Counselling Psychology

A CASE-STUDY ON JOHN

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THE HUMANISTIC APPROACH TO COUNSELLING FOR JOHN This paper shall consider the humanistic approach to counselling developed by Carl Rogers (1902-1987) in examining the case-study of John. It shall also explain the rational for adopting this counselling approach to help John in his psychological problem. In dealing with Johns situation, the paper will consider the humanisticperson centered therapeutic techniques and skills which can help John gain control to make positive choices regarding his life. In carrying out the counselling therapeutic process to help John, there is the need to be conscious of the limitations inherent in the humanistic person centered approach. John is believed to be suffering from different psychological issues which tend to affect both his cognitive and behavioural approach to life. Johns psychological problem is believed to be wide ranging, it includes issues such as low esteem, anxiety, bullying experience, lack of confidence, self-denial, emotional disorders, identity crisis, social issues, bereavement, college transitional issue (see case-study). John's psychological problem can consequentially be underpinned to certain factors arising from his environment, family financial problem and bullying as well. Other factors can include his loss of a role model, bereavement and also his incongruency. The consequences resulting from some of these factors contributed to Johns psychological problems and led to his views, perception and attitudes about himself and the world around him to be negative. Johns psychological problems cannot be seen as "a product of abstract dysfunctional and internal structures such as egos or schemas, nor of isolated conditioned habits and responses, nor of biology" (Bohart, et al., 1997). The theoretical framework that underpins the psychological problems which may be affecting Johns life can be drawn from the explanation given by Carl Rogers as explained by Jarvis & Russell, (2003, pp. 44-49) According to research carried out by humanistic psychologists, it is believed that low self-esteem, depression and anxiety can be attributed to bullying (Shore, 2005, p. 5). This can explain why Johns body language indicate his lack of self-confidence, depression and low self-esteem. The environmental factor that may have contributed to Johns psychological problem might be linked to his transition from rural area to urban area, this according to Andersen & Taylor, (2005, p. 573) can have an impact in ones life. This can be deduced from the statement which says John found himself feeling extremely homesick. The death of Johns grand mother can be another psychological factor that caused his depression and disorientation. The family financial difficulty, his lack of social interation and personality
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disorder are other factors that can emotionally and psychologically impact Johns life. These factors are in conformity to what Seligman & Reichenberg, (2011, chp.1-5) said concerning psychological triggers of life. While the psychological problem affecting John can be examined using other forms of psychodynamic approaches, such as Psychoanalytic theoretical Approach, Cognitive-Behavioral approach, Existential theoretical approach, it is supposed that the best counselling therapeutic approach that can help John overcome his problems is the humanistic client-centered approach introduced by Carl Rogers (Corey, 2012, p. 172). The rational for using the humanistic client-centered counselling approach in Johns situation, is informed by the assumption that John needs empowerment to help him choose his own destiny, and gain control over his life and to be able to make authentic choices in whatever direction he wish to go. This is based on a number of humanistic theoretical assumptions that are evidenced based. As a counselling psychologist using the humanistic approach to therapy, there is need to take care, consideration and make the right judgment to ensure that the theory behind the praxis can truly benefit John and encourage him to change in a positive way. According to Benson & Thistlethwaite, (2008, p. 49), humanistic theory is a Person-centered therapy that uses nondirective approach to counseling and psychotherapy, placing much of the responsibility for the treatment process on the client, with the therapist taking a nondirective role. This type of counselling therapy is what John requires if he is to make progress. He lacks the will to take initiative, John does not need to be criticised, he requires unconditional positive regard. In addition John psychological problem requires a holistic approach, taking into consideration the different issues going on in his life. The Client-centered therapy will help to encourages John to draw from his inner strenght, it will help to emphasis growth and self-actualization tendency in John. It is a therapy that can help John gain self-confidence and acquire the needed skills with which to control of his life (Vincent, 2005, p. 11). Taking into context the unique circumstance of John from his childhood to adolescent age it can be understood that despite having ambitious desires when he was growing up, (see case-study), Johns psychological problem became compounded with low self-esteem, anxiety which might have been caused by bullying at school or the death of his grand mother. John is also known to have suffered depression, lack of confidence, loneliness, isolation and pressure due to family expectation. John might have suffered emotionally as the youngest child because he might have been the familys container where family emotion, anger, provocation and tension are dumped. According to Alfred Adler (1870 1937) who examined birth-effect order, believes that the youngest child in a family may be at risk due to sense of greater insecurity as a result of lifelong pattern of being overprotected by family memebrs which at the long run leaves the child
