Group therapy or psychotherapy in the United States, has a long history that dates back into the late nineteenth and early twentieth centuries. During this time the America was being bombarded by masses of immigrants. Most of these immigrants settled in large cities. Organizations such as Hull House in Chicago were founded to assist them in adjusting to life in the United States. Known as settlement houses, these agencies helped immigrant groups lobby for better housing, working conditions, and recreational facilities.
These early social work groups valued group participation, the democratic process, and personal growth (Kaplan, 1998). Eventually these groups began meeting in prisons, mental hospitals, and public assistance agencies; and that is what we now know as the beginning of early group therapy, in which one or more therapists treat a small group of clients together as a group. Group therapy varies from the one on one therapeutic relationship between therapist and patient to additional individuals in the session to assist with individual growth and problem solving.
There are several different types of therapy groups, Psychodynamic, conceived by Sigmund Freud, focuses on helping individuals become more sensitive to their unconscious needs and motivations as well as the concerns common to all group members. Freud would concentrate on the authority of the group leader to the members and the affection between group members to understand relationships and the affection individuals themselves. In another form of therapy, behavior therapy, individuals are encouraged to become self aware, and to pay attention to events that happen before, during and after problems occur.
Techniques are then developed to replace the problem behavior with new more adaptive behavior. (Hales, 1995) There is also the practice of phenomenological therapies. Within this type of therapy you will find psychodrama, developed by Jacob Moreno, which allows members to act out conflict in their lives. It is especially helpful for those who may find it difficult to use words. Finally, there is also Fritz Perls and his Gestalt therapy, in which members take turns and become aware of feelings they had through an empty chair technique.
This essay will focus on further discussion psychologist Carl Rogers and his therapeutic approach: the underlying concentration of the person -centered belief is that humans are capable of consciously controlling their behavior and ultimately taking responsibility for their actions. Person-centered therapy was developed by psychologist Carl Rogers in the early 1940s. It is one of the most inflectional and commonly used models in mental health and psychotherapy (Prochaska, & Norcross, (2007).
In this technique, therapists create a comfortable, non-judgmental atmosphere by demonstrating congruence empathy, and unconditional positive regard toward their patients while using a non-directive approach. This allows the patients to seek out their own answers to their problems. Carl Rogers assisted his patients taking responsibility for themselves and their lives. He believed that the experience of being understood and valued gives the individual the freedom to grow.
Rogerian counseling involves the counselor's entry into the person's unique phenomenological world. In mirroring this world, the counselor does not disagree or point out contradictions (Ward & King.,et al, 2000). Neither does he or she attempt to probe into the unconscious of the patient. Rogers describes counseling as a process of liberating a person and removing obstacles so that normal growth and development can proceed and the person can become more independent and self-directed( Haggbloom,2002).
Rather than viewing the therapist as an expert, Rogers believed that the client's own drive toward growth and development is the most vital therapeutic factor. It is the therapist’s job to empathize with the client's feelings and perceptions, helping him or her gain insight and develop a constructive plan of action.
Rogers's person-centered therapy became the basis for the intensive group experience known as the encounter group, in which the leader helps members discuss their feelings about one another and, through the group process, grow as individuals (Walker, 2001). Rogers emphasized honest feedback and the awareness, expression, and acceptance of feelings. He believed that a trusting and unified atmosphere is imperative to the therapeutic effect of the group.
This therapeutic counseling closely resembles that of Gestalt and Existential group counseling as it stresses the importance of self awareness. Rogers believed that each member has a tendency of growth within the group to a healthy state and has the capacity to be responsible and caring towards the other individuals who are engaging in the group. There is an emphasis on the subjective feelings of the individual, rather than an objective goal oriented frame of reference (Khan, 1999).
The group leader’s authority in the group is one based upon the relationship of the leader to group members rather than the group leader’s ability to direct based upon the dynamics of the group. It is centered on the anticipation that group members have the ability to transform based upon their own self understanding. The movement is away from the concept of control direction of events to one self realization.
Rogers believed that the most important factor in successful therapy was not the therapist's skill or training, but rather his or her attitude. Three consistent attitudes on the part of the therapist are essential to the success of person-centered therapy, congruence, unconditional positive regard, and empathy (Myers, 2000).
Congruence refers to the therapist's or group leader’s openness and genuineness and the willingness to relate to clients without hiding behind a professional front. Therapists who act in this particular way have all their feelings accessible to them in therapy sessions and may choose to share significant emotional reactions with their clients at various moments. This does not mean, however, that the leader will divulge their own personal problems and in anyway turn the focus away from the group members (Kensit, 2000).
Next, in good Rogerian form the therapist would have the upmost unconditional positive regard for the members of the group and accepting them in their entirety for who they are without evaluating or censoring, and not disapproving of particular feelings, actions, or characteristics that they may display.
The group leader’s attitude should not be threatening, hostile or defensive, where the individuals of the group may feel a sense of negative response or rejection. But yet, there should be open communication among the group and a non judgmental atmosphere where the group feels the openness and willingness to share raw and abnormal feelings without being disrupted.
Rogers also discusses it is important as the therapist to listen to the patient or group members but be aware of advice giving in a therapeutic setting (Cooper & Schmid., et al, 2007). And the last necessary element that Rogers discussed of a therapist's attitude is empathy. It is the therapist’s job to strive to understand the patient’s circumstances from his or her point of view.
