Person Centered Approach as a Depression Therapy - Research Paper Example

Depression Therapy; Person-Centered Approach Table of Contents Depression Therapy; Person-Centered Approach 1 Table of Contents 1 Introduction 3 Case Study 4 Analysis of the Case Study 7 Strengths and Appropriateness of Person Centred Approach 8 Weaknesses of the Person Centred Approach 9 Similarities of Person-Centred Therapy with Normal Management of Such Cases 9 Differences between this Management from Normal Management Approaches 10 Lessons Learnt On Reflection 10 Other Counselling Theories That Can Be Incorporated For Effective Therapy 11 Cognitive Behaviour Therapy (CBT) 11 Integrative Therapy 12 Gestalt Therapy 12 Psychoanalysis Sigmund Freud Theory 13 Reality Theory 13 Existence Therapy 13 Conclusion 14 Works Cited 15 Person Centered Approach as a Depression Therapy Introduction Psychotherapy is frequently the first form of treatment suggested in treatment of depression as well as other forms of psychological disturbances. Therapy involves a number of techniques that aims at enhancing restoration of the clients control over his or her life. Client-Centered Approach of counseling is a type of therapy, which involves improving the sociability of a client by creating an environment where the counselor experiences the client’s problem by being open, trustworthy, empathetic, and genuine. The approach is diverse from the one previously used by psychodynamic psychologists who believed that the counselor was the expert and thus distinguished the clients problem better. This approach emphasizes that the client knows his or her problems better and is therefore the one who is capable of coming up with the appropriate solution but with some assistance from the counselor or the therapist. This therapy initially referred to as self-directive, was pioneered by the psychologist Dr. Carl Rogers who lived between 1902 and 1987. Other effective ways of dealing with depression include, exercise, medication as well as lifestyle change. This paper focuses on the person-centered approach in resolving depression, in comparison to other approaches. Person centered approach therapy enables the client to be open since a feeling of less peril both physically and psychologically is created. For a counselor to make any therapeutic transformation on the personality of the client, three conditions are vital. First, the counselor must be in a position to identify with the clients problem, the counselor must also accept the clients problem positively and evade being judgmental, lastly the counselor must also be in a position to share or experience the problem with the client. Since the client is conversant with the problem, the counselor is only supposed to be a companion and help the client rediscover him or herself. Person centered care involves empowering the person involved to carry out as much activities for themselves as possible, explaining to the person what exactly you are doing, and cultivating an intuition of freedom on the individual other than that of control. According to person- centered theory, trying to act as the expert by taking control over the clients problem only make them feel more incapable of dealing with their problems. Sometimes, merging more than one therapy approach provides better and fast results. However, when applying other therapies, some degree of flexibility on the regularity enhances a feeling of freedom on the person. Case Study The case study I will recount involved a young woman suffering of depression referred to me by her doctor. The depression had started after her two-year husband died in a tragic road accident leaving her with a son suffering of Kawasaki disease to take care of. I thus accepted to help the woman deal with the problem and scheduled for our meeting. The initial symptoms included weight loss due to reduced appetite, hypersomnia, agitation, suicidal thoughts, feeling of worthlessness, and diminished interest in almost everything. The issue at hard was vast since the woman was grieving for the loss of a loved one and at the same time had to take care of an ailing toddler. Assessing depression involve considering the degree of harm as well as the period under which the client has had the problem. It entails improving the self-esteem of the client. When she arrived, she sat at the edge of the table and kept fidgeting which made me sense she was still uncomfortable and require time before she could share the problem. I welcomed her, introduced myself, and acknowledged I was anxious, which happens to me when meeting new people or places. I submissively told her I suspected she was also nervous like I, which she admitted. I sought to know if she understood what counseling is and she admitted she was did not understand much about counseling. I therefore introduced basic aspects concerning person centered counseling and some background information about my working style and myself. I also elucidated to her what we could expect of each other if we decided to work together, which I assured her, was necessary. At this point, I realized she was looking a bit serene and she agreed with me that it would perhaps be helpful. I therefore began by explaining to her that as a person centered counselor I believed that all human beings positively strive to accomplish the best in all their endeavors. I also let her know that I regard every human being as unique and reasonable in all his or her decisions, which should therefore be appreciated. I also guaranteed her that she was the only specialist who understood her inner feelings and had the authority to decide who to become or what to do with her life. I counseled her that a positive relationship between us was important, as it would enable her feel recognized and not judged. I also assured her I would be genuine