A Person Centered Theory Approach, Case Study Example

The person centered approach in counseling was established in 1942 by Carl Rogers, which contributed largely to the widespread use of humanistic psychology (Rogers, 1942). While humanistic psychology is traditionally thought of as psychoanalysis and behaviorism, certain approaches within the field are useful for making clients come to their own realizations as to what they need to fix in their lives through recurring therapy sessions. Therefore, instead of focusing on two these aspects of psychology, the person centered approach takes advantage of humanism, existentialism, and phenomenology. Using these three philosophical principles will help Kat understand more about her situation, why she has and is currently making certain life decisions, and give her the ability to change the course of her actions.

In order for the person centered approach to work effectively and help Kat, the proper therapist-patient relationship between myself and my client must be established. To do so, Rogers recommends six conditions; since Rogers established the person centered approach, these will be adhered to throughout the dialogues held with Kat. These principles state: the therapist and the patient must be in psychological contact, the patient should be in a state of incongruence where they are vulnerable or anxious, the therapist should be congruent or integrated in the relationship, the therapist should experience unconditional positive regard for the patient, the therapist must have an empathetic understanding of the patient’s situation and see things from the patient’s point of view, and the therapist should constantly communicate this understanding to the client (Rogers, 1957). Although all six of these conditions are important during discussions with the patient, this approach focuses mostly on the therapist’s understanding to promote growth in the patient; therefore, the conditions that apply directly to the therapist are considered the most important.

The person centered approach is ideal for Kat for several reasons. Firstly, she was not the one to recognize that she is suffering from a psychological problem; she was referred to me by her female doctor and seems to not realize that her situation is actually detrimental to her mental health. The best way to make Kat come to this realization is through talking to me about her life and coming to her own conclusions that the recurring behavior with her boyfriends is not typical behavior so that she will be able to make the changes to her life that she wants accordingly. In addition, this approach is ideal for who Kat is as a person; she seems to confide completely in her female doctor who she also considers a friend. It is difficult to tell whether Kat considers “friendship” as the ability to talk to and confide in a person or whether it refers to seeing the person frequently outside of the doctor-patient relationship; if the relation between Kat and the female doctor is the former, then it should be easy to generate the information required to help Kat because she should form a similar relationship with me as her therapist. Since Kat always feels the need to give out advice to other people and not take any herself, the person centered approach is also ideal because it will allow her the opportunity to finally have a conversation with someone about her life and her choices.

The recognition of the underlying concepts of existentialism, humanism, and phenomenology will greatly aid Kat during her conversations with me using the person centered approach. Firstly, the humanist philosophy states that each human being has dignity and worth. It also states that people are generally rational and have full capacity for goodness. Under this model, people are always striving to better themselves or become something more ideal. In Kat’s situation, this is her constant need to help charity organizations; while she doesn’t consciously realize the problems with her life, she does subconsciously and uses charity and religion as an attempt to atone for the things that she has done wrong. Although Kat didn’t explicitly state it during the interview, it is possible that is obsessively involved with charity work because of her regret for how she left her family. It is clear that her family are religious people because when she left they told her that she would “go to hell”; however, charity is an act that they would approve of. It is unclear of whether Kat has rekindled her relationship with her family, but a major goal in therapy should be getting her to realize that she should make an attempt to reconnect with them if she hasn’t. Kat’s way of thinking and acting may improve once she is shown that people believe in her and support her.

The existentialist philosophy deals with free will, choice, and personal responsibility. It states that “because we make choices based on our experiences, beliefs, and biases, those choices are unique to us – and made without an objective form of truth” (Casemore, 2011). In other words, there is no specific set of rules that any one of us must follow, we make our own rules and follow them accordingly. Kat has in part defined what these rules are for her, although they often lead to consequences that are not positive. Although the universe has no defined set of rules, it is important for her to understand that certain thoughts and actions will lead to either positive or negative consequences and that it is better to strive for the actions that lead to positivity in our lives. One of Kat’s major problems is that she seems to enter only relationships that are harmful to her; although her most recent ex-boyfriend hit her once, she seems to think this is okay and that it was her fault. This is a typical feeling of many women who are involved in abusive relationships, so it is important to make her understand this during the therapy session. In addition, it is important to note that even though this boyfriend only physically abused her this reported once time, Kat says that “I often tell him things he should know about himself and he gets furious”. Therefore, although Kat’s most recent ex-boyfriend was only physically abusive once, he seems to be verbally abusive quite frequently. Furthermore, he was emotionally abusive to her as well because he would have affairs with other women and make her aware of this. Even though Kat and her abusive ex-boyfriend are no longer together, Kat is dating a man who appears to be similar to him; he is also a substance abuser, and although not a lot of information was provided about him, he contrasts Kat’s “goody goody” nature based on the fact that he is a Nazi enthusiast. Therefore, a secondary goal of therapy should be to get Kat to realize why she is ending up with these men and turning down the others who are genuinely interested. Women are frequently unwilling to break off relationships with abusers because they feel that the abuse is either their own fault, they’re afraid to be independent, or they need to be needed. Based on the information provided about Kat, it is likely that she likes being with them because she things she can help change them; this is evident when she says that she told her ex-boyfriends “things he needed to know about himself” to motivate him. It is important for Kat to realize that she can be independent and the abuse was not her fault; she has many options available in life and if she “needs” to help people, there are many charity organizations she can get involved with to accomplish this.

