Are you sick and tired of people telling you that ‘person-centred therapy doesn’t work’? Does your manager try and convince you that there’s no evidence for the approach? Would you like to scream at the next person who tells you person centred therapy is ‘just the basics’ and that ‘everyone does it all anyway’? If so, here’s ten facts about the evidence base for person-centred therapy that might just keep you sane… and everyone else that better bit informed.
Humanistic and experiential therapies, of which person-centred approaches form a substantial part, bring about large and significant reductions in psychological distress (see Elliott et al.’s 2021 comprehensive meta-analysis for the definitive review).
The effects of humanistic and experiential therapies, overall, tend to be similar to other therapies, including CBT. This is particular true when the allegiance of the researchers is taken into account (see Elliott et al., 2021). However, a major recent study did find that, 12 months after assessment, person-centred experiential counselling for depression had slightly poorer outcomes than CBT (see here). There is also some evidence that non-directive therapy may be a little less effective than other therapies for depression (see here). Overall, what the research shows is that the more active, process-guiding forms of person-centred therapy are as effective as other therapies, but a strictly non-directive approach may be marginally less effective than most.
Studies which compare the outcomes of person-centred therapy in real world settings (e.g., IAPT) show that these are very similar to CBT and, indeed, may be achieved in a shorter period of time (see Pybis et al., 2017).
There’s no consistent evidence that CBT or psychodynamic therapies have longer lasting effects than person-centred therapy, or that they ‘work’ more quickly. Indeed, in the recent major study (see #1), person-centred therapy actually seemed to act more quickly.
It’s the dodo bird, stupid (though maybe don’t say the ‘stupid’ bit to your manager!). Again and again, what the research tends to show is that ‘everyone has won and all must have prizes’—all therapies, overall, do about as well as each other.
There is an overwhelming body of data to show that Rogers’s three ‘core conditions’—empathy, unconditional positive regard, and congruence—are all associated with positive outcomes (see Norcross and Lambert, 2019).
Studies which ask clients what they found helpful in therapy (whether CBT, psychodynamic, or humanistic) show, again and again, that much of what they most value is relational qualities closely associated with a person-centred approach: e.g., therapist warmth, caring, and trustworthiness (see here for one very recent example).
Consistent with person-centred theory, research shows that, by far, the largest contribution to therapeutic outcomes comes from clients: their levels of motivation, involvement, engagement. It’s clients that make therapy work, not therapists (see Bohart and Wade, 2013).
Person-centred counselling with children, and with young people, also shows good outcomes, at a level generally consistent with other therapeutic orientations.
Even if there are small differences in the overall effectiveness of different orientations, this doesn’t take into account the fact that different clients do better or worse in different therapies (and at different points in time). Research shows, for instance, that clients who are more independent, who deal with issues in a more ‘internal’ way, and who particularly want space to talk are likely to do very well in a person-centred approach (see my Facts are Friendly).
The bottom line… be proud of being a person-centred practitioner and all the evidence behind our approach. But be informed as well (see here for an overview of all the evidence). There’s every reason to challenge someone who belittles the evidence base for person-centred therapy, but you need to know your research and what it all means.