Case study linked to theory!
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1 - DO NOT COPY - THIS ASSIGNMENT EXEMPLAR IS FOR REFERENCE PURPOSES ONLY Many organisations, including awarding bodies, use software to check that your content is original. Use this assignment exemplar as a reference to guide you when compiling your own original work. Level 4 Assignment Exemplar 6 Case study linked to theory Student: xxxxx Word count 1665 Title page and bibliography51 Words used 1614 This case study covers six, one hour, sessions of counselling offered at xxxxxx. The model used is Person Centred Approach to Counselling (PCA) developed by Carl Ransom Rogers, PCA is based on humanistic philosophy that all people are born good, and hold within themselves the ability to find solutions to their distress if given certain conditions. Carl Rogers famously identified six specific conditions that bring about client change that he labeled, necessary and sufficient, these are that two persons are in psychological contact. The client is incongruent, being vulnerable or anxious. The counsellor is congruent, real and integrated in the relationship expressing unconditional positive regard (UPR) and empathic understanding towards the client in such a way that the client feels this to some level. The counselor acts as a non-authoritarian facilitator as the client moves from incongruence and rigidity through stages of process to a state of fluidity and acceptance resulting in a more accepting, fully functioning person. 1
2 XXXXX is a middle aged, slim build, female with shoulder length hair; she arrived on time for her fist session at Westbrook Medical Centre, XXXXX avoided eye contact focusing on her hands clutching a tissue she was unraveling as she sobbed quietly. The first, who we shall term the client, is in a state of incongruence, being vulnerable or anxious. Rogers second condition, highlighted as necessary for therapeutic change to occur is an incongruence in the client. This means the client comes into counselling in a state of distress, feelings within them may be mismatched causing turmoil, this was evident in XXXXX s appearance and first words. XXXXX I m sorry I m probably just going to be wasting your time " XXXXX negatively valued her own worth seeing my time as more valuable than her hurt. XXXXX was operating from an external locus of evaluation; this means valuing from the outside in, using an outsiders valuing system as opposed to from the inside out trusting her own internal voice. Operating from an external locus of evaluation causes a clash between internal feeling and external action and this presents as emotional turmoil as organismic valuing is ignored. XXXXX spoke of recently losing her mother to alcohol. She told of how her parents had been in danger of losing their home she had felt obligated to buy it from them. XXXXX I should be grateful to have such a nice home but it doesn t feel like my house XXXXX is operating from Conditions of worth, meaning she has adopted the view of her parents who provided positive regard, conditional to her buying their house. XXXXX has been told how fortunate she is to have this opportunity, she adopted this as truth ignoring her own feeling because the positive regard from her parents is so important, XXXXX feels incongruence as her own internal organismic valuing process is ignored causing her distress. Carl Rogers identified a theoretical structure outlining seven stages of personality change or process that a client will move through going from rigidity to fluidity becoming a more fully functioning person. I feel XXXXX entered therapy at stage three categorized by her recognition of contradictions in her own experience i.e. feeling uneasy about buying the house, but also accompanied by her belief that her personal choices were largely ineffective. Example I am at the lowest band at work; it s not worth me applying for the higher posts as I won t get it XXXXX seemed to me to be a victim of her own life. 2
3 Session 2 XXXXX I m sorry I m tearful, I have been looking at photographs of my mother before coming, I probably shouldn t have done it Counsellor You re really emotional, you have been thinking about your mother. I feel honoured you are willing to share this emotion with me " This is unconditional positive regard (UPR). Rogers identified UPR as a necessary condition in providing the conditions for change. By fully embracing XXXXX without judgment or agenda she felt prized and more able to express her feelings without fear of judgment and this deepened our therapeutic relationship. For me UPR is caring, and I dare use the word, loving the client, for who they are, just as they are. It s not about me picking the bits I like and ignoring the bits I don t, its unconditional positive regard of the person as a whole. This can be challenging and I constantly check my inner feelings. With XXXXX I felt a warmth and understanding and felt UPR came naturally in the relationship for me. The third condition identified by Rogers as necessary is The second person, who we shall term the counsellor, is congruent