about my feelings since she was the expert as long as her life was concerned thus if any answer was to be found it was within her. I reassured her that I would not probe her to tell me more than she was willing and she was free to express herself emotionally by actions such as crying or even silence whenever she felt like. I also informed her I was going to be very sincere on how I experienced her problem but at the same time required her to be genuine of her feelings. I told her I hoped she was also going to be sincere with me and notify me in case she felt like I was being judgmental or too inquisitive. I concluded by making it clear to her that my aim was to create an affable environment where she will feel accepted and understood such that she will freely express herself. I explained that I believed feelings of all people should be respected and was optimistic I would create an atmosphere so that we would be able to deal with whatever was troubling her. This start was very vital and broke the barrier that had appeared to exist between us. From that meeting she became a bit open and started enjoying the sessions. She would freely cry when the situation called for that since she knew she could trust me not to judge her. At the start of the therapy, she felt that her life was awful and nothing good came her way. She blamed herself for the death of her husband as well as her inability to fully pay the medical bills and provide better medical care for her ailing baby. Each session proofed more helpful and one year later she was a confident woman who had opened up a business to enable her take care of her son though she still came for her therapy. Her self-esteem had improved and she dealt better with her emotions as opposed to the hot temperament she had adopted before starting the therapy. At some point, I was forced to incorporate aspects of other therapies since I realized she required more assistance to deal with her fears, anxiety and change some behaviors such as withdrawal. Though she is still undergoing therapy, she is very different from the woman I met at the start. She at times demonstrates a sign of bitterness or feeling of emptiness but the suicidal thoughts that would previously torment her have almost ceased. She has completely rediscovered her worth and though his son is still undergoing treatment she believes she will never let any problem overshadow her ambitions. Analysis of the Case Study Depression is harmful in that it bars the affected persons from performing their duties since they are tensed and mentally disturbed. Sorrow of losing a loved one may never go away completely but the emotions are supposed to dwindle with time. After loss of a loved one, the mourning process starts and lasts for different times depending on the strategies applied in the attempt to deal with the loss. After the initial stages of mourning, the client got into complicated grief and ultimate depression. Depression occurs when one cannot accept the loss even after a long period and the grief thwarts him or her from carrying out their daily activities normally. Depression in my client was characterised by a deep sense of guilt, suicidal thoughts, hopelessness, and had phantasms at times. Treatment included stabilizing the feelings of grief by letting the client know it is right to grief and providing the right platform for this so that the client does not end up injuring herself or getting worse (Saisan et al, 2012, Web). The foundation principles applied in the above case study were the core conditions of person-centered approach, which are empathy, unconditional positive regard, and congruency. The three conditions enabled the client to build up and inflate her identity since the pressure to think or act in a particular way is slowly is eliminated. The three conditions are a contrast to the conditions believed to cause physiological disturbance. Unconditional positive regard entailed accepting the depressed woman without judging her, which enabled her to investigate her opinions and outlook without fear of rejection or denunciation. The fact that the counselor does not set any standards on the client enables the clients to express themselves without panic (Martin, 2010, Web). Empathetic understanding involves appreciating the thoughts and feelings of the client as well as their implication. This enables the counselor perceive the problems from the clients viewpoint, which builds confidence in the client that their views are valued making them feel accepted. My client’s self-esteem was fragile and she had fear being condemned thus I had to keep reassuring her that it was just a transient jiffy, which can happen to anyone. The therapy included assuring that the client of her capability to deal with the problem to enhance self-growth and development. The aim of this is eliminating any fears of rejection and cultivating a feeling of acceptance on the client (Ramsom, 1995, p. 107-113). Congruence signifies genuineness of the counselor and the client feels more comfortable and at par with the counselor. The client feels no need to contemplate on outlook of the counselor since a sentiment of transparency is created. Initially, my client dreaded speaking about her problems and felt she was lesser than I was and incapable of dealing with her personal problems. I therefore had to convince her she was doing the right thing and that I would have done the same thing. Others will feel irrational if they realize or consider the therapist to be an expert. The sole aim of the counselor should be to cultivate an environment for the client to pick up from past deprivations and visualize themselves as novel and more capable individuals (Martin, 2010, Web). Strengths and Appropriateness of Person Centred Approach The efficacy of the person centred or person directive