Introduction

Person-centered therapy, also referred to as non-directive, client-centered, or Rogerian therapy, was

pioneered by Carl Rogers in the early 1940s. This form of psychotherapy is grounded in the idea that
people are inherently motivated toward achieving positive psychological functioning. The client is
believed to be the expert in their life and leads the general direction of therapy, while the therapist
takes a non-directive rather than a mechanistic approach.

The therapist's role is to provide a space conducive to uncensored self-exploration. As the client
explores their feelings, they will gain a clearer perception of themselves, leading to psychological
growth. The therapist attempts to increase the client's self-understanding by reflecting and carefully
clarifying questions. Although few therapists today adhere solely to person-centered therapy, its
concepts and techniques have been incorporated eclectically into many different types of therapists'
practices.[1]

Issues of Concern

Origins of Person-Centered Therapy

Person-centered therapy, also referred to as non-directive, client-centered, or Rogerian therapy, was

pioneered by Carl Rogers in the early 1940s. His ideas were considered radical; they diverged from the
dominant behavioral and psychoanalytic theories at the time. Rogers' method emphasizes reflective
listening, empathy, and acceptance in therapy rather than the interpretation of behaviors or
unconscious drives.[1]

In the 1960s, person-centered therapy became closely tied to the Human Potential Movement, which
believed that all individuals have a natural drive toward self-actualization. In this state, one is able to
manifest their full potential. According to Rogers, negative self-perceptions can prevent one from
realizing self-actualization.

Process

Rogers postulated that a state of incongruence might exist within the client, meaning there is a
discrepancy between the client's self-image and the reality of their experience. This incongruence leads
to feelings of vulnerability and anxiety.[2]

Person-centered therapy operates on the humanistic belief that the client is inherently driven toward
and has the capacity for growth and self-actualization; it relies on this force for therapeutic change.[3]
The role of the counselor is to provide a nonjudgmental environment conducive to honest self-
exploration. The therapist attempts to increase the client's self-understanding by reflecting and carefully
clarifying questions without offering advice. The therapist functions under the assumption that the client
knows themselves best; thus, viable solutions can only come from them.
Direction from the therapist may reinforce the notion that solutions to one's struggles lie externally.
Through client self-exploration and reinforcement of the client's worth, person-centered therapy aims
to improve self-esteem, increase trust in one's decision-making, and increase one's ability to cope with
the consequences of their decisions.[4] Rogers did not believe that a psychological diagnosis was
necessary for psychotherapy.[2]

The Necessary and Sufficient Conditions

Rogers identified six conditions that were necessary and sufficient to facilitate therapeutic change.[2]

Therapist-client psychological contact: the therapist and client are in psychological contact

Client incongruence: the client is experiencing a state of incongruence

Therapist congruence: the therapist is congruent, or genuine, in the relationship

Therapist unconditional positive regard: the therapist has unconditional positive regard toward the
client

Therapist empathic understanding: the therapist experiences and communicates an empathic

understanding of the client's internal perspective

Client perception: the client perceives the therapist's unconditional positive regard and empathic
understanding

Core Conditions

Rogers defined three attitudes on the therapist's part that are key to the success of person-centered
therapy. These core conditions consist of accurate empathy, congruence, and unconditional positive
regard.[3][2]

Accurate Empathy

The therapist engages in active listening, paying careful attention to the client's feelings and thoughts.
The therapist conveys an accurate understanding of the patient's private world throughout the therapy
session as if it were their own. One helpful technique to express accurate empathy is reflection, which
involves paraphrasing and/or summarizing the feeling behind what the client says rather than the
content. This also allows clients to process their feelings after hearing them restated by someone else.

Congruence

The therapist transparently conveys their feelings and thoughts to genuinely relate to the client. Within
the client-therapist relationship, the therapist is genuinely himself. The therapist does not hide behind a
professional façade or deceive the client. Therapists may share their emotional reactions with their
clients but should not share their personal problems with clients or shift the focus to themselves in any
way.

Unconditional Positive Regard

The therapist creates a warm environment that conveys to clients that they are accepted
unconditionally. The therapist does not signal judgment, approval, or disapproval, no matter how
unconventional the client's views may be. This may allow the client to drop their natural defenses,
allowing them to freely express their feelings and direct their self-exploration as they see fit.

