Case Conceptualization: Person Centered Therapy

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Abstract

Person-centered therapy is a kind of treatment that gives clients an opportunity to figure out how their deeds and thoughts affect their health. The therapy is client-oriented. Therefore, clients assume the responsibility for their treatment course under the guidance of therapists.

Carl Rogers developed the treatment after realizing that the success of therapy depends on close interaction between therapist and client. For person-centered therapy to succeed, three conditions are necessary. These are empathy, congruence, and unconditional positive regard. Therapists should treat clients with utmost respect and not criticize or judge them.

Person-centered therapy can be used to treat clients suffering from depression, identity crisis, and alcohol disorders. Person-centered therapy is prone to ethical and cultural challenges. One of the ethical challenges is therapist’s attitude towards a client.

Therapists should not have a negative attitude towards their customers no matter their situation. Since person-centered therapy gives clients the liberty to decide on the treatment course to use, it might not work for clients who hail from cultures that value consultation. Person-centered therapy is to some extent compatible with Christian teachings. However, some of its practices and beliefs contradict Christian teachings.

Person Centered Case Conceptualization

Person-centered therapy (PCT) is also referred to as person-centered counseling. It is a kind of talk-psychotherapy established by Carl Rogers. The primary objective of person-centered therapy is to present clients with a chance to create a sense of character, where they can figure out how their actions, emotions and mindsets are being adversely affected (Cooper, O’Hara, Schmid & Wyatt, 2007).

Person-centered therapy gives much of the duty of healing course to the patient, with the therapist assuming a nondirective responsibility. Other objectives of person-centered therapy to clients are “greater openness to experience and increased self-esteem” (Cooper et al., 2007, p. 46). The therapy seeks to establish close conformity between clients’ idealized and real selves. It also aims to promote self-understanding and reduce cases of insecurity.

Rogers had a conviction that therapy should “take place in a supportive environment created by a close personal relationship between client and therapist” (Cooper et al., 2007, p. 53). Thus, he came up with the term client to demonstrate his rebuff of the conventionally hierarchical correlation between counselor and client and his perception of them as equals.

Rogers believed that therapist’s attitude plays a great role in helping a client. He asserted that congruence, empathy and unconditional positive regard are three correlated attitudes that are critical to person-centered therapy. Person-centered therapy seeks to boost self-esteem and help a client to interact with others.

Research in humanistic therapies has shown that individuals who are treated through person-centered therapy sustain steady changes over a long period. Besides, studies have shown that the changes exhibited by a patient treated through person-centered therapy are comparable to those exhibited by patients treated through other forms of treatment.

A five-year evaluation of the effectiveness of person-centered therapy in treating clients suffering from mental problems proved that the treatment is effective (Gibbrad & Hanley, 2008). Most of the clients evaluated showed significant improvement after therapy.

Rogers initially developed person-centered therapy to help in treating children. With time, therapists started to use PCT to treat even the adults. Person-centered therapy is mainly used to help individuals suffering from depression, cognitive dysfunction, alcohol disorders and anxiety (Cooper et al., 2007). In addition, the therapy can be used to treat any personality disorder.

Person-centered therapy helps in treating clients suffering from low self-esteem and those suffering from identity crisis. The therapy assists clients to come up with techniques to reconnect with themselves and attain self-actualization. Hence, person-centered therapy is the most appropriate treatment to use for my client because it will help him to gain inner locus of control and overcome anxiety and depression (Gibbrad & Hanley, 2008).

The therapy will allow my client to assume full responsibility for his treatment course. Hence, it will guarantee him a full recovery. One of the ethical issues that might arise when using person-centered therapy is therapist’s attitude towards a client. A therapist ought to treat a client as a person with dignity despite his or her situation.

Therapist ought to conduct themselves in a way that does not devaluate clients (Gibbrad & Hanley, 2008). Additionally, they should respect the client’s right to self-direction rather than imposing directions on the clients. In other words, therapists should make sure that they try as much as possible not to dominate their clients.

Rogers overlooked the concept of cultural diversity when coming up with person-centered therapy. One of the multicultural issues that might arise when using PCT with clients is a need for dependence on parents or relatives (MacDougall, 2002). The therapy encourages self-direction as the ultimate way to help clients overcome their challenges.

However, this approach may not work, especially when dealing with clients whose cultures require one to consult before making decision. In addition, it might be hard for the counselor to meet cultural expectations when helping a client to attain self-actualization. Person-centered therapy can be used in a crisis situation. The therapy is client-oriented.

