Some implications

Although the client-centered approach had its origin purely within the limits of the psychological clinic, it is proving to have implications, often of a startling nature, for very diverse fields of effort. I should like to suggest a few of these present and potential implications.

In the field of psychotherapy itself, it leads to conclusions that seem distinctly heretical. It appears evident that training and practice in therapy should probably precede training in the field of diagnosis. Diagnostic knowledge and skill is not necessary for good therapy, a statement which sounds like blasphemy to many, and if the professional worker, whether psychiatrist, psychologist or caseworker, received training in therapy first he would learn psychological dynamics in a truly dynamic fashion, and would acquire a professional humility and willingness to learn from his client which is today all too rare.

The viewpoint appears to have implications for medicine. It has fascinated me to observe that when a prominent allergist began to use client-centered therapy for the treatment of non-specific allergies, he found not only very good therapeutic results, but the experience began to affect his whole medical practice. It has gradually meant the reorganization of his office procedure. He has given his nurses a new type of training in understanding the patient. He has decided to have all medical histories taken by a non-medical person trained in nondirective techniques, in order to get a true picture of the client's feelings and attitudes toward himself and his health, uncluttered by the bias and diagnostic evaluation which is almost inevitable when a medical person takes the history and unintentionally distorts the material by his premature judgments. He has found these histories much more helpful to the physicians than those taken by physicians.

The client-centered viewpoint has already been shown to have significant implications for the field of survey interviewing and public opinion study. Use of such techniques by Likert, Lazarsfeld, and others has meant the elimination of much of the factor of bias in such studies.

This approach has also, we believe, deep implications for the handling of social and group conflicts, as I have pointed out in another paper (9). Our work in applying a client-centered viewpoint to group therapy situations, while still in its early stages, leads us to feel that a significant clue to the constructive solution of interpersonal and intercultural frictions in the group may be in our hands. Application of these procedures to staff groups, to inter-racial groups, to groups with personal problems and tensions, is under way.

In the field of education, too, the client-centered approach is finding significant application. The work of Cantor, a description of which will soon be published, is outstanding in this connection, but a number of teachers are finding that these methods, designed for therapy, produce a new type of educational process, an independent learning which is highly desirable, and even a reorientation of individual direction which is very similar to the results of individual or group therapy.

Even in the realm of our philosophical orientation, the client-centered approach has its deep implications. I should like to indicate this by quoting briefly from a previous paper.

As we examine and try to evaluate our clinical experience with client-centered therapy, the [p. 422] phenomenon of the reorganization of attitudes and the redirection of behavior by the individual assumes greater and greater importance. This phenomenon seems to find inadequate explanation in terms of the determinism which is the predominant philosophical background of most psychological work. The capacity of the individual to reorganize his attitudes and behavior in ways not determined by external factors nor by previous elements in his own experience, but determined by his own insight into those factors, is an impressive capacity. It involves a basic spontaneity which we have been loathe to admit into our scientific thinking.

The clinical experience could be summarized by saying that the behavior of the human organism may be determined by the influences to which it has been exposed, but it may also be determined by the creative and integrative insight of the organism itself. This ability of the person to discover new meaning in the forces which impinge upon him and in the past experiences which have been controlling him, and the ability to alter consciously his behavior in the light of this new meaning, has a profound significance for our thinking which has not been fully realized. We need to revise the philosophical basis of our work to a point where it can admit that forces exist within the individual which can exercise a spontaneous and significant influence upon behavior which is not predictable through knowledge of prior influences and conditionings. The forces released through a catalytic process of therapy are not adequately accounted for by a knowledge of the individual's previous conditionings, but only if we grant the presence of a spontaneous force within the organism which has the capacity of integration and redirection. This capacity for volitional control is a force which we must take into account in any psychological equation (9).

So we find an approach which began merely as a way of dealing with problems of human maladjustment forcing us into a revaluation of our basic philosophical concepts.