Psychotherapy: Theory, Research, Practice, Training Copyright 2007 by the American Psychological Association

2007, Vol. 44, No. 3, 249 –252 0033-3204/07/$12.00 DOI: 10.1037/0033-3204.44.3.249

WHAT HAS PSYCHOTHERAPY INHERITED FROM

CARL ROGERS?

MARVIN R. GOLDFRIED
Stony Brook University
Rogers’ classic article on the necessary necessary and sufficient conditions for therapeutic
and sufficient conditions for therapeutic change (Rogers, 1957), especially since this was
change—now 50 years old— has made probably most important article I read as a first year
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.

graduate student. I have vivid recollections of the

an indelible impact on the field. In his
This document is copyrighted by the American Psychological Association or one of its allied publishers.

excitement when reading it and even have the orig-

brief article, Rogers broke with the inal journal with my parenthetical comments in the
past, making a compelling case for the margins. I saw it then, as I do now, as being a
importance of subjecting our hypothe- landmark contribution to the field.
ses about how therapy works to empiri-
cal test. Moreover, his emphasis on the Impact on the Field
importance of the therapy relationship
is now routinely accepted as necessary, This brief article of Rogers— only nine pages
long— contains the foundation for much of what
even if not sufficient for change to oc- exists in contemporary psychotherapy. It has
cur. Having moved beyond Rogers’ been cited in the literature over a thousand times,
necessary and sufficient conditions, the in professional writings originating in 36 coun-
field of therapy now recognizes that as tries. As can be seen in Figure 1, it is more popular
important as the therapy relationship now than it was 20 years ago, with some indication
might be, there are certain clinical that its impact continues to be recognized.
In many respects, this pivotal article reflects a
problems that require the use of spe- break with the past. The latent theme contained in
cific techniques to bring about change. Rogers’ contribution is that we can no longer
Still, it is currently recognized that assume therapy procedures or theory are valid at
therapist acceptance is essential, that face value, and that we can no longer rely on the
nondirective methods can be effective in say-so of articulate or charismatic clinicians. In-
stead, theoretical conceptions of psychotherapy
improving client motivation, and per- must be translated into if-then hypotheses, which
haps most important, that the needs to are capable of empirical investigation. Indeed,
work toward the development of Rogers also suggests that a comprehensive theo-
evidence-based interventions. retical superstructure may not even be necessary
in order to test the hypotheses.
Keywords: psychotherapy, psychother- Rogers’ emphasis on psychotherapy research
has provided a platform on which current out-
apy research, evidenced-based therapy, come and process investigations have been based.
psychotherapy integration, therapy Although the field has clearly become much more
relationship specialized over the years, Rogers conducted
some of the earliest studies to determine whether
or not a therapeutic intervention worked. More-
It is especially gratifying to have been given over, his use of wire recordings—which predated
asked to comment on Rogers’ classic article on the the tape recorder—served as a ground-breaking
methodology by which the process of therapy
Correspondence concerning this article should be ad- could be investigated.
dressed to Marvin R. Goldfried, Department of Psychology, The fact that client-centered therapy has all but
Stony Brook University, Stony Brook, NY 11794-2500. disappeared is an indication of the very important
E-mail: [email protected] impact that Rogers has made. In contrast to the

249
 Goldfried
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
This document is copyrighted by the American Psychological Association or one of its allied publishers.

FIGURE 1. Year by year citations of Rogers’ 1957 article since its publication.

presumed mechanisms of change associated with the years that carefully arranged exposure to the
psychodynamic therapy at the time (e.g., inter- feared object or situation is needed.
pretation, insight), Rogers emphasized the thera- Rogers’ 1957 article may very well have led
peutic value of a good therapy relationship. Over some workers in the field to conclude that it is the
the years, clinical experience and empirical re- therapeutic relationship accounts for most of the
search has affirmed his thesis, such that most change and that specific techniques have little
approaches to therapy now acknowledge what impact (see Goldfried & Davila, 2005). The con-
Rogers emphasized a half century ago. Indeed, temporary debate as to whether it is the relation-
one of the signs that a movement has been suc- ship or the technique that produces change fails
cessful is the fact that it convinces everyone that to recognize that each can have a significant
it is justified and, therefore, no longer needs to influence on the other. Without a strong thera-
exist as a separate movement. peutic bond, exposure techniques in dealing with
anxiety disorders (e.g., PTSD) could not be im-
Limitations of Rogers’ Contributions plemented. In order to be able to tolerate the
anxiety and discomfort associated with exposure,
One of the underlying assumptions of Rogers’ clients need to have a safe environment and the
approach is that people possess an inborn ten- belief that tolerating such discomfort will help.
dency to grow psychologically, and that all the This feeling of safety and faith in the distressing
therapist needs to do is to provide for the condi- procedures requires the assurance of a trusted
tions for change to occur. Is always been my therapist. Moreover, there are instances where the
impression that this basic assumption is tied to therapy relationship is enhanced by the effective
the fact that Rogers’ early work with client- use of a technique, as in the case where clients
centered therapy was used with college students, finding that relaxation training helps them to cope
many of whom were searching for their identity with their anxiety. As Gelso and Hayes (1998)
and direction in life. Under such circumstances, have observed, the therapeutic relationship and
acceptance, reflection, and other similar aspects technique:
of the client-centered approach were all that was
necessary to provide the needed clarification. Constantly interact with and influence one another. There is a
profound synergism between the two. The techniques used by
However, if one is dealing with a very clearly the therapist, for example—and certainly the manner in which
delineated clinical problem, such as a phobic they are used—influence the kind of relationship that unfolds.
reaction, it has been clearly demonstrated over Likewise, how the therapist feels toward the client will have

