Optimal Conditions for Constructive Therapeutic Change

1. The client is sufficiently distressed in an area of significant relevance, has a desire for help, and willingly seeks professional assistance in the alleviation of problems or to attain something the client wants.

Most people do not seek psychotherapy unless their level of psychological distress is intolerable or at least unacceptable. While anxiety or incongruence may be an adequate reason for some persons to enter or continue therapy and to motivate change, most persons tolerate varying levels of psychological discomfort on their own and consequently do not seek therapeutic assistance. Further, when the level of discomfort diminishes to a tolerable level, many clients drop out of therapy. The dropout rate for clients varies from about 40% to as high as 67% (e.g., Clarkin & Levy, 2004) and the modal number of sessions attended by clients is one. Clearly many persons who might enter or continue in therapy will not do so unless they are sufficiently troubled and desirous of change.

The experience of being “sufficiently distressed” reflects clients’ subjective sense that their problems, however defined, are no longer bearable and interfere their functioning or quality of life to an unacceptable degree. The level of psychic discomfort will vary but will be characterized by a sense of urgency to alleviate stress or attain something in an area deemed important enough (e.g., finding purpose in life) to seek professional assistance. Further, the person feels unable to deal with distress on his or her own and recognizes a need for assistance, has a desire to be helped, and willingly seeks and accepts help. Subjectively, the potential client is likely to experience something like, “I am extremely unhappy and cannot deal with this important issue on my own. I need and want help “Persons experiencing such psychological states are likely to seek psychotherapy willingly and be receptive to ongoing assistance. In short, therapy is likely to be more successful when clients freely choose to attend based on an unacceptable level of distress.

2. The client is actively involved and receptive in the therapeutic endeavor, participates cooperatively, and has a positive expectation that therapy will be helpful.

As mentioned earlier, Rogers basically left client responsibility for therapy participation and change out of his formula. In the last few decades, accumulating evidence regarding the critical role of the client in change has dramatically altered our understanding of the importance of client involvement in successful outcome. As veteran researchers Bergin and Garfield (1984) concluded after reviewing decades of psychotherapy research,

it is the client more than the therapist who implements the change process. If the client does not absorb, utilize and follow through on the facilitative efforts of the therapist, then nothing happens. Rather than argue over whether or not “therapy works” we could address ourselves to the question of whether or not “the client works”! . . . Clients are not inert objects upon whom techniques are administered. . . . People are agentic beings who are effective forces in the complex of causal events . . . As therapists have depended more upon the client’s resources, more change seems to occur. (p. 826)

Despite the fact that most reasonably well-trained and competent therapists of varying persuasions offer clients something of value to promote learning and growth, some clients fail to make use of whatever the therapist provides. It appears that clients’ involvement and active participation in therapy play a large role in whether or not they progress. Research shows that client role engagement or personal involvement is a strong predictor of good outcome. In a series of 54 outcome studies, 65% showed a positive relationship to good outcome (Sachse & Elliott, 2002). From the therapist’s perspective, 92% of findings show a significant positive relationship to outcome (Orlinsky et al., 1994). Art Bohart, a respected person-centered therapist and coauthor of How Clients Make Therapy Work (1999), cites considerable evidence that client involvement in therapy is the most important factor making therapy effective and that therapists should support, stimulate, and encourage client investment in therapy.

As defined here, client involvement entails client cooperative engagement and commitment to the therapy process. It also suggests that clients take responsibility for themselves, attend sessions as scheduled, have a focus and goals, come prepared to engage their issues, and are receptive to learning and change. Research indicates that client openness (i.e., willingness to disclose and process problematic aspects of experience and self), versus defensiveness, is related to good outcome in 80% of studies (Orlinsky et al., 1994). Similarly, research shows a significant association with positive outcome for cooperative participation, client motivation, or desire for therapeutic involvement and clients’ behavioral and cognitive processing (Orlinsky et al., 1994). The evidence seems clear: When clients are active and involved participants, they are likely to make progress.

3. The therapist and client are mutually accepting and affirming.

This premise expands on Rogers’s belief about the constructive effects of therapist unconditional positive regard by suggesting that mutual acceptance and affirmation are more powerful than just the therapist’s acceptance of the client. Clients don’t work well with therapists they don’t like. Nor do therapists work well with clients they don’t like since the quality of their relationship is likely to be compromised or strained. Client affirmation, defined as respect and liking for the therapist, is positively related to outcome in about 69% of the studies while therapist affirmation of the client (acceptance, warmth, or positive regard) is associated with positive outcome in 56% of 154 studies (Orlinsky et al., 1994). Reciprocal affirmation between therapist and client is significantly and positively related to outcome in 78% of 32 studies (Orlinsky et al., 1994). It would appear that when client and therapist are mutually affirming, clients are most likely to achieve constructive change.

4. The therapist is consistently present and actively engaged in all aspects of the therapeutic process.

On several occasions, I had the opportunity to view Carl Rogers close up when he did therapeutic demonstrations. I was struck by his exceptional capacity to concentrate on the client before him. It was as if he and the client entered an impenetrable bubble in which only they existed, despite the fact that they were being watched by a large number of observers. The quality of Rogers’s contact and engagement with his client was extraordinary. He simply brought all of himself fully to his client, without wavering, and trusted that the sheer quality of his “being with” his client had healing potential. Rogers commented about his presence:

I find that when I am the closest to my inner, intuitive self—when perhaps I am in touch with the unknown in me—when perhaps I am in a slightly altered state of consciousness in the relationship, then whatever I do seems to be full of healing Then simply my presence is releasing and helpful. (Baldwin, 1987, p. 50)

When present in this manner described by Rogers, clients are often drawn into moments of fully engaged and present living with their therapists, an experience that is gratifying, meaningful, hopeful, instructive, and sometimes transformative as they glimpse the possibility of carrying such experiences into their relationships with others. Clients also learn that the quality of their lives in general is enhanced by living fully in the present.

When fully present, therapists bring a sustained, mindful, and focused attention to their clients. They make powerful contact and immerse themselves in their clients’ worlds and draw their clients into a meaningful encounter. They are fully and transparently themselves in the moment and without any agenda except to be with and receive their clients, thereby creating a sense of safety that enables them to disclose themselves more fully. When present, the therapist indwells the client’s world, is for the client and is with the client as a separate self who is willing to engage in an I–Thou encounter (Moustakas, 1995). A variety of therapist relational qualities and behaviors related to presence have been supported by 40 years of research (e.g., Asay & Lambert, 1999). Research shows that client perception of the therapist’s contribution to the therapeutic bond or alliance was related to positive outcome in 67% of studies and was never negatively associated with outcome when viewed from the client’s perspective (Sachse & Elliott, 2002). Similarly, the client’s contribution to the bond was positively significant and positively associated with outcome in 67% of 55 studies suggesting, again, that clients affect their therapists’ quality of presence (Orlinsky et al., 1994d). Presence-related research by Elliott (1985) suggested that effective therapists focused on client problems, paid attention to affect, helped clients focus their awareness and become more involved, and maintained personal contact.

