Chapter 5 - Person Centered Therapy

Front 1

Carl Ransom Rogers

Back 1

Client-centered ther --> person-centered ther

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PCT - Theory of Personality

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all humans have one basic motivational force towards ACTUALIZATION -- motivates us

born with ORGANISMIC VALUING that lets us value positively the exps we see as enhancing our life -- regulate us

SELF CONCEPT includes our perceptions of what is characteristic of I or me, of our rlshps to others, to the world and the values attached to these perceptions. Devlp a need for POSITIVE REGARD for that self.

Coming to value need of love from others over our own organismic valuing makes us see and like or dislike our selves based on how other people see or like us (SELF REGARD). Learned self-regard means we can regard behaviours negatively that aren't actually experienced as unsatifying, like masturbating. Self-Regard: try to be the person that others see. This leads to CONDITIONS OF WORTH.

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PCT - Theory of Psychopathology

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more conditional the love of parents, the more likely pathology will develop; b/c of need for Self Regard kids begin to see their exps selectively in terms of their parent's conditions of worth.

As some exps are denied or distorted thre is INCONGRUENCE between what is being expected and what is symbolized as part of a person's self-concept.

Psychopathology reflects a divide personality.

As people live in a state of estrangement exps incongruent with the self as subceived as threatening. SUBCEPTION is the ability to discriminate stimuli at a lvl below what is required for conscious recognition. Use things like symptoms as dfs to stop threatening material from reaching consciousness.

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PCT - Ther. Rlshp

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ther. rlshp is the NECESSARY AND SUFFICIENT CONDITIONS FOR THER.

There are 6 conditions:
1. Relationship - obv there's one
2. Vulnerability - this motivates client to seek help
3. Genuineness - ther is feely and deeply themselves, and congruent
4. Unconditional Positive Regad: must give it to the client
5. Accurate Empathy - view client's world as if we were them
6. Perception of Genuineness - client must see ther as genuine

Front 5

PCT - Ther. Processes

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Client's Work - Rogers calls PCT NONDIRECTIVE b/c the client directs ther.

Ther's Work: Traditionally their work to increase client's consciousness was seen to be all a REFLECTION. "you feel"

CATHARSIS:

Client's Work - begin by avoiding emotionally laden exps; describe external probs, but in resp to pos regard and empathy, clients describe their feelings, but they are typically still past emotions and thus lacking in intensity. But as they get more comfortable they focus on the present.

Ther's Work - continually redirect client's attn to the feeling aspect of whatever is being discussed

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PCT- Ther Content - IntrApersonal Conflicts

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Anx and Defence - anx is the consequence of a divided life. Allow a gradual corrective emo exp to occur.

Self Esteem: Rogers calls this SELF REGARD and put the need at the core of intrapersonal probs; prob is that our concept of ourself is too meager to let us be all that we were born to be!

Striving for self esteem keeps us locked into trying to actualize self concepts created from our parents' confining conditions of worth. Dont strive for self-esteem but rather widen your conditions of self worth.

Responsibility - becoming resp means learning again to respond to our natural organismic valuing instead of the values of others; resp person is the actualizing person who moves from HETERONOMY to AUTONOMY.

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PCT- Ther Content - IntrEpersonal Conflicts

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Intimacy and Sexuality -
int = therapeutic and therapy is int. Need pos regard, accurate empathy and interpersnl genuineness

Communication - accurate empathy lets us express feelings to comm. properly; so comm prob is no longer a lang one but about caring.

Hostility - not inherent

Control: we let ourselves be controlled by others due to our conditions of worth

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PCT- Ther Content - Individuo-Social Conflicts

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Adjustment vs. Trancendence - must transcend acculturation process to be a whole person.But once congruent you can bepart of society.

Impulse Control - natural organismic valuing provides inherent regulation oer impulses. Once ppl feel good about who they are and aren't under constant stress to be what others want, they won't resort to overeating, drinking, or smoking to feel food for the moment or reduce stress. Acceptance of self begets control of impulses.

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PCT- Ther Content -Beyond Conflict to Fulfillment

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Meaning in life - meaning comes from actualizing our tendences to become all that we are intended to be.

Ideal ind - a fully functioning person, who shows organismic trusting, is open to new exp, not need to ruminate about decisions, and being opening indicates person is living in the present. FFP does not proces exp through structured categories but through EXISTENTIAL LIVING- people let the self and personality emerge from exp. Self is thus a rich, exciting, challenging and rewarding process.

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PCT - Practicalities

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Central focus in on SELF AUTHORITY mitigates use of psychometric tests and routine assessment.

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Motivational Interviewing - a major alternative

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Miller; "Rogers in new clothes" - MI; a person-centered, directive approach that enhances intrinsic motivation to change by helping clients explore and resolve ambivalence.

Combines elemnts of PCT style (warmth, empathy, egalitarian rlshp) and PCT technique (key questions, reflective listening).

Expands on PCT goals by incorporating therapist goals about desirable changes and by providing specific methods to move the patient towards behav change.

4 principles of MI-
1. Express empathy by using reflective listening to convey understanding of the client and express genuine care for person.
2. Develop discrepency btwn client's deeply held values and current behav. Change is motivated by the perceived discrepancy. Clients LITERALLY TALK THEMSELVES INTO CHANGING.
3. Roll w/ resistance by meeting if with reflection, not confrontation. Resistance is simply understood as clients voicing the status quo side of their ambivalence, and resistance is client's way of signaling ther should do something new.
4. Support

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Project MATCH

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1 of the largest psychotherapy outcome studies in history, 4 seshs on an early form of MI compared to 12 CBT and 12 sesh of 12-Step.. the briefer MI was jsut as effective at each follow up as the lengthier and more est other thers.

VERY EFFECTIVE FOR ETHNIC MINIORITIES AND RESISTANT CLIENTS.