250
 Special Section: Rogers’ Legacy

a profound effect on the techniques he or she uses and the ing. Rogers defines unconditional positive regard
manner in which they are used with each client (Gelso & as the therapist “experiencing a warm acceptance
Hayes, 1998, p. 8).
of each aspect of the client’s experience”
Thus relationship and technique both contribute (Rogers, 1957, p. 98). A prime example of
to the change process. Rogers’ enduring influence on contemporary ap-
Rogers’ article appears to be based on the proaches is Linehan’s (1993) dialectical behavior
assumption that when it comes to therapeutic therapy for the treatment of borderline personal-
intervention, one size fits all. Upon reflecting on ity disorder. In her attempts to use behavior ther-
his original training as a client-centered therapist, apy techniques with this population, it became
Greenberg (2001) put it this way: apparent that clients’ ultra sensitivity to nonac-
ceptance led them to interpret the therapist’s sug-
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.

The greatest limitation in the client-centered view was that the

gestion of how they might change as criticism
This document is copyrighted by the American Psychological Association or one of its allied publishers.

therapist’s influence was regarded as nontherapeutic. Thera-

pist interpretation or direction was seen as robbing the client and invalidation. Consequently, dialectical be-
of an opportunity to discover a self-direction and actualize the havior therapy emphasizes achieving a balance
self. The problem was that this view could become a straight- between acceptance of the client for who they are
jacket, preventing one from offering or doing different things
at different times (pp. 253–254). and what they are experiencing and being avail-
able to help them learn how to change when they
The stance that all the therapist needed to do so desire.
was to be accepting and empathic may also have Upon reflecting on their past clinical experi-
been a function of the fact that Rogers was writ- ences, a group of well-seasoned clinicians of
ing at a time when there were relatively few different orientations conveyed an underlying
research findings on psychotherapy. Indeed, the theme of the importance of therapeutic patience
first generation of outcome research in which he (Goldfried, 2001). Clients do not always change
participated had as its focus the impact of thera- at the pace that therapists would like, and it is
peutic intervention on personality change. This essential that therapists accept the fact that their
very general research question is clearly no clients cannot always do what they are supposed
longer the focus of current research efforts, where to. Indeed, research has shown that therapists can
there are numerous interventions, each of which be at risk for communicating frustration and non-
is directed toward a given clinical problem. We acceptance under such conditions, the result of
have clearly advanced in our research and prac- which is that clients fail to improve or perhaps
tice and may have even gone to the other even deteriorate (Castonguay, Goldfried, Wiser,
extreme—the proliferation of therapy interven- Raue, & Hayes, 1996; Henry, Schacht, & Strupp,
tions. Indeed, I believe that we need to find some 1986). Rogers’ 50-year-old advice can clearly be
intermediary approach, such as the clinical use of helpful in facilitating therapeutic patience.
and research into the principles of change that Another theme that emerged from the personal
underlie all therapy orientations (Castonguay & and professional reflections of these experienced
Beutler, 2005; Goldfried, 1980; Goldfried & therapists is that, over the years, they became
Davila, 2005; Pachankis & Goldfried, 2007; more themselves in their therapeutic interactions.
Westen, Morrison, & Thompson-Brenner, 2004). When one is just learning to become a therapist,
there is a very specific and somewhat constrained
Enduring Aspects of Rogers’ Contributions role that needs to be learned. As this role be-
to Psychotherapy comes second nature, therapists apparently be-
come comfortable in blending their personal and
One of the principles of change that is common professional roles. In essence, they become more
to all therapy orientations consists of the therapy genuine in their interaction with clients.
alliance, which is comprised of client-therapist
agreement on goals and methods of change and Other Aspects of Rogers’ Contributions
the presence of a good bond between the two
(Goldfried & Davila, 2005). Rogers’ description In addition to the contributions noted above,
of the necessary conditions for change has clearly the impact of Rogers’ classic paper may be seen
underscored the importance of this bond and has in other aspects of contemporary psychotherapy
operationalized it as being comprised of uncon- practice and research. The important work cur-
ditional positive regard and empathic understand- rently being done on motivational interviewing

