The Concept of Applied Therapeutic Orientation - Case Study Example

Clinical Case Formulation Clinical Case Formulation Brief Introduction The client, known as Mary, is a 34 year old female who is seeking help with anxiety and emotional “breakdowns.” The chosen orientation of formulation selected is the person-centered therapy. The person-centered therapy (PCT) is founded on Carl Rogers’ conceptual approach to individuals facing all forms of personal challenges or disturbances in life (Thorne, 2012). Roger formulated the theory with disturbed children, and proceeded to expand his conceptual perspective to incorporate work with families, spouses, and groups. According to him, it is possible for psychological therapy to be friendlier and more optimistic compared to that favored by psychodynamic or behavorial practitioners (Timulak, 2011). PCT differs significantly from the cognitive-behavorial (CBT) and psychodynamic therapies because it holds that individuals would be better assisted if they were motivated to concentrate on their prevailing subjective understanding instead of someone else understanding of the situation or some insentient motive (Tasman, 2013). Rogers had a strong conviction that to improve a client’s situation psychologists should be warm, honest and empathetic. Relevant Background In my initial phone consultation Mary revealed that recently she could become nervous in crowded places and becomes anxious and agitated when travelling in a car. This was usually linked with sweating, becoming clammy, feeling faint, wanting to get out of the car, feeling distressed, thinking that she was in danger and thinking that she was going to die. Mary also described her relationship with her mother, whom she was in regular contact with, but who has untreated “depression.” Mary’s main approach to coping with her stress and anxiety is through work and keeping busy. Her father left the family when she was five years old and never returned. Her mother appeared to blame her for her father leaving and soon became depressed, agitated and overly critical of her. Mary remembered never being able to ‘get things right’ for her mother and constantly being told that she was not ‘good enough’. One year ago, her only son Dexter, who was a student at Bishop’s Hill Primary, was tragically killed in a road traffic accident. Mary blamed herself for Dexter’s death and felt that she was a bad mother. She no longer wants to discuss the event, stating that she has to be a strong woman and has never allowed herself to cry or think too much about the incident since the funeral. Applied Therapeutic Orientation The PCT focuses on the richness of the client/therapist relationship. The theory assumes that clients are essentially honest and have the inner strength to find solutions to their dilemmas (Ashworth, 2012). PCT is a less prescriptive approach on the therapist’s behalf, implying that clients have the freedom to define their own goals and cultivate the conditions that will enable them to understand their needs and behaviors (Sanders and Hill, 2014). Counselors themselves facilitate the client’s development by offering a war, open, positive, benevolent, and trusting relationship with the client. The three vital attributes the therapist should exhibit are unconditional positive attitude, genuineness, and correct emphatic comprehension of. There are no permanent techniques in applying PCT (Weiner, Stricker, and Widiger, 2012). Instead, there is a battery of principles that guide therapists in implementing its concepts. Mary is exhibiting a contrast between the way she sees herself, the “correct” portrait of themselves and the reality of her condition. She also feels helpless and incapable of controlling her own life and making decisions. The biggest issue from Mary’s background information appears to be the death of her son and her father’s abandonment of their family (for which her mother made her feel guilty). Mary appears to be running away from the death of her son, and the problems she endured in her childhood, and this has gotten to the point where she becomes anxious and paranoid. She tries to escape her problems and grieve by immersing herself in work. She claims that she is a string woman and yet she cannot bring herself to mourn her son once and for all. Once she was in my office, I approached her like a friend and encouraged her to let out her problems. I informed her that there was nothing wrong with grieving, and that it was not in any way a sign of weakness. I gave Mary all the space to express herself and allowed her to most of the talking. I only interrupted her to encourage her and to support her positively – not criticize. While