Role of the Client

When Rogers articulated his “necessary and sufficient conditions” hypothesis, he specified only two conditions for the client: that the client and therapist are in psychological contact and that the client be “in a state of incongruence, being vulnerable or anxious” (1957, p. 96). Rogers believed that if clients experienced anxiety, or incongruence between their experiences and self-concepts, they would be sufficiently motivated to alleviate distress. This belief is also grounded in Rogers’s assumption of an inherent master motivation, the actualizing tendency, which serves to maintain and enhance the organism. Rogers’s concept of an organismic valuing process, a trustworthy evaluative mechanism that enables persons to experience satisfaction in behaviors that serve the person’s growth, was seen as a source of wisdom in the client. The concept of “psychological contact” meant to Rogers that at least a minimal relationship between therapist and client existed, one in which therapist and client make a perceived difference in the field of the other. He stated his belief that “significant personality change does not occur except in a relationship” (1957, p. 96). Rogers’s faith was that if certain specifiable therapist qualities were experienced by the client, then the actualizing tendency would propel the client toward growth and psychological health.

As in any therapy, the client’s responsibility is to identify and discuss meaningful concerns and problems. As clients do so and experience their therapists’ nonjudgmental empathy, they tend to elucidate their issues further, explore and reflect on them, and assess how new learnings and insights might be applied to their daily lives. Since person-centered therapy is fundamentally nondirective, it is the client’s responsibility to determine the direction of therapy and how to participate. Since person-centered therapy is basically a relational therapy, clients are likely to benefit to the degree that they engage effectively with their therapists. Clients’ willingness to express their feelings and process them is also a critical client task. In addition, it is the client’s responsibility to make the choice to change and the effort to incorporate change in their daily lives.

Clients of person-centered therapists sometimes need to adjust to the reality that their therapist will not guide, suggest, direct, or otherwise attempt to influence their decisions. Although this may create discomfort and uncertainty, clients of person-centered therapists often benefit ultimately by learning how to make choices and direct their lives. By doing so, they eventually become their own locus of evaluation and the authors of their lives. Most clients who find the person-centered therapist’s nondirectiveness to be uncomfortable usually come to understand its purpose and adapt to it reasonably well. Person-centered therapy’s effectiveness is, to a large degree, dependent on the client’s inclination toward and capacity for self-reflection, something that can be cultivated to varying degrees in most clients.

Recently, a client of mine, a 26-year-old female doctoral student in a clinical psychology program, spontaneously addressed her experience with the nondirective structure of her therapy at the beginning of her 10th session. She stated:

I want to comment on the therapy process itself, because this style of therapy or the way you do therapy, for me has been such a learning experience. And I think it’s so effective for me, and so effective in general as well. I often think about how it’s not structured, or the structure doesn’t come from you. It comes from me and I just think it’s really amazing. It has been amazing for me because I can see how I have to do all the work in a sense. I feel like I can’t just come in here and sit, and then you sort of direct and guide and create the structure and I sort of fill in the blanks. Instead, I know that when I come in here that whatever is done in here will come from me. And so that has been so interesting because I think that it causes clients to work a lot more outside of sessions. And I just find that very powerful. And it’s very difficult for me because I like structure and my barometer sort of lies in the external, and so it’s just been really scary, but in a good way, and it’s just been very powerful for me. And I am just so impressed with this style of therapy. . . . I just find it interesting for me that it just so fits with what I need and I like that a lot. I think it’s really challenging me and it’s not comfortable yet but I’m OK with it. I think it’s a “good” uncomfortable. And I just find myself working outside of session a lot because I know “OK, what am I going to bring on Monday.”. . . I think it’s been just really good for me and I really appreciate this therapy style itself and the way that you do it. So I just wanted to [share that]. (personal communication, 2009)

This insightful client, one who prefers structure in her life, has come to understand that the minimal structure and high level of freedom in person-centered therapy has its frustrations and rewards. Though somewhat ambivalent and uncomfortable initially about taking responsibility for how she uses therapy, she has noticed that she continues to reflect on her concerns and learning outside of the therapy session. Although person-centered therapy is challenging, it has resulted in her stretching herself. To her credit, this client has made great progress by fearlessly exploring sensitive aspects of herself and becoming accepting of heretofore-disowned aspects of herself.

In recent years, a number of experts in the field of psychotherapy (e.g., Bohart and Tallman, 1999) have come to realize that it is the client rather than the therapist who is the primary agent of constructive change.

When Rogers formulated his if-then hypothesis, it implied that if the therapist provided certain relational conditions, then the client would respond with constructive change. Although Rogers designated his approach as client/person-centered, his hypothesis placed most of the responsibility for creating the conditions for change on the therapist. In contrast, Bergin and Garfield’s view (1994) suggests that clients’ active participation and involvement in therapy are primarily responsible for their success. Further, research conducted by Michael Lambert (1992) suggests that 40% of the variance in outcome depends on client characteristics and resources. Clearly, clients don’t change if they are passive or uninvolved participants; they need to take responsibility for their lives and make efforts to change.

BRIEF AND LONG-TERM STRATEGIES

A misconception about person-centered psychotherapy is that it is inevitably long-term therapy. It is not. Although it is not well known, most therapy is brief therapy. The modal number of sessions clients attend is one and most courses of psychotherapy are six sessions or less (Miller, Duncan, & Hubble, 1997). Similarly, the length of client-centered therapy varies from as few as 1 to more than 100 sessions, depending on the client’s goals and severity of problems. I have seen many clients who have benefited from a single session, and the majority of clients make good progress in 10 sessions or less.

There is no fundamental alteration in the way client-centered therapy is practiced to achieve brevity. However, like other brief therapies, client-centered therapy may have a more limited focus, which results in the therapist and client agreeing to keep their attention and efforts on some circumscribed aspect of the client’s problems.

A LONG COURSE OF THERAPY