Criticisms

Critics have contended that the principles of person-centered therapy are too vague. Some argue that
person-centered therapy is ineffective for clients who have difficulty talking about themselves or have a
mental illness that alters their perceptions of reality. There is a lack of controlled research on the
efficacy of person-centered therapy, and no objective data suggests its efficacy was due to its distinctive
features.[1] People have asserted that the unique qualities of client-centered therapy are not effective,
and the effective aspects are not unique but characteristic of all good therapy.[5]

Clinical Significance

Indications for Psychotherapy

Clinicians may initiate or refer a patient to psychotherapy for reasons not limited to the following:

Treatment of a psychiatric disorder

Help with maladaptive thoughts or behaviors

Support during stressful circumstances or when a chronic problem impairs functioning

Improve a patient's ability to make positive behavioral changes, such as healthy lifestyle changes or
increasing adherence to medical treatment

Helping with interpersonal problems

Person-centered therapy can be used in various settings, including individual, group, and family therapy,
or as part of play therapy with young children. There are no set guidelines on the length or frequency of
person-centered therapy, but it may be used for short-term or long-term treatment. Person-centered
therapy may be a good choice for patients who are not suitable for other forms of therapy, such as
cognitive-behavioral therapy (CBPT) or psychoanalysis, which require homework assignments and the
ability to tolerate high levels of distress that may occur when elucidating unconscious processes.[6]
Person-centered therapy relies on the client's active participation and may not be appropriate for
individuals who lack motivation or insight into their emotions and behaviors.

Efficacy

To examine the efficacy of person-centered therapy in the treatment of various psychiatric conditions,
this article will include recent studies using any form of non-directive counseling based on Rogerian
principles, including person-centered therapy/client-centered therapy (PCT/CCT), non-directive
supportive therapy (NDST), and supportive counseling/therapy (SC/ST).

Important limitations exist as NDST is not a popular focus of most researchers in the field. It is often only
included as a control for nonspecific therapeutic conditions, and therapists may not have administered
optimal treatments. Consequently, the researcher's allegiance to a specific therapy could skew results.
[7][8] Additionally, given the inherent vagueness of this type of therapy, there could be differences in
how NDST/SC/ST was defined and implemented.

Depression

There is evidence in the literature to support the efficacy of non-directive therapy as a treatment for
depression. Three meta-analyses conducted within the past decade concluded that ST/NDST is an
effective therapy for adult depression but may be less effective than other forms of therapy.[7] [Level 1]

Importantly, the authors mention that researcher bias may have played a role in the superiority of the
other psychotherapies. After controlling for researcher allegiance, the differences in efficacy between
non-directive therapy and other psychotherapies disappeared. This was true for all three meta-analyses.
One study also notes no significant difference in effect sizes of non-directive supportive therapy versus
full person-centered therapy. However, this was only based on two studies.[7]

A 2021 randomized, non-inferiority trial comparing person-centered therapy with CBT as a therapeutic
intervention for depression found that person-centered therapy was not inferior to CBT at six months;
however, person-centered therapy may be inferior to CBT at 12 months. The authors suggest that there
needs to be continued investment in person-centered therapy to improve short-term outcomes.[9]
[Level 1]

In adults with depression over the age of 50, one meta-analysis found non-directive counseling to be
effective, with effects maintained for at least six months. However, non-directive counseling was less
effective than CBT and problem-solving therapy.[10] [Level 1]

A 48-week randomized control trial compared nonspecific supportive psychotherapy with cognitive
behavioral analysis system of psychotherapy (CBASP) in patients with chronic depression that were
unmedicated (n=268). Both groups demonstrated a reduction in depressive symptoms. Patients who
received nonspecific supportive psychotherapy had a lower response rate than patients who received
CBASP.[11] [Level 1]

However, there were fewer severe adverse events with nonspecific supportive psychotherapy.[12]
[Level 1] Follow-up two years posttreatment found the benefits of the two treatments were comparable
on multiple measures, including the number of asymptomatic weeks.[13] [Level 1]

Bipolar disorder

One randomized controlled trial (n=76) compared ST/SC to CBT in treating bipolar disorders and
observed no difference in relapse rates.[14] [Level 2]

Anxiety

Non-directive psychotherapy may be comparable to CBT and other forms of psychotherapy in treating
generalized anxiety disorder in older adults.[15]

Post-Traumatic Stress Disorder (PTSD)

In the treatment of PTSD, non-directive therapy may be an effective treatment.[16] Person-centered

therapy may be comparable to evidence-based treatments for PTSD, with fewer dropouts.[17] Trauma
treatment research consistently shows lower dropout rates with person-centered therapy compared to
other types of treatment. PCT may be a reasonable option in settings without the resources to provide
the high levels of training required in other therapeutic modalities for PTSD.