approach lies in its ability to make the client feel at ease, less fearful and hence share their problem with the counsellor. Most individual with depression are liable to be withdrawal and require to be assured of their potential. Person-centred therapy is different from other types of approach in that it views the client as the one with full authority on their lives as well as the ability to establish the cause and solution to their problem. The role of the counsellor is to generate a favourable environment for the client to effectively deal with the problem (Martin, 2010, Web). The environment enables the client feel accepted, that someone else understands what they are experiencing, and is willing to help the carry their burden. The therapy is advantageous since it deems on the values of the client, and helps the clients understand themselves better. It also encourages the client to focus much on the present and not the past hence reduces pressure (Mulhauser, 2011, Web). Weaknesses of the Person Centred Approach The approach may not work with some clients who expect the counsellor to guide them in the recovery process by advising as well as instructing them on how to deal with their problems. Some clients may be too depressed and remain reserved longer and therefore the therapy may take longer than necessary. Another problem that makes the theory hard to apply is the fact that it does not use procedure. This makes it hard to apply given that it equally relies on the personalities of the client and the therapist (Mulhauser, 2011, Web; McLeod, 2008, Web). Similarities of Person-Centred Therapy with Normal Management of Such Cases Rogers ideas formulated in the person centred approach exist in other occupations such as health profession. Akin to client or person centred therapy, self-psychology applied in mental health sciences resembles the unconditional positive regard (The John D. & Catherine T. MacArthur Foundation, 2009, p.5-6). Differences between this Management from Normal Management Approaches In heath and most other therapies, the sufferer is referred to as patient as opposed to client in counselling therapy. This is because the therapists view themselves as experts in solving the problem while counsellors believe the client has the power to decide on their problem and possible solution. This approach is different from the usual style of managing depression in that it involves the client more. Normal management involve practitioners using competent frameworks with regular and competent supervision of the depressed individual (McLeod, 2008, Web). Combined treatment with psychological intervention is applied. Assessment is done using questionnaires, which are filled by the client or the patient as referred by medical profession. Interventions such as use of medications such as antidepressants are preferred in several cases. Treatment first involves assessment to determine the level of depression after which the management begins and involves a number of steps that encompasses use of medication as well as psychological intervention. Counselling in this form of treatment is only used as a supportive strategy to minimise depressive symptoms. The major difference of this approach from psychological approach is that the medical approach include a combination of several strategies to assess, treat and manage depression (The John D. & Catherine T. MacArthur Foundation, 2009, p.7-10). Lessons Learnt On Reflection From the above case study, I learnt that the relationship between the therapist and the client is very vital in determining the recovery process and speed of the client. The client just requires a favourable environment to open up and realize they are capable of resolving their problem. Any attempts to judge or argue with the client may result in withdrawal. In between the therapy, I realized that the client required more guidance from me than the approach I was use enabled and decided to incorporate other some aspects not suggested in person-centered theory. Below is a list of other theories I realized could be integrated in depression therapy for better and speedy results (Saisan et al, 2012, Web). Other Counselling Theories That Can Be Incorporated For Effective Therapy Therapeutic counselling involves use of several theories since one theory may not be applicable to all people or all situations. A counsellor of medical professional mostly decides upon the theory to use after carefully analysing the client. In the case study above the client was still in the mourning period thus application of person centred theory alone would have require much time (Grossmark, 2002). Therapy can be given in different formats, which include couples in case of married people, individual, or family whereby the family is involved in monitoring the progress of a client. Other theories used in depression therapy include integrative therapy, gestalt, CBT, behaviour therapy, Existence therapy, and Psychoanalysis Sigmund Freud theory. Cognitive Behaviour Therapy (CBT) Cognitive Behaviour Therapy (CBT) use in management of mental and some physical problems endeavours to change the client’s way of thinking, feeling thence behaviour. The theory argues that one’s way of thinking is vital and can either trigger or prevent occurrence of health problems such as depression. According to this theory, counselling therapist should aim at identifying the detrimental thoughts in a client and motivate the client to adopt different and fit thoughts. Remedy to change ones way of thinking is referred to as cognitive therapy while that aimed at adjusting the behaviour is referred to as behavioural therapy (Jones, 2006, p. 336). Change in the mode of thinking consequently alters behaviour and may prevent condition such as anxiety helping the client deal with stressful situations. An