594 CHAPTER 15
to increase intrinsic motivation to bring that change about (Arkowitz & Miller, 2008).
As originally conceived, the four principles of MI were to express empathy, develop
discrepancy between the client’s present behaviors and values, roll with resistance, and
support the client’s self-efficacy (Miller & Rollnick, 2002). While still true to its founda-
tions, MI has recently been updated and now consists of four broad processes: engaging
with the client to develop a therapeutic working alliance, focusing on the goals and direc-
tion of counseling, evoking and eliciting the client’s motivation to change, and when the
client is ready to change, planning how to implement change (Miller & Arkowitz, 2015;
Miller & Rollnick, 2013). The idea of resistance has been recast, with a focus on differen-
tiating sustain talk, conversations reinforcing no change, from change talk, conversations
leading to improvement (Corbett, 2016; Miller & Rollnick, 2013). Although it was origi-
nally developed and validated as effective for addictive disorders, it has also been useful
in the treatment of anxiety and mood disorders (Arkowitz & Miller, 2008; Barlow et al.,
2013), with applications to both health and mental health increasing (Corbett, 2016).
GESTALT THERAPY Another therapy based on humanistic ideas is called Gestalt therapy.
The founder of this therapeutic method is Fritz Perls, who believed that people’s problems
often stemmed from hiding important parts of their feelings from themselves. If some part of
a person’s personality, for example, is in conflict with what society says is acceptable, the per-
son might hide that aspect behind a false “mask” of socially acceptable behavior. As happens
in Rogers’s theory when the real and ideal selves do not match, in Gestalt theory the person
experiences unhappiness and maladjustment when the inner self does not match the mask
(Perls, 1951, 1969).That sounds pretty much like the same thing, only with slightly
different words. How is Gestalt therapy different from person-
centered therapy?The two therapy types are similar because they are both based in humanism. But
whereas person-centered therapy is nondirective, allowing the client to talk out con-
cerns and eventually come to insights with only minimal guidance from the therapist,
Gestalt therapists are very directive, often confronting clients about the statements they
have made. This means that a Gestalt therapist does more than simply reflect back cli-
ents’ statements; instead, a Gestalt therapist actually leads clients through a number of
planned experiences, with the goal of helping clients to become more aware of their own
feelings and take responsibility for their own choices in life, both now and in the past.
These experiences might include a dialogue that clients have with their own conflicting
feelings in which clients actually argue both sides of those feelings. Clients may talk with
an empty chair to reveal their true feelings toward the person represented by the chair
or take on the role of a parent or other person with whom they have a conflict so that the
clients can see things from the other person’s point of view. The Gestalt therapist pays
attention to body language as well as to the events going on in the client’s life at the
time of therapy. Unlike psychoanalysis, which focuses on the hidden past, Gestalt therapy
focuses on the denied past. Gestalt therapists do not talk about the unconscious mind.
They believe everything is conscious but that it is possible for some people to simply
refuse to “own up” to having certain feelings or to deal with past issues. By looking at
the body language, feelings both stated and unstated, and the events in the life of the
client, the therapist gets a gestalt—a whole picture—of the client.
EVALUATION OF THE HUMANISTIC THERAPIES Humanistic therapies have been used to
treat psychological disorders, help people make career choices, deal with workplace prob-
lems, and counsel married couples. Person-centered therapy in particular can be a very
“hands-off” form of therapy because it is so nondirective: Most often, there’s nothing that the
therapist says that the client has not already said, so the therapist runs a lower risk of misin-
terpretation. However, omission or not reflecting some things back might be a source of error.Gestalt therapy
form of directive insight therapy in
which the therapist helps clients to
accept all parts of their feelings and
subjective experiences, using leading
questions and planned experiences
such as role-playing.
In Gestalt therapy, it is not unusual to find
a client talking to an empty chair. The chair
represents some person from the past with
whom the client has unresolved issues, and
this is the opportunity to deal with those
issues.