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Clinical Psychology
Spring 2015Kyle Stephenson
Overview – Day 10
•Phenomenological Theory•Client-centered techniques•Strengths and weaknesses•Related interventions
▫Gestalt therapy▫EFT
•Strengths and weaknesses•Evidence regarding efficacy
• Carl Rogers: originally a child clinician
• Phenomenology: an individual’s behavior is completely determined by his or her phenomenal field, or everything that is experienced by the person at any given point in time▫Phenomenal self =
“me”
Client Centered Therapy
Client-Centered Therapy
•Theoretical propositions▫Client’s experience as most important
factor in therapy Reliance on self reporting
▫Self actualization▫Behavior = goal directed attempts to
satisfy needs
Client-Centered Therapy
•The “self”: awareness of one’s being and functioning▫Primarily formed through interactions with
the environment and other people•Three possibilities following an
experience:▫“Symbolized” into some relationship to self▫Ignored because it is irrelevant to self▫Denied/distorted because it is inconsistent
to self
Overview – Day 10
•Phenomenological Theory•Client-centered techniques•Strengths and weaknesses•Related interventions
▫Gestalt therapy▫EFT
•Strengths and weaknesses•Evidence regarding efficacy
Client-Centered Therapy•Goal: be able to integrate wide range of
experiences into general sense of self-worth, releasing potential for growth
•“Principal condition”▫Complete absence of threat to self▫Rationale for atmosphere of client-centered
therapy
Creating the atmosphere• Empathy
▫Genuine understanding▫Basis for therapeutic relationship
• Unconditional positive regard▫Respect, complete lack of judgment
• Congruence*▫Expression of behavior, feelings, or attitudes
stimulated by client (even if negative)▫Clients respond favorably to genuineness and
honesty• Rogers in action
Specific interventions?
•Attitude vs. technique▫State of mind, not a set of techniques▫Non-directive, allow for client self
discovery▫Self-fulfillment and health emphasized over
pathology and symptoms▫Experience over empirical
Do’s and Don’ts•Therapeutic process IS
▫Acceptance▫Recognition▫Clarification▫Structuring
•It is NOT▫Advice & information▫Reassurance & persuasion▫Interpretation▫Diagnosing
Client-Centered Therapy
•Diagnosis▫Deemphasized/ avoided▫Impedes autonomy and self-actualization
This assumption needs scientific support▫Focused on feelings themselves, not
whether feelings are “correct”
Overview – Day 10
•Phenomenological Theory•Client-centered techniques•Strengths and weaknesses•Related interventions
▫Gestalt therapy▫EFT
•Strengths and weaknesses•Evidence regarding efficacy
Strengths▫Respect for clients as people
Self determination over biological determination
Freedom of choice▫Equal client/ therapist standing▫Less emphasis on the past
And more on presenting problems▫Shorter duration▫Emphasis on research?
Weaknesses▫Therapists cannot induce change; client
inner potential “released” Avolition? Unhealthy relationships?
▫Importance of individual therapist characteristics Idiosyncratic beliefs, personality,
interpersonal style▫Difficult to study
Vague, idiosyncratic concepts Little evidence that it’s better than other
therapies▫Effectiveness potentially limited for less
verbal, lower intellect clients No concrete changes to make
Overview – Day 10
•Phenomenological Theory•Client-centered techniques•Strengths and weaknesses•Related interventions
▫Gestalt therapy▫EFT
•Strengths and weaknesses•Evidence regarding efficacy
Humanistic- Existential Movement•Humanistic Perspective – related
theoretically to client-centered therapy (although sometimes hard to tell in practice!)▫Free choice & self actualization▫Unified, whole, unique beings▫Emphasis on health, not on sickness
Gestalt Therapy• Heterogeneous mix of techniques and ideas• Emphasis on the present and emotional
connection with the self• “Now= Experience= Awareness= Reality”• Nonverbal clues
•Gestalt therapy in action
Emotion Focused Therapy (EFT)
▫Integration of Gestalt and Client-Centered Therapy
▫Emotions are fundamentally adaptive▫Necessary for personal growth:
Acknowledgment/understanding of emotions Appropriate expression of emotions Self-regulation of emotions
▫Dysfunction = result of emotional impairment
Overview – Day 10
•Phenomenological Theory•Client-centered techniques•Strengths and weaknesses•Related interventions
▫Gestalt therapy▫EFT
•Strengths and weaknesses•Evidence regarding efficacy
Humanistic-Existential Movement•Strengths
▫Experience is more than just data – helps capture abstract aspects of human
experience that can be underplayed by other therapies
▫Choices and free will emphasized▫Focus on the now
Can see immediate change and facilitate powerful experiences in-session
▫Positive growth▫Emphasis on therapeutic relationship
It’s important in all therapies, but really receives attention here
Humanistic- Existential Movement•Limitations
▫Over-emphasis on emotions? Other factors are important, especially
behavior!▫“Phenomenal field” and other factors are
hard to define and measure▫Assessment de-emphasized
Difficult to have organized treatment without theories of disorders or specific treatment goals
▫Techniques vague▫Lack of comparative research
Overview – Day 10
•Phenomenological Theory•Client-centered techniques•Strengths and weaknesses•Related interventions
▫Gestalt therapy▫EFT
•Strengths and weaknesses•Evidence regarding efficacy
Efficacy – does it work?•Client-centered
▫Better than nothing, not better than other therapies
•EFT▫Better than nothing, difficult to know if
better than other therapies▫Much of the best work being done with
couples and with trauma survivors•Gestalt and others
▫???▫Some are largely anti-research
Take-Home• Client-centered therapy can be partly understood
as a response to psychoanalytic therapy• It focuses on the way in which people make
sense of the world and themselves, using a warm therapeutic relationship/environment to allow for exploration and growth
• Client-centered therapy has grown in many different directions, some of which seem promising
• These therapies generally seem better than no treatment, but it’s difficult to tell if they’re better than other therapies (especially CBT)