5. The therapist views clients as resourceful persons capable of constructive change and strives to support their freedom and autonomy in determining the direction of therapy and how their goals will be achieved.

Rogers believed that the actualizing tendency in clients would be optimized when they experienced an interpersonal environment characterized by adequate levels of empathy, acceptance, and congruence in their therapists. Similarly, Bohart and Tallman (1999) make a compelling argument that therapy is a learning process and that engaging the client’s self-healing potential is essential in helping them. Further, evidence presented by Bohart and Tallman (1999) suggests that most people/clients manage their lives adequately without the assistance of professional helpers by drawing on their own and other resources (e.g., self-help books, supportive friends and family, and other readily available resources).

Lambert’s research (1992) indicated that about 40% of outcome in therapy was related to client resources, while another 15% of outcome is accounted for by clients’ positive expectation and hope that therapy will be helpful. Such hopefulness is strongly influenced by the therapist’s optimism and conviction that clients can mobilize their resources for change. As therapists embrace this view, they depend more on their clients to deal with their problems. This clearly shifts therapists’ responsibility from effecting change to that of facilitating clients’ capacity to mobilize their current resources and potential for change.

Person-centered therapists place a high value on encouraging and supporting client freedom and autonomy in decision making about what they wish to change and how such change might be achieved. This value emerges naturally from the person-centered therapist’s belief that clients have the right to choose what they want and how to conduct their lives without undo influence, guidance, advice, or specific suggestions for change.

6. The therapist and client individualize each therapy by being collaborative partners in the definition of the client’s problems, desired goals, means to achieve those goals, and development of an optimal therapeutic relationship.

A compelling argument can be made that no one knows the client better than the client. Thus, clients are the best experts on themselves, and this belief is critical for the therapist to work effectively with the client. Therefore, I contend that therapists cannot maintain that clients knows what is best for them and, at the same time, define, a priori, what specific conditions are necessary and sufficient for all clients. Similarly, I would consider a prescription for therapist nondirectiveness under all circumstances to present the same dilemma. Each client and each course of therapy are unique. Further, clients need and benefit from different things at different times. Therefore, each course of therapy needs to be cocreated by therapist and client as it evolves to increase the likelihood of client benefit. Although clients take the lead in deciding what problems are to be addressed and their related goals, therapists and clients work together in defining and creating an optimal therapeutic relationship and course of therapy to achieve those goals.

Research reported earlier indicates that client perceptions of therapist behavior are better predictors of outcome than those of the therapist or external judges. Bachelor’s research (1985) showed that what the client defines as empathy varies from client to client and that the therapist needs to ensure that qualities and behaviors beneficial to the client are perceived/experienced. Grote’s (2005) qualitative research on “feeling understood” shows that multiple therapist qualities and behaviors other than empathic ones contributed to this experience. Rennie’s (2002) qualitative research shows that clients are self-aware agents in therapy and therefore respond in their own ways to the therapist’s responses and proposals. Further, it appears that clients creatively use whatever their therapists offer them selectively and in their own way (Rennie, 2002). These studies and others like them make a compelling case that therapists need to remain constantly mindful of what is likely to best serve the client at a given time. If therapists take the role of learners in relationship to their clients, they are likely to observe and inquire about what is needed or likely to be most fruitful in specific situations. Clinical wisdom and many prominent therapists (e.g., Lazarus) point to the importance of individualizing therapy. It is the therapist’s responsibility to adapt and accommodate in a manner that works best for a given client. Therapists’ metacommunication about therapy is vital in helping them know what fits and works for a specific client. I have found that incorporating a post-session dialogue with the client is often helpful in providing mutual feedback about how therapy is progressing and what adaptations or changes might be desirable or necessary on the part of the therapist or client.

7. The therapist understands the subjective reality of the client and empathically communicates that understanding to the client.

Constant therapist empathic attunement remains the bedrock of all versions of person-centered psychotherapies. Therapists of every school of thought understand that empathy, in various forms, is foundational for developing a therapeutic alliance with their clients, in catalyzing client interpersonal and intrapersonal learning, and in achieving good outcomes. Empathy, as perceived by the client, was associated with positive outcome in 72% of 47 studies (Orlinsky et al., 1994). The majority of studies show a positive correlation between therapist empathy and outcome, and no studies shows a negative relationship between therapist empathy and outcome. Feeling understood is one of the primary experiences clients identify as being helpful. Rogers’s greatest contribution to the field of psychotherapy is that he taught us to listen, enter the client’s world, and communicate that understanding for the client’s reflection. This contribution remains as vital as ever.

8. The therapist engages relevant aspects of his or her self in a congruent manner intended to be in the best interests of the client.

The therapist–client relationship itself often creates growth-enhancing experiences in the client. Thus, it is essential that therapists engage various aspects of themselves on behalf of their clients. The greater the depth and range of the therapist, the more the therapist has to offer the client. Although person-centered theory suggests that therapist empathy, congruence, and acceptance are sufficient qualities for client growth, both research evidence and clinical experience indicate that other qualities enhance the relationship and provide personal resources that benefit the client.

One of the professors in my master’s program said something that has always remained with me: “You can best be yourself and nobody else.” The best way therapists can engage themselves on behalf of the client is to be themselves. The person you are during therapy should largely resemble the person your best friends and family know. When therapists express various aspects of themselves in a genuine manner, clients come to know and trust the person of the therapist. This often results in a more involved relationship that allows clients to share and be more themselves.

Engaging in a therapeutic relationship with our clients provides us with an opportunity to be the best of our selves. Each of us has distinctive personal qualities that are likely to enhance our relationships with our clients and effect change. The challenge for therapists is to know who they are and bring forward those aspects of self that serve the best interests of their clients.

9. The therapist brings forth for the client’s consideration any and all personal and professional resources that may be of value to the client.

Clients want and deserve to have available to them all aspects of the therapist’s personal qualities, skills, professional knowledge, and resources, just as we should expect no less from our physicians. When clients come to therapy, they typically indicate that they hope we will understand them, be supportive and caring, help them understand themselves, and deal more effectively with their concerns. They often express a desire to attain some tools or skills to help them cope and function better. In some cases our clients don’t know what they need to help them think, feel, and do better, but they certainly recognize what is helpful and what is not. Thus, person-centered therapists would do well to depend on their clients to assess the value of whatever their therapists might offer. If we collaborate with our clients effectively, we will learn together what will benefit our clients and how to achieve it.

Person-centered therapists operate from a theoretical framework that provides cohesiveness to their belief system and guidelines for practice. In my view, this is fully appropriate as it enables them to work from a set of convictions that grounds their therapy with their clients. Yet all theories, person-centered included, have limitations and need to be modified to adapt to the needs of clients.

While I fully believe that therapists should be grounded in their therapeutic beliefs and values, theoretical allegiance should never limit therapists from doing what is in the best interests of their clients, regardless of whether it fits or diverges from their theory of psychotherapy. As mentioned previously in this text, there are problems for which person-centered therapy is not ideally suited, at least not without supplementation or modification. I contend that therapeutic pragmatism, or doing “what works” is an ethical and professional responsibility. Most clients care little about our theoretical predilections and rarely inquire about them, since their primary concern is whether we can assist them with their problems.

