Existential Approach with Person-Centered Therapy - Assignment Example

Existential Approach with Person-Centered Therapy I will be using an Existential approach with Patrick, a 9-11 wounded fireman whose freedom of life choices is severely restricted in response to losses (death and divorce) endured in childhood and adulthood. These responses involve anxious behavior and are currently limiting his occupational and social relationship freedom. Strengths and Limitations of Existential Approach Strengths A primary strength of the Existential approach is that it stresses freedom of choice for client and therapist (Corey, 2009). Additionally, the Existential approach stresses anxiety as a common theme, anxiety about identity and authenticity, and how encounters with death, or the prospect of one’s death can be useful in using freedom wisely and making authentic choices, rather than using anxiety to escape from taking responsibility for present and future (Corey, 2009). Furthermore, the Existential model was contributed to by men of extreme experience in their backgrounds, Victor Frankl and Rollo May [Artnd]. This approach is well-aligned to Patrick’s presenting issues and extreme experiences, as he lost a brother and colleagues to death, faced the potential of his own death in 9/11, and has anxious feelings and anxiety about social relationships. Existential angst is a normal response to lived experience [Cla10]. Resisting these anxious feelings keep him from the choices he wishes he could make but doesn’t realize that he indeed can make. The Existential approach gives the therapist the capacity to assist the client toward insight and building new meaning (Corey, 2009). Limitations Because the Existential approach does not advocate a particular set of techniques (Corey, 2009), it is necessary to be familiar with the techniques of other theoretical approaches, where supportive listening is not enough. In this case, exploring loss might be done through Psychoanalytic (Rorschach or dreams) or Gestalt techniques (empty chair technique to talk with those lost). There is no uniform template. Cultural, Age, and Gender Issues Firemen are heroes. They rescue kittens from trees and people from burning buildings. They keep in shape and jump quickly to effect a rescue. They watch each other’s backs. Young boys dream of being like them. They embody the cultural ideal of a male: strong, fast, courageous, handsome in uniform, protective, righting wrongs and controlling chaos. Patrick’s injuries, anxiety, social insecurities, and 9/11 memories, as well as likely fear response to encountering death, are at odds with this cultural ideal. This causes identity anxiety. Legal and Ethical Issues Patrick should be encouraged to take responsibility for his choice to continue working and take a break when he is detached, anxious, and preoccupied, to manage risk. Work is good because his limited social life is connected to work, as is his exercise regime. It is not stated whether Patrick has come for evaluation, on his own, or whether his employer has referred him or whether this is a court-appointed evaluation. Confidentiality is always assured but sometimes the court or company might have some ownership of confidentiality. Informed consent must include full disclosure of this and shared information needs informed consent before disclosure. Overall Therapeutic Goal At the end of therapy, the client will recognize his freedom to design his own experience and responses, rather than being limited by past events (Corey, 2009, 71) and will view past grief and loss as an opportunity for change and growth [Jen11]. How to Proceed with Therapy Because Patrick feels anxious and lacks relationship confidence, I will begin by building rapport and trust, explaining that I will listen and be on his side always, no matter what, and that I will always be honest with him and will help him toward a goal of recognizing his own freedom of choice and hearing his own inherent wisdom (Corey, 2009). Although Existential therapists are wary of labels, it is good to learn from other approaches when the situation warrants it (Corey, 2009). With experience congruent with PTSD, a major goal of therapy will be more liberated functioning in the performance of his role as a fireman, since that is his chosen life. I would give him information about PTSD, explain that his current limitations are not indications of weakness or insanity and do not need to forever limit him. I would caution him about not being defined by a label but to use the information to feel reassured about normalcy and liberate himself (Corey, 2009). I would also be certain that I responded to Patrick as an evolving being (Corey, 2009) and not as a PTSD case. Participation in a support group of other fire fighters who have been through loss and injury would support his insight into this experience and support his recognition of self-limitation. Another goal is increasing the client’s social confidence by broadening his world. He needs to gain insight into how his confidence has been compromised by resistant responses to the death of his elder brother, his parents’ divorce, his status as step-sibling, a failed marriage, and the shock of 9/11 in which he lost friends and colleagues and was wounded and scarred. Existential therapy leaves freedom to use any appropriate techniques with the client (Corey, 2009). Patrick’s social confidence might be increased through building a social life (take a class, join a hobby group, attend church functions, dating, volunteering with a Big Brother organization or other mentoring project). This would add another layer of meaning to his life. I would encourage him to explore his ideas and feelings around family and social relationship, since he has had so much loss. When we are processing those losses, I would encourage him to see that he was not the cause for these events, and they cannot be changed, but his use of these events in imposing unnecessary restrictions on his life can be changed. Children commonly feel they are to blame when a sibling dies and when parents divorce, and it is understandable that he would feel at fault for failing to save friends. I want to help Patrick let go of the restrictions his past places on his choices in the present. I want him to feel free and able to make new choices. Conclusion Existential Therapy bases its approach on the client’s lived experience Patrick has a lot of loss informing his lived experience. His barren social life attests to the restrictions he places on himself, unknowingly, in response to those losses. His anxiety results from a lack of authenticity as he uses losses to hide from being the author of his present and future. The existential approach is well-suited to his issues and liberation. References Corey, G. (2009). Theory and practice of counseling and psychotherapy (7th ed.). Belmont, CA: Thomson Brooks/Cole. Artnd: , (Hunter, n.d.), Cla10: , (Mann, 2010), Jen11: , (Stevens, 2011), Read More