My_Approach_to_Adlerian_Counselling

My Approach to Adlerian Counselling Author: Magnus Irvine Date of Submission: 4th December 2012 Word Count: 2000 |Confidentiality Statement | |Any and all clients, family and group members referred to in this paper are represented by a random initial and names of | |counselling agencies have been omitted. Any possible identifying information relating to these people and places has been | |changed so as to maintain confidentiality. | Introduction This paper looks at my approach to Adlerian counselling and how I work with clients. From the first contact with the client, be it in person, correspondence, or by telephone, I start to get a sense of how he[1] relates to others and how he sees himself in his world. In our first meeting it is necessary to assess the client’s needs and to align his and my goals for the establishment of a cooperative therapeutic relationship (Dreikurs, 1977). If the client has no idea of Adlerian therapy I may briefly explain the Adlerian concept of lifestyle; that each person has a view on his or her place in the world, and that others are viewed, and life is lived, from this position. I ask if they have ever had therapy before and, if so, what worked for them and what did not, therefore avoiding repetition of previous unsuccessful interventions. Contract In the first session we agree on the contract for our work together, which plays a very important role in the therapeutic relationship (for copy see appendix A). Within the contract the boundaries of the therapeutic relationship, such as the session length, length of therapy, the cost, breaks, and timing, are set out. This helps to define a framework within which our therapeutic relationship can grow and where the client can feel contained (Casement, 1985). It is also the first step in building social interest in the client during therapy as it represents a connection between the client and another, and with it comes responsibility and empowerment. The terms of the contract may elicit strong feelings in the client and addressing these is essential to maintain an open and productive relationship. For example, the notion of having to pay for missed sessions might seem unreasonable to the client but in such cases I will discuss the need for the therapy to have value, for the agreement to be a professional one, and that with the contract comes a commitment and responsibility on both sides of the therapeutic relationship. Presenting Problem Finding out about what brought the client to therapy is a good starting point as it identifies and validates his current struggles and it surely links in to his lifestyle as our lifestyle is in everything we do (Dreikurs, 1977). Identifying the presenting problem also helps to clarify the goals and duration of therapy, and can begin to indicate where the client’s strategies, ways of relating, and private logic have been unable to help him cope with particular struggles in life. It is essential to spend time unpicking this presenting problem, and to revisit it both during sessions and during the course of therapy. For example a married client of mine initially presented with a problem giving up her pre-marital affair. As the therapy progressed we revisited the presenting problem and found it had, with the ending of the affair, become a struggle to maintain intimacy with her husband and with other family members. In refining the problem with the client it becomes possible to get to specifics around the actual problem and for both our goals to be therefore better aligned. The Therapeutic Relationship As previously mentioned, my goals and interests need to be aligned with those of the client for a cooperative therapeutic relationship. When they are not then the therapy may feel stagnated and the relationship and related goals need to be readdressed and mutual cooperation re-established (Dreikurs, 1977). Building rapport with the client helps to reach a level of acceptance and cooperation. To build rapport I need to communicate my availability to the client and a willingness to understand his worldview and ‘walk a mile in his shoes’. I do this by being non-judgemental, putting my own interpretations and bias to one side, trying to understand the client’s world. Actively listening to what the client is saying helps him feel that his lived experience and point of view is valid. Using the non-verbal listening technique known as SOLER can also help; facing the client Squarely, having an Open body shape, Leaning forward slightly, maintaining Eye contact and appearing Relaxed can all help the client feel more listened to. Dreikurs (1977) writes of the need for mutual trust and respect between counsellor and client, and it is therefore essential that the client feels the sessions are his and that we are both working towards a common goal. As a counsellor I need a deep rooted trust and belief in the potential of my client as a human being, laying the foundation for the building of a truly empathic therapeutic relationship based on equality of worth. I need to respect who and where my client is, and see the choices he makes and has made as logical choices based on his private logic and style of life. Tell the Story A major part of understanding the client’s struggle is getting him to tell his story. This helps to further define the presenting problem as it may become more apparent how and when things began to be a struggle. Allowing the client to tell his story also helps to build rapport as it gives space to be heard and to feel belonging. It is interwoven throughout therapy, with each session providing more pieces of the puzzle. As the client tells his story I mirror the things he talks about back to him to help him feel heard, I ask open-ended questions such as “What was that like for you'” to elicit his opinions and views, and I make use of clarifying closed questions if I feel I have grasped what he is describing. Assessment/Analysis For the client to see the roots of his current predicament he needs to understand how he sees the world and himself in it, and the private logic he uses in solving life’s tasks and problems. This is done by assessing his lifestyle and the relational dynamics within it (Dreikurs, 1977). Although I generally avoid taking notes in sessions as this can disturb the therapeutic relationship, I sometimes do so during the lifestyle assessment. I make sure I communicate this to the client and if it seems to be too disruptive or anxiety provoking for him I will stop. When assessing a client’s lifestyle I am interested in a number of things. His