Adlerian Theory
(All clients are profiled from scenarios in Laureate Education books. The clients are fictitious for the purpose of practice.)
The Adlerian approach has many benefits that would create a collaborative therapeutic relationship between the counselor and Abby, a 57-year-old African-American client who is entering therapy for the first time. She explains that her husband has just been diagnosed with cancer, and the last few months have been difficult. She constantly feels exhausted, has no appetite, and is losing weight. She also takes various medications for the migraine headaches she experiences 2-3 times a month. She also drinks 2-3 times a week, 1-2 drinks each time. She feels guilty about her husband’s condition and feels she could have done things better for him to avoid cancer. She does not know how she is going to cope when he is gone. She has always felt inferior to those around her; she has low self-esteem and feels hopeless about her life. She is the third child of six and her father is deceased. She did not complete her master’s degree because she got married, and she always feels guilty that she has had a good life and should not feel so depressed (Taylor, 2011).
One benefit of the Adlerian approach is that its power derives from encouragement, self-confidence, and courage (Corey, 2010), characteristics that Abby desperately needs to strengthen. Similarly, the Adlerian approach is “not bound by any technique”(Corey, 2009, p. 48), which would benefit someone like Abby, who would hopefully enjoy the collaborative creative process. There are four goals that Abby and her therapist will achieve using the Adlerian approach: (1) establish a therapeutic relationship, (2) work within a soothing and healing environment for her to recognize her fundamental beliefs and feelings of her own identity, (3) help her understand her self-defeating behaviors, and (4) develop other “ways of thinking, feeling, and behaving by encouraging her to translate her insights into action”(Corey, 2009, p. 67). However, in Abby’s current state of depression, any encouragement may not be effective without a psychopharmacological intervention to help ease her more insistent psychological imbalances (Laureate, 2010).
After a thorough psychopharmacological intervention or assessment, Adlerian therapy would begin with a subjective interview, where the therapist will listen empathetically and encourage Abby to communicate her interests, fears, feelings, and life situations (Corey, 2009). Corey suggests the next step is to ask “The Question”, “What would you be doing, what would change, if you didn’t have these symptoms or problems?”(Corey, 2009, p. 60). Abby’s response would more than likely be to finish her degree, have a healthy relationship with her husband and family, and have more energy to do the things she imagined herself accomplishing in life. Next, Adlerian therapists would do a lifestyle assessment, where Abby would detail her “family constellation; the life tasks of friendships; occupation; intimacy; and early recollections” (Corey, 2009, p. 61). This step is crucial to Adlerians because of the importance of how a person copes, perceives, handles weaknesses, and finds conviction (Corey, 2009).
Once these lifestyles assessments are made, the therapist and Abby can introduce goals and purposes to her conscious. This step includes reeducating her emotional behaviors in social situations (Corey, 2009). Adlerians do not necessarily change physical behaviors of clients, but rather they help them learn to cope and perceive situations differently as it comes to them unpredictably, regardless of their old patterns of behavior. With Abby, this may mean she must become aware of the guilt she feels about (1) her husband, (2) her “comfortable life”/not wanting to complain because she does not feel worthy to complain, and (3) how this guilt gets in the way of her achieving the goals she would like to achieve. Becoming aware of how much her guilt holds her back will be the impetus to achieve the goals she sets forth for herself in the years ahead, regardless of the future or condition of her husband. But most importantly, Abby should be treated with the utmost sense of optimism, hope, and encouragement throughout her therapy.
There are also age, gender, and cultural issues that would have to be addressed when working with Abby. Racial prejudices and age/gender-based maltreatments must be addressed in sessions in order to create a healthy therapeutic relationship (Laureate Education, 2010). Having these issues addressed will allow the therapist and Abby to further strengthen the working relationship and climate because it will allow the therapist to understand Abby’s life in a much bigger sense (Laureate Education, 2010). A therapist must not assume that his or her own life experience is anything like a client’s, and he or she must do as much possible to fully comprehend and explore those differences.
Likewise, legal and ethical issues that must be addressed with Abby are her severe depression symptoms. A therapist must determine when a client is in danger of suicide and/or harm to themselves or others. In the American Counseling Association 2005 Code of Ethics Section B.2.a, therapists must report when a client is in “serious and foreseeable harm”. Abby fits this description with her admittance of guilt and extreme depressed symptoms. A therapist should take precautions and send her to a psychologist of psychiatrist who could prescribe or treat her for these suicidal symptoms.
Finally, the overall goals for Abby include short and long-term goals. The short-term goals are to alleviate her depression symptoms and suicidal guilt so that she is able to handle the condition of her sick husband. If she does not alleviate these symptoms, her husband’s worsening condition could send her into a deeper depression, and even worse, into committing suicide (Laureate, 2010). Once these short-term goals are achieved, her long-term goals are to gain confidence and help understand her self-defeating behaviors, and develop other “ways of thinking, feeling, and behaving by encouraging her to translate her insights into action”(Corey, 2009, p. 67). The Adlerian approach has a deadline to its treatment; this deadline could be the optimistic forward-looking future that Abby so desperately needs. A well-defined set of goals within a certain timeframe encourages improvement and hopefully a brighter sense of accomplishment.
References
American Counseling Association (ACA). (2005). 2005 ACA code of ethics [White Paper]. Retrieved from the ACA website: http://www.counseling.org/Files/FD.ashx?guid=ab7c1272-71c4-46cf-848c-f98489937dda
Corey, G. (2009). Case approach to Adlerian therapy. In Case approach to counseling and psychotherapy (7th ed., ).
Corey, G. (2010). Theory and practice of counseling and psychotherapy (8th ed.). Belmont, CA: Brooks/Cole.
Laureate Education (Executive Producer). (2010). Walden University: Foundations [DVD]. Baltimore, MD: Author.
Laureate Education. (2010). Client Profile 1: Abby. Baltimore, MD.
Taylor, M. (2011). Psychodynamics application: discussion. Retrieved from http://www.waldenu.edu