Despite mixed evidence of its efficacy compared to other forms of psychotherapy, person-centered
therapy is consistently recommended as a viable option, given the rising demand for psychological
therapy.[9] The literature suggests an important role for PCT in low-resource communities where the
training and supervision of more technical psychotherapies may be less readily available, and access to
mental healthcare is limited.[17][18]

Enhancing Healthcare Team Outcomes

It is estimated that 1 in 5 adults living in the United Kingdom and the United States suffer from mental
illness.[19] Most patients receive treatment for a nonpsychotic psychiatric disorder in a primary care
setting. In recent years, mental health care in children and adolescents has increased more rapidly
compared with adult mental health care. Again, most of this mental health care has been provided by
non-psychiatrist providers.[20]

In response to this rising need, there have been recent efforts to integrate behavioral health and
primary care—an interprofessional care strategy will result in the best outcomes. The Collaborative Care
Model employs a team-based approach emphasizing collaboration between different providers and has
demonstrated improvement in depression outcomes compared to the usual care that persists for at
least 24 months.[21] [Level 1]

Compared to other forms of psychotherapy, person-centered therapy has the advantage of being more
readily available and more easily implemented in other healthcare roles.[11] Rogers himself stated that
professional psychological knowledge is not required of the therapist; the qualities of the therapist and
their experiential training are more important than intellectual training.[2]

In a small randomized controlled trial comparing various psychotherapeutic interventions of PTSD in a

low-resource setting, all participants experienced symptom reduction regardless of the intervention.
Importantly, nurses felt that supportive counseling was the most transferable to their respective work
environments.[18] [Level 2] Another pragmatic trial (n = 228) found that non-directive counseling
provided by public health nurses is an efficacious treatment for post-partum depression.[22] [Level 3]

Non-directive supportive counseling has a broader application beyond behavioral health. Healthcare
providers can employ these principles to help patients make informed decisions about their physical
health; however, more research is necessary to assess the impact of this approach on healthcare
outcomes.[23] [Level 1]

References

1.Hill CE, Nakayama EY. Client-centered therapy: where has it been and where is it going? A comment on
Hathaway (1948). J Clin Psychol. 2000 Jul;56(7):861-75. [PubMed]

2.ROGERS CR. The necessary and sufficient conditions of therapeutic personality change. J Consult
Psychol. 1957 Apr;21(2):95-103. [PubMed]

3.ROGERS CR. Significant aspects of client-centered therapy. Am Psychol. 1946 Oct;1(10):415-22.

[PubMed]

4.Goodman RF, Morgan AV, Juriga S, Brown EJ. Letting the story unfold: a case study of client-centered
therapy for childhood traumatic grief. Harv Rev Psychiatry. 2004 Jul-Aug;12(4):199-212. [PubMed]

5.Client-centered therapy. Harv Ment Health Lett. 2006 Jan;22(7):1-3. [PubMed]

6.Grover S, Avasthi A, Jagiwala M. Clinical Practice Guidelines for Practice of Supportive Psychotherapy.
Indian J Psychiatry. 2020 Jan;62(Suppl 2):S173-S182. [PMC free article] [PubMed]

7.Cuijpers P, Driessen E, Hollon SD, van Oppen P, Barth J, Andersson G. The efficacy of non-directive
supportive therapy for adult depression: a meta-analysis. Clin Psychol Rev. 2012 Jun;32(4):280-91.
[PubMed]

8.Cuijpers P, Quero S, Noma H, Ciharova M, Miguel C, Karyotaki E, Cipriani A, Cristea IA, Furukawa TA.
Psychotherapies for depression: a network meta-analysis covering efficacy, acceptability and long-term
outcomes of all main treatment types. World Psychiatry. 2021 Jun;20(2):283-293. [PMC free article]
[PubMed]

9.Barkham M, Saxon D, Hardy GE, Bradburn M, Galloway D, Wickramasekera N, Keetharuth AD, Bower
P, King M, Elliott R, Gabriel L, Kellett S, Shaw S, Wilkinson T, Connell J, Harrison P, Ardern K, Bishop-
Edwards L, Ashley K, Ohlsen S, Pilling S, Waller G, Brazier JE. Person-centred experiential therapy versus
cognitive behavioural therapy delivered in the English Improving Access to Psychological Therapies
service for the treatment of moderate or severe depression (PRaCTICED): a pragmatic, randomised, non-
inferiority trial. Lancet Psychiatry. 2021 Jun;8(6):487-499. [PubMed]