place in the family of origin helps show how his world view and way of relating may have been formed so I ask about his family constellation – important figures in his life up until the age of six or seven and their relation to him. I pay attention to sibling relationships, looking for signs of competitiveness and rivalry, birth order, and age difference. I look for information about the parents, as it is their opinions, rules and expectations that heavily influence the client’s worldview. I am interested in alliances that may have been formed between family members, people who may have died, and the quality of familial relationships. I also pay attention to, and ask for descriptions of, family members to get a better feel for how the client sees his siblings and his parental figures. Above all it is the significance that all these parts of the family constellation have for the client. Finding out about the client’s family values during childhood, together with a family motto, can help provide valuable pointers to his private logic and lifestyle. I ask which family values he lives by, which he rejected, and who he associates as the purveyor of each family value. This can give more clues to his view of, and acceptance of, others, and to the expectations communicated to him by influential figures such as parents and grandparents. I enquire about the family atmosphere as it gives an idea of the setting that all interpersonal relationships within the family find themselves. The family atmosphere as with the family values come from the influential parental figures (Dreikurs, 1977), and I often find that the description of these parental figures can be further expanded here. With early recollections and dreams we begin to delve deeper into the lifestyle of the client. Everything the client says and does gives a glimpse of his lifestyle (Schürer, 2011), and with early recollections and childhood dreams, the character and attitude of the lifestyle is brought into awareness (Dreikurs, 1989). During the course of the assessment, which may span a number of sessions, I ask the client for two or three early memories and one dream, preferably from childhood. After each recollection or dream I work with the client to define the syllogism, how he sees himself, others, the world, and what he needs to do to get by in that world. I look for the feelings of inferiority in how the client sees himself and the movement in the strategies he employs to attain a position of perceived superiority. An example of this is a client of mine who recounted an early memory of coming home to an empty house and feeling unloved and alone (inferiority feelings), then talked of how people had to pass the numerous tests and challenges he set (his strategy to avoid inferiority feelings) to be granted access to his ‘castle’ (a place of perceived superiority). Interpretation As the lifestyle of the client becomes more apparent through the assessment I begin to make links back to the presenting problem using material from the assessment. I look for similarities in the movement of the client in his lifestyle and movement through his current problem in life. Linking the two together helps to provide insight into how he often finds himself in similarly distressing situations with similarly distressing feelings. I try to emphasise the goals that the client seeks to reach and how, in many instances, they may be unobtainable or misguided. Reorientation When the client understands his world view or lifestyle it opens up the possibility of other ways of being and relating, and it is hard to continue to down a path that leads to the same old struggles. I work with difficult early memories from the lifestyle assessment and let the client offer alternative versions of the early memory that he would be satisfied with. We will then look at these and try to understand what the client wants to gain from the newly created outcomes. I pay attention to signs of social interest in the reoriented early memory and if lacking it shows the client is simply trying to find new ways of reaching a position of perceived superiority which needs to be addressed. Encouragement is an important part of Adlerian counselling as it is client’s discouragement about his place in the world that is interwoven in all his struggles. Encouragement goes hand in hand with the aforementioned empathic trust and respect, and it is a deep-seated empowering belief in the client’s right and ability to belong. It is essential if the client is to accept that equality of worth and useful relations make sense in day-to-day living. Part of encouragement is focusing on the strengths that the client exhibits and these can be found in early memories, dreams, how the client has overcome difficulties, how the client relates to others etc. I let the client suggest strengths and also suggest my own, looking for strengths that emphasise the client’s sense of self and others that emphasise his regard for others. Strengths cannot be formulaic and have to ‘fit’ the client as he, consciously or unconsciously, knows his lifestyle. By maintaining an empathic relationship and, through understanding of my own lifestyle, avoiding acting out of the client’s relational roles (transference) I can further encourage and strengthen the client’s ability to relate usefully and feel belonging. Ethical Closure At the end of each session I will review where we are in relation to what the client brought to the session and find out how he now feels, bringing the session to a close. It is important to make sure that we do not explore difficult early memories or dreams at the end of the session as this can leave the client feeling alone, discouraged and abandoned. Every six sessions and at the end of therapy I review with the client how he has experienced our work together, how he now feels, whether his presenting problem has changed, and where he now is in comparison to the beginning of therapy. This helps to keep our goals aligned and maintain a productive therapeutic relationship. Bibliography Casement, P. (1985). On Learning from the Patient. London: Routledge. Dreikurs, R (1989). Fundamentals of Adlerian Psychology. Chicago: Adler School of Professional Psychology Dreikurs, R. (1977). Psychodynamics, Psychotherapy, and Counseling. Alfred Adler Institute of Chicago. Schürer, Y (2011). How we can detect a person’s lifestyle, A508 Using lifestyle for problem solving. The 44th Rudolf Dreikurs Summer Institute, unpublished ----------------------- [1] Although I refer to the client as masculine no gender bias is intended.