Therefore, it contributes to establishing a calm environment for clients to come to terms with their challenges. Additionally, the therapy advocates genuineness on the side of a therapist (Kensit, 2002). A therapist identifies with client’s challenges and assists the client to come up with strategies to cope with the challenges. Thus, person-centered therapy can be helpful in a crisis situation since it begins by establishing a good rapport between a client and therapist.

Humanistic Case Conceptualization: Example Treatments

Presenting Problems

John Cater is an African American, who presents himself as depressed after university administration thwarts his dream of becoming a civil engineer. John alleges that he was accused of orchestrating a strike in the university. In spite of him not being part of those who organized the strike, the school expelled him together with six other students.

After staying at home for two months, John secured a job with a local contractor. He was committed to his work, though his commitment earned him nothing but expulsion. He was accused of misappropriation of financial resources. The expulsion aggravated his depression.

As if this was not enough, John lost his childhood sweetheart after losing his job. He tried to plead with his wife to stay as he attempts to look for ways to sustain the family, but the wife was adamant to leave. All these incidences happened very fast such that it was hard for John to comprehend.

Goals for Counseling

John feels depressed after being unable to salvage his future and rescue his family. The first goal of seeking counseling is to help him change his attitude towards relationship. Even though John would like to marry again, he feels that he cannot keep a relationship because of his financial hardships. The second goal is to help John regain his self-esteem.

John claims that he developed low self-esteem after losing his work and wife. Hence, it is imperative to help him regain his self-worth. John’s predicament has made him irritable and hasty. The third goal of therapy is to assist him deal with his emotions, which are critical if he has to get another job and establish a family.

The three objectives aim to help John live a happy and confident life. John holds the key to solutions to his challenges. Person-centered therapy will help John to determine the direction of treatment that suits his objectives. As a result, he will assume control of the treatment course, thus being in a position to recover completely.

Interventions

Congruence. Kensit (2002) defines congruence as, “The willingness to relate to clients without hiding behind a professional façade” (p. 347). Therapists who demonstrate congruence in their counseling processes shares important sensational reactions with their patients. Congruence will be of significant help in helping John to accomplish his goals.

As a therapist, I will be open with John and establish a counseling environment that allows us to relate without fear of intimidation. Such an environment will make John disclose other challenges that he might not be comfortable revealing to people. In the process, I will help him to come up with a comprehensive treatment course that addresses all the challenges.

By being open, I will help John to cope with his emotions and come up with measures to shun anxiety. I will help John to learn that negative feelings keep him far from his loved ones and might deny him a chance to get a job in the future. I will do this by asking John to determine the number of friends he has made, or job applications he has tried since he lost his job and family. Such an exercise will help him to understand that his emotions may be one of the factors that frustrate his desire to live a happy life.

Unconditional Positive Regard. Unconditional positive regard implies that “The therapist accepts the client totally for who he or she is without evaluating or censoring, and without disapproving of particular feelings, actions, or characteristics” (Kensit, 2002, p. 350). Therapists exhibit unconditional positive regard through listening to clients’ stories without criticizing, disrupting or giving advice.

Positive regard establishes a non-threatening background, which allows a client to share freely sensational, aggressive, or atypical feelings without fear. Unconditional positive regard will help John to deal with his low self-esteem. I will allow John to give his side of the story without interruptions. Besides, I will make sure that I do not criticize John for his actions, feelings or decisions.

Showing unconditional positive attitude will help John to believe in himself and trust that he can still achieve his dreams regardless of the hardships he has gone through. I will assist John to identify fears and perceptions that make him develop low self-esteem and guide him on how to deal with the fears. Besides, I will help John to explore concerns and perceptions that are most critical to his dreams and guide him on how to work on the perceptions.

Empathy. Empathy refers to therapist’s attempt to understand client’s predicament from the client’s point of view. Empathy acts as a prelude step that determines if therapy session will proceed. One way that I will show empathy when helping John is by paying attention to his story (Blair, 2013).

Additionally, I will use reflection technique, which involves summarizing what John is saying. Such an approach will make John to feel that I am listening accurately, thus give him a chance to examine his thoughts and feelings. Through empathy, I will help John to deal with his attitude towards relationship (Walker, 2001).

I will request John to elaborate on his thoughts about relationship and assist him to change the views. I will endeavor to create an environment that will allow John to discern solutions to his challenges by himself.

Person Centered Therapy Conceptualization & Spiritual Application

Compatibilities

Person-centered therapy addresses matters that are often encountered in Christian teachings. First, person-centered therapy helps individuals to determine their identity. MacDougall (2002) argues that person-centered therapy helps clients to pursue pure conscience, which enables them to understand the meaning of their lives and to live as expected.