example of a practice used in behavioural therapy is deep breathing. Cognitive behavioural therapy is recommended for individuals whose way of thinking is likely to trigger depression or emotional stress. Another group advised to use this therapy are persons who are incapable of taking antidepressants as well as individuals who often suffer depression affecting their interpersonal relationships (The Cleveland Clinic Foundation, 2012, Web). Integrative Therapy Integrative therapy involves incorporating the behaviour of the client and making it consistent to come up the cognitive and behavioural systems of the person. It focuses at acting in response to the emotional, religious, cognitive as well as the physiological levels requirements of the client. The theory argues that no single theory is capable of offering solution in all situations or all people thus there should be suppleness in choosing the appropriate therapy. However, it emphasises on the need for appropriate attitude between the client and therapist characterised by respect, openness, and parity between the client and counsellor (McLeod, 2008, Web). Gestalt Therapy Fritz and Laura founded Gestalt therapy in 1940’s, which focuses on the need for residing in the current moment. The theory further argues that we are all responsible of our lives thus emphasizes on the need for the client to struggle for realization of a zeal for living. It also accentuates on the importance of contact and awareness to address emotional, physical, mentality and spiritual aspects. It best applies for individuals looking for safe and private clarity on issues such as relationship hitches, depression, or anxiety (Jones, 2006, p.113). Psychoanalysis Sigmund Freud Theory Psychoanalytic theory claims that man is evil, specious, and irrational and is therefore prone to making mistaken choices. The theory aims at correcting man’s irrationality to enhance making of reasonable choices. To prevent this, man requires constant guidance in order to be logical, rational, and cognisant while making decisions. This theory is best applicable in counselling cases relating to vocational choice as it offers ideas of altering ones career choice in case the decision is illogical (Jones, 2006, p. 20-30). Reality Theory The theory claims that clients select unsuitable ways to control the world with the aim of fulfilling their needs thus end up being depressed. The theory aims at identifying the needs of the client and providing appropriate advice to the clients on how to make sound decisions (Jones, 2006, p. 5-10) Existence Therapy The therapy focuses on assisting the clients deal with fretfulness related to death, freedom, and feelings of either isolation or worthlessness. The therapy focuses on assisting the clients deal with fretfulness related to death, freedom, and feelings of either isolation or worthlessness throughout the therapy I encouraged the client to deal with her fears (The Cleveland Clinic Foundation, 2012, Web). Conclusion Person centered therapy posits that client understand themselves better and are more capable of detecting the cause of their problems more than the counselor or therapist. The counselor should only aim at creating an appropriate environment for the client to initiate and journey towards positive personal change. The environment should involve a genuine, accommodating and understanding stance to enable the client discard their defenses and denial, accept the mistakes that may have occurred and focus on humanizing their lives. The psychotherapist seeks to recognize the clients experience as well as the point of view and value all the facet of the client with the aim creating a genuine friendship. This motivates the client to open up. Gestalt therapy focuses on the current moment of the client’s life on aspects pertaining to thoughts feelings and behaviors. Depression is associated with decreased social activeness and spoilt livelihood. Psychodynamic is a type of therapy, which posits that depression arises from unresolved issues in the life of the client and thus aims at helping the patient cope or deal with the underlying issues. When dealing with the client in the case study discussed, I realized that incorporation of a number of theories might work better than choosing a single theory. Initially I had only focused on person-centered theory but later realized I required integrating cognitive and behavioral therapies to help the client deal with her fears. I also learnt that studying the problem of the client prior to choosing the appropriate therapy is important in making sound choices. Other therapies employed differ from the person centered in that in most of them the therapist other than the client is more participative in resolving the problem especially in extreme depression. Works Cited Jones, Richard 2006, Theory, and Practice of Counseling and Therapy. Sage, London. Martin Anna 2010, The person Centered Approach to Counseling, viewed 14 May 2012 < http://www.thecounsellorsguide.co.uk/person-centered-approach-counselling.html> McLeod, Saul 2008, Simple Psychology; Psychology Research Methods. Viewed 14 May 2012 http://www.simplypsychology.org/research-methods.html Mulhauser, Greg 2011, Evaluating Therapeutic Effectiveness in Counseling and Psychotherapy, viewed 14 May 2012 Ramsom, Carl 1995, On Becoming a Person: A Therapist’s View of Psychotherapy. Houghton Mifflin Harcourt, Massachusetts. Saisan, Joanna, et al 2012, Depression Treatment: Therapy, Medication, and Lifestyle Changes That Can Help. Viewed 15 May 2012 The Cleveland Clinic Foundation 2012, Psychotherapy for Depression. Viewed 15 May 2012 The John D. & Catherine T. Macarthur Foundation 2009, Depression Management Tool Kit. Viewed 14 May 2012 http://www.depression-primarycare.org/images/pdf/macarthur_toolkit.pdf Read More