251
 Goldfried

(Miller & Rollnick, 2002) credits Rogers’ contri- CASTONGUAY, L. G., GOLDFRIED, M. R., WISER, S. L.,
butions. Recognizing that certain clients may lack RAUE, P. J., & HAYES, A. M. (1996). Predicting the
effect of cognitive therapy for depression: A study of
motivation to change (e.g., substance abusers, unique and common factors. Journal of Consulting and
batterers), Miller and Rollnick have developed an Clinical Psychology, 64, 497–504.
interview format based on Rogers’ work that is GELSO, C. J., & HAYES, J. A. (1998). The psychotherapy
designed to increase motivation to change. Thus relationship: Theory, research, and practice. New York:
within a general interactional client-centered Wiley.
style, the therapist empathizes, accepts, and val- GOLDFRIED, M. R. (1980). Toward the delineation of
therapeutic change principles. American Psychologist,
idates the resistant client’s experience and behav- 35, 991–999.
ior and gradually leads him or her to become aware GOLDFRIED, M. R. (ED.). (2001). How therapists change:
of the negative consequences of their behavior. Personal and professional reflections. Washington, DC:
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.

As indicated at the outset of this article, Rogers

This document is copyrighted by the American Psychological Association or one of its allied publishers.

APA.
made a strong case for the importance of con- GOLDFRIED, M. R., & DAVILA, J. (2005). The role of
ducting research on psychotherapy process and relationship and technique in therapeutic change. Psy-
chotherapy: Theory, Research, Practice, and Training,
outcome, adding that actual research findings 42, 421– 430.
should take precedence over the theoretical back- GREENBERG, L. S. (2001). My change process: From
ground from which testable hypotheses might be certainty through chaos to complexity. In M. R.
generated. Some 50 years later, the field of psy- Goldfried, (Ed.). How therapists change: Personal
chotherapy has reached the point of accepting the and professional reflections (pp. 247–270). Washing-
need for empirical accountability, with the cur- ton, DC: APA.
HENRY, W. P., SCHACHT, T. E., & STRUPP. H. H. (1986).
rent movement toward evidenced-based therapy Structural analysis of social behavior: Applications to a
becoming evermore important. study of interpersonal processes in differential psycho-
With the emphasis on empirical verification therapeutic outcome. Journal of Consulting and Clini-
over theoretical elegance, the field has also be- cal Psychology, 54, 27–31.
come more accepting of psychotherapy integra- LINEHAN, M. M. (1993). Cognitive-behavioral treatment
tion (Norcross & Goldfried, 2005). It is interest- of borderline personality disorder. New York: Guilford
Press.
ing to note that Rogers had something to say MILLER, W. R., & ROLLNICK, S. (2002). Motivational
about this as well. Extending the empirical em- interviewing: Preparing people to change (2nd ed.). New
phasis in the necessary and sufficient conditions York: Guilford Press.
article, he wrote an article six years later, “Psy- NORCROSS, J. C., & GOLDFRIED, M. R. (EDS.). (2005).
chotherapy today or where do we go from here?” Handbook of psychotherapy integration (2nd ed.) New
(Rogers, 1963), in which he observed that the York: Oxford University Press.
PACHANKIS, J. E., & GOLDFRIED, M. R. (2007). An inte-
field was “in a mess.” He went on to say that grative, principle-based approach to psychotherapy. In
we were at a point where we should shed our S. Hofmann & J. Weinberger (Eds.) The art and science
limiting theoretical orientations—including of psychotherapy (pp. 49 – 68). New York: Routledge.
client-centered therapy—and instead base our ROGERS, C. R. (1957). The necessary and sufficient con-
therapy on what has been found to work. It is ditions of therapeutic personality change. Journal of
heartening that the field of therapy may finally be Consulting Psychology, 21, 95–103.
ROGERS, C. R. (1963). Psychotherapy today or where do
moving in this direction. we go from here? American Journal of Psychotherapy,
17, 5–15.
References WESTEN, D., MORRISON, K., & THOMPSON-BRENNER, H.
(2004). The empirical status of empirically supported
CASTONGUAY, L. G., & BEUTLER, L. E. (2005). Principles psychotherapies: Assumptions, findings, and reporting
of therapeutic change that work. New York: Oxford in controlled clinical trials. Psychological Bulletin, 130,
University Press. 631– 663.

252