The Facilitative Conditions

One of the wisest therapists of the last century was Carl Rogers. He went beyond the "blank screen" approach of earlier psychoanalysts to suggest that a human relationship between therapist and client creates the best climate for real change and healing to occur.

Rogers identified the most important qualities of effective therapeutic relationships, which he called "facilitative conditions." They include:

• Empathy
• The therapist's ability to accurately understand what the client is experiencing (thinking, feeling, sensing, perceiving) from the client's own frame of reference, AND the therapist's ability to communicate that understanding back to the client both verbally and nonverbally
• Feeling heard and understood strengthens rapport, and makes it more likely that the client will share sensitive information in the future.
• The most advanced empathic responses involve accurately surmising more than the client has said, based on past experiences with the client, theoretical knowledge, and practice wisdom.
• Positive Regard
• Unconditional respect, acceptance, and a nonjudgmental attitude that reflects the client's inherent dignity and worth, irrespective of the client's choice, characteristics, or outcomes
• Paradoxically, feeling accepted however s/he is in the moment allows the client to take steps toward change.
• Congruence
• The therapist's verbal and nonverbal communication, affect, and behavior are aligned, conveying sincerity 
• When one of more of these elements is not aligned with the others, it at best creates confusion, and at worst can be hurtful (as with sarcasm)
• Genuineness
• The therapist conveys the sincere desire to work with and help the client, without seeming fake
• The therapist seems comfortable in the helping role, and interventions do not feel rehearsed or contrived
• The therapist is spontaneous and willing to engage in appropriate self-disclosure (that is, self-disclosure that furthers the therapeutic relationship and the client's goals, rather than the therapist's needs or agenda)

Which of these do you see as most important? Which one is hardest to maintain?

For more information of Roger's approach and the facilitative conditions, see Corsini and Wedding (2010) Current Psychotherapies