Adlerian Therapy Case Study
During this consultation hour, a Psy.D. student describes a current case and poses the question of how to effectively work with an inconsistent client, while managing her own feelings of frustration. Feedback and suggestions are provided for effectively approaching inconsistent clients. Throughout the consultation hour, Drs. Colker and Carlson provide suggestions for working through her frustration and effectively approaching this client about inconsistent attendance.
Regarding client history, the client sought therapy after being recently released from jail. Initially, the client appeared enthusiastic about therapy, but her attendance started to taper off. Most recently, after many failed attempts to reach the client, the client contacted the therapist and made an appointment. However, the client did not show for her appointment, and subsequently contacted the therapist to schedule a new appointment.
Video Length: 50:24
Key Words: attendance, case study, recently released clients, failed therapy
Areas of Focus:Case Conceptualizatons, Individual Therapy, Jon Carlson , Adlerian Counseling/Psychotherapy, Jay Colker
Resource Type: Video
Stan Case Study
Therapy with Stan
In order to develop appropriate therapeutic intervention in Stan’s case, it is necessary to integrate four theoretical perspectives into the counseling program: Adlerian therapy, Glasser’s choice theory, Rogerian approach and existential therapy. The combination of those four theories will have adequate impact on Stan, who seems to have a really low self esteem due to the impression he has made of himself in his early childhood, when he was treated by his parents in such a way that made him feel inferior. By careful analysis of the perspectives outlined, we will be able to derive adequate strategies to be used in the therapeutic sessions with Stan.
“Significance means overcoming inferiority and striving for perfection or superiority”. (Corey, 2005) This striving helps one develop individuality. I also feel behavior in itself has a purpose and is goal-oriented. Although basic goals are set forth by our parents at an early age, it is during the time of adolescences that we start to narrow these goals for ourselves. As we start to make decisions for ourselves, we will narrow these goals to fit what we want out of life. In the case with Stan, it will be useful to structure the six sessions in such a way that he gradually feels himself just as normal as everyone else is, so that his feeling of inferiority is terminated. We will need to convenience Stan that his success depends solely on himself; by clear vision of possible future success, Stan will get rid of his inferiority complex. Technically, in order to make Stan feel successful, we will need to capitalize on his strengths and achievements, no matter how scarce they are.
Adlerians believe that this path to reach these goals is very important. If problems are encountered in trying to reach the goals, it can cause maladjustment and psychosocial problems. The term fictional finalism refers to an imagined central goal that guides a person’s behavior (Corey, 2005). For instance, setting goals for doing well on exams in a particular class may help achieve the bigger goal of graduating and getting a degree. Therefore behavior is defined in the contexts as we try to reach the goals whether small or big. One of the most important concepts I find useful for Stan in Adlerian therapy is the term lifestyle. Lifestyle refers to an individual’s basic orientation to life, or one’s personality, and includes the themes that characterize the person’s existence (Corey, 2005).
Stan’s lifestyle is help shaped experiences within the family and relationships with others. During the early years of childhood the relationship between the mother and father will play a significant role in shaping a child’s lifestyle. In case of Stan, we see that in his childhood he had rather negative experiences with and feelings from his parents. This will need to be corrected as well within the scope of the six sessions conducted.
Glasser’s Choice Theory is a very important perspective that should be incorporated in helping Stan. From birth until death, all any of us do is behave. All behavior is chosen. Glasser does not talk about responsibility that much any more because it’s already built into the system. (Corey, 2005) Everyone’s always responsible for what they do. He believes that all human beings, who aren’t absolutely poverty-stricken or sitting in Iraq waiting for the war to end, suffer from one problem: unhappiness. Every person who sees a counselor is unhappy; I completely agree with Glasser and that is why his theory appeals so much to Stan’s case.
Anyway, why is Stan unhappy? There has to be a reason why. Everyone’s unhappy, if you look at unhappiness, assuming that you’re not at the poverty level or suffering from severe illness, one of the major human causes of unhappiness is caused by unhappy marriages. Stan says “I’m depressed.” In counseling with Choice Theory, the person who has the major chance of helping Stan is the counselor. Whether he is getting along badly, which he is, with the important people in his life, he doe snot get along badly with the counselor. The counselor has the skill to get involved with Stan and get to know him, talk with him, support him, etc. In that, the counselor delves into the relationship. He can counsel Stan both so he gets along better with other people.
Why don’t people get along better with each other? There’s an understandable reason for this. In the world we live in, all human beings use external control psychology. (Corey, 2005) You may go through the whole day and never even think about using this psychology. But if you have difficulty, you’ll immediately start to use it. If you get along well with the people you work with, you won’t ever have to use it, but when you have difficulty, you immediately start to use external control psychology.
Another important perspective that would definitely need to be integrated into Stan’s therapeutic sessions comes from the existentialists. Existential therapy, although many researchers claim that the potential negative tone that is often associated with existential theory can be transcended, to a large degree, by focusing on the positive side of existentialism. (Corey, 2005) A cornerstone of a positive view is the concept of existential authenticity. Existential authenticity recognizes the individual’s ultimate freedom and responsibility to choose how to live in the world.