10.Cuijpers P, Karyotaki E, Pot AM, Park M, Reynolds CF. Managing depression in older age:
psychological interventions. Maturitas. 2014 Oct;79(2):160-9. [PMC free article] [PubMed]

11.Schramm E, Kriston L, Zobel I, Bailer J, Wambach K, Backenstrass M, Klein JP, Schoepf D, Schnell K,
Gumz A, Bausch P, Fangmeier T, Meister R, Berger M, Hautzinger M, Härter M. Effect of Disorder-
Specific vs Nonspecific Psychotherapy for Chronic Depression: A Randomized Clinical Trial. JAMA
Psychiatry. 2017 Mar 01;74(3):233-242. [PubMed]

12.Meister R, Lanio J, Fangmeier T, Härter M, Schramm E, Zobel I, Hautzinger M, Nestoriuc Y, Kriston L.

Adverse events during a disorder-specific psychotherapy compared to a nonspecific psychotherapy in
patients with chronic depression. J Clin Psychol. 2020 Jan;76(1):7-19. [PubMed]

13.Schramm E, Kriston L, Elsaesser M, Fangmeier T, Meister R, Bausch P, Zobel I, Bailer J, Wambach K,

Backenstrass M, Klein JP, Schoepf D, Schnell K, Gumz A, Löwe B, Walter H, Wolf M, Domschke K, Berger
M, Hautzinger M, Härter M. Two-Year Follow-Up after Treatment with the Cognitive Behavioral Analysis
System of Psychotherapy versus Supportive Psychotherapy for Early-Onset Chronic Depression.
Psychother Psychosom. 2019;88(3):154-164. [PubMed]

14.Meyer TD, Hautzinger M. Cognitive behaviour therapy and supportive therapy for bipolar disorders:
relapse rates for treatment period and 2-year follow-up. Psychol Med. 2012 Jul;42(7):1429-39.
[PubMed]

15.Hall J, Kellett S, Berrios R, Bains MK, Scott S. Efficacy of Cognitive Behavioral Therapy for Generalized
Anxiety Disorder in Older Adults: Systematic Review, Meta-Analysis, and Meta-Regression. Am J Geriatr
Psychiatry. 2016 Nov;24(11):1063-1073. [PubMed]
16.Bisson JI, Roberts NP, Andrew M, Cooper R, Lewis C. Psychological therapies for chronic post-
traumatic stress disorder (PTSD) in adults. Cochrane Database Syst Rev. 2013 Dec
13;2013(12):CD003388. [PMC free article] [PubMed]

17.Ghafoori B, Wolf MG, Nylund-Gibson K, Felix ED. A naturalistic study exploring mental health
outcomes following trauma-focused treatment among diverse survivors of crime and violence. J Affect
Disord. 2019 Feb 15;245:617-625. [PubMed]

18.van de Water T, Rossouw J, Yadin E, Seedat S. Adolescent and nurse perspectives of

psychotherapeutic interventions for PTSD delivered through task-shifting in a low resource setting. PLoS
One. 2018;13(7):e0199816. [PMC free article] [PubMed]

19.Ramanuj P, Ferenchik E, Docherty M, Spaeth-Rublee B, Pincus HA. Evolving Models of Integrated

Behavioral Health and Primary Care. Curr Psychiatry Rep. 2019 Jan 19;21(1):4. [PubMed]

20.Olfson M, Blanco C, Wang S, Laje G, Correll CU. National trends in the mental health care of children,
adolescents, and adults by office-based physicians. JAMA Psychiatry. 2014 Jan;71(1):81-90. [PubMed]

21.Camacho EM, Davies LM, Hann M, Small N, Bower P, Chew-Graham C, Baguely C, Gask L, Dickens CM,
Lovell K, Waheed W, Gibbons CJ, Coventry P. Long-term clinical and cost-effectiveness of collaborative
care (versus usual care) for people with mental-physical multimorbidity: cluster-randomised trial. Br J
Psychiatry. 2018 Aug;213(2):456-463. [PMC free article] [PubMed]

22.Glavin K, Smith L, Sørum R, Ellefsen B. Supportive counselling by public health nurses for women with
postpartum depression. J Adv Nurs. 2010 Jun;66(6):1317-27. [PubMed]

23.Jull J, Köpke S, Smith M, Carley M, Finderup J, Rahn AC, Boland L, Dunn S, Dwyer AA, Kasper J, Kienlin
SM, Légaré F, Lewis KB, Lyddiatt A, Rutherford C, Zhao J, Rader T, Graham ID, Stacey D. Decision
coaching for people making healthcare decisions. Cochrane Database Syst Rev. 2021 Nov
08;11(11):CD013385. [PMC free article] [PubMed]

