This theory was put forward by an American psychologist Carl Rogers in the 1930s (minddisorders.com 1). Person-centered therapy is known by other terms which include client-centered, non-directive or Rogerian therapy. It is an approach to counseling and psychotherapy that focuses on the client during the treatment process without the therapist taking a directive role. In other words it emphasizes on the person in need of the therapy rather than the therapist. Person-centered therapy is aimed at increasing ones self-esteem and openness to experience. This kind of therapy seeks to enhance better self understanding, lower defensiveness, reduce guilty and insecurity, promote better relationships with others and freedom to express feeling as they occur.
Carl Rogers, the developer of the theory believed that therapy needs to take place in a supportive environment with close relationship between the client and the therapist. Rogers used the term client instead of patient to portray an image that both the therapist and the client are equals. With this therapy, the client decides how the therapy should be carried out while the therapist gives some clarifications to the client through the use of the informal questions. Person-centered theory became associated with the human potential movement contrary to other theories which depicted human beings as corrupt and selfish. This theory portrayed human nature as good and their behavior is motivated by the need to accomplish one's potential. Self-actualization is used in the person-centered therapy which refers to the act of human beings to move forward, grow and achieve their set goals. When human beings strive to achieve self-actualization, they normally develop concern for others and tend to behave in honest, dependable and constructive ways. Self-actualization emphasizes on human strengths rather than their weaknesses. Rogers claimed that self-actualization can be hampered by an unhealthy self-concept like developing negative attitudes towards oneself.
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Variations of personal-centered therapy have been developed recently. These are experiential therapy which was developed by Eugene Gendlin in 1979 and then the process-experiential therapy which was developed by Leslie Greenberg in 1993 (minddisorders.com 1). Rogers believed that what matters in this therapy are not the therapist's skills and training but his attitude towards administering the therapy to the client. Therapist need to possess congruence, empathy and unconditional positive regard in order to be successful in his/her therapy. Congruence refers to willingness of the therapist to relate to the client without withholding anything. The therapist needs to exercise openness and genuineness when interacting with the client to realize meaningful results. Therapists who exercise this attribute find themselves with vital feelings which they can share with their clients freely. However, congruence does not mean the therapist should disclose all his/her personal problems to the client.
Unconditional positive regard is where the therapist accepts the client totally without evaluating i.e. accepting him/her for who he/she is without considering certain feelings, characteristics or actions. The therapist communicates with the client without giving any advice, interrupting or judging him/her. This attitude helps the clients to feel free to share with the therapist their problems, hostile situations and painful experiences. Then the third attitude that should be exercised by the therapist when dealing with the client is the empathy where the therapist tries to understand and appreciate the client's point of view showing emotional sensitivity towards the client's feelings throughout the therapy period. The efficient way for a therapist to show empathy is through active listening to what the client is saying. Person-centered therapist employ a technique called reflection where he/she summarizes what the client has said. This enable the client to examine his/her own thoughts as they hear them repeated by another person. Rogers assures that when these three attributes are used by the therapist when conducting a therapy, clients feel free to relate with the therapist without any worry of what the therapist think of him/her.
Based on the principle of self-actualization, the person-centered therapy promotes personal growth. Rogers believed that the client knows what hurts, what directions to go, what problems are crucial and what experiences have been buried (person-centered-counseling.com 1). Person-centered therapy is aimed at improving one's self esteem, trust and increasing ability to learn and also to decrease defensives, guilty and insecurity. However, if the therapy is not successful the client will continue with self-defeating attitudes or rigid ways of thinking. The success of the person-centered therapy depends on the interest of an individual, the skill of the therapist and the client's level of comfort with the therapy. With this therapy, there is only one motivating force on a client which is the actualizing tendency (personcentered.com 1). The merits of person-centered therapy consist of enhanced understanding to have belief in oneself, decline in anxiety and feeling of panic, improved associations, decreased depression, and diminished guilty feelings (Iamindepression.com 1).
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Cognitive Behavior Therapy
Cognitive behavior therapy was developed by psychologist Aaron Beck in 1960s (minddisorders.com 1). This therapy is a combination of both psychological and social aspects that assume that bad thinking patterns also called cognitive patterns contribute to emotional responses and maladaptive behavior. Based on this therapy, the treatment focuses on changing the thoughts to solve both psychological and personality problems. Cognitive-behavioral therapy aims at changing client's bad behavior by cognitive restructuring which means scrutinizing assumptions behind the thought patterns and also by use of behavior therapy techniques. It treats mental problems like depression, eating disorders dissociative identity disorder, generalized anxiety disorder, insomnia and panic disorder. However, cognitive-behavioral therapy is not appropriate for all kinds of disorders. Patients with brain injury and those who are not willing to participate willingly are not good candidates for this kind of therapy. In cognitive-behavioral treatment, the therapists collaborate with the patient to determine the thoughts causing distress and later administer behavioral therapy techniques to alter the behavior. Patients may be holding to core beliefs called schemas that are not good and have negative consequences on the patient's functioning and conduct. For instance a person suffering from depression may have a social phobia since he is certain that he is boring and impracticable to love. This assumption is tested by the therapist who asks the patient about his friends and family who care for him and like his company. The therapist uses this information to change the patients mind and provide new model of thinking so that the patient can change his behavior pattern.
This therapy is normally administered in an outpatient setting by a skilled therapist. Therapists are psychologists, clinical social workers, counselors and psychiatrists. In order to assist patients scrutinize and change ideas and behaviors, cognitive-behavioral treatment therapists use several techniques. They include validity testing where the therapist conducting the therapy asks the patient to defend his beliefs and thoughts. If the patient is unable to produce enough evidence to support his beliefs, then his assumptions, the invalidity is exposed. Another technique is cognitive rehearsal where the therapist asks the patient to imagine a difficult situation met in the past and then collaborates with the therapist to cope with the problem.
Guided discovery is another technique where the therapist enquires from the patient a sequence of questions to guide the patient towards the realization of his/her cognitive distortions. Patients keep a diary of daily life, the emotions and thoughts around them. Then the therapist together with the patient reviews them to determine maladaptive thought pattern and how they influence behavior. The therapist may also ask the patient to do some homework assignments in order to encourage self-discovery and strengthen insights made in the therapy. Therapist uses role playing exercises to react to different situations allowing patients to model this behavior. Then there is use of aversive conditioning that seeks to lessen the strength of a behavior that is so difficult to change because the behavior is either customary or temporarily satisfying. The client is subjected to an unpleasing stimulus while thinking about the behavior in question. All these techniques are used by the cognitive-behavioral therapy therapist to change the behaviors of patients. For the therapy to be successful, a comfortable working environment is essential because it is a collaborative effort involving both the patient and the therapist. This therapy involves interactive session between the therapist and the patient where they come to know each other. Cognitive-behavior therapy is essential in treating bulimia nervosa, reduces cases of re-hospitalization, treating hypochondriasis, treating depression, insomnia and obsessive-compulsive disorder. It is being used to help criminal offenders change their behaviors (scumdoctor.com 1).
While person-centered therapy focuses on the client without the therapist taking the directive role, the cognitive-behavioral therapy uses a skilled therapist to administer the therapy where there is direct interaction with the patient. In person-centered theory, the term client is normally used to show that both the therapist and the client are equals while in the cognitive-behavioral theory, the term patient is used to indicate the therapist has got directive authorities over the patient. Both theories are used to alleviate a certain problem or disorder without necessary involving chemical or medical intervention. The two therapies are a means of saving a situation before it escalates thus saving the cost of treating it later.
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