Adopting authenticity as an existential value in counseling requires the counselor to confront the client with the ways he or she has played an active role in the development and maintenance of experienced symptoms and problem situations. Such a challenge is difficult and often met with resistance but, when transcended, can free Stan to direct his life and living in positive and more adaptive directions. Stan should be convinced that he should take joy in life and try to explore it in full, by making new friends and not holding on his feelings to women.
Stan may be empowered to embrace personal change through a therapeutic process that reduces the constricting hold that self-and-world perceptions have on choices in current living. Essentially, the constricted perceptions Stan has about personal concerns and problems are as much a part of the problem as “the problem” is itself. (Corey, 2005) Such a perspective changes the nature of the therapeutic issues.
The question now becomes, what perceptions are holding Stan’s experiencing of self-and-world in its present form? Is that form experienced as one that constricts choice or one that enables possibilities? What would Stan have to relinquish to reduce the hold of constricting self-and-world perceptions? These process questions are founded on the existential psychology principle that “the agency of therapeutic change is the opening of perceptual boundaries” (Corey, 2005).
Adopting existential authenticity as a guiding ethic in counseling Stan leads the counselor to assume specific value stances during counseling. In order for the counseling process to reflect these value stances, the counselor must regard Stan as thinking, feeling, acting, being–not an object to be explained. It is equally important for the counselor to challenge Stan to take full ownership and responsibility for all choices (past, present, future).
In the process of enacting the first two fundamental values, the counselor must show respect for Stan as a separate, autonomous human being in the world. Finally, the counselor must challenge Stan to examine, to the fullest extent possible, the self-and-world construct system that gives Stan’s life meaning. (Corey, 2005) In many ways, using an existential philosophy during counseling is to work more intentionally with what is “already there” in Stan’s way of being in the world. The result is practical and useful; emotional distress can be reduced, and Stan may be able to discover and choose more adaptive ways of being (living) in the world.
Person – centered therapy developed by Rogers applies to the case with Stan because “Rogers brought to clinical practice the American psychologist’s interest in pragmatic interventions, operational definitions, and scientific research” (Corey, 2005). Rogers introduced the rigorous study of transcripts and videotapes of actual therapy sessions into psychotherapy research. His publications were unique and original in including long verbatim transcripts of therapist-client dialogue, illustrating the actual therapeutic interaction. Rogers’s orientation shifted the attention of psychotherapy research away from the internal dynamics of the patient and toward these transactions between therapist and patient. The result is a large body of empirical research on the therapeutic process.
Rogers emphasized the client-centeredness of his counseling because the counselor concentrates on how “the client seems to himself” (Corey, 2005). Rogers encouraged the therapist to put aside his or her preoccupation with actively diagnosing, evaluating, or guiding the patient. Instead, the therapist must place his or her entire personal energies into understanding the patient at a deep emotional level and into conveying a genuine acceptance for the client.
In the next phase Rogers labeled his approach experiential as he expanded his concept of the therapist’s personal contribution to therapy. If the therapist is challenged to be genuine with Stan, then it is artificial to suspend the entire range of his or her personal feelings and experiences from the therapeutic dialogue. Rogers now encouraged the therapist to express personal reactions in a facilitating way and to establish a full reciprocity between client and counselor in the therapeutic dialogue. He emphasized that if the therapist’s actions and statements were congruent with what he or she felt and believed, then their impact would be therapeutic for the client.
Rogers conceptualized guidelines as fundamental humanistic values, with as much application in everyday life as in the counseling office. He believed that teaching and actualizing these values in our lives will bring about the growth of healthier relationships in families, schools, communities, and societies. Person-centered principles have been applied to the training of Peace Corps and Vista volunteers; marriage and family therapy; staff relationships within corporations, schools, hospitals, and clinics; management development; and foreign relations (Corey, 2005). In Rogers’s vision of a better society, the growth of all persons and groups will be nurtured as a way of being.
If those four perspectives are integrated into Stan’s counseling programs, it is quite possible that he will be able to increase his self esteem significantly and to start fell pride in himself. He should become more easy going and forget about his disastrous habits, such as drugs and alcohol. Instead, he should consider relationships with women, because such relationships will make hi will normal person, a person that is fully compatible with the surroundings. Stan’s situation is definitely correctable, but he will need to bring forth a great deal of efforts on his part as well.
The six sessions that will help Stan to recover and start to appreciate his true self will need to be held within two weeks – three sessions a week. Within the scope of those sessions, the main goal will be to provide hi with enough reasons to feel that he is absolutely normal young man that is about to achieve all major successes in his life. Stan’s positive traits should be highlighted by all the means possible; Stan should be convinced that all endeavors he starts are going to be successful.
Stan Should feel support and sympathy during the sessions held; he should feel that his fate and life is of interest at least to someone. He should feel appreciated as an individual, as a person who has his own ideas and goals in life. Stan will definitely recover once he feels that someone believes in his strength and is fully convinced that it is possible for him to achieve something. Stan’s life has been so distracted due to negative connotations from the attitude his parents had towards him. Now he should get rid of those bad memories and go ahead with his life, life where he will be completely new person.
It is quite possible that after the six sessions are over, Stan will need little more help during the next two three months. However, by that time, he will be recovered completely, and it will be more of a check than a necessity. Overall, Stan has all the chances to become self sufficient person that holds complete responsibility for his actions and life at large.
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