Doing what works or what is in the best interests of a given client may take various forms. Since therapists’ fundamental commitment is to their clients’ well-being, it is appropriate and desirable that they bring forth their perspectives, values, beliefs, perceptions, knowledge, relational skills, and therapeutic processes and procedures for their client’s consideration. As a collaborative partner the therapist offers, but does not insist on, whatever he or she believes may be of most value to the client. Such a therapeutic approach would be more client-directed and client-informed and thus truly more client-centered in the sense that the client is always an active and agentic participant in the therapy. This model of person-centered therapy would alter the premise that therapists remain absolutely nondirective in their approach to clients since doing so may restrict the availability of the therapist’s professional and personal resources. In this approach therapists are free to offer noncoercively whatever is believed to be in their clients’ best interests while clients are ultimately free to choose what fits and reject what doesn’t. As suggested in dialogical approaches, there are times when it is appropriate for therapist and client to “wrestle” with each other in an effort to help the client achieve clarity in choosing the optimal course to take in his or her life.

As existential therapist Clark Moustakas (1995) concluded, there are times when it may be more important for the client to make the best decision possible rather than a freely made decision that may have unwanted consequences. In this approach, an optimal course for the client is likely to be based on consideration of all the available perspectives, options, and resources.

10. The therapist focuses on and encourages the client to attend to and process potent emotional experiences with an intent to facilitate adaptive client learning and more effective behavior.

A compelling argument can be made that meaningful experience is embodied, that we experience our world through our body, that the body “knows” more than can be articulated initially, and that we cannot fully grasp our realities without access to the meaning of our bodily felt senses. Most problems that trouble clients have a strong emotional component. Person-centered/experiential approaches to therapy view emotion as a critical source of adaptive learning, good judgment, and effective decision making. When affective and cognitive appraisal converge (i.e., when a possible course of behavior sounds right and feels right), the client is more likely to choose an effective course of action. Therefore, giving high priority to helping clients attend to and process emotion is in clients’ best interests.

There is a substantial and growing body of research that demonstrates that effective processing of client emotion and bodily felt experiences leads to good outcome. Recent process research (Elliott, Watson, Goldman, & Greenberg, 2004) has consistently demonstrated a relationship between in-session emotional activation and outcome in various therapies. Emotion-focused therapy in particular has a sound base of research demonstrating the importance of processing emotion to good outcome.

Research on depth of experiencing in therapy has been shown consistently to relate to outcome, especially in client-centered therapy (Greenberg et al., 2002). Warwar and Greenberg’s (1999) research indicated that clients with good outcomes in the treatment of depression showed both higher emotional arousal and depth of experiencing on emotion episodes. Alvin Mahrer and colleagues (Mahrer, Nadler, Dessaulles, Gervaize, & Sterner, 1987) have shown that certain good moments in therapy are characterized by emotional expression. Other studies have found similar results showing a relation between emotional experiencing and outcome in therapy (Beutler, 1999; Foa & Jacob, 1998; Greenberg & Foster, 1996; Hirscheimer, 1995; Malcolm, 1999; Orlinsky et al., 1994; Paivio & Greenberg, 1995). In brief, the evidence is strong and growing that working effectively with client emotion leads to good outcome. One should note, however, that emotional arousal alone is not sufficient, and good outcomes are distinguished from poor ones by clients making sense of their emotions. In short, emotional experiences need to be aroused, processed, and reflected upon cognitively for optimal benefit.

11. The therapist continuously monitors the quality of the therapeutic relationship, client progress, and any strains in the relationship and collaborates with the client to make any needed or desirable adjustments.

Research from several sources indicates that clients’ and therapists’ views of the same therapy are often discrepant, sometimes substantially so. In fact, studies often show that therapists are not good judges of their own behavior and impact on the client, often overestimating their effectiveness. As Rennie’s research (2002) showed, clients often do not share their views of the therapist or therapy. Therefore, the responsibility for monitoring the therapy falls to the therapist. This should be an ongoing part of therapy that is done at frequent intervals. In the last few years, my graduate students and I have found that a post-session dialogue with the client at the end of each session can be extremely useful in assessing how the therapy is going and to stimulate productive discussion about what adjustments may be desirable. Therapists would do well to converse with their clients at any time they sense that something is awry. Such input is especially valuable when there are strains and potential ruptures in the therapist–client relationship. Safran, Muran, and Samstag, (1994) have noted that successful therapy is often characterized by a rupture–repair cycle in the therapeutic alliance that may occur at any time during therapy. However, it tends to occur when the therapist begins to address maladaptive client patterns. Such ruptures may also occur as a result of therapist criticism, indifference, and dislike of the client. Their findings suggest that therapist focus on the client’s feelings about the therapy and the therapist is crucial in repairing the rupture and that failure to address such ruptures will likely lead to increased client negativity and unsuccessful outcomes. While it may take some time, effort, and courage for therapists to assess how therapy is going from the client’s perspective, such information is vital in keeping the therapy on track and thriving.

12. The client experiences in the therapist the relevant constructive relational qualities, behaviors, and intents to a degree that facilitates change and growth as defined by the client.

Rogers was aware that for therapy to be effective, the core conditions needed to be perceived or experienced by the client to be effective. Both research and clinical experience suggest that several therapist qualities, attitudes, and behaviors lead to constructive therapeutic change in the client. However, since each client and course of therapy is unique, it is essential that the therapist is aware that what is important for each client to benefit optimally from therapy will vary. What matters most to a given client (e.g., feeling supported or encouraged) will vary, and when the specific constellation of therapeutic qualities and behaviors needed by the client to use therapy effectively are offered and perceived, then therapeutic effectiveness will be increased.

SUMMARY

In an era characterized by increasing technology, multitasking, overly busy and stressed lives, depersonalization, and medication as a first choice for alleviation of a variety of debilitating psychological problems, person-centered therapies become increasingly needed and relevant. A therapy that stresses the importance of the quality of relationship and that encourages clients to listen to themselves and to live in a more self-accepting and authentic manner will always be needed. Good ideas, like good art, endure. Rogers’s system of psychotherapy has endured for 70 years, and the therapist qualities of empathy, congruence, and unconditional positive regard have been acknowledged by almost every major system of psychotherapy as fundamental contributors to clients’ growth.

Today person-centered therapy continues to be an influential force in the larger field of psychotherapy. As you will recall, Rogers was identified as the most influential therapist of any era in surveys conducted in 1982 and 2007. Today, Rogers’s influence on American psychotherapy is enormous, though often indirect. His fundamental ideas have been absorbed by many diverse approaches to psychotherapy. A substantial number of training programs for graduate students in psychology and counseling typically emphasize the importance of empathic listening and responding skills and attitudes, as well as the critical importance of unconditional positive regard for the client and therapist congruence. Rogers, more than any other therapist, taught us to listen with sensitivity and caring and to understand that the quality of the therapist–client relationship, in itself, has the potential to foster personal learning and growth in the client.

