Client-Centered Therapy

What Is Client-Centered Theory and Therapy?

Client-centered theory was originated by Carl Rogers more than five decades ago, at a time when the humanistic approach to psychology was evolving and clearly differentiated from the more analytical styles of that period.

The client-centered therapist shows respect in recognizing that the client is the expert, inherently capable of resolving their challenges in order to live a more complete and satisfying life (Cepeda & Davenport, 2006; Green, 2006).

Client-centered theory and therapy are not based on stages of development or steps of actions to take sequentially with the client; rather, they rely solely on the stance of the therapist to genuinely possess three key humanistic characteristics:

1. Empathy
2. Congruency
3. Unconditional positive regard

Furthermore, these three attitudes are manifested by the therapist and accessed during counseling sessions with the client, who is often experiencing a sense of incongruence, vulnerability, and anxiety.

It is essential to the theory of client-centered work that the client perceives and recognizes to some extent these therapeutic attitudes (Bozarth & Brodley, 1991). Table X-1 offers a more detailed explanation of each of the three elements that are central to the therapist’s behavior as client-centered.

In 1957, Carl Rogers hypothesized six conditions as “necessary and sufficient” to promote what he called constructive personality change in the individual (p. 241).

It is also suggested that as long the therapist is able to interrelate the three salient qualities discussed earlier (congruence, empathy, and unconditional positive regard), then at a minimum the client will experience positive growth (Snodgrass, 2007; Snyder, 2002).

Table X-2 represents the key principles of client-centred theory.

In addition to Rogers’ explanation of the client-centered approach in the helping profession, there have been many others who built on this original hypothesis by expanding its application.

One such contributor to this approach is Robert Carkhuff, who elaborated on the three core conditions by adding confrontation, immediacy, and concreteness, also noted as “facilitative conditions deemed essential for effective counseling” (Horan, 1977).

In this realm, these qualities or conditions parallel Rogers’s core conditions in the following way:

• Concreteness in empathetic understanding is about “being specific”
• Immediacy with congruence refers to “what goes on between us right now”
• Confrontation is seen as useful in “all three of Rogers’ conditions” (Brazier, 1996) as “telling it like it is” (Carkhuff, 1971, as cited in Horan, 1977).

Carhuff’s emergences in the client-centered approach are often seen as more active and direct than the original precepts and are recognized as qualities that further aid the helping process of the client.

The effectiveness of client-centered therapy is primarily dependent on the relationship between the client and therapist, whereby the therapist is completely aware of him- or herself in relationship to the client and the client is able to communicate unexpressed feelings and emotions that have caused confusion with his or her notion of self.

Ultimately, clients are able to experience on their own accord that they are loved and valued, which allows them to realize their fullest potential through self-actualization.

The Client-Centered Perspective Applied to Social Work

The conditions of client-centered theory match the fundamental values and skills of social work. The two have a historically organic relationship based on the shared belief and respect for the individual’s worth and dignity, autonomy, self-determination, and ability to improve whatever conditions exist through empowerment of the individual, group, or community.

The core skills used by social workers in purposeful relationships include empathy, respect (unconditional positive regard), and authenticity (congruence), which are also noted as the key elements/attitudes to the client centered approach (da Silva, 2005; Rooney, & Larsen, 2001).

The following case is presented to illustrate the use of the client-centered approach in social work.

In reviewing this case, we can see that the stance of the therapist was to establish a trusting relationship with the client using the three key characteristics of a client-centered approach. Throughout this relationship the social worker

• shows unconditional positive regard for the client by being warm, and nonjudgmental of the client’s presenting conflict;
• demonstrates empathy by being able to communicate an understanding through accurate reflection of the client’s feelings; and
• remains congruent even with expressing her own experience of Liz as lovable.

Through verbalizing unexpressed emotions, Liz succeeded in reconciling her feelings of despair over the role of caregiver versus her need to be loved and was able to fully realize her potential for happiness and achieve a greater and more fully integrated sense of self.

The Larger Perspective

Social workers can use client-centered practice in a multitude of settings, including family and couples counseling, group therapy, and the larger context of community work. In each of these settings, the therapist uses the three key skills to address each individual or member and his or her unique needs and concerns, ultimately facilitating an ideal scene from the present scene.

Conclusion

If there were a code of conduct for client-centered therapy it might read something like this.

Client-centered therapy focuses on the uniqueness of the individual by respecting, nurturing, loving, and fostering the fragmented aspects of the client’s notion of self while the therapist demonstrates and maintains an integrated sense of wholeness.

Client-centered therapy can be viewed as a significant precursor to other effective therapies that are intentionally directive, problem-solving, or behavior-changing in their focus. At a minimum, the client-centered approach is seen as significant in assisting the client to feel understood, loved, and fully integrated through establishing a safe, trusting, and reliable rapport with the therapist.