Christians are supposed to live as per their potential and meaning. Failure to achieve this leads to profound guilt. Person-centered therapy helps clients to focus on real conscience and budge forward. Second, Christianity encourages self-emptying. Christians regard self-emptying as “God’s way of being in the world” (Thorne, 2008, p. 87).

On the other hand, person-centered therapy encourages self-emptying as a way to understand oneself and seek solutions to challenges facing an individual. Third, person-centered therapy “offers a supportive bearing in relating to others” (Jones & Butman, 2011, p. 43). Undoubtedly, the Bible approves genuineness. Person-centered therapy requires therapists to be honest in all they do.

Besides, therapists are called to love and treat their clients with love. They are obliged to serve all clients diligently regardless of their social status. In person-centered therapy, therapists take their time to listen to clients without criticizing or interrupting them. It demonstrates the love, which Christianity advocates.

Incompatibilities

There are glaring inconsistencies between person-centered therapy and spiritual teachings. First, person-centered therapy assumes that mankind is innately provoked towards positive growth. Nevertheless, this is not the reality. We were created in God’s likeness, and we know that one benefits from being good.

However, we always find ourselves committing sins. Person-centered therapy holds that an individual can improve his or her life by striving to do well (Jones & Butman, 2011). However, Christianity teaches that man can only be made perfect through intercession of the Holy Spirit. Second, person-centered therapy encourages selfishness, which is against Christian teachings.

Person-centered therapy promotes self-actualization. Self-actualization involves, “Removing personal barriers, knowing ourselves and reaching our full potential” (Thorne, 2008, p. 91). In most cases, self-actualization makes individuals fail to discharge their duties to others and become self-centered.

Thorne (2008) alleges, “Person-centered therapy holds that human nature is intrinsically good and it supposes that self-actualization leads to goodness” (p. 95). However, the Bible encourages people to be selfless. Another incompatibility between person-centered therapy and Christianity is that person-centered therapy is phenomenological. The treatment “Uses subjective experience to determine a client’s concept of truth” (Thorne, 2008, p. 101).

It encourages therapists to accept a client no matter his or her situation. Therefore, it gives room for truth to be relative. Diverse clients may delineate ethics differently, and a counselor is required to acknowledge all the delineations. Christianity is very strict on the issue of morality, and it does not give room for morality to be relative. Thorne (2008) alleges, “In person-centered therapy, however, unconditional positive regard can be a trap” (p. 103).

Even though Christianity encourages people to love one another unconditionally, it emphasizes on the importance of truth. Christians are obliged to love one another. However, they are not forced to acknowledge everything their colleagues do. Christianity asserts that people should establish limits and encourage restraint in the lives of their loved ones.

Conclusion

With time, it is hoped that John will cope with his emotions and regain his self-esteem. It is also expected that John will understand how his emotions push him far from people and deprive him a chance to establish new relationships that might eventually lead to marriage. Besides, he will understand that it is hard for him to get a job without interacting with people.

It will be significant for John to know that it is possible for one to develop depression after going through hardships. However, one is not supposed to dwell on his past but to look for ways to overcome his or her challenges. It is hoped that John will gain the courage to apply for jobs and approach women in search of a suitable lady to marry.

One of the most challenging aspects of treatment will be helping John to regain self-esteem. He believes that he is worthless and spends most of his time alone. It will be challenging to convince him to start relating with people that he perceives to be in a high social status.

References

Blair, L. (2013). Ecopsychology: challenges for person-centered therapy. Person-centered & Experiential Psychotherapies, 12(4), 368-381.

Cooper, M., O’Hara, M., Schmid, P., & Wyatt, G. (2007). The Handbook of person-centered psychotherapy and counseling. London: Palgrave MacMillan.

Gibbrad, I., & Hanley, T. (2008). A five-year evaluation of the effectiveness of person-centered counseling in routine clinical practice in primary care. Counseling and Psychotherapy Research, 8(4), 215-222.

Jones, S., & Butman, R. (2011). Modern psychotherapies: A comprehensive Christian appraisal (2nd ed.). Downers Grove, IL: Intervarsity Press.

Kensit, D. (2002). Rogerian theory: a critique of the effectiveness of pure client-centered therapy. Counseling Psychology Quarterly, 13(4), 345-351.

MacDougall, C. (2002). Rogers’s person-centered approach: consideration for use in multicultural counseling. Journal of Humanistic Psychology, 42(2), 48-65.

Thorne, B. (2008). Person-Centered Counseling: Therapeutic and Spiritual Dimensions. New York: John Wiley & Sons.

Walker, M. (2001). Practical applications of the Rogerian perspective in postmodern psychotherapy. Journal of Systemic Therapies, 20(2), 41-57.

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