Relational depth and expressions of person-centered practice: a commentary on Sommerbeck et al

This paper critically examines the first part of Mearns’ interaction with his client named Dominic, as published in Developing Person-Centered Therapy. While the transcript is presented as an example of effective therapy grounded in relational depth, the authors argue that it does not fully demonstrate Rogers’ core conditions - namely, unconditional positive regard (UPR), congruence, and empathic understanding as well as key therapeutic factors in relational depth therapy. The authors clarify that their critique focuses on the specific therapeutic exchange rather than a broader evaluation of relational depth as a form of therapy in its own right, because relational depth is wholly dependent on individual therapist idiosyncrasies. Or, said in other words, such a thing as relational depth therapy does simply not exist. Thus, the authors present a specific alternative by inserting client-centered empathic responses (EURs) into the transcript, offering what they consider good person-centered therapy. A commentary on Mearns’ rationale for his responses is also included.

Aim:Working at relational depth is considered to be one of the pillars of an effective intervention within person-centred approach. So far, the literature has been mainly focused on the description of the phenomenon. However, there has been little evidence explaining how the therapists can enhance their ability to work at depth. This paper seeks to add to a growing body of literature on the factors that can contribute to the development of the therapist’s ability to work at relational depth.Method and Analysis:The case study is based on a systematic analysis of the therapy sessions’ recordings, the client and supervision notes, and the researcher’s reflective diary. The analysis was aimed to track down the development process of relational depth. This was achieved by identifying critical incidents from the therapy sessions and matching these with the incidents from the therapist’s personal therapy and supervision.Findings:The findings from this case study suggest that the therapist’s ability to work at relational depth can be developed through the expansion of the therapist’s self. The more parts of the self the therapist is able to employ during a therapeutic encounter, the greater the potential they have of being able to work at relational depth with their clients.Discussion:The results point to the crucial role of the therapist’s growing self-awareness (expansion of self) and self-acceptance in the development of their ability to work at relational depth. The theory of configurations of self and accurate symbolisation is used to discuss these findings.

I argue that person-centered therapy is a “fuzzy set” with a variety of members that bear a family resemblance to one another. I suggest that some members of this fuzzy set are approaches that integrate various activities and procedures into their practice along with traditional empathic understanding responses. Based on quotations from Carl Rogers I demonstrate that these approaches deserve to be included as members of the family and that if one follows what Rogers said there is no warrant for the idea that classical nondirective practice is the only “true” person-centered therapy. I argue that one can practice person-centered therapy in an integrative way by including techniques and procedures from other approaches, by meeting at relational depth, and by focusing on experiencing and emotions. I conclude by arguing that it is important that we be open to alternative ways of actualizing person-centered principles.

In recent years, the topic of ‘relational depth’ has attracted the attention of researchers and practitioners. This paper aims to critically examine Mearns and Cooper’s relational depth model. We question whether relational depth is an advancement to the practice and theory of the person-centered approach. We describe how there are two different understandings of what relational depth means. The first, despite differences in terminology, is essentially descriptive of person-centered therapy and theory. In contrast, the second is a version in which relational depth has become unanchored from its person-centered origins, encouraging a more instrumentalised approach to therapy. We conclude that the existence of these two different understandings has led to confusion rather than advancement. Relational depth by the first understanding is simply repetitive of the person-centered approach, and by the second, it is incompatible. We recommend that future researchers clarify which of these understandings informs their use of the term.

Youth with ASD often show limited or atypical empathic responsiveness. The direct effects of social skills interventions on enhancing empathic responsiveness is unknown. Data from a randomized controlled trial were used to investigate whether a Theory of Mind training improves the empathic responsiveness, measured through structured observations. The current study included a large sample (n = 135) of 8–13-year-old children with ASD. When comparing the change scores of empathic responsiveness from baseline to post-test, the intervention group performed significantly better than the waitlist group. Thus, the current findings support the use of Theory of Mind training as intervention of ASD by showing its efficacy also in improving one’s empathic responsiveness, in addition to previous knowledge regarding the improvements in empathic understanding.