Globally, person-centered therapy flourishes in the United Kingdom, many European countries, South America, Japan, and increasingly in Russia and China. In their article “The Current Status of Carl Rogers and the Person-Centered Approach” (2005), Kirchenbaum and Jourdan indicate that between 1987 and 2004, a total of 777 person-centered publications, including 141 books, were published. This total far exceeds all of the previous publications over the 40-year period from 1946 to 1986. Further, there are approximately 200 person-centered organizations and training centers worldwide. Kirschenbaum and Jourdan conclude: “By all these indicators, the person-centered approach is . . . alive and well” and “client-centered principles permeate the practice of many, if not most therapists” (p. 48). Person-centered therapy is as vital and effective as it has ever been and continues to develop in ways that will make it increasingly so in the years to come.

Glossary of Key Terms

ACTUALIZING TENDENCY  The inherent tendency of the organism to develop all its capacities in ways that serve to maintain or enhance the organism.

CONDITIONS OF WORTH  Circumstances of self-experience that a person either seeks out or avoids because of his or her discrimination that the experience is more or less worthy of self-regard.

CONGRUENCE  A state in which the person’s self-concept and experiences, including thoughts and behavior, are in harmony.

EMPATHY  The process of accurately perceiving the internal frame of reference of another, including both the emotional aspects and meaning of the experience.

EXTERNAL FRAME OF REFERENCE  Perception of the person solely from one’s own subjective internal frame of reference without empathizing with the observed person.

INCONGRUENCE  State of discord between self-concept and experience.

INTERNAL FRAME OF REFERENCE  All of the realm of experience available to the awareness of the individual at a given moment; the subjective experience of the person.

LOCUS OF EVALUATION  Refers to the source of the person’s values. If the source is internal, the person is the center of the valuing process, with the evidence supplied by his or her own senses. When the locus of evaluation resides in others, their judgment as to the value of an experience becomes the criterion of value for the individual.

ORGANISMIC VALUING PROCESS  Built-in, trustworthy, evaluative mechanism that enables the organism to experience satisfaction in those behaviors that maintain and enhance the organism and the self.

POSITIVE REGARD  Exists when a person perceives that some aspect of his or her behavior makes a positive difference to someone else.

PSYCHOLOGICAL ADJUSTMENT  Exists when self-concept is such that all experiences are or may be assimilated on a symbolic level into the gestalt of the self-structure.

PSYCHOLOGICAL MALADJUSTMENT  Exists when the organism denies awareness or experiences distortion in awareness of significant experiences, which consequently are not accurately symbolized and organized into the gestalt of the self-structure, thus creating incongruence between self and experience.

SELF, SELF-CONCEPT  The organized, consistent conceptual gestalt composed of perceptions of characteristics of the “I” or “me” together with the values attached to those perceptions.

SELF-ACTUALIZATION  Actualization of aspects of experience defined as the self.

UNCONDITIONAL POSITIVE REGARD  Exists when we perceive that any self-experience is viewed as worthy by another person.

Suggested Readings

Bohart, A. C., & Greenberg, L. S. (1997). Empathy reconsidered: New directions in psychotherapy. Washington, DC: American Psychological Association.

Bozarth, J., Zimring, F., & Tausch, R. (2002). Research in client-centered therapy: The evolution of a revolution. In D. J. Cain & J. Seeman (Eds.), Humanistic psychotherapies: Handbook of research and practice. Washington, DC: American Psychological Association.

Cain, D. J. (2002). Classics in the person-centered approach. Herefordshire, England: PCCS Books.

Cooper, M. (2007). Developmental and personality theory. In M. Cooper, M. O’Hara, P. F. Schmid, & G. Wyatt (Eds.), The handbook of person-centered psychotherapy and counseling (pp. 77–92). New York, NY: Palgrave Macmillan.

Cooper, M., O’Hara, M., Schmid, P. F., & Wyatt, G. (Eds.). (2007). The handbook of person-centered psychotherapy and counseling. New York, NY: Palgrave Macmillan.

Elliott, R., Watson, J. C., Goldman, R. N., & Greenberg, L. S. (2004). Learning emotion focused therapy. Washington, DC: American Psychological Association.

Gelso, C. J. (Ed.). (2007). The necessary and sufficient conditions at the half century mark. Psychotherapy, 44(3), 239–299.

Gendlin, E. T. (1996). Focusing-oriented psychotherapy. New York, NY: Guilford Press.

Greenberg, L. S., Watson, J. C., & Lietaer, G. (1998). Handbook of experiential psychotherapy. New York, NY: Guilford Press.

Kirschenbaum, H. (2007). The life and work of Carl Rogers. Ross-on-Wye, England: PCCS Books.

Mearns, D., & Thorne, B. (2007). Person-centered counseling in action (3rd ed.). London, England: Sage.

Rogers, C. R. (1951). Client-centered psychotherapy. Boston, MA: Houghton Mifflin.

Rogers, C. R. (1961). On becoming a person. Boston, MA: Houghton Mifflin.

Rogers, C. R. (1980). A way of being. Boston, MA: Houghton Mifflin.

Watson, J. C., Goldman, R. N., & Warner, M. S. (2002). Client-centered and experiential psychotherapy in the 21st century: Advances in theory, research and practice. Herefordshire, England: PCCS Books.

References

Asay, T. P., & Lambert, M. J. (1999). The empirical case for the common factors in therapy. In M. A. Hubble, B. L. Duncan, & S. D. Miller (Eds.), The heart and soul of change (pp. 23–55). Washington, DC: American Psychological Association.

Bachelor, A. (1988). How clients perceive therapist empathy: A content analysis of ‘received’ empathy. Psychotherapy, 25(2), 227–240.

Baldwin, M. (1987). Interview with Carl Rogers on the use of self in therapy. In M. Baldwin & V. Satir (Eds.), The use of self in therapy (pp. 45–52). New York, NY: Haworth Press.

Barrett-Lennard, G. T. (2007). The relational foundations of person-centered practice. In M. Cooper, M. O’Hara, P. F. Schmid, & G. Wyatt, The handbook of person-centered psychotherapy and counseling. New York, NY: Palgrave McMillan.

Bergin, A. E., & Garfield, S. L. (Eds.). (1994). Handbook of psychotherapy and behavior change (4th ed.). New York, NY: Wiley.

Beutler, L. (1999, June). The differential role of therapist relationship skills and techniques in effective psychotherapy. Paper presented at the Society for Psychotherapy Research, Braga, Portugal.

Beutler, L. E., & Clarkin, J. F. (1990). Systematic treatment selection. New York, NY: Bruner Mazel.

Bohart, A. C. (1998). Review of the book Successful psychotherapy: A caring, loving relationship. Person-Centered Journal, 5, 66–70.

Bohart, A. C. (2007). The actualizing person. In M. Cooper, M. O’Hara, P. F. Schmid, & G. Wyatt (Eds.), The handbook of person-centered psychotherapy and counseling (pp. 47–63). New York, NY: Palgrave Macmillan.

Bohart, A. C., & Greenberg, L. S. (1997). Empathy reconsidered: New directions in psychotherapy. Washington, DC: American Psychological Association.