or integrated in the relationship " XXXXX feels understood; I have shown congruence, showing my true self, being transparent, authentic and truthful within our relationship. Congruence is vital as without it XXXXX would not know where she stands, she needs to have something concrete to lay the foundations of her trust on, without congruence the relationship would shatter. Rogers came to believe that congruence or genuineness is the most fundamental of the attitudinal conditions that promote therapeutic growth. " B. Thorne (2003) Carl Rogers For me to maintain this level of authenticity requires me to check my inner feelings my outer actions both verbally and through my body language. This can sometimes be a risk as my congruent feeling may be contrary to how the client may wish me to react but to deny them is to deny congruence and without congruence there can be no relational depth. 3
4 I entered XXXXX s world being fully emerged in her frame of reference, standing with her in her internal, subjective world showing empathy. I, metaphorically, walked with XXXXX and tried to understand her world as she does, I then reflected this back in such a way that XXXXX felt understood. For me empathy is about listening, rally listening and caring what is being said, hearing the music behind the words sometimes clarifying if my understanding is accurate. If XXXXX didn t feel fully understood she would not be able to trust her inner feelings and without this trust there would be no progress. There were times that I shared XXXXX s emotions and I too felt a tear in my eye, but I am conscious that this is not my life and after a session I need to put it down. When XXXXX feels prized, understood and feels truth within the relationship she begins to trust her own inner feeling. XXXXX yeh, it feels good to be understood, my daughter doesn t understand, she says I should just get a grip Rogers based his theory primarily on these necessary and sufficient conditions that bring about psychological change. Session 3 XXXXX speaks of a post advertised at work XXXXX that s exactly what I need, a new direction " Rogers believed strongly that all people have an internal force that will strive to be the best it can in the conditions it finds itself and he named this the actualising tendency. We clearly see the actualising tendency when XXXXX moves from rigidity I ll never get it to the fluidity of her above statement. The organism has one basic tendency and striving - to actualize, maintain, and enhance the experiencing organism (Rogers, 1951, p.487)." Rogers underpinned his Person Centred Approach (PCA) with 19 axioms or propositions based on his observations and experience. Proposition 4 deals with a theory originated by Abraham Maslow and adopted by Carl Rogers which states that through self actualisation the organism, or client, moves towards individuality and away from being controlled by other people or external events. XXXXX is beginning to trust her inner voice or organismic voice and begin to operate from an internal locus of evaluation, meaning she is seeing the world from her own perspective and trusting her own feelings. XXXXX tells of how when young, her mother would tell her she would not be able to do things. XXXXX saw this as if for the first time realising that she takes responsibility for her 4
5 own life and actions clearly demonstrating autonomy and operation from her own frame of reference. Session 5 XXXXX I don t care what people think of me anymore XXXXX was finding her own way, growing and trusting herself and developing within a, non directive relationship. Non directive means I did not lead or try to show XXXXX the solutions nor did I attempt to fix or advise what or how she should proceed. Rogers clearly identified the client as the expert, believing that each person behaves as a result of their subjective experience making the PCA phenomenological. Session 6 XXXXX I feel I have got what I wanted from counselling In front to me sat an upbeat woman who looked me in the eye and smiled. XXXXX was wearing more colourful cloths; her hands were folded on her lap with no clenching, fighting or signs of discomfort. I gladly shared with XXXXX the difference I saw and how I had felt privileged to be part of her journey. I feel XXXXX moved to a high stage 4 of Rogers 7 stages of process, from rigidity to fluidity, she was more trusting of herself and her own experiences and was evidently no longer a victim of her own life. XXXXX taught me to trust the PCA process, her progress was significant in a relatively short period of time showing me the, almost magical, effects of just being with another human being. I passed XXXXX at my surgery recently and she gave me a smile, a simple gesture from another human being made my heart leap with joy. Being a counsellor is a true privilege and I look forward to the lessons other clients will teach me. Bibliography Thorne, B. (2003) Carl Rogers second addition. London: Sage Publications Rogers, C. (2004) On becoming a person. London: Constable & Robinson Ltd 5
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