Reality Therapy

Daughters plant flowers in the yard with their mother.Reality therapy, developed by Dr. William Glasser
in 1965, is founded on the principles of choice theory and has developed into a widely recognized form
of therapy. Parents as well as many professionals in the fields of education, mental health, and social
services have embraced the fundamentals of this therapy, which suggests that all human issues occur
when one or more of five basic psychological needs are not met and that an individual can only control
their own behavior. Glasser believed that when someone chooses to change their own behavior rather
than attempting to change someone else's, they will be more successful at attaining their own goals and
desires.

UNDERSTANDING REALITY THERAPY

Reality therapy focuses on current issues affecting a person seeking treatment rather than the issues the
person has experienced in the past, and it encourages that person to use therapy to address any
behavior that may prevent them from finding a solution to those issues. This type of therapy encourages
problem solving and is based on the idea that people experience mental distress when their basic
psychological needs have not been met. These needs are:

Power: A sense of winning, achieving, or a sense of self-worth.

Love and belonging: To family, to a community, or to other loved ones.

Freedom: To be independent, maintain personal space, autonomy.

Fun: To achieve satisfaction, enjoyment, and a sense of pleasure.

Survival: Basic needs of shelter, survival, food, sexual fulfillment.

The fact that everyone is constantly striving to meet these basic needs is at the heart of reality therapy.
When a person feels bad, reality therapists maintain it is because one of the five needs have not been
fulfilled. People participating in reality therapy might learn ways to be more aware of any negative
thoughts and actions possibly preventing them from meeting their needs, as according to the tenets of
reality therapy, changing one's actions may have a positive effect on the way that individual feels and on
their ability to attain their desires. These changes ideally take place through the use of Glasser's choice
theory, which uses questions such as "What are you doing/What can you do to achieve your goals?"

OVERVIEW OF THE THERAPEUTIC PROCESS

In reality therapy, the therapist might begin the therapeutic process by guiding a person's attention
away from past behaviors in order to focus on those that occur in the present. Present needs are what
are relevant, as they are the needs that can be satisfied. Reality therapists also tend to not focus on a
person's symptoms, as Glasser believed symptoms of mental distress manifest as a result of a person’s
disconnection from others.

Individuals who enter reality therapy generally have a specific issue of concern, and the therapist may
ask them to consider the effects their behavior has on that area, helping that person focus on things
they can actually change rather than things beyond their control. In reality therapy, the focal point is
what the person in therapy can control. By understanding one's own needs and desires and developing a
plan to meet those needs while refraining from criticizing or blaming others, reality therapists believe
that a person may be able to form, reform, or strengthen connections with others.

ROLE OF THE THERAPIST IN REALITY THERAPY

Because reality therapy seeks to treat individuals who experience difficulty in their relationships with
others, forming a connection with the therapist is an important beginning in reality therapy. This
connection is considered by reality therapists to be the most important dynamic in facilitating healing.
Once this relationship is stable, it can be used as a model to form fulfilling connections outside of the
therapeutic environment.

Those in therapy can learn how to best strengthen relationships outside of therapy while in the “safe”
therapeutic relationship and as a result, be able to more easily expand on those methods in daily life.
Reality therapists hold that when a person in therapy can employ the behaviors, actions, and methods
developed through therapy in life successfully, they will often be able to improve external relationships
and experience a more fulfilling life.

APPLICATION OF REALITY THERAPY

Reality therapy is considered an effective therapeutic strategy for addressing many issues, but it can be
especially valuable in treating difficulties faced by children and young adults at school and in their
communities.

Research has shown improvements in overall classroom functioning, cooperation, and a decrease in
challenging behaviors when teachers and school counselors are adequately trained in reality therapy.
Studies have also indicated that reality therapy is useful when applied to certain issues with behavioral
components, including teen pregnancy. Reality therapy works from the perspective that people must
assume responsibility for their behavior if they wish to change it.

Reality therapy has also been effective in the broader community, such as when integrated into athletic
coaching and in work with juvenile offenders, to facilitate behavioral change. This form of therapy can
help bridge the gap between intolerance and ignorance through education and equality, often resulting
in a more unified group.

CONCERNS AND LIMITATIONS OF REALITY THERAPY

Findings show that reality therapy has been applied with positive results in schools for problems
concerning behavior. However, little long-term research on the effectiveness of this approach in school
populations has been conducted. These studies are also limited due to the lack of experimental control
in areas such as sample size and training of teachers, as well as questions concerning voluntary
participation.

