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)