The group leader should try to connect on an emotional level with the members of the group to show an emotional understanding and sensitivity to each of their feelings throughout the sessions (Myers, 2000) “In other systems of therapy, empathy with the client would be considered a preliminary step to enabling the therapeutic work to proceed; but in person-centered therapy, it actually constitutes a major portion of the therapeutic work itself” (Bohart, 2003).
The most important approach of presenting empathy to the members of the group is by active listening that shows careful and observant attention to what the patient is actually saying. Rogers also encourages the therapist, when using his methods to utilize reflection to the group members. This would mean when a patient or member is talking you not only use eye contact and active listening but you as the leader paraphrasing and summarizing what the client has just spoken.
This allows the client and the group to reflect on what they have just said and examine their own thoughts and emotions on that subject and also for the therapist to listen diligently and precisely to be able to elaborate on the client’s feelings and emotions that were just expressed. When the therapist is correctly utilizing congruence, unconditional positive regard, and empathy, Rogers conveys that this allows the group members or clients to unreservedly be themselves throughout the therapeutic process and without fear of the leader judging them.
The therapist’s job is not to change the client's beliefs or thought’s in any way. Even if the group members are to express negative feelings or thoughts these are also validated as justifiable and acceptable experiences (Kensit, 2000). This approach of being nondirective, allowing the client to lead and explore the issues that are most important in their lives, allows them to choose which is most vital at that moment and this way it not chosen by the therapist.
A true Rogerian believes the main goal for any therapeutic process, whether it be in a group or one on one counseling, is for your patients to find self-actualization. The therapist or leader will facilitate this process by creating an environment in which the group or client can connect in an undirected, uncensored self- exploration and alternative ways of thinking and encourage personal growth.
In researching person-centered or client-centered group therapy, Rogers emphasized particular characteristics that the ones who should model his methods should know as a true Rogerian. But as a true Rogerian, He did point out there was no proper techniques to his methods that was not a word he chose to use often . Carl Rogers encouraged the therapist or group leader to be genuinely empathetic with a non -possessive warmth for empathy expressing this was the most important element of the process as Rogers’s states in his own words “Then, in my experience, there are other situations in which the empathic way of being has the highest priority.
When the other person is hurting, confused, troubled, anxious, alienated, terrified; or when he or she is doubtful of self-worth, uncertain as to identity, then understanding is called for. The gentle and sensitive companionship of an empathic stance - accompanied of course by the other two attitudes - provides illumination and healing. In such situations deep understanding is, I believe, the most precious gift one can give to another."
Every therapist should have a genuine caring and respect for its clients or group members, but the foundation of an effective group program is to provide the feeling of stability in order to not only facilitate meaningful insight, but to reduce anxiety and increase the feeling of security. Leadership in a group setting must provide the supervision necessary to facilitate the growth of the members. Every successful therapeutic group program provides this. An effective group leader can be both genuinely empathetic and understanding and at the same time directive.
Works Cited Bohart, A.C. (2003). Relational Healing: To Be Understood And To Understand Journal of Humanistic Psychology January 43: 86-104 Cooper M., Schmid P., O'Hara M., Wyatt G. (2007). The Handbook of Person-Centered Psychotherapy and Counseling. Basingstoke: Palgrave. Haggbloom, S.J. et al. (2002). The 100 Most Eminent Psychologists of the 20th Century. Review of General Psychology. Vol. 6, No. 2, 139–15. Haggbloom et al. Hales, D. & Hales, R.E. ( 1995). Caring for the Mind: A Comprehensive Guide to Mental Health.
New York: Bantam Books, Kahn, E. (1999). A Critique of Nondirectivity in the Person-Centered Approach. Journal of Humanistic Psychology 39, no. 4 94-110. Kaplan, H. I. & Sadock, B.J. (1998). Synopsis of Psychiatry. 8th edition. Baltimore: Lippincott Williams and Wilkins. Kensit, D. A (2000). Rogerian Theory: A Critique of the Effectiveness of Pure Client-Centred Therapy. Counselling Psychology Quarterly 13, no. 4 345-351. Myers, S. (2000).
Empathic Listening: Reports on the Experience of Being Heard. Journal of Humanistic Psychology 40, no. 2 148-173. Norcross, J. C. & Prochaska, J. O. (2007). Systems of Psychotherapy: A Transtheoretical Analysis, Sixth Edition. Belmont, CA: Thompson Brooks/Cole. Walker, M. T. (2001). Practical Applications of the Rogerian Perspective in Postmodern Psychotherapy. Journal of Systemic Therapies 20, no. 2 41-57. Rogers, C. R. (1975) Empathic — an Unappreciated Way of Being. The Counseling Psychologist 5, no. 2 2-10.
Also published in Rogers, Carl R. A Way of Being. Boston: Houghton-Mifflin, (1980). Ward, E., King,M., Lloyd,M., Bower,P., Sibbald, B., Farrelly, S., et al. (2000) Randomised Controlled Trial of Non-Directive Counselling, Cognitive-Behaviour Therapy, and Usual General Practitioner Care for Patients with Depression. I: Clinical Effectiveness. British Medical Journal 321, no. 72731383-1388.