While reality therapy has been found to reduce issues with misbehavior of target groups in schools,
findings are limited regarding its capacity for improving the personal experiences of youth, their self-
esteem, and self-concept. These findings suggest that reality therapy is effective in addressing
symptomatic behavioral issues but not underlying causes and reasons for the behavior.

References:

Choice theory/reality therapy. (n.d.). Retrieved from http://www.apacenter.com/therapy-types/choice-

theory-reality-therapy
Harris, M.A. (1992). Effect of reality therapy/control theory on predictors of responsible behavior of
junior high school students in an adolescent pregnancy prevention program. Retrieved from
https://www.popline.org/node/333690

Mason, C.P., & Duba, J.D. (2009). Using reality therapy in schools: Its potential impact on the
effectiveness of the ASCA national model. International Journal of Reality Therapy, 29(2), 5-12. Retrieved
from http://digitalcommons.wku.edu/csa_fac_pub/33/

Neri, G. (2007, November 1). William Glasser's choice theory and reality therapy. Retrieved from
http://gurukul.edu/newsletter/issue-25/william-glassers-choice-theory-and-reality-therapy

Prout, H.T, & Fedewa, A.L. (2015). Counseling and psychotherapy with children and adolescents: Theory
and practice for school and clinical settings. John Wiley & Sons, Inc. Retrieved from
http://media.wiley.com/product_data/excerpt/87/11187726/1118772687-11.pdf

Reality Therapy. (2010). Retrieved from http://www.wglasser.com/the-glasser-approach/reality-

therapy.

Rational Emotive Behavioral Therapy (REBT)

Rational emotive behavioral therapy (REBT), developed by Albert Ellis in 1955 and originally called
rational therapy, laid the foundation for what is now known as cognitive behavioral therapy. REBT is
built on the idea that how we feel is largely influenced by how we think. As is implied by the name, this
form of therapy encourages the development of rational thinking to facilitate healthy emotional
expression and behavior.

RESHAPING CORE BELIEFS WITH REBT

“People are not disturbed by things but rather by their view of things.” –Albert Ellis

Often, ways of thinking ingrained in our brains at an early age or resulting from painful or traumatic
events continue to subconsciously influence our behaviors and perceptions into adulthood. REBT seeks
to reshape these core beliefs in those experiencing a wide range of mental health conditions, thereby
enabling them to live full, satisfying lives free from unnecessary psychological distress.

For example, say an individual feels continuously plagued by feelings of rejection. Rational emotive
behavioral therapy might uncover that he or she harbors the following belief: “I am an outcast. Nobody
likes me.” As a result, this person is likely to interpret a number of everyday occurrences in a negative
light; a downcast expression seen on another’s face or a lack of positive feedback from a colleague
becomes a direct reinforcement of that core inner concept. Naturally, this triggers a negative emotional
response and increases the likelihood of depression, social anxiety, antisocial behavior, and/or low self-
esteem, among other manifestations of the “nobody likes me” belief.

THE ABCS OF REBT

Based on the notion that we are typically unaware of our deeply imbedded irrational thoughts and how
they affect us on a day-to-day basis, Ellis established three guiding principles of REBT. These are known
as the ABCs: activating event, beliefs, and consequences.

Activating (or Adverse) Event. First, it is essential to identify the situation or event that triggers the
negative emotional and/or behavioral response. In the case of the above example, the activating event
is the downcast expression or lack of positive feedback from a colleague.

Beliefs. Second, the core beliefs that are attached to the emotional or behavioral response must be
identified and examined. Again, using the above scenario, the core beliefs would be “I am an outcast.
Nobody likes me.” A therapist employing REBT techniques would guide a person to explore where these
beliefs originate and develop a plan for recognizing and replacing them with positive affirmations.

Consequences. The combination of the activating event and the core beliefs will produce a result or
consequence, such as depression, social anxiety, antisocial behavior, or issues with self-esteem.
Similarly, the deconstruction of these ingrained negative beliefs and integration of fresh, positive
perceptions can drastically improve a person’s outlook and experience of life.

FROM IRRATIONAL TO RATIONAL: PRACTICAL APPLICATIONS

Again, identifying the thought culprits is key to letting them go. Though the specific tasks used to alter
irrational thought patterns vary from person to person, they often include a combination of journaling
or some other form of introspective exploration, guided imagery, meditation, and/or emotional
expression.

