Just as psychoanalysis is based on the personality theories of Freud and the neo- Freudians, humanistic therapy is a psychological treatment based on the personality theories of Carl Rogers and other humanistic psychologists. Humanistic therapy is based on the idea that people develop psychological problems when they are burdened by limits and expectations placed on them by themselves and others, and the treatment emphasizes the person’s capacity for self-realization and fulfillment. Humanistic therapies attempt to promote growth and responsibility by helping clients consider their own situations and the world around them and how they can work to achieve their life goals.
Carl Rogers developed person-centered therapy (or client-centered therapy), an approach to treatment in which the client is helped to growand develop as the therapist provides a comfortable, nonjudgmental environment. In his book, AWayof Being (1980), 1 Rogers argued that therapy was most productive when the therapist created a positive relationship with the client—a therapeuticalliance. The therapeutic alliance is a relationship between the client and thetherapist that is facilitated when thetherapist is genuine (i.e., heor shecreates no barriers to free-flowing thoughts and feelings), when thetherapist treats the client with unconditional positive regard (i.e., values the client without anyqualifications, displayingan accepting attitude toward whatever the client is feeling at themoment), and when thetherapistdevelops empathy with the client(i.e., that heor sheactivelylistens to andaccuratelyperceives thepersonal feelings that the client experiences).
The development of a positive therapeutic alliance has been found to be exceedingly important to successful therapy. The ideas of genuineness, empathy, and unconditional positive regard in a nurturing relationship in which the therapist actively listens to and reflects the feelings of the client is probably the most fundamental part of contemporary psychotherapy (Prochaska & Norcross, 2007). 2
Psychodynamic and humanistic therapies are recommended primarily for people suffering from generalized anxiety or mood disorders, and who desire to feel better about themselves overall. But the goals of people with other psychological disorders, such as phobias, sexual problems, and obsessive-compulsive disorder (OCD), are more specific. A person with a social phobia may want to be able to leave his or her house, a person with a sexual dysfunction may want to improve his or her sex life, and a person with OCD may want to learn to stop letting his obsessions or compulsions interfere with everyday activities. In these cases it is not necessary to revisit childhood experiences or consider our capacities for self-realization—we simply want to deal with what is happening in the present.
Cognitive-behavior therapy (CBT) is a structuredapproach to treatment that attempts to reduce psychological disorders through systematicprocedures based on cognitiveand behavioral principles. As you can see in Figure 13.2, CBT is based on the idea that there is a recursive link among our thoughts, our feelings, and our behavior. For instance, if we are feeling depressed, our negative thoughts (“I am doing poorly in my chemistry class”) lead to negative feelings (“I feel hopeless and sad”), which then contribute to negative behaviors (lethargy, disinterest, lack of studying). When we or other people look at the negative behavior, the negative thoughts are reinforced and the cycle repeats itself (Beck, 1976). 3 Similarly, in panic disorder a patient may misinterpret his or her feelings of anxiety as a sign of an impending physical or mental catastrophe (such as a heart attack), leading to an avoidance of a particular place or social situation. The fact that the patient is avoiding the situation reinforces the negative thoughts. Again, the thoughts, feelings, and behavior amplify and distort each other.
CBT is a very broad approach that is used for the treatment of a variety of problems, including mood, anxiety, personality, eating, substance abuse, attention-deficit, and psychotic disorders. CBT treats the symptoms of the disorder (the behaviors or the cognitions) and does not attempt to address the underlying issues that cause the problem. The goal is simply to stop the negative cycle by intervening to change cognition or behavior. The client and the therapist work together to develop the goals of the therapy, the particular ways that the goals will be reached, and the timeline for reaching them. The procedures are problem-solving and action-oriented, and the client is forced to take responsibility for his or her own treatment. The client is assigned tasks to complete that will help improve the disorder and takes an active part in the therapy. The treatment usually lasts between 10 and 20 sessions.
Depending on the particular disorder, some CBT treatments may be primarily behavioral in orientation, focusing on the principles of classical, operant, and observational learning, whereas other treatments are more cognitive, focused on changing negative thoughts related to the disorder. But almost all CBT treatments use a combination of behavioral and cognitive approaches.