Bohart, A., & Tallman, K. (1999). How clients make therapy work: The process of active self-healing. Washington, DC: American Psychological Association.

Boss, M. (1963). Psychoanalysis and daisensanalysis. New York, NY: Basic Books.

Bozarth, J. D. (2002). The nondirective attitude in client-centered therapy. Journal of Humanistic Psychology, 42(2), 78–83.

Bozarth, J. D., Zimring, F. M., & Tausch, R. (2002). Client-centered therapy: The evolution of a revolution. In D. J. Cain & J. Seeman (Eds.), Humanistic psychotherapies: Handbook of research and practice (pp. 147–188). Washington, DC: American Psychological Association.

Brodley, B. T., & Brody, A. F. (1990, August). Understanding client-centered therapy through interviews conducted by Carl Rogers. Paper presented at the annual convention of the American Psychological Association, Boston.

Buber, M. (1958). I and thou (R. G. Smith, Trans., 2nd rev. ed.). New York, NY: Scribner.

Burckell, L. A., & Goldfried, M. R. (2006). Therapist qualities preferred by sexual-minority individuals. Psychotherapy: Theory, Research, Practice, Training, 43(1), 32–49.

Burton, A. (1972). Twelve therapists. San Francisco, CA: Jossey-Bass.

Cain, D. J. (1989). The paradox of nondirectiveness in the person-centered approach. Person-Centered Review, 4(2), 123–131.

Cain, D. J. (1990). Further thoughts about nondirectiveness and client-centered therapy. Person-Centered Review, 5(1), 89–99.

Cain, D. J. (1996). Rogers and Sylvia: An intimate and affirming encounter. In B. A. Farber, D. C. Brink, & P. M. Raskin (Eds.), The psychotherapy of Carl Rogers (pp. 275–283). New York, NY: Guilford Press.

Clarkin, J. F., & Levy, K. N. (2004). The influence of client variables on psychotherapy. In M. J. Lambert (Ed.), Bergin and Garfield’s handbook of psychotherapy and behavior change (5th ed., pp. 194–226). New York, NY: Wiley.

Combs, A. W. (1986). What makes a good helper? Person-Centered Review, 1(1), 51–61.

Combs, A. W. (1989). A theory of therapy. Newbury Park, CA: Sage.

Combs, A. W. (1999). Being and becoming. New York, NY: Springer.

Conte, H. R., Ratto, R., Clutz, K., & Karasu, T. B. (1995). Determinants of outpatients’ satisfaction with therapists-relation to outcome. Journal of Psychotherapy Practice and Research, 4(1), 43–51.

Cooper, M. (2003). Between freedom and despair: Existential challenges and contributions to person-centered and experiential therapy. Person-Centered and Experiential Psychotherapies, 2(1), 43–56.

Cooper, M. (2004). Existential approaches to psychotherapy. In P. Sanders (Ed.), The tribes of the person-centered nation (pp. 95–124). Ross-on-Wye. England: PCCS Books.

Cooper, M. (2008). Essential research findings in counseling and psychotherapy. London. England: Sage.

Cooper, M., O’Hara. M., Schmid. P. F., & Wyatt. G. (2007). The handbook of person-centered psychotherapy and counseling. New York. NY: Palgrave Macmillan.

Cornelius-White, J., & Cornelius-White. C. (2005). Reminiscing and predicting: Rogers’s beyond words speech and commentary. Journal of Humanistic Psychology, 45(3), 383–396.

Corsini, R. J., & Auerbach, A. J. (Eds.). (1998). Concise encyclopedia of psychology. New York. NY: Wiley.

Damasio, A. R. (1994). Decartes’ error. New York. NY: Grosset/Putnam.

Dekeyser, M., Prouty, G., & Elliott, R. (2008). Pre-therapy process and outcome: A review of research instruments and findings. Person-Centered and Experiential Psychotherapies. 7(1), 37–55.

Elliott, R. (1985). Helpful and nonhelpful events in in brief counseling interviews: An empirical taxonomy. Journal of Counseling Psychology, 32, 307–322.

Elliott, R., & Greenberg, L. S. (2002). Process-experiential psychotherapy. In D. J. Cain & J. Seeman (Eds.), Humanistic psychotherapies: Handbook of research and practice. (pp. 279–306). Washington. DC: American Psychological Association.

Elliott, R., Greenberg, L. S., & Lietaer, G. (2004). Research on experiential psychotherapies. In M. J. Lambert (Ed.), Bergin and Garfield’s handbook of psychotherapy and behavior change (5th ed., pp. 493–539). New York. NY: Wiley.

Elliott, R., Watson, J. C., Goldman, R. N., & Greenberg, L. S. (2004). Learning emotion focused therapy. Washington. DC: American Psychological Association.

Farber, B. A., Brink, D. C., & Raskin, P. M. (Eds.). (1996). The psychotherapy of Carl Rogers: Cases and commentary. New York. NY: Guilford Press.

Farber, B. A., & Lane, J. S. (2002). Positive regard. In J. C. Norcross (Ed.), Psychotherapy relationships that work (pp. 175–194). New York, NY: Oxford University Press.

Feifel, H., & Eels, J. (1963). Patients and therapists assess the same therapy. Journal of Consulting Psychology, 27(4), 310–318.

Foa, E. B., & Jaycox, L. H. (1999). Cognitive–behavioral treatment of posttraumatic stress disorder. In D. Spiegel (Ed.), Efficacy and cost-effectiveness of psychotherapy (pp. 23–61). Washington, DC: American Psychiatric Publishing.

Francis, K. C. (2009). Questions and answers: Two hours with Carl Rogers. Person-Centered Journal, 16(1–2), 4–35.

Frankl, V. E. (1963). Man’s search for meaning. New York, NY: Washington Square Press.

Frankl, V. E. (1967). Psychotherapy and existentialism. New York, NY: Clarion.

Friedman, M. (1985). The healing dialogue in psychotherapy. New York, NY: Jason Aronson.

Friedman, M. (1986). Carl Rogers and Martin Buber. Person-Centered Review, 1(4), 409–435.

Friedman, M. (1992). Dialogue and the human image. Newbury Park, CA: Sage.

Friedman, M. (2002). Martin Buber and dialogical psychotherapy. Journal of Humanistic Psychology, 42(4), 7–36.

Gendlin, E. T. (1970). A theory of personality change. In J. T. Hart & T. M. Tomlinson (Eds.), New directions in client-centered psychotherapy (pp. 129–173). Boston, MA: Houghton Mifflin.

Gendlin, E. T. (1986). Talk on Experiential Focusing and Rogers’s Contributions [Videotape]. Presented at Beyond Words Symposium at the Chicago Counseling and Psychotherapy Center.

Gendlin, E. T. (1996). Focusing-oriented psychotherapy. New York, NY: Guilford Press.

Glass, C. R., & Arnkoff, D. B. (2000). Consumers’ perspectives on helpful and hindering factors in mental health treatment. Journal of Clinical Psychology, 56(110), 1467–1480.