Mary looked to me for direction at some point, I shaped the sessions to emphasize on her to account for her own decisions and to learn exploiting the therapeutic relationship to expand her self-understanding. Using the PCT, I tried to comprehend Mary’s world by listening to, respecting, accepting, and empathizing with her. In doing so, I integrated myself into my relationship with her. I did not give her room to ignore me, as some counselors and therapies do (Smyth, 2013). I also tried to experienced real compassion and acceptance of Mary as a client and as a human being. Failure to do this would have resulted in Mary feeling that I was feigning concern and would have withdrawn and hesitated to fully express her feelings (Motschnig and Nykl, 2014). As she experienced me listening to her and embracing her, Mary learned how to accept herself. She learned how to accept her condition and the experiences she has had by viewing them as part of life’s motions instead of as her own unique tribulations that no one can ever understand. As Mary experienced me caring for her, she started viewing herself as valuable and worthwhile. She stopped blaming herself for her son’s death and started viewing herself in more positive ways. As I interacted with her and showed her some realness, she was encouraged to move on from her experiences by perceiving them as just memories (Casemore and Tudway, 2012). She also learned to discard her pretences with herself and other people. Recommendations and Future Potential Goals The PCT therapy provides a friendly, warm and empathetic environment that encourages clients to express themselves and avoid subscribing to unrealistic perceptions and thoughts (Rust and Golombok, 2014). When using the PCT, therapists must learn to picture themselves in the client’s position and encourage them to voice whatever problems they have. Applying PCT also requires good interpersonal and communication skills so that therapists “get through” to the client (Hakala, 2013). Studies show that there is often a communication barrier between clients and therapists that starts with the first encounter. Clients always seek help with reservations about some issues (Miller, 2014). There are things they feel they cannot tell the therapist either because of embarrassment or a feeling of insecurity. On the other hand, therapists often go into sessions wanting to get as much information from the client as possible, and wanting to provide the most comprehensive solutions to the client (Hopwood and Bornstein, 2014). Both parties’ approaches are quite contrasting, and create communication obstacles in the therapeutic process (Acton, 2013). PCT is more affected by these challenges because it is more personal than other theories (CBT and psychodynamic). Therapeutic goals of PCT include building a relationship with the client and providing a support system for the client to voice their concerns (Elliott, 2014). References Acton, A. (2013). Issues in clinical psychology, psychiatry, and counseling (2011 Ed.). New York: ScholarlyEditions. Ashworth, P. (2012). Psychology and human nature (Annotated Ed.). London: Taylor & Francis. Casemore, R., & Tudway, J. (2012). Person-centred therapy and CBT siblings not rivals. Los Angeles: Sage. Elliott, G. (2014). Counselling Psychology. Methods of Therapy and Ethical Considerations (Unabridged Ed.). Munich: GRIN Verlag GmbH. Hakala, C. (2013). AP psychology 2014. New York: Kaplan Pub. Hopwood, C., & Bornstein, R. (2014). Multimethod clinical assessment. London: Guilford Publications. Miller, C. (2014). Assessment and Outcomes in the Arts Therapies: A Person-Centred Approach. London: Jessica Kingsley. Motschnig, R., & Nykl, L. (2014). Person-Centred Communication Theory, Skills and Practice. Maidenhead: McGraw-Hill Education. Rust, J., & Golombok, S. (2014). Modern psychometrics: The science of psychological assessment (Revised Ed.). London: Routledge. Sanders, P., & Hill, A. (2014). Counselling for depression: A person-centred and experiential approach to practice. London: British Association for Counselling & Psychotherapy. Smyth, D. (2013). Person-centred therapy with children and young people (Illustrated Ed.). London: SAGE Publications. Tasman, A. (2013). The psychiatric interview evaluation and diagnosis. Chichester, West Sussex: John Wiley & Sons. Thorne, B. (2012). Counselling and spiritual accompaniment bridging faith and person-centred therapy. Chichester, West Sussex, U.K.: Wiley Blackwell. Timulak, L. (2011). Developing your counselling and psychotherapy skills and practice. London: SAGE. Weiner, I., Stricker, G., & Widiger, T. (2012). Handbook of psychology (2nd Ed.). New York: Wiley. Read More