Case Study on "Person Centered Treatment Plan"

Case Study 8 pages (2507 words) Sources: 6 Style: APA

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Person-Centered Counseling Case Study

This case involves the application of person-centered counseling in connection with a client who believes that her problematic relationship with the previous two men in her life is attributable to something about her and her inability to "keep a man." In one relationship, her partner (and father of her infant child) refused to marry her; in her subsequent (current) relationship, he partner has been unable to reciprocate her affections to her satisfaction and he initiated an affair with another woman for which the client says she chosen to forgive him. A person-centered approach to counseling focused on the manner in which the client's formative period in her family of origin has left her with the fear of parental disapproval and the tendency to assume responsibility for the faults and actions of others, particularly of the male partners in her life. Through counseling, the client learned to recognize what elements of her relationships with men are appropriate and inappropriate to be considered her responsibility. She also learned that the failure of her relationships was not caused by her.

Person-Centered Study of Jasmine

A Conceptualization and Treatment Plan

Jasmine is a 29-year-old Hispanic female. She is in a troubled relationship with her live-in boyfriend, Lenny. Lenny has not been able to reciprocate Jasmine's level of commitment to their relationship and has pursued the affections of another woman during his relationship with Jasmine. Jasmine has expressed anger about the affair, but her statements also indicate that she believes that Lenny's decision to violate their relationship was, at least in part, her fault. More specifically, Jasmine has indicated that she believes there is something about her that accounts for her inability to "keep a man" and that Lenny has not been able to commit to Jasmine (and her young son) and that he had an affair, at least partly, because Jasmine did something wrong or failed to do something in their relationship. Jasmine has decided to forgive Lenny for cheating and seeks counseling to help her find peace in that decision, achieve genuine forgiveness, and better understand her situation. The goal of person-centered counseling will be to help Jasmine recognize the ways that her negative self-concept causes her to accept fault and blame for the actions of others and to help Jasmine recognize and understand the appropriate and inappropriate contexts of the concept of responsibility and forgiveness.

Presenting Concerns

Jasmine presents herself as being "unable to keep a man in [her] life." She feels saddened and depressed that the father of her three-year-old son was unwilling to commit to marriage after his birth and she feels saddened and depressed that her current live-in boyfriend has been unwilling to reciprocate her level of emotional commitment. She reports that whereas she would like for them to be married, he has resisted that commitment and that he engaged in an affair. Jasmine considers her past relationship history to reflect the fact that she must be doing something wrong in relationships. More specifically, she has expressed the belief that her current partner initiated an affair at least partly because of things that Jasmine said or did or failed to say or do.

Other aspects of Jasmine's account of her life reveal that she believes that her parents love her but that their love, emotional support, and approval is substantially dependent on her satisfying their expectations of her. Jasmine's account of the circumstances of her own motherhood reveals that she considers herself to be a "failure" in the eyes of her parents because she became pregnant and had a child out of wedlock. At the time of first seeking therapy, Jasmine had made the intellectual decision to forgive her boyfriend for his affair and to stay with him, but she has requested assistance with the emotional component of that decision and has expressed considerable anxiety over her self-perceived inability to "keep a man in [her] life."

Case Conceptualization

It seems that within her family of origin, Jasmine was subjected to parental attitudes and patterns of expressing love, approval, and disapproval that created the belief in Jasmine that the love of others for her is highly conditional rather than unconditional and directly dependent on her satisfying their expectations and needs. It appears that Jasmine accepts the proposition that if her relationship with a man fails or if her partner chooses to have an affair outside of their relationship, that the fault in both cases must lie with her mistakes or inadequacies. Her account of her partner's infidelity is that the pressure from her to get married caused him to seek out an affair outside their relationship.

This conditional self-concept has caused Jasmine to be substantially if not entirely unable to recognize situations where her partner is at fault for violating their relationship. She appears not to realize the possibility that the problem in her current relationship is not her fault, principally, because infidelity is never pursued as a solution to pressure within a relationship; in fact, infidelity greatly increases any pressure. Meanwhile, Jasmine seems oblivious to the fact that her first relationship began to fail only in the fourth year, after she began pressuring Carlos to get married, largely because Jasmine desperately feared the reaction of her parents to her bearing a child out of wedlock.

Treatment Plan

Goals for Counseling

In principal, the goals of Rogerian psychotherapy are to assist the client recognize any internalized impediments to positive self-regard so that those impediments can be analyzed objectively and differentiated from their underlying unreality (Schmid, 2003). More specifically, Rogerian analysis presumes that clients present with problems that are direct functions of incongruence between their beliefs about themselves and their objective awareness of the actual source of their problems and anxiety (Schmid, 2003). Moreover, the Rogerian approach presumes that clients' inability to perceive a more accurate self-concept is partly attributable to the acute anxiety associated with consciously questioning the bases for that self-concept (Cepeda, & Davenport, 2006).

Those internalized conditions that are responsible for the absence of positive self-regard result in the impairment of the locus of control and compromised the ability to self-actualize (Murdoch, 2008). The goal of Rogerian person-centered psychotherapy is to restore (or establish anew) positive self-regard through reconnection with those elements of self from which the client has been disconnected. More specifically, Rogerian person-centered therapy seeks to accomplish that goal through the creation of facilitative conditions (i.e. empathy, positive regard, and congruence) by the therapist (Friedlr, King, Lloyd, & Horder, 1997; Shanks-Glauser & Bozarth, 2001).

In general, Rogerian theory relies on the following principal elements: (1) Close relationships between clients and therapists in which therapists do not merely listen dispassionately but actively promote a close connection; (2) Sharing by therapists such as by offering and drawing from personal anecdotes and experiences to establish a fundamental congruence in the context of the therapist-client relationship; (3) Focus on increasing congruence in the context of the disconnect between patient perceptions of self and the reality of self; (4) Unconditional positive regard for the patient by the therapist and manifestation of that positive regard through communication of acute empathic understanding; and (5) the recognition and appreciation, on the part of the client, of the therapist's empathic understanding and positive regard for the client. (Kirschenbaum & Jourdan, 2005).

Interventions

To create the necessary therapist-client bond required by Rogerian person-centered psychotherapeutic treatment, the therapist listened actively to the client's account of her problems and feelings. In that regard, the therapist employed techniques such as repeating, paraphrasing, and rephrasing the client's perceptions to demonstrate understanding (Murdoch, 2008; Schmid, 2003). The therapist then shared personal anecdotes of situations involving disappointment in relationships, emotional reaction to instances of infidelity, anger, sadness, shame, and considerations of self-responsibility. The therapist posed direct questions, beginning first with hypothetical situations, then situations from the therapist's life, and finally confronted the client with nearly identical situations from her accounts of her relationships to force her to apply the same conclusions she drew in hypothetical situations and the conclusions she supported from the therapist's life stories to her own situation (Murdoch, 2008; Schmid, 2003).

More particularly, the therapist sought to present the client with examples of extreme parental attitudes that clearly exhibited inappropriate messages about conditional parental love. Those discussions involved situations where parents exerted inappropriate control over the lives of children continuing into adulthood based on the underlying assumption that a child is only a good person to the extent he or she follows the directives of parents in matters that, in reality, should be functions of autonomous adult choice. Some of the examples discussed concerned parents who threatened to withdraw their love and support over decisions of what career their adult children pursued, what religion (or degree of orthodoxy in religion) their children chose, and who their children decided to date or marry. That discussion incorporated anecdotes from the therapist's life including the reactions of the individuals involved, the way it affected the family, and the ultimate outcome of various decisions.

The therapist then guided the… READ MORE

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