Goldman, R., Greenberg, L., & Pos, A. (2005). Depth of emotional experience and outcome. Psychotherapy Research, 15, 248–260.

Goldman, R. N., Greenberg, L. S., & Angus, L. A. (2006). The effects of adding emotion-focused interventions to the client-centered relationship conditions in the treatment of depression. Psychotherapy Research, 16(5), 537–549.

Gordon, T. (1970). Parent effectiveness training. New York, NY: Peter H. Wyden.

Grant, B. (2004). The imperative of ethical justification in psychotherapy: The special case of client-centered therapy. Person-Centered and Experiential Psychotherapies, 3(3), 152–165.

Greenberg, L. S., Auszra, L., & Herman, I. R. (2007). The relationship among emotional productivity, emotional arousal and outcome in experiential therapy of depression. Psychotherapy Research, 17(4), 482–493.

Greenberg, L. S., Elliott, R., & Lietaer, G. (1994). Research on humanistic and experiential psychotherapies. In A. E. Bergin & S. L. Garfield (Eds.), Handbook of psychotherapy and behavior change (4th ed., pp. 509–539). New York, NY: Wiley.

Greenberg, L. S., Elliott, R., Watson, J. C., & Bohart, A. C. (2001). Empathy. Psychotherapy: Theory, Research, Practice, Training, 38(4), 380–384.

Greenberg, L. S., & Foerster, F. (1996). Resolving unfinished business: The process of change. Journal of Counseling and Clinical Psychology, 64, 439–446.

Greenberg, L. S., Korman, L. M., & Pavio, S. C. (2002). Emotion in humanistic psychotherapy. In D. J. Cain & J. Seeman (Eds.), Humanistic psychotherapies: Handbook of research and practice (pp. 499–530). Washington, DC: American Psychological Association.

Greenberg, L. S., & Van Balen, R. (1999). The theory of experience-centered therapies. In L. S. Greenberg, J. C. Watson, & G. Lietaer (Eds.), Handbook of experiential psychotherapy (pp. 28–57). New York, NY: Guilford Press.

Greenberg, L. S., & Watson, J. C. (2006). Emotion-focused therapy for depression. Washington, DC: American Psychological Association.

Grote, B. (2005). The experience of feeling really understood in psychotherapy: A phenomenological study. Unpublished doctoral dissertation.

Hart, J. T., & Tomlinson, T. M. (1970). New directions in client-centered therapy. New York, NY: Wiley.

Hendricks, M. N. (2002). Focusing oriented/experiential psychotherapy. In D. J. Cain & J. Seeman (Eds.), Humanistic psychotherapies: Handbook of research and practice (pp. 221–251). Washington, DC: American Psychological Association.

Hill, C. E. (2007). My personal reactions to Rogers (1957): The facilitative but neither necessary nor sufficient conditions of therapeutic personality change. Psychotherapy: Theory, Research, Practice, Training, 44(3), 260–264.

Hirscheimer, K. (1996). Development and verification of a measure of unfinished business. Master’s thesis, Department of Psychology, York University, Toronto, Ontario, Canada.

Hobbs, N. (1951). Group-centered psychotherapy. In C. R. Rogers, Client-centered psychotherapy (p. 292). Boston, MA: Houghton Mifflin.

Hubble, M. A., Duncan, B. L., & Miller, S. D. (1999). Directing attention to what works. In M. A. Hubble, B. L. Duncan, & S. D. Miller (Eds.), The heart and soul of change (pp. 407–447). Washington, DC: American Psychological Association.

Iberg, J. R. (1996). Using statistical experiments with post-session client questionnaires as a student-centered approach to teaching the effects of therapist activities in psychotherapy. In A. Hutterer, R. Pawlowsky, P. F. Schmid & R. Stipsits (Eds.), Client-centered and experiential psychotherapy: A paradigm in motion (pp. 255–271). Frankfurt am Main, Germany: Peter Lang.

Johnson, S. M. (2007). The contribution of emotionally focused couples therapy. Journal of Contemporary Psychotherapy, 37(1), 47–52.

Johnson, S. M., Hunsley, J., Greenberg, L., & Schindler, D. (1999). Emotionally focused couples therapy: Status & challenges. Clinical Psychology: Science & Practice, 6, 67–79.

Jordan, J. V. (1991). The development of women’s sense of self. In J. V. Jordan, A. G. Kaplan, J. B. Miller, L. P. Stiver, & J. L. Surrey (Eds.), Women’s growth in connection: Writings from the Stone Center (pp. 81–96). New York, NY: Guilford Press.

Kirschenbaum, H. (1979). On becoming Carl Rogers. New York, NY: Delacorte.

Kirschenbaum, H. (2007). The life and work of Carl Rogers. Ross-on-Wye, England: PCCS Books.

Kirschenbaum, H., & Jourdan, A. (2005). The current status of Carl Rogers and the person-centered approach. Psychotherapy, 42(1), 37–51.

Klein, M. H., Kolden, G. G., Michels, J. L., & Chisholm-Stockard, S. (2002). Congruence or genuineness. In J. C. Norcross (Ed.), Empirically supported psychotherapy relationships. Psychotherapy: Theory, Research, Practice, Training, 38(4), 396–405.

Kluckhohn, C., Murray, H., & Alexander, H. (Eds.). (1959). Personality formation: The determinants. In C. Kluckholm, H. A. Murray, & D. M. Schneider (Eds.), Personality and nature, society and culture (pp. 53–67). New York, NY: Knopf.

Koch, S. (Ed.). (1959). Psychology: A study of a science. New York, NY: McGraw-Hill.

Laing, R. D. (1969). The divided self. Middlesex, England: Penguin.

Lambert, M. J. (1992). Implications of outcome research for psychotherapy integration. In J. C. Norcross & M. R. Goldstein (Eds.), Handbook of psychotherapy integration. New York, NY: Basic Books.

Lambert, M. J. (2003). Psychotherapy outcome research: Implications for integrative and eclectic therapists. In J. C. Norcross & M. R. Goldfried (Eds.), Handbook of psychotherapy integration (pp. 94–129). New York, NY: Basic Books.

Lazarus, A. A. (2007). On necessity and sufficiency in counseling and psychotherapy (revisited). Psychotherapy: Theory, Research; Practice, Training, 44(3), 253–256

Leijssen, M. (1996). Characteristics of a healing inner relationship. In A. Hutterer, R. Pawlowsky, P. F. Schmid, & R. Stipsits (Eds.), Client-centered and experiential psychotherapy: A paradigm in motion (pp. 427–438). Frankfurt am Main, Germany: Peter Lang.

Levant, R., & Shlien, J. (Eds.). (1984). Client-centered therapy and the person-centered approach. New York, NY: Praeger.

Lietaer, G. (2001). Unconditional acceptance and positive regard. In J. Bozarth & P. Wilkins (Eds.), UPR: Unconditional positive regard (pp. 88–108). Ross-on-Wye, England: PCCS Books.

Lietaer, G., Rombauts, J., & Van Balen, R. (Eds.). (1990). Client-centered and experiential psychotherapy in the nineties. Leuven, Belgium: Leuven University Press.

