Which type of therapy would be best for me?

With so many people seeking help with mental health issues I thought it may be helpful to evaluate two common forms of therapy, Person Centred Therapy (PCT), sometimes referred to as Rogerian Psychotherapy and Cognitive Behavioral Therapy  (CBT). Both PCT and CBT therapies are well researched, and both report good results in the treatment of mental health issues such as depression. I hear of many people who are not happy with the counselling they have received so hopefully the following  evaluation can help you to make an informed decision.

Person Centred Therapy

Person Centred Therapy is a common form of therapy used to treat conditions such as depression. As the name suggests, Person Centred Therapy (PCT), focuses on the individual or client as the centre of the therapeutic process. It is a humanistic approach to counselling founded by Carl Rogers in the mid twentieth century. Rogers believed that humans have an innate ability to reach their full potential and achieve a rewarding and fulfilling life. He maintained that, given an environment that fostered genuineness, empathy and unconditional positive regard, most people could achieve their goals and desires. Additionally, he acknowledged that while many people do not experience this type of environment in the real world, presenting this environment in therapy sessions would grant clients the opportunity to become, as he described, a fully functioning person.

Person Centred Therapy is a non-directive form of therapy where the therapist considers the client as an expert on their own life and holds the view that they have the ability to self-heal. The foundation of genuineness, empathy and unconditional positive regard is fundamental in promoting a safe environment from which the client is free to implement normal growth and development. The therapist uses a number of techniques to establish PCT’s core conditions. Reflecting the thoughts and feelings of the client, confirming and summarising those thoughts and feelings back to the client while maintaining an understanding, accepting and non-judgemental persona are among these techniques.

It is these core conditions of genuineness, empathy and unconditional positive regard that form the foundation of PCT. Rogers suggested positive change will occur when these core conditions are present. These core conditions enable a client to resolve problems and correct irrational beliefs, such as those associated with depression, without the therapist’s direct intervention. Unlike some more directive forms of therapy where the client is expected to do something, whether during the session or as homework, PCT seeks to provide an environment where the client can attain their own self-understanding and healing. It is these core conditions and resulting inner congruence of the client that are attributed to PCT’s success at treating conditions such as depression.

Cognitive Behavioural Therapy

Cognitive Behavioural Therapy seeks to initially establish a strong therapeutic relationship between therapist and client in much the same way as PCT does. However unlike PCT, it uses the therapeutic relationship as a foundation to implement further techniques. As CBT is a directive process, a good working relationship between therapist and client is desirable, but not essential. In the cognitive approach to CBT, the therapist challenges the cognitive meanings of a client in an attempt to change the behavioural and emotion result. CBT focuses on an ABC approach, where (A) is the activating event or circumstance, (B) is the belief held by the individual, and (C) is the consequence of the activating event (A). According to the cognitive approach of CBT, the consequence (C) is dependent on the belief (B) regardless of the activating event (A). CBT asserts that it is this belief, either core or based on a specific event, where distortions and irrationality occur. This is where the belief in an event affects the consequence.

When this model is specifically applied to conditions such as depression it highlights how belief can influence emotion. If an individual has a belief such as “I always get things wrong” it is not difficult to conceptualise how any event where they make a mistake would result in considerable negative emotions and behaviour. From an objective view it is difficult to imagine an individual who ‘always’ got things wrong, although all individuals will make mistakes. The cognitive approach of CBT seeks to challenge these false beliefs and in turn produce a more positive consequence from life events. This would then result in a reduction in negative emotions and depression. It is this challenging and changing of irrational beliefs that is accredited to the success of the cognitive aspect of CBT in treating conditions such as depression.

In the behavioural approach to treating depression with CBT, the behaviour is the focus of treatment. In particular, a common symptom of depression is lack of energy or interest in activities, as well as neglecting responsibilities. A depressed person may decrease their activity level and their responsibilities in life due to a lack of energy. This can set up a vicious cycle where the individual becomes more symptomatic as neglected tasks accumulate and become overwhelming. A behavioural approach would primarily seek to deal with these neglected tasks in a systematic and achievable way. This change in behaviour is often achieved through planning a weekly schedule, where not only required tasks are completed, but where pleasurable, and often physical activities are also planned. This can create more positive thoughts as the individual experiences a sense of achievement in accomplishing tasks that previously appeared overwhelming. This in turn can reduce depressive symptoms. Additionally, becoming more physically active during this process, can be helpful as research suggests, that increasing physical activity is beneficial in alleviating depressive symptoms.

This is a brief explanation of PCT and CBT. Choosing the best type of therapy is important as it is an investment in your own well-being. Not all people will respond to person centred therapies non-directive style as not all people will respond to cognitive behavioural therapies directive and structured approach.

Wishing you the best in your journey

Phil Miranda

Sources:  Corey, G. (2013). Theory and practice of counseling and psychotherapy, (9th ed). Australia; Belmont, CA: Brooks/Cole / Cengage Learning,
Rogers, C. R. (1959). A theory of therapy, personality, and interpersonal relationships: As developed in the client-centered framework. Psychology: A Study of a Science Formulations of the Person and the Social Context, 1(3), 184-256

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