Although the principles of existentialism aren’t necessarily positive, they are important for Kat to understand. In particular, the ideas that humans have free will, life has many choices and the decisions that people have to make create stress, some things are irrational and there is no reason for them, one must follow through with their decisions, and that the meaning of life is the one that we give it, can be helpful in enabling Kat to understand where she wants to go from here. The therapy sessions should be aimed to demonstrate that she is free to make her own choices, whatever they may be, and once she develops a plan of action she needs to stick with it. One of the major issues that is evident in Kat’s case is that she doesn’t seem to have an established life purpose. Although I was told of her past relationships with men, relationships in general, and briefly about her job, she doesn’t seem particularly driven in any of these areas. She excels at work because she feels a need to but there is no end goal in sight. Therefore, a third goal of these therapy sessions should be for Kat to define what she wants out of life; she should be allowed to discover what her idea job and relationships are and work towards those goals rather than focus exclusively on charity and the men she dates. There is a lot that Kat is missing out on in life because of her unique situation, and through counseling, she needs to teach herself that there is more to life than what is just happening right now. One of the most important ideas that existentialism teaches is that decisions cause us stress; this is inevitable and whether the decision is difficult or easy, it will still cause us some level of uncertainty. Therefore, Kat needs to make the best choice for her regardless of whether it is the easier choice because either way something could go wrong.

The philosophy of phenomenology teaches that “the events, feelings, experiences, behaviors, words, tones of voice and anything else that we see or hear, as they are in the moment” are important and we should avoid interpreting them out of the context of the situation (Casemore, 2011). Based on this principle, it is important to have many additional sessions with Kat because psychologists using the person centered approach are not able to apply information learned in one situation to a second. The important lies in the details of each unique situation and it is important to consider that the motivation behind each action or feeling differs with each detail. The ultimate goal of these therapy sessions is to guide Kat to stage seven of the “stages of becoming fully functional in counseling”. According to the provided interview, Kat is currently in stage 2; “the client becomes slightly less rigid and will talk about external events or other people” (Casemore, 2011). A patient who is in the final stage of this counseling scheme is “a fully-functioning, self-actualizing individual who is empathic and shows unconditional positive regard for others. This individual can relate their previous therapy to present-day real-life situations” (Casemore, 2011).

As mentioned above, the major goals that Kat should achieve through the person centered therapy sessions include the realization that her relationship with her family is broken and this is impacting her emotionally, that her relationship with men is detrimental to her emotional well-being, that her abuse was not her own fault and she is free to leave the situation, that she should work on building friendly relationships with her co-workers and other people around her, and that she should establish a long term life goal so that she is working towards something rather than just focusing on problems that exist in the moment. Since I am using the person centered approach of therapy, I cannot inform Kat that she needs to do this directly; rather I need to engage her in conversation about these topics and allow her to provide me with information about the subjects. When she is able to completely confide in me about these topics and has gone through them frequently and with enough detail, she will come to the conclusion that these are the changes she needs to make to be happy. I believe that this is the most effective way of counseling Kat because she may be resistant to these ideas if she doesn’t come to them on her own; it is important to note that based on Kat’s personality profile, she is resistant to change as evidenced by her tendency to repeat the same decisions a multitude of times. Once she realizes that she has these problems, she will be able to take the steps required to fix them; again, she needs to determine these solutions on her own, although I am able to guide her during the therapy sessions.

As mentioned earlier, it is also important to consider that a family/systems intervention may greatly help Kat in her road to discovering her issues and recreating her life. Before such an intervention could be put in place, it is important to determine whether Kat has any family members besides her immediate family whom she left and told her to “go to hell”. If she has any other relatives that she still speaks to or is closer to than her immediate family, this would be a good starting point for the family intervention. This systems framework would best address potential underlying family dynamics and relational aspects inherent in the presented case because it would allow Kat to first discuss the problems she is having with people other than her immediate family, who she should reconcile with. A family systems intervention would be helpful in this situation, because it would greatly reduce Kat’s level of stress knowing that she was first able to approach other members of her family. This would also make Kat feel less like she is the only one at fault for breaking the relationship between family members because everyone present will be able to contribute to this conversation in a positive way.

It is also possible that Kat does not have any family members other than her immediate family who she abandoned. If this is the case, it is important to set up the family systems intervention with them so that everyone in the family has a chance to speak about what’s on their minds about the falling out with Kat and how it impacts them. It is also a good chance for the family members to step up and take partial responsibility for Kat’s desire to leave home. Once this occurs, the family will hopefully reconcile and Kat’s family will become a part of her life again. This is a major breakthrough that will help Kat get the rest of her life together again; since her family knew her as a child, they will be able to offer her advice and guidance that no one else will be able to because they know her best and they knew her before she got into trouble. For an optimal result, the family interventions method can be combined with the person centered approach. Although the family members are not psychologists, they have an ideal capacity to listen to Kat’s problems and she will be more willing to open up to them over time. Eventually, they will help her come to the realization that she has problems that she needs to address and give her advice as to what potential solutions she can pursue.

In Kat’s specific situation, one of the major drawbacks of family systems intervention is that Kat’s family may not forgive her for leaving them or be understanding of her current situation. If Kat receives this kind of negativity from her family, it might cause her situation to get worse or not improve; she may continue to date abusive men, fail to establish relationships with people, and have a lack of drive in her life. In addition, this would be negative to the therapist-patient relationship because the advice to participate in the family systems intervention would damage Kat’s confidence and cause her stress. As a consequence, any individual counseling approach used after this point will not be as effective.

References

Casemore, R. (2011). Person-Centered Counseling in a Nutshell. SAGE Publications Ltd.

Rogers, C. (1942). Counseling and Psychotherapy. Retrieved from http://www.archive.org/details/counselingandpsy029048mbp

Rogers, C. (1957). The Necessary and Sufficient Conditions of Therapeutic Personality Change. Retrieved from http://shoreline.edu/dchris/psych236/Documents/Rogers.pdf