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suffering from the fear of being unable to cope in the world on their own (Benson & Haith, 2009, p. 59). John might have been exasperated as he sees himself unable to carry on the family future hope. The thought of his fathers sickness who is suppose to be his role model, the family financial pressure and, the death of his grand mother could be some of the issues that might account for Johns depression, disappointment, lack of self-worth, anxious and self-guilt. Though the family value of putting on a brave face was no longer be working for John. The attitude of Johns mother did not help the situation because she had to let family be soaked and drain in emotional and psychological pains. Rather than confront headlong the family issues she let them pretend in silent and endure psychological pains. Johns psychological problem became evident right from the moment of his first visit to the counselling therapist. He lacked confidence, was depressed and anxious as he sat with his head down .seldom making eye contact. According to Boyd, (2005, p. 210), such attitude on the part of John is a sign of disturbance of low-esteem. The humanistic client centered therapeutic approach is the best suited for dealing with Johns multiple psychological problems. This is because the theoretical framework of the therapy encourages a holistic approach to psychological problems, it encourages and emphasizes the experience of the client in helping them to effect a change and it is non-judgmental (Seligman & Reichenberg, 2011). This is what John requires because the objective is to help him become more authentic and truly himself. The basis for the client-centered counselling as designed by Carl Roger (1902-1987) is that it encourages self-determination, which is the ability of the client to reflect on issues and take positive action. In Johns situation, the humanistic therapist recognizes that he has his own individual experiences and different perception to those experiences. And that the therapist work involves helping and assisting John to take the responsibility of finding meanings in his own life and become congruent since part of his psychological problem stems from his being incongruent (Nairne, 2008, p. 499). The humanistic client centered therapy which has its root in phenomenology and some components of existentialism believes that the goal of every person is rooted in self-actualizing tendency (Nicholas, 2008, pp. 226-227), which is what John needs to achieve. The psychological problem faced by John requires that the therapist be aware of his sensitivity and as such avoid being judgmental. In addition, it requires the therapist to show unconditional positive regard, empathy, understanding, active listening, being congruent on the part of the therapist in helping John. These techniques and skills are what humanistic therapy embodies and if applied rightly in Johns situation; it will help to resolve his inner conflict and help him become truly authentic. This approach is in line with what Rogers meant when he said; humanistic client-centered therapy is a self-directed growth process with the idea of an organic
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actualizing tendency (Boa, 2004, p. 123). The objective of the client-based therapy is to empower John with the ability to overcome and build the capacity for agreement between his idealized self and actual self. It is to help and enable him have a better self-understanding and to foster more positive and comfortable relationships between John and others. The expected result will be increased capacity on Johns part to experience and express his feelings which have been characterized with sense of failure, guilt and insecurity. If John is to benefit wholly from the therapy, the therapist has to assist him to fulfill his innate capacity to become everything his genetic potential allows him to become, so as for him to re-emerge as a self-fulfilled person. Johns inherent and intrinsic tendencies toward self-actualization can only be realized if according to Rogers, the therapist in his role is able to apply the following skills; being congruent, show unconditional positive regard and empathic understanding toward John. It also includes the therapist being able to establish trust and active listening (Kirshenbaum & Henderson, 1994). The aim of the therapist is to avoid blame and criticism but recognize John as an individual that possess inherent value of worth (Plotnik & Kouyoumjian, 2010, p. 444) . Regardless of Johns personal action which may have contributed to his psychological problem, what is important is for the therapist to show him unconditional positive regard. As a therapist the focus must be how to help John achieve personal growth through self-improvement and selfknowledge which eventually will guarantee him true happiness (Brandell, 2011, p. 229). Taking into consideration the nature of Johns psychological problem and the initial assessment of him using the humanistic theoretical approach, one begins to see a true picture of what went wrong with John. It is possible to summarize the experience of John as a person who is experiencing conflict, because of the incongruence in his projection of true self and false self. Johns consistent total experience cannot be said to be consistent with his self-concept and selfimage. Johns experience led him to some level of denial and twisting of perception even though he is fully aware of his experience nevertheless in a distorted manner. Johns experience indicates that he is incongruent and it is possible that he is not aware of that. John's inability to comprehend the full extent of his incongruence makes him even more vulnerable to anxiety and disorientation. It leads him to become defensive each time his experience threatens his selfconcept and makes him to experience low self-esteem. According to Corey, (2008), there are six core conditions necessary and equally sufficient for personality changes to in a person-centered therapy. First the therapist has to understand that for John to achieve any positive result out of the therapy both the client and the therapist must be in contact. Remaining in contact will help give meaningful engagement throughout the treatment process (Kaslow & Massey, 2002, p. 404). The second condition is that while John is in a state of
