Person-Centered Therapy vs. Cognitive-Behavioral Therapy: What’s the Difference?

September 27, 2017

If you’re like most people, you’ve probably struggled with some sort of behavior change, like exercising more regularly, better managing stress, or eating more healthfully. There are many benefits to working with someone else, whether it’s a therapist, counselor, or coach. While there is a relational quality to all types of counseling (a client/patient must want to talk and share with their therapist, after all!), approaches come in all shapes and sizes.

Person-centered therapy (PCT) is based on a foundation of empathy, unconditional positive regard, and authenticity. It assumes that people are naturally inclined toward positive growth and that they have a great capacity for self understanding and modifying their behavior and attitudes, given the right environment/climate/support.

Cognitive-behavioral therapy (CBT), on the other hand, is based on the assumption that most problems are a result of negative thoughts, which means that existing cognitive patterns must be altered in order to move past emotional or behavioral issues.

To help bring these definitions to life, below are two similar conversations, one that uses the PCT approach we favor here at LifeDojo, and one that uses a CBT approach.

Please note that these imagined conversations have been simplified for the purposes of this post.

Session 1

PCT Coach: Hello! What would you like to focus on today?

Client: I’ve been feeling pretty stressed out lately. I guess that’s what I’d like to focus on—but I’m not sure where to start or what to do.

PCT Coach: It sounds like you must be under a lot of stress but aren’t sure how to take a step forward. You’re in the right place. How we react to stress is such a worthwhile topic to focus on. I want to congratulate you on being aware and voicing that goal, and I look forward to helping you on your journey.

I come with no judgment, and I’m here to help you make the changes you feel would help you the most, since you’re the expert on your own life. Is there anything more specific about how you react to stress that you’d like to address together?

Client: I eat pretty badly when I’m stressed out. I feel like I eat pretty well under normal circumstances, but when I get stressed everything goes out the window. I should know better—but in those moments I just can’t help it.

PCT Coach: Try not to be too hard on yourself. Our eating habits are often affected by stressful periods. To be honest with you, even though I’m a health coach I don’t eat perfectly all the time!

We’ll work together and create goals for you to work on that. Do you have any ideas of how you’d like to approach your goal of addressing your stress?

Client: I’m not sure how well I’ll do, but I want to stop eating so much junk food late at night. I just want to relax and forget about the day, but it makes me feel sick afterward and I also end up feeling really guilty about it.

PCT Coach: It sounds like you’d like to reduce or entirely stop the junk food you eat in the evenings. Do you have any ideas of how you’d like to proceed?

Client: Not really. I’ve wanted to stop in the past but haven’t been able to.

PCT Coach: Would you like me to share some ideas, and then you can see what sounds good to you?

Client: Yes, that sounds good.

The client made a goal to substitute the typical junk food for healthier alternatives at least 4 out of 7 days of the following week.

Session 2:

PCT Coach: How have things gone since our last chat? Your goal last week was to work on responding to your stress differently. Were you able to try any of those techniques?

Client: It went okay… one night I did try the alternative snacks we talked about, but I feel like a failure because the rest of the week I had junk food.

PCT Coach: Congratulations on giving those alternatives a shot! I’m sorry to hear that it didn’t work as well as you had hoped, but it’s great that you tried. Don’t worry that things weren’t perfect. That’s what coaching is about—figuring out what will work for you.

During our work together, progress won’t always be linear. This type of change can be hard, especially when it’s been a habit that’s been in your life for a long time. I’ve been there, too. We’ll keep working together on this until you get to where you want to be.

Do you have any ideas about how that might go differently next time? Or would you like to adjust the goal you made last week?

The client decided to kept the same goal as the previous week, but added an additional commitment to get rid of remaining junk food in the house so they would not be tempted.

Session 1

CBT Coach/therapist: Hello! What would you like to focus on today?

Client: I’ve been feeling pretty stressed out lately. I guess that’s what I’d like to focus on—but I’m not sure where to start or what to do.

CBT Coach/therapist: Well you’re in the right place. It’s wonderful you have that awareness that you’d like to improve your response to stress. My job is to help you identify and change negative emotions and related behaviors that hold you back from reaching your goals. Is there anything more specific about how you react to stress that you’d like to address together?

Client: I eat pretty badly when I’m stressed out. I feel like I eat pretty well under normal circumstances, but when I get stressed everything goes out the window. I should know better— but in those moments I can’t help it.

CBT Coach/therapist: Try not to be too hard on yourself—stress negatively affecting eating habits is extremely common. We’ll work together and create goals for you to work on that. Is there anything specific about your eating habits that you would like to change?

Client: I’m not sure how well I’ll do, but I want to stop eating so much junk food late at night. I just want to relax and forget about the day, but it makes me feel sick afterward and I also end up feeling really guilty about it.

CBT Coach/therapist: I understand. Negative thoughts and emotions trigger behavior, so we will work on interrupting those negative thoughts and basically rewire your responses to those emotions. I will teach you to change your behavior over time so that you can stop eating junk food when you’re stressed. We’ll work on changing thoughts, which will help change behavior.

Let’s start by creating a goal for you to work on this week.

Client: Okay, that sounds good.

The client made a goal to substitute the typical junk food for healthier alternatives at least 4 out of 7 days of the following week and to open awareness to their automatic thoughts around stress and eating.

Session 2:

CBT Coach: How have things gone since our last chat? Your goal last week was to work on responding to your stress differently. How did it go?

Client: It went okay… one night I did try the alternative snacks we talked about, but I feel like a failure because the rest of the week I had junk food.

CBT Coach: Congratulations on giving those alternatives a shot! I’m sorry to hear that it didn’t work as well as you had hoped, but it’s great that you tried. I’m noticing some negative thoughts coming up for you right now, which is completely normal. For you to make progress though, we have to address negative thought patterns that hold you back from achieving your goals. The issue here is negative thoughts.

This week I would like you to try a “thought journal” and tally how many times you have the negative thought that you’re “a failure.” Once you start to notice negative thoughts, the next step is to begin interrupting the thoughts. Some strategies to do that might be thinking about a big red stop sign, or even the word “stop.” Then you substitute a positive thought for the negative one, so instead of telling yourself you’re “a failure,” remind yourself that you are in a much better place than you were a few weeks ago, and that you are working toward making more progress to eat more healthfully.

The client adjusted their goal to try a “thought journal” suggested by the coach and to record their experience with automatic negative thoughts and to attempt to substitute in a positive thought instead.


You can see that there are some similarities and some differences between these conversations. The PCT approach relies on a lot of input and direction from the client, while in the CBT approach, the coach is driving the conversation and making recommendations. Both approaches have their merits, but here at LifeDojo we focus on the person-centered approach because we believe it is the best way to harness intrinsic motivation and to achieve long-lasting behavior change. We believe that individuals are the best experts on their own lives, and that positive change is not only possible but within reach, provided the right support is available.

If you’d like to learn more about how a person-centered approach could benefit your employee wellbeing offerings, download our “5 Pillars of Employee Behavior Change” white paper by clicking on the button below.

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