Understandably, rewiring years-old patterns of thinking is a work- and time-intensive process, so active
participation and openness in the therapy process is essential to success. Along those lines, a practice of
reciting daily mantras to continually replace negative beliefs is also encouraged. These mantras should
reflect a shift in consciousness from negative, self-defeating views to ones that reflect rational
acceptance of self, others, and the world.

References:

Fundukian, L. J., Ed. (2011). Cognitive-behavior therapy. In The Gale Encyclopedia of Medicine, Vol. 2,
4th ed. (pp. 1061–1064). Detroit, MI: Gale.

Kassel, K. S. (August 2013). “Cognitive-Behavioral Therapy (CBT): Rational Emotive Therapy; Rational
Behavior Therapy; Rational Living Therapy; Dialectic Behavior Therapy; Schema Focused Therapy.”
Conditions & Procedures In Brief. Consumer Health Complete. Retrieved from
http://search.ebscohost.com.ez.trlib.info/login.aspx?direct=true&db=cmh&AN=HL101930&site=chc-live

Warren, J. M. (Jan 2012). “Mobile Mind Mapping: Using Mobile Technology to Enhance Rational Emotive
Behavior Therapy.” Journal of Mental Health Counseling, 34.1, 72–81. Retrieved from
http://search.proquest.com.ez.trlib.info/familyhealth/docview/918717231/140FAE5382D7B02E3AA/1?
accountid=1229.
Humanistic Psychology (humanism)

A woman sits on a bench under a tree and looks out at a lakeHumanistic psychology (humanism) is
grounded in the belief that people are innately good. This type of psychology holds that morality, ethical
values, and good intentions are the driving forces of behavior, while adverse social or psychological
experiences can be attributed to deviations from natural tendencies.

Humanism incorporates a variety of therapeutic techniques, including Rogerian (person-centered)

therapy, and often emphasizes a goal of self-actualization.

THE DEVELOPMENT OF HUMANISTIC PSYCHOLOGY

Humanism arose in the late 1950s as a “third force” in psychology, primarily in response to what some
psychologists viewed as significant limitations in the behaviorist and psychoanalytic schools of thought.
Behaviorism was often criticized for lacking focus on human consciousness and personality and for being
deterministic, mechanistic, and over-reliant on animal studies. Psychoanalysis was rejected for its strong
emphasis on unconscious and instinctive forces and for being deterministic, as well.

In 1957 and 1958, Abraham Maslow and Clark Moustakas met with psychologists who shared their goal
of establishing a professional association that emphasized a more positive and humanistic approach. The
discussions revolved around the topics they believed would become the core tenets of this new
approach to psychology: Self-actualization, creativity, health, individuality, intrinsic nature, self, being,
becoming, and meaning.

After receiving sponsorship from Brandeis University, The American Association for Humanistic
Psychology was founded in 1961. Other major contributors to the development of humanistic
psychology were Carl Rogers, Gordon Allport, James Bugental, Charlotte Buhler, Rollo May, Gardner
Murphy, Henry Murray, Fritz Perls, Kirk Schneider, Louis Hoffman, and Paul Wong.

Some fundamental assumptions of humanistic psychology include:

Experiencing (thinking, sensing, perceiving, feeling, remembering, and so on) is central.

The subjective experience of the individual is the primary indicator of behavior.

An accurate understanding of human behavior cannot be achieved by studying animals.

Free will exists, and individuals should take personal responsibility for self-growth and fulfillment. Not all
behavior is determined.

Self-actualization (the need for a person to reach maximum potential) is natural.

People are inherently good and will experience growth if provided with suitable conditions, especially
during childhood.
Each person and each experience is unique, so psychologists should treat each case individually, rather
than rely on averages from group studies.

HUMANISTIC PSYCHOLOGY VS. THE MEDICAL MODEL

One of the basic principles of humanistic psychology is the belief that focus on an individual is more
beneficial and informative than a focus on groups of individuals with similar characteristics. Humanism
also stresses the importance of subjective reality as a guide to behavior.

The medical model assumes that behavioral, emotional, and psychological issues are often
consequences of physical problems; thus, a medical approach to treatment should be taken. While this
may be true of some conditions that result from physical damage, such as a traumatic brain injury, it can
be problematic to apply a medical model to all mental health concerns.

Some of the most obvious differences between mental and physical health issues lie in the nature and
treatment of concerns. Mental health difficulties, unlike physical problems, often improve when the
individual experiencing the difficulty speaks about what is wrong or talks through the issue. Further,
physical illness may occur as a result of physiochemical interactions or the activity of pathogens, while
mental health issues are often closely linked to interpersonal relationships.