Lindauer, M. S. (1998). The phenomenal method. In R. J. Corsini & A. J. Auerbach (Eds.), Concise encyclopedia of psychology. New York, NY: Wiley.

Mac Dougall, C. (2002). Rogers’ person-centered approach: Considerations for use in multicultural counseling. Journal of Humanistic Psychology, 42(2), 48–65.

Mahoney, M. J. (1991). Human change processes. New York, NY: Basic Books.

Mahrer, A. R., Nadler, W. P., Dessaulles, A., Gervaize, P. A., & Sterner, I. (1987). Good and very good moments in psychotherapy: Content, distribution, and facilitation. Psychotherapy, 24, 7–14.

Mahrer, A. (2007). To a large extent, the field got it wrong: New learnings from a new look at an old classic. Psychotherapy: Theory, Research, Practice, Training, 44(3), 274–278.

Malcolm, W. (1999). Relating process to outcome in the treatment of unfinished business in process experiential therapy. Unpublished doctoral dissertation, York University, Toronto, Ontario, Canada.

Maslow, A. H. (1987). Motivation and personality. New York, NY: Harper and Row.

May, R. (1958). Existence: A new dimension in psychiatry and psychology. New York, NY: Simon and Schuster.

Mearns, D., & Cooper, M. (2005). Working at relational depth in counseling and psychotherapy. London, England: Sage.

Mearns, D., & Thorne, B. (2007). Person-centered counseling in action (3rd ed.). London, England: Sage.

Merrill, C., & Anderson, S. (1993). A content analysis of person-centered expressive therapy outcomes. The Humanistic Psychologist, 21, 354–363.

Miller, S. D., Duncan, B. L., & Hubble, M. A. (1997). Escape from Babel. New York, NY: Norton.

Missirlian, T., Toukmanian, S., Warwar, S., &. Greenberg, L. (2005). Emotional arousal, client perceptual processing, and the working alliance in experiential psychotherapy for depression. Journal of Consulting & Clinical Psychology, 73(5), 861–871.

Mohr, D. C. (1995). Negative outcome in psychotherapy—a critical review. Clinical Psychology: Science and Practice, 2(1), 1–27.

Moustakas, C. E. (1995). Being-in, being-for, being-with. Northvale, NJ: Jason Aronson.

Nicholas, M. (1994). The mystery of goodness and the positive moral consequences of psychotherapy. New York; NY: Norton.

Orlinsky, D. E., Grawe, K., & Parks, B. K. (1994). Process and outcome in psychotherapy: Noch einmal. In S. L. Garfield & A. E. Bergin (Eds.), Handbook of psychotherapy and behavior change (4th ed., pp. 270–376). New York, NY: Wiley.

Ornish, D. (1997). Love and survival. New York, NY: Harper Collins.

Paivio, S., & Greenberg, L. (1995). Resolving unfinished business: Efficacy of experiential therapy using empty-chair dialogue. Journal of Consulting and Clinical Psychology, 63, 419–425.

Patterson, C. H. (1996). Multicultural counseling: From diversity to universality. Journal of Counseling and Development, 74, 227–231.

Paulson, B. L., Everall, R. D., & Janice, S. (2002). Client perception of hindering experiences in counseling. Counseling and Psychotherapy Research, 1(1), 53–61.

Pedersen, P. B. (1991). Multiculturalism as a generic approach to counseling. Journal of Counseling & Development, 70, 6–12.

Pedersen, P. B., Lonner, W., & Draguns, J. (Eds.). (1976). Counseling across cultures. Honolulu, HI: University Press of Hawaii.

Prouty, G. (1994). Theoretical evolutions in person-centered/experiential therapy applications to schizophrenic and retarded psychoses. Westport, CT: Praeger.

Prouty, G. (1999). Pre-therapy and pre-symbolic experiencing evolutions in person-centered/experiential approaches. In L. S. Greenberg, J. C. Watson & G. Lietaer (Eds.), Handbook of experiential psychotherapy (pp. 388–409). New York, NY: Guilford Press.

Prouty, G., VanWerde, D., & Portner, M. (2002). Pre-therapy: Reaching contact-impaired clients. Ross-on-Wye, England: PCCS Books.

Rennie, D. L. (2002). Experiencing psychotherapy: Grounded theory studies. In D. J. Cain & J. Seeman (Eds.), Humanistic psychotherapies: Handbook of research and practice (pp. 117–144). Washington, DC: American Psychological Association.

Rice, L. N. (1974). The evocative function of the therapist. In D. A. Wexler & L. N. Rice (Eds.), Innovations in client-centered therapy (pp. 289–311). New York, NY: Wiley.

Rogers, C. R. (1937). Clinical treatment of the problem child. Boston, MA: Houghton Mifflin.

Rogers, C. R. (1942). Counseling and psychotherapy. Boston, MA: Houghton Mifflin.

Rogers, C. R. (1951). Client-centered Therapy. Boston, MA: Houghton Mifflin.

Rogers, C. R. (1957). The necessary and sufficient conditions of therapeutic personality change. Journal of Consulting Psychology, 21(2), 95–103.

Rogers, C. R. (1959). A theory of therapy, personality, and interpersonal relationships as developed in the client-centered framework. In S. Koch (Ed.), Psychology: A study of science, Vol. 3 Formulations of the person and the social context (pp. 184–256). New York, NY: McGraw-Hill.

Rogers, C. R. (1961). On becoming a person. Boston, MA: Houghton Mifflin.

Rogers, C. R. (1967). The therapeutic relationship and its impact: A study of psychotherapy with schizophrenics. Madison: University of Wisconsin Press.

Rogers, C. R. (1970). Carl Rogers on encounter groups. New York, NY: Harper & Row.

Rogers, C. R. (1972). My personal growth. In A. Burton (Ed.), Twelve therapists (pp. 28–77). San Francisco, CA: Jossey-Bass.

Rogers, C. R. (1977). Carl Rogers on personal power. New York, NY: Delacorte.

Rogers, C. R. (l980). A way of being. Boston, MA: Houghton Mifflin.

Rogers, C. R. (1986). A comment from Carl Rogers. Person-Centered Review, 1, 3–5.

Rogers, C., & Dymond, R. (1954). Psychotherapy and personality change. Chicago, IL: University of Chicago Press.

Rogers, C. R., & Sanford, R. C. (1989). Client-centered psychotherapy. In H. I. Kaplan & B. J. Sadock (Eds), Comprehensive handbook of psychiatry (pp. 1482–1501). Baltimore, MD: Williams & Wilkins.

Rogers, C. R., & Stevens, B. (1967). Person to person: The problem of being human. New York, NY: Pocket Books.

Rogers, C. R., Perls, F. S., & Ellis, A. (1965). Three approaches to psychotherapy [Film]. Psychological Films, Inc.

Rogers, N. (n.d.). Welcome to my website. Retrieved October 2, 2009, from http://www.nrogers.com.

Sachse, R., & Elliott, R. (2002). Process-outcome research on humanistic therapy variables. In D. J. Cain & J. Seeman (Eds.), Humanistic psychotherapies: Handbook of research and practice (pp. 83–115). Washington, DC: American Psychological Association.