AimThis research explored the experience of relational depth between therapist and client during a single session recorded during a skills practice activity.Method and AnalysisAn archived skills practice video was rated by client and therapist for perceived depth of connection. This rating was completed at each minute using a 0 to 10 scale (0=not at all connected, 10=deeply connected). Following this, the discussion about the ratings was audio recorded and transcribed verbatim. The data was analysed using grounded theory.FindingsTwo core-categories were generated: These were the client and therapist’s perception of: (1) moments of connectedness; and (2) moments of disconnectedness. Within the moments of connectedness three subcategories were found: (i) experience of therapist’s congruence; (ii) experience of being listened to; and (iii) experience of having the time to process. Within moments of disconnectedness two sub-categories were found: (i) experience of not being ‘in tune’ with the therapist; and (ii) experience of the therapist working too hard.DiscussionThe findings are consistent with the literature suggesting that there is a high level of consensus in therapist-client perception of relational connectedness, and the deepening of this, albeit at a slower rate, as the session progresses (Cooper, 2012). The findings also point to links between the two core categories and their lower order counter-parts, and as such show clients’ perceptions of therapist skills under which the relational depth was experienced and near reverse of therapist skills in which it was not. Although much of the literature has concentrated upon relational depth in person-centred therapy, this study demonstrates that moments of relational depth can be experienced by participants from other therapeutic orientations.

AimThis research explored the experience of relational depth between therapist and client during a single session recorded during a skills practice activity.Method and AnalysisAn archived skills practice video was rated by client and therapist for perceived depth of connection. This rating was completed at each minute using a 0 to 10 scale (0=not at all connected, 10=deeply connected). Following this, the discussion about the ratings was audio recorded and transcribed verbatim. The data was analysed using grounded theory.FindingsTwo core-categories were generated: These were the client and therapist’s perception of: (1) moments of connectedness; and (2) moments of disconnectedness. Within the moments of connectedness three subcategories were found: (i) experience of therapist’s congruence; (ii) experience of being listened to; and (iii) experience of having the time to process. Within moments of disconnectedness two sub-categories were found: (i) experience of not being ‘in tune’ with the therapist; and (ii) experience of the therapist working too hard.DiscussionThe findings are consistent with the literature suggesting that there is a high level of consensus in therapist-client perception of relational connectedness, and the deepening of this, albeit at a slower rate, as the session progresses (Cooper, 2012). The findings also point to links between the two core categories and their lower order counter-parts, and as such show clients’ perceptions of therapist skills under which the relational depth was experienced and near reverse of therapist skills in which it was not. Although much of the literature has concentrated upon relational depth in person-centred therapy, this study demonstrates that moments of relational depth can be experienced by participants from other therapeutic orientations.

The role of empathic understanding and responsiveness is central to therapies anchored in self psychology and intersubjectivity theory. The process of achieving and communicating empathic understanding, however, is complex and multiply determined. Understanding on a theoretical level the rationale for employing an empathic mode of observation and response does not necessarily mean that one knows how to do so effectively. To help bridge this gap between theory and practice, the author offers a series of concrete, experience-near suggestions or principles for enhancing empathic understanding and responsiveness. Starting with Kohut, several writers have stated their belief that empathic resonance is a skill that can be developed through training and learning. The author references these previous efforts and adds to them here by defining several choice points and subtleties of how we respond that can make empathic communication more effective. These suggestions emerged from the process of training and supervising mental health professionals in all disciplines and thus are presented as a resource not only for clinicians, but also for teachers and supervisors.

This paper examines the advantages relational depth offers the person-centered approach and, indeed, psychotherapy in general. Relational depth contemporizes and broadens our understanding of in-depth therapeutic relating by moving away from the limiting and divisive notion of “I” and focusing on the inclusive language and dynamics of “relationship.” I seek to explore the micro and macro effect of the concept in terms of: self-relationship, relationship with another, and societal relationship. The idea of relational depth does not move us away from the foundations of person-centered theory, but helps us to appreciate the essence of the approach more fully in our current context.

