Client-centered therapy (CCT) was introduced by Carl Rogersâ€™ in the 1950s. He believed that clientâ€™s experiences and thoughts were important to understand and that the therapist should not make any assumptions. It is this style of therapy that shows empathy, forms trust, identifies boundaries, and supports the clientâ€™s emotions which are both positive and negative. This style of therapy allows the individual to reflect and allows a genuine, non-judgmental relationship and accompanies a more holistic approach (Eklund et. al., 2019; Shefer, Carmeli, & Cohen-Meit, (2017).
Using CCT, children are encouraged to express themselves openly, and in a manner and pace they feel comfortable using (Silk et al., 2018). The role of the therapist is to assume a supportive, nondirective position while projecting unconditional positive regard, empathy, and genuineness (Silk et al., 2018). Several techniques are applied when using child-centered therapy, including reflection, accurate empathy, active listening, and encouragement to discuss feelings (Silk et al., 2018). The open structure of the approach further encourages children to gain acceptance of their feelings and develop greater self-awareness (Silk et al., 2018). The original CCT manual highlighted the approach’s effectiveness on children suffering from anxiety and PTSD (Cohen et al., 2004). The unstructured nature of this approach allows the child to explore his or her emotions surrounding a traumatic event which ultimately allows for greater self-awareness, self-confidence, and acceptance surrounding the event.
This theory has been applied to teenagers by Isma and Nassima (2022). The authors did a study and noted that Carl Rogersâ€™s theory could assist in this population because teenagers do things in groups. The study found that in a group setting, teenagers could have the ability to express themselves and learn about themselves as a topic is discussed. This is how an individual grows, a â€œprocess of unguided guidance (Isma & Nssima, 2022).â€ Next, we can see that Carl Rogerâ€™s theory can also be applied by teachers helping kids and teens with learning disabilities with the humanistic theory. CCT evolved from humanistic theory (Yin, 2018). The teachers found that students did better after they could identify their problems instead of the teachers identifying it for them. This allows the individual to achieve positive change and further self-actualization.
This theory can be applied to a teenager with post-traumatic stress disorder. For example, a 13-year-old girl, was raised with her parents and witnessed her father hitting her mother and being verbally abusive. She often has nightmares thinking about the events and is afraid when her mother leaves the home as she believes her dad may attack her. When having this child in a therapy session it may look like this:
Practitioner: What is it you would like to talk about today?
Teenager: Iâ€™m stressed, I canâ€™t sleep, and my mom is making me come, and its not fair.
Practitioner: â€œSo, itâ€™s not fair, can you tell me why you think this?â€ â€œHow should it be?â€
Teenager: â€œMy mom is the one getting hit and bit and stayed with my dad for a long time, she is the one that needs help, not me.â€
Practitioner: â€œYou know, sometimes things can affect us without even knowing it. For example, if you were on the sidewalk and saw a car hit another car, I wonder what your reaction would be.â€
Teenager: â€œI donâ€™t know, I guess I would be shocked and I would hope they are ok, and I would see if they needed a phone to call for help.â€
Practitioner: â€œI see, so it is a normal instinct to want to help someone.â€ â€œI wonder how you might be feeling when you cannot help your motherâ€¦â€
With 70-90 percent of adults exposed to trauma in the United States, PTSD is a very common mental health disorder (Kaiser et al., 2017). CCP has been widely implemented in the adult population struggling with PTSD (Shea, 2022). In adults, the approach focuses on improving dignity, strength, and empowerment by fostering acceptance and promoting self-awareness (Kaiser, Wachen, Potter, Moye & Davison, 2017). As with other age groups, the therapist projects empathy, genuineness, and unconditional positive regard while using a supportive, non-directive approach (Kaiser et al., 2017). The non-directive approach allows the client to explore emotions comfortably without the risk of psychologically pushing the client (Slaughter, 2017). According to Rogers, environments where individuals do not feel understood and unconditionally accepted result in the sense of worthlessness (Slaughter, 2017). Left unchecked, distortions to self-concepts and incongruence occurs (Slaughter, 2017).
Therapy using the CCP approach offers the patient suffering from PTSD a relationship based on a deep empathetic understanding that views them with unconditional positive regard. Within this trusting environment, the patient feels accepted, validated, and empowered to grow toward healthy functioning and resolve traumatic experiences (Slaughter, 2017).
Client-centered therapy has also been utilized in the geriatric population. According to Bardach and Schoenberg (2018), primary care providers can use this approach to help facilitate change in the geriatric population. For example, when explaining to patients that they have high cholesterol and are concerned about coronary artery disease, the patient is educated about the findings. And it is the provider that guides the patient to develop goals from which they could benefit and enhance their life.
In conclusion, Rodgers and Tutor (2018) provide that for a practitioner to be successful with the application of this Rogerâ€™s client-centered theory, the practitioner must be: genuine, and empathetic, build trust and allow for a non-guided approach. With that in mind, there are three basic principles found within this therapy model, which include the therapist being â€œcongruentâ€ with the patient, providing â€œunconditional positive regardâ€ and showing empathy (McLeod, 2019). These principles can be applied by starting the visit off with a time expectation, on how long to talk, donâ€™t make any assumptions, clarifying what the patient is saying in your own words, allowing them to make the final decision, and focusing on what they are saying and be natural (McLeod, 2019). It is also important to identify if you feel that you may not be the best therapist for their situation.
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