Safran, J. D., Muran, J. C., & Samstag, L. W. (1994). Resolving therapeutic alliance ruptures: A task analytic investigation. In A. O. Horvath & L. S. Greenberg (Eds.), The working alliance: Theory, research, and practice (pp. 225–255). New York, NY: Wiley.

Samstag, L. W. (2007). The necessary and sufficient conditions of therapeutic personality change: Reaction to Rogers’s 1957 article. Psychotherapy: Theory, Research, Practice, Training, 44(3), 295–299.

Sanders, P. (Ed.). (2004). The tribes of the person-centered nation. Ross-on-Wye, England: PCCS Books.

Schneider, K. J., & May, R. (1995). The psychology of existence. New York, NY: McGraw-Hill.

Seeman, J. (1965). Perspectives in client-centered therapy. In B. B. Wolman (Ed.), Handbook of clinical psychology (pp. 1215–1229). New York, NY: McGraw-Hill.

Seeman, J. (1988). Self-actualization: A reformulation. Person-Centered Review, 3(2), 304–315.

Seeman, J. (2002). Looking back, looking ahead: A synthesis. In D. J. Cain & J. Seeman (Eds.), Humanistic psychotherapies: Handbook of research and practice (pp. 617–636). Washington, DC: American Psychological Association.

Shlien, J. M. (2003). To lead an honorable life. Ross-on-Wye, England: PCCS Books.

Silberschatz, G. (2007). Comments on "the necessary and sufficient conditions of therapeutic personality change." Psychotherapy: Theory, Research, Practice, Training, 44(3), 265–267.

Smith, D. (1982). Trends in counseling and psychotherapy. American Psychologist, 37, 802–809.

Sue, D. W., & Sue, D. (1990). Counseling the culturally different: Theory and practice (2nd ed.). New York, NY: Wiley.

Sue, S. (1983). Ethnic minorities in psychology: A reexamination. American Psychologist, 38, 583–592.

Sullivan, H. S. (1947). Conceptions of modern psychiatry. Washington, DC: William Alanson White Foundation.

Taft, J. (1933). The dynamics of therapy in a controlled relationship. New York, NY: Macmillan.

Tageson, C. W. (1982). Humanistic psychology: A synthesis. Homewood, IL: Dorsey Press.

The top 10: The most influential therapists of the past quarter-century. (2007, April). The Psychotherapy Networker.

Truax, C. B., & Carkhuff, R. R. (1967). Toward effective counseling and psychotherapy. Chicago, IL: Aldine.

Truax, C. B., & Mitchell, K. M. (1971). Research on certain therapist interpersonal skills in relation to process and outcome. In A. E. Bergin & S. L. Garfield (Eds.), Handbook of psychotherapy and behavior change (pp. 299–344). New York, NY: Wiley.

Twenge, J. M. (2006). Generation me. New York, NY: Free Press.

Vollmer, B., Grote, J., Lange, R., & Walker, C. (2009). A therapy preferences interview: Empowering clients by offering choices. Psychotherapy Bulletin, 44(2), 33–37.

Wachtel, P. L. (2007). Carl Rogers and the larger context of therapeutic thought. Psychotherapy: Theory, Research, Practice, Training, 44, 279–284.

Warner, M. (2000). Person-centered psychotherapy: One nation, many tribes. Person-Centered Journal, 7(1), 28–39.

Warwar, N., & Greenberg, L. (1999, June). Emotional processing and therapeutic change. Paper presented at the International Society for Psychotherapy Research Annual Meeting, Braga, Portugal.

Watson, J. C. (2002). Re-visioning empathy: Research, practice and theory. In D. J. Cain & J. Seeman (Eds.), Humanistic psychotherapies: Handbook of research and practice (pp. 445–471). Washington, DC: American Psychological Association.

Watson, J. C., Goldman, R. N., & Warner, M. S. (Eds.). (2002). Client-centered and experiential psychotherapy: Advances in theory, research and practice. Ross-on-Wye, England: PCCS Books.

Watson, J. C., Greenberg, L. S., & Lietaer, G. (1998). The experiential paradigm unfolding. In L. S. Greenberg, J. C. Watson, & G. Lietaer (Eds.), Handbook of experiential psychotherapy (pp. 1–27). New York, NY: Guilford Press.

Watson, N. (1984). The empirical status of Rogers’s hypothesis of the necessary and sufficient conditions for effective psychotherapy. In R. E. Levant & J. M. Shlien (Eds.), Client-centered therapy and the person-centered approach (pp. 17–40). New York, NY: Praeger.

Wexler, D., & Rice, L. (1974). Innovations in client-centered therapy. New York, NY: Wiley.

Wolman, B. B. (Ed.). (1965). Handbook of clinical psychology. New York, NY: McGraw-Hill.

Worsley, R. (2004). Integrating with integrity. In P. Sanders (Ed.), The tribes of the person-centered nation (pp. 125–147). Ross-on-Wye, England: PCCS Books.

Yalom, I. (1980). Existential psychotherapy. New York, NY: Basic Books.

Yalom, I. (1989). Love’s executioner. New York, NY: Basic Books.

Yontef, G. (1993). Awareness, dialogue and process: Essay in gestalt therapy. Highland, NY: Gestalt Journal Press.

Yontef, G. (2007). The power of the immediate moment in gestalt therapy. Journal of Contemporary Psychotherapy, 37(1), 17–23.

Zimring, F. M., & Raskin, N. J. (1992). Carl Rogers and client/person-centered therapy. In D. K. Freedhelm (Ed.), History of psychotherapy (pp. 629–656). Washington, DC: American Psychological Association.

About the Author

David J. Cain, PhD, ABPP, is the editor of Humanistic Psychotherapies: Handbook of Research and Practice (2002) and of Classics in the Person-Centered Approach (2002). He received his doctorate in clinical and community psychology from the University of Wyoming. At present, he teaches at the California School of Professional Psychology at Alliant International University, San Diego, and in the psychology department at Chapman University. A former colleague of Carl Rogers, he is the founder of the Association for the Development of the Person-Centered Approach and was the founder and editor of the Person-Centered Review. He is a diplomate and fellow in clinical psychology of the American Board of Professional Psychology and a member of the National Register of Certified Group Psychotherapists. Dr. Cain is the psychotherapy editor for the Journal of Humanistic Psychology and serves on the editorial boards of The Humanistic Psychologist, Person-Centered and Experiential Psychotherapies, Person-Centered Journal, and the Journal of Contemporary Psychotherapy. He edited a special issue of the Journal of Humanistic Psychotherapy entitled “Advancing Humanistic Psychology in the 21st Century” and edited a special issue of the Journal of Contemporary Psychotherapy entitled “Contributions of Humanistic Psychotherapies to the Field of Psychotherapy.” Dr. Cain is a former president of the Society for Humanistic Psychology of the American Psychological Association and initiated its first annual conference. His primary professional commitment is the advancement of humanistic psychology and psychotherapy. He maintains a private practice in Carlsbad and San Marcos, California.