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STEPHEN JOSEPH believes client-centred psychotherapy is a misunderstood approach with profound significance.
THE profession of psychology has traditionally had an uneasy relationship with the profession of psychotherapy. However, times are changing and the British Psychological Society is now in the process of preparing a register of those psychologists who specialise in psychotherapy. Now seems a good time for an overview of personcentred theory - the rationale for the 'client as expert' and the implication this has for therapeutic practice, recent trends, and the evidence base for client-centred psychotherapy.
Most psychologists will already have briefly come across person-centred theory and client-centred psychotherapy at some point in their careers, perhaps as undergraduates studying personality or abnormal psychology. But person-centred theory and client-centred psychotherapy are often given only superficial coverage, and the full significance of the view that it is the client who knows best is often misunderstood.
Person-centred theory
Carl Rogers (1957) proposed six necessary and sufficient conditions that when present in a relationship lead to constructive personality development (see Box 1). Constructive personality change would occur only if all six conditions were present, and the more that they were present the more marked the constructive personality change of the client. When the conditions are fully present, the client feels accepted and valued, listened to and understood, not judged or pushed.
Rogers was saying that all psychotherapies are effective if the necessary and sufficient conditions are present: the conditions were an integrative statement and not a description of clientcentred psychotherapy as such. Certainly, the necessary and sufficient conditions outlined by Rogers describe the three core attitudinal qualities of the client-centred psychotherapist, their congruence, empathy and unconditional positive regard; but the fundamental idea of client-centred psychotherapy, and the aspect of theory that is most often misunderstood, is that these core attitudinal qualities are the interpersonal climate that foster what Rogers called the actualising tendency.
The actualising tendency is the foundation stone of person-centred theory and thus of client-centred psychotherapy. In person-centred theory it is thought to be the basic and sole motivation of persons, always resulting in growth, development and autonomy of the individual. In writing about the actualising tendency, Rogers (1963) states:
We are, in short, dealing with an organism which is always motivated, is always...