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incongruency, the therapist has to be congruent. The therapist congruency will help John to be aware of how human reality can be influenced by past experience, present perceptions, and future expectations. According to Schor, (1998, p. 132) as mentioned by SAMHSA, (1999, p. 109), being aware that human experiences assume meaning as apperception can help provide insight and the capacity for John to adapt and act in new ways. The fourth condition demands that the therapist experience unconditional positive regard for the client; and the fifth condition requires that the client experience empathy for the clients internal frame of reference to the extent that the client perceives of it. The sixth condition demands that the therapist ensures that a level of communication is achieved. These conditions are in line with the research conducted by Hubble, Duncan & Miller (1999) which emphasized that the effectiveness of humanistic therapy depends on the relationship that exist between the therapist and the client. Equally other studies have supported such understanding which further demonstrates that humanistic techniques and skills are very reliable (Stricker & Widiger, 2003, p. 321). Therefore in Johns situation the therapist can become an active listener, show empathy, being congruent and show unconditional positive regard. According to Rogers, for the active listening technique to work it requires the therapist to be an intense listener. As Cournoyer, (2010, p. 195) explained, active listening is the combination of talking and listening in a way that the patient feels that he is being understood and encouraged to express himself further. It is a form of feedback process that involves being able to listen, reflect and communicate back to the patient. This technique is important in Johns situation because it helps John to speak more openly and freely about his condition. Another technique that is needed in Johns situation is empathy. Empathy as a therapeutic technique, conveys a sense of being heard and understood, it means identifying with the client in his condition. According to Carter, Seifert, & Carter, (2012, p. 587), being empathetic means understanding the clients inner world. Johns condition requires also unconditional positive regard from the therapist; it is careful acceptance of Johns feelings and thoughts without being judgmental. It is total acceptance of John without evaluating or censoring, and without disapproving of any of his feelings, actions, or characteristics. According to Carter, Seifert, & Carter, (2012), it is a sense of respect and love unlinked to any behaviour, it is not earned. Such technique if applied to John would increase his self-respect, self-worth and self-acceptance and lead him to greater self-understanding. The last technique necessary in Johns situation is the therapist being congruent. It speaks of the therapist level of genuineness and authenticity in the relationship (Carter, Seifert, & Carter, 2012, p.587). In order for the therapist to express genuineness, it is vital for the therapist to focus on the here and now and not on the clients previous and past experience. Being congruence implies
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absolute sense of transparency which when perceived by the client, as in this case John, would help him to become aware of his own experience and as such be able to express them. Being congruent, entails being genuine, integrated, and authentic, without a false front or facade. It implies the therapist to be open in expressing his/her feelings and attitudes which are present in the relationship with the client. The person-centered therapy requires that therapist see their attitudes, behaviour and ways of acting as being more important than the techniques they use. The aim and objective of the therapist according to Rogers (1977) should not be to solve John's problem but to assist him in making progress and be in a position to cope well with his problems and possibly other future problems he may encounter (Bellack & Hersen, 1988, p. 236). According to Rogers, the therapeutic process is to help facilitate and provide the needed climate that is conductive to helping client become once again a fully functioning individual, which is what John requires. During the therapeutic process John is expected to understand and recognize that he lost contact with reality and his true self hence he was incongruence. In essence the therapeutic process will afford John the possibility of choosing other ways to act and conduct himself. The process will help him to become actualized and being able once again to have an open experience, a trust in himself and the willingness to grow even more and better (Corey, 2012, p. 197) . With John being facilitated and encouraged using the person centered approach, the tendency is there for him to be in a position to define his own goals and work towards achieving them. It is important not to lose sight of the fact that the humanistic person-centered approach counselling has its limitations; and being aware of it should help the therapist to consider adopting a more integrated approach should the need arise. The humanistic person centered approach to counselling has been criticized for lack of scientific evidence, because often in clinical studies, the control groups were not persons who needed therapy (Corey, 2012). The person-centered techniques are complex to innovate and lack appropriate ways by which to measure its efficacy (Corey, 2008, p. 189). The person-centered approach has also been criticized by researchers as having methodological errors in some of the studies where it has been applied (p. 189). Cultural research studies tend to suggest that clients may prefer more structural approach than the person-centered approach (Araya, 2001, p. 92). The therapy has been criticized for lacking in specific methodology in its use of techniques and that has impacted in its ability to standardize the treatment process. Therapist authenticity and congruence may be difficult to realize as they must find ways to express their own reactions to clients. In conclusion, this paper has in a nutshell tried to use humanistic client-centered therapy developed by Carl Rogers to apply to Johns dysfunctional and psychological problem. The
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paper emphasized the humanistic theory approach as used by Carl Rogers in helping clients realize their potential and inherent ability to bring about change in their own life. This is why the psychological problem of John is better served using this counselling approach. Johns psychological problem is a case in study that demonstrates the strength and advantage of using the humanistic client-centered approach as a counselling method. The paper discussed the rationale behind choosing this method to apply in Johns circumstance. It also mentioned the different techniques and skills needed to make the therapeutic process a success with regards to Johns problem. Lastly, it considered the limitations the inherent in using this therapeutic approach.

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