogers argued that the impetus of his theories were rooted in his experiences in psychotherapy, not is exposure to Rousseau. The comparison is nevertheless of value. So we see that creating conditions that allow clients to realize this nature improves the chances at self-actualization. 3. Counselor statements using this technique: As previously stated, this technique is rooted in how the therapist views the client, and then how the therapist presents this view through his or her actions towards to client, and statements are difficult to pin down. In fact, the more you talk in session, the less you are able to listen, and this can be a detriment of the relationship. Here are some things I like to say when establishing a therapeutic relationship: - "I want you to know that I view you (the client) as the expert on you. I've just met you and want to learn from your experiences." - "The experience you describe sounds quite difficult to cope with, yet you are coping. Can you explain to me how you are coping with this experience?" Remember, these are just generic statements. The true formation of the relationship comes from how you act towards the client. If you view yourself as the expert, simply disseminating interpretations and new ideas to the client, this impedes self-actualization and a trusting relationship.

1. What is the concept of this technique? Once again, these are not techniques per say, but rather elements of the counseling relationship that must be acknowledged in order for change to manifest. a. Counselor-client psychological contact: the relationship must exist. b. Client Incongruence: the incongruence that exists between the client's experiences and the awareness of these experiences c. Counselor congruence, or genuineness: The therapist is congruent with the client in the relationship, they are deeply involved in it and are not acting. d. Unconditional Positive Regard: accepting the client unconditionally, without judgment or disapproval, experiencing the client as a having the potential to cope with their own distorted view of self-worth. e. Empathic understanding: Counselor experiences the client's internal frame of reference with an empathic understanding . f. Client participation: The counselor communicates congruence, unconditional positive regard, and empathy in a way that the client genuinely experiences them. 2. How does it relate to the theory? The person-centered counselor has the goal of creating a psychological environment that is facilitative towards the self-actualization of the client. Through self-actualization, the client can experience lasting and meaningful changes in their lives. Examples strategies include:

What is the concept of this technique? Open questions encourage the client to respond. They typically begin with what, how, and could. Where closed questions only require a limited response and often begin with is, do, or are. 2. How does it relate to the theory? Open ended questions allow clients to explore patterns in their lives that have gone unnoticed. The ability to empathize is especially important in this process, the counselor must be able to feel what it is like to be the client. This is accomplished by listening to the client and how they respond to the open ended questions. This technique lends itself to the self-actualization process and allows the counselor to see the perspective that the client has about themselves and their lives. 3. Counselor statements using this technique and theory: • What brings you to see me? • How are you feeling today? • What would you like to talk about?

1. What is the concept of this technique? In reflection of feelings, the counselor must be able to discriminate clients' feelings, hear accurately what messages they are sending, and reflect the deeper meanings that they are attempting to communicate. This does not mean merely repeating what the client says. It is grasping the more subtle messages of clients and reflecting the feelings along with the content. 2. How does it relate to the theory? The person-centered approach emphasizes understanding clients from an internal frame of reference. Reflecting the client's feelings can lead to accurate empathetic understanding, a core concept in person-centered theory. Empathetic understanding allows for the counselor to perceive the internal frame of reference of another by grasping the person's subjective world. 3. Counselor statements using this technique and theory: • It sounds like you are feeling frustrated. I hear a lot of anger when you talk about your husband. • I sense that you feel undervalued. That no one listens to you. Is that correct? • I hear a sadness in your voice. And you are saying you feel unloved.

congruent therapist is one who provides unconditional positive regard and empathy, therefore stimulating change in a vulnerable person to become more congruent with one's potential (which is creative, responsible, developing individual). The CCT provides a therapeutic atmosphere that is real, caring, and nonjudgmental the person can develop to their full potential.

Self (or self-structure) Symbolization Congruence Actualizing Tendency Necessary and Sufficient (non-)Conditions for Change

Structure of the self: manner that the individual integrates all perceptions into the me, I, my experiences (from environment) Phenomenological relationship between the external field and internal interpretation as organized whole Symbolization We are the best experts on ourselves Have need for positive regard from external forces in nature (other beings)

Defined: self-defined sense of what is good/not good for self, based on your own values, etc., not on what others think Making decisions based on Conditions of Worth (i.e., messages from others & world that define for us what would make us "worthy"); leads to external locus of evaluation (and perceptual distortions about world) Organismic Valuing Process helps us to make judgments about what is good for us & not good Biologically, psychologically influenced Driven by the actualizing tendency

Ideal self Gap between the Self and the Ideal Self -- the "I am" & the "I should", called incongruity. The greater the gap in one's sense of self, the more incongruity which in turn provokes more suffering Forced to live with conditions of worth that are out of step with organismic valuing (internal), and receive only conditional positive regard and self-regard--the concept of self that you would like to be (to be valued by others, which is natural)

Define: perceptions of self are harmonious with experiences and relationships Harmony between real self and ideal self Open to experience - no distortion or denial is necessary, perception of them is accurate Have internal locus of evaluation Under these conditions, the Self is more empathetic & accepting of experiences and others Accept full responsibility for own actions Self-directing, works toward positive experiences Creative & take risks in life Aware of their impulses Positive self-concept (unconditional self-regard) Minimal external conditions of worth Authenticity in expression of self, including feelings See life as a process, not as a destination, flexible sense of self Trust self to follow right path, follows the Organismic Valuing Process Living in harmony with culture/society (get own needs met and work with society) & living in the present Moving/growing toward full potential

Defined: energy force to maximize self-defined potentials forming complex, differentiated, & integrated life structures throughout the lifespan We naturally own potential (i.e., no negative tendencies) as directed towards autonomy & independence All feelings are valid (e.g., anger fits within certain personal contexts) Categories and intensities of emotions are related to personal reality and personal definitions of significance of prompting conditions

3 qualities if embodied (by counselor) and experienced (by client) then the client will improve Congruence - genuineness, honesty with the client (by counselor) Unconditional positive regard - Counselor shows complete acceptance and caring for client, prizing Empathy - able to experience the client's world as if you are the client Less developed 4th condition - transcendence, connected with client

1)individual is center of a continually changing world of experience 2)Organism reacts based on their reality 3)Organism reacts as an organized whole 4)Organism has one basic tendency-actualization 5)Behavior is goal directed based on perception of reality 6)Emotion accompanies and facilitates goal directed behavior 7)Best point to understand behavior is from the individual's frame of reference 8)Part of the perceptual field is differentiated as the self 9)Self is formed through interaction 10)Values come from experience and introjection from others 11)Experiences are integrated, ignored or denied 12)Behavior is generally consistent with self concept 13)Behaviors inconsistent with self concept can occur but are seen as "not owned" 14)Psychological maladjustment comes from denied experiences 15)Psychological adjustment occurs when experiences are assimilated 16)Inconsistent experiences are threats 17)Under the right conditions inconsistent experiences can be examined and assimilated 18When the individual integrates in all of their experiences they are more understanding of others 19)As experiences are integrated an internal locus-of-evaluation develops