1. Clinical Psychology Spring 2015 Kyle Stephenson

2. Overview – Day 10 Phenomenological Theory Client-centered techniques Strengths and weaknesses Related interventions ▫Gestalt therapy ▫EFT Strengths and weaknesses Evidence regarding efficacy

3. 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

4. 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

5. 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

6. Overview – Day 10 Phenomenological Theory Client-centered techniques Strengths and weaknesses Related interventions ▫Gestalt therapy ▫EFT Strengths and weaknesses Evidence regarding efficacy

7. 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

8. 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

9. 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

10. Do’s and Don’ts Therapeutic process IS ▫Acceptance ▫Recognition ▫Clarification ▫Structuring It is NOT ▫Advice & information ▫Reassurance & persuasion ▫Interpretation ▫Diagnosing

11. 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”

12. Overview – Day 10 Phenomenological Theory Client-centered techniques Strengths and weaknesses Related interventions ▫Gestalt therapy ▫EFT Strengths and weaknesses Evidence regarding efficacy

13. 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?

14. 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

15. Overview – Day 10 Phenomenological Theory Client-centered techniques Strengths and weaknesses Related interventions ▫Gestalt therapy ▫EFT Strengths and weaknesses Evidence regarding efficacy

16. 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

17. 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

18. 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

19. Overview – Day 10 Phenomenological Theory Client-centered techniques Strengths and weaknesses Related interventions ▫Gestalt therapy ▫EFT Strengths and weaknesses Evidence regarding efficacy

20. 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

21. 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

22. Overview – Day 10 Phenomenological Theory Client-centered techniques Strengths and weaknesses Related interventions ▫Gestalt therapy ▫EFT Strengths and weaknesses Evidence regarding efficacy

23. 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

24. 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)