This article traces the historical development, current state, and future directions of the Person-Centred Approach (PCA) in Switzerland through the lens of pcaSuisse, the Swiss Association for the Person-Centred Approach. Emerging in the 1970s under the influence of Carl Rogers and early European pioneers, PCA in Switzerland evolved from small practitioner groups into a nationally recognized association offering psychotherapy and counselling training accredited at the federal level. Drawing on archival sources and a 2024 member survey (N = 211), the article examines the professional, organizational, and cultural dimensions of PCA practice across Switzerland’s multilingual regions. The findings highlight members’ strong academic background, commitment to humanistic values, and satisfaction with experiential training, while also revealing challenges such as organizational complexity, regional disparities, and limited public visibility. By situating Swiss developments within international PCA movements, the article identifies key factors supporting growth—such as flexibility, experiential pedagogy, and interregional collaboration—and proposes strategic directions for enhancing research, communication, and institutional presence. Ultimately, the study offers both a historical reflection and a forward-looking framework to sustain and advance PCA within Switzerland’s evolving psychotherapeutic and societal landscape.

Following on from a previous publication (Schmid & Mearns, 2006), this paper continues the authors' investigation of the relationship emphasis within person-centered therapy. It explores the concept of relational depth (Mearns & Cooper, 2005), especially in regard to work with hard-to-reach clients, outlining the particular challenges to the therapist seeking to engage the different parts of the client, even those in self-protective conflict with the therapeutic process. The ethical boundaries of therapeutic confrontation and dialogue that constitute relational depth are explored as is the developmental agenda for the therapist.

Four aspects of Barbara Temaner Brodley’s practice of ‘classical’ client-centered therapy (CCT) are appraised in ways to suggest a rapprochement with the process-guiding experiential therapies that she opposed. First, I discuss her affinity with, and alienation from, these therapies particularly in relation to her conceptions of the ‘empathic understanding response process’ and ‘presence.’ Second, her therapeutic work is analyzed utilizing Gendlin’s process model, particularly in terms of Gendlin’s ‘interaction first’ principle and his process conception of embodied time. Third, I discuss her scientific attitude in relation to her extensive empirical analysis of Rogers’ verbalized empathic responses that informed her distinctive CCT perspective and opposition to Gendlin. Finally, I focus upon the paradox of Brodley’s self-disclosure and therapist-frame responses when she responded to a client’s questions or requests for advice. I conclude that Brodley worked effectively with her clients at a deeper relational level than her theoretical exposition suggests.

The question of patient agency in medical contexts demands frameworks that transcend the sterile dichotomy between mechanistic determinism and abstract libertarian autonomy. This essay builds upon my previous work on hermeneutic medicine, therapeutic tzimtzum, and the sacred-profane dialectic to reconceptualize patient agency as a relational, emergent phenomenon rather than an intrinsic property. Drawing on recent neuroscience (readiness potentials, addiction neurobiology), clinical realities (adherence challenges, chronic pain), and Jewish mystical theology (tzimtzum, Shekhinah, the broken vav), I argue that the therapeutic encounter itself creates the possibility space within which patient agency emerges. This framework has immediate implications for addiction treatment, medication adherence, and the moral dimensions of clinical practice, suggesting that the physician's role involves not assessing pre-existing capacity but co-creating conditions for maximal patient agency through therapeutic presence and sacred attention.

This paper synthesizes Dr. Julian Ungar-Sargon's theological and healing essays with comparative scholarship to develop an integrative framework for understanding the sacred dimensions of medical practice. Modern healthcare increasingly operates within a paradigm of scientific reductionism that can inadvertently reduce patients to collections of symptoms and laboratory values. Drawing upon hermeneutic philosophy, phenomenology, and theological perspectives, we argue that authentic healing emerges from recognizing the sacred-profane dialectic inherent in therapeutic encounters. The analysis explores four key domains: hermeneutic approaches to medical practice that emphasize interpretation over mere technical application; the sacred-profane dialectic in therapeutic spaces that transforms ordinary clinical settings into healing environments; evidence distortion in clinical decision-making that acknowledges the interpretive dimension of all medical knowledge; and a theological framework for physician-patient relationships grounded in covenantal rather than contractual models. By integrating these perspectives, we propose a model of healing that honors both scientific rigor and spiritual dimensions of human experience. This framework has significant implications for clinical practice, medical education, and healthcare ethics, offering concrete strategies for creating healing environments that address the full scope of human suffering. The paper contributes to ongoing interdisciplinary dialogue regarding the relationship between spirituality and medicine, particularly from Jewish theological perspectives that complement existing Christian and secular approaches.

The Person-Centred approach: similarities and differences with relational depth