Client-Centred and Humanistic Approaches

1A third force

By the 1950s two approaches dominated psychology: psychoanalysis, which saw people as driven by unconscious forces, and behaviourism, which saw them as shaped by rewards and punishments. A group of psychologists including Carl Rogers and Abraham Maslow proposed a "third force": humanistic psychology, which sees people as free, responsible and naturally inclined to grow. Rogers summed up a central paradox of his counselling: "when I accept myself just as I am, then I can change" (On Becoming a Person, 1961). This lesson looks at client-centred therapy and its humanistic relatives: Gestalt and existential approaches.

21. Rogers' theory of the person

Carl Rogers believed that every person has an actualising tendency, like a plant growing towards light. Children need positive regard (love, acceptance). When it comes only with conditions of worth, children learn to deny or distort experiences that do not fit what others value: a boy taught that "real men don't cry" may deny his sadness. The result is incongruence: a gap between the self he believes he is, the self he thinks he should be, and what he actually experiences (Figure 1). Incongruence produces anxiety, defensiveness and low self-worth.

Figure 1. Congruence in Rogers' theory: the closer the person a client believes he or she is (self-concept) comes to the person he or she feels they should be (ideal self) and to actual experience, the healthier the person. Client-centred counselling aims to increase the overlap.

32. Client-centred (person-centred) therapy

• Non-directive: the client chooses what to talk about and finds his or her own solutions; the counsellor does not interpret, diagnose or advise.
• The relationship is the therapy: the counsellor offers the three core conditions you met in Unit 9, congruence, unconditional positive regard and empathy, which allow the client to drop defences, accept denied experiences and become more congruent.
• Main technique: reflection. For example:

The counsellor neither reassures nor advises, but reflects the feeling, and the client moves deeper by herself. Rogers called clients "clients", not "patients", to stress that they are responsible, capable people.

43. Maslow's hierarchy of needs

Abraham Maslow (1943) proposed that needs form a hierarchy: physiological needs (food, water, sleep), safety, love and belonging, esteem and, at the top, self-actualisation. Lower needs must usually be met before higher ones motivate us. For counsellors, the practical lesson is clear: a student who is hungry, unsafe at home or isolated needs those problems addressed before talk of goals and growth will help. Evaluation: reviews have found little support for a strict order (Wahba and Bridwell, 1976); a study of people in 123 countries (Tay and Diener, 2011) found that the needs were linked to well-being everywhere, but people could experience belonging or respect even when basic needs were unmet.

54. Gestalt therapy

Gestalt therapy, developed by Fritz Perls, Laura Perls and Paul Goodman (1951), focuses on awareness in the here and now: what the client is feeling, thinking and doing in the present moment, including in the body. It aims to help clients finish "unfinished business", such as feelings never expressed to someone who has died. In the empty-chair technique, the client speaks to an imagined person in an empty chair and may then answer as that person. A version of this technique, used in emotion-focused therapy, helped clients resolve unfinished business with a significant other in a controlled trial (Paivio and Greenberg, 1995).

65. Existential approaches and logotherapy

The Austrian psychiatrist Viktor Frankl survived Nazi concentration camps, including Auschwitz. In Man's Search for Meaning (1946) he argued that the main human motive is the will to meaning, and that people can find meaning even in unavoidable suffering, through the attitude they take to it. His logotherapy helps clients discover meaning through work, love and courage in adversity. Irvin Yalom (1980) described four "ultimate concerns" that existential therapy explores: death, freedom (and responsibility), isolation and meaninglessness.

76. Evaluation

• Strengths: respect for the client's autonomy and experience; the core conditions have influenced every other approach, and research links empathy and positive regard to good outcomes; meta-analyses find humanistic-experiential therapies effective, broadly comparable to other therapies for depression and relationship problems (Elliott and others, 2021).
• Weaknesses: concepts such as self-actualisation are vague and hard to measure; non-directive work gives little structure for severe disorders such as psychosis, OCD or severe phobias; the emphasis on individual growth and autonomy reflects individualist Western values and may fit less well for clients whose decisions are shared with family and community; critics also call its view of human nature too optimistic.