Supporters of the medical model might view individuals experiencing mental health concerns as
“patients” who have an “illness” that can be “diagnosed” and “cured” after specific “symptoms” are
identified. However, humanistic psychologists believe that each individual is a unique, valuable social
being who is often best assisted through genuine person-to-person relationships. Rather than focusing
on specific symptoms, supporters of the humanistic approach emphasize issues such as self-
understanding, positive self-regard, and self-growth, with the aim of helping each individual by
addressing and treating the whole person.

HUMANISTIC PSYCHOLOGY IN THERAPY

Humanistic psychologists typically refrain from using techniques that foster objective study, such as non-
participant observation and scientific experimentation. As humanistic therapists tend to believe that
reducing human nature to mere numbers robs it of its richness, they are more likely to use qualitative
methods of study, such as unstructured interviews and participant observation.

Unstructured interviews allow the therapist to gain access to an individual’s thoughts and experiences
without directing the session toward any particular topics or ideas. Participant observation, which
requires that the therapist take part in the study, facilitates the formation of personal relationships and
allows the therapist the opportunity to get direct feedback from the person in therapy. Other forms of
qualitative data collection include the analysis of biographies, diaries, and letters.

Humanistic psychology integrates multiple therapeutic techniques, such as Carl Rogers' person-centered
therapy, which is also known as "Rogerian therapy." Humanism suggests that a person is created with a
distinct priority of needs and drives and that each person must rely on a personal sense of inner wisdom
and healing. Psychologists who practice this method of therapy take a non-pathological approach,
targeting productive, adaptive, and beneficial traits and behaviors of an individual in treatment.

HUMANISM’S CONTRIBUTIONS TO PSYCHOLOGY

The humanistic approach has made several significant contributions to the field of psychology. It
presented a new approach to understanding human nature, new methods of data collection in human
behavioral studies, and a broad range of psychotherapy techniques that have been shown to be
effective. Some of the major concepts and ideas that emerged from the humanistic movement include:

Hierarchy of needs

Person-centered therapy

Unconditional positive regard

Free will

Self-concept

Self-actualization

Peak experiences

Fully-functioning person

Humanism has inspired many contemporary modes of therapy, and most therapists value Rogerian
principles such as unconditional positive regard, even if they do not identify themselves as proponents
of the humanistic approach. This value-oriented approach views humans as inherently driven to
maximize their creative choices and interactions in order to gain a heightened sense of liberty,
awareness, and life-affirming emotions, and the therapist and person in therapy cooperate in order to
set therapeutic goals and work to reach the established milestones that may help promote positive
change. Self-actualization is often considered to be central to this approach.

Humanistic psychology stresses the inherent value of human beings and focuses on their ability and
willingness to maintain dignity while growing in self-respect and competence. This value orientation is
considered to be responsible for the creation of various other therapy models that utilize interpersonal
skills for the purpose of maximizing one’s life experience.

LIMITATIONS OF HUMANISTIC PSYCHOLOGY

Humanism’s reliance on the subjective experiences of individuals may make it difficult to objectively
measure, record, and study humanistic variables and features. The emphasis on gathering qualitative
data makes it almost impossible to measure and verify any observations made in therapy. Not only
might it be challenging to compare one set of qualitative data with another, the overall lack of
quantitative data means that key theories cannot be supported by empirical evidence.
Other criticisms of the approach include its lack of effectiveness in treating severe mental health issues
and the generalizations made about human nature, as well as the complete rejection of some important
behaviorist and psychoanalytic concepts. For example, although humanistic psychology holds that
animal studies are useless in the study of human behavior, some animal studies have led to concepts
that are applicable to people. Additionally, humanistic psychology focuses exclusively on free will and
the conscious mind, but research does show that the unconscious mind plays a significant role in human
psychology.

References:

Association of Humanistic Psychology. (1991). Historic review of humanistic psychology. Retrieved from
http://www.ahpweb.org/about/history/what-is-humanistic-psychology.html

Sammons, A. (n.d.). The humanistic approach: The basics. Retrieved from

http://www.psychlotron.org.uk/newResources/approaches/AS_AQB_approaches_HumanisticBasics.pdf

University College London. (n.d.). Basic competencies for humanistic psychological therapies. Retrieved
from http://www.ucl.ac.uk/clinical-psychology/CORE/Humanistic_Competences/
basic_humanistic_competences.pdf

Wong, P. T. P. (2014). Humanistic theories. Retrieved from http://www.drpaulwong.com/humanistic-

theories-2