The Psychology of Personality: Counselling Process

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Table of Contents

Introduction
Background
Conclusion
References

Introduction

This case study outlines the process of counselling, which composed of six sessions that my client underwent. The case study I have chosen has great significance to my life and career due to several reasons. Firstly, it was my first experience dealing with a client during my first year of training as a counsellor.

Secondly, I managed to counsel a client successfully despite the conditions that surrounded her life. Thirdly, the experience was quite enriching as it gave me the impetus to build my career. Nevertheless, I will elaborate how the case study is significant to me through the six sessions of counselling that my client underwent.

Confidentiality is important in counselling because it protects clients from undue stigma arising from the use of confidential information. Since confidentiality is important in protecting clients, I have used different names to protect my client’s identity as well as identities of her relatives and friends.

To elaborate the case study well, I will outline it as follows:

Firstly, I will introduce the case study by providing background information of the client and the case study. The background information will enable readers to get a glimpse and understand the essence of the case study.

Secondly, I will describe the six sessions that my client underwent, as an endeavour to elucidate the process of counselling that occurred in the case study.

In the description section, I will describe the following aspects of the case study: therapeutic interventions, the client’s process, experienced instincts, my own process, evolution of our relationships, learning gained, and the role that my supervisor played. Description of these aspects gives an insight of my experience coupled with client’s experience.

Moreover, I will discuss how supervision played a role in helping me overcome the numerous challenges that I encountered during the six sessions. Given that the case study represents my first experience as a counsellor, supervisor helped me to resolve ethical dilemmas and apply my theoretical knowledge professionally.

Although I will try to recapture all that transpired in the case study, I admit that I cannot recapture every detail. Therefore, I will try to provide a glimpse of what transpired during the six sessions in an attempt to present my firsthand experience in counselling. Interaction with my client involved intricate nuances that I cannot articulate well or present them as they occurred during counselling.

How can I explain the nature of glances that my client usually gave or describe the nature of pain and depression my client expressed in my presence? Thus, it is impossible to explain the emotions that my client was fighting at the time of our interaction throughout the counselling session.

Background

The case study underscores the life of my client who is a 65-year-old female showing signs of depression. For the sake of confidentially, I have named her Ita. Ita is a depressed woman because she has many issues bothering her. Firstly, she is a widow because her husband died five years ago, and his death anniversary is approaching.

She is also about to celebrate her 40^th wedding anniversary without her husband in a few months’ time. Ita lives a lonely life because she has only one daughter who rarely visits her due to their volatile relationship.

Moreover, Ita has several health complications as she has an inoperable breast cancer, diabetes, Parkinson’s disease, and arthritis in her both hands. Cancer therapy leaves her fatigued and sensitive to warm sunny weather.

Given her conditions, Ita is unapproachable, bitter, and angry about the world. Her family members have forsaken her; they did not even support her during her husband’s illness. Moreover, they have cut off any communication with her. Ita is also upset by the negligence on the part of her family members because they have not done much to help her disabled sister, who suffers from schizophrenia.

The First Session

During the first session, Ita came to the room that I had rented since she was my first client. After we talked and I understood her condition, I decided to employ the Rogerian model of psychotherapy in helping her to overcome depression. As it was the first session, I started by seeking an informed consent from her and creating a rapport.

According to the Rogerian psychotherapy, relationships between a client and a psychotherapist form the basis of a therapy. Thyer (2008) states, “Rogerian therapy sought to transform the therapist from a resident expert to transparently honest human sojourning with the client” (p.299). During the first session, I aimed at creating a good relationship between Ita and me, so that we could engage freely in subsequent sessions.

When Ita arrived at the counselling room, she had many reservations. She did not want to express her depressing conditions because she had fears regarding the revelation of her confidential information. Moreover, Ita expressed some of the problems she had been experiencing in life.

With my counselling skills, I probed her gently and assured that the information she could give would only be applicable in the counselling process only. Glassman and Hadad (2008) warn, “The therapist must act in an open and genuine way; not hiding behind a professional façade” (p.431). After managing to create a rapport, Ita was in a position to communicate freely without any fears.

At the end of session one, I had obtained enough information from Ita, which enabled me to understand the cause of her depression. Eventually, Ita went home happy because she got someone who listened to her problems attentively and was willing to help her.

When Ita entered the counselling room, I welcomed her warmly and offered her a seat. Although it was difficult to introduce myself, I gathered courage and informed her that I was a counsellor and I would take her through several sessions of psychotherapy. After the brief introduction, Ita sat restlessly and somehow bored.

As a counsellor, I had to take charge of the situation and create a friendly environment to enable her participate actively in the therapy. Although I managed to encourage Ita to express her misery, she intermittently broke into tears.

Shulma (2011) argues, “psychotherapists should understand the power of emotion in their own lives before understanding their impacts on clients” (p.322). Thus, although her feelings moved me, I managed to control them so that I could help her.

The relationship between Ita and me developed gradually as we shared our experiences. The more she narrated her experiences in life, the more we became close to one another. The narration of her experiences moved both of us and in some way bonded even more.

Thyer (2008) notes, “The fundamental change is determined by the relationship between the therapist and the client” (p.299). Hence, in the first session, the relationships between Ita and me transformed from just being a client to being friends who could share anything to each other.

The first session was the first experience in dealing with a client, and I gained from it a great deal of empirical skills. The major skill that I gained during the first session is that, I learned how to create the necessary rapport for any therapy.

Close interaction with Ita resulted into fruitful communication, which enabled me to gather enough information for the therapy. I applied the Rogerian psychotherapy strategy of creating psychological contact between the client and the psychotherapist. Ultimately, I learned that client-psychotherapist relationship plays a significant role in the process of psychotherapy.

Prior to my first session, my supervisor and I discussed what I was to do on my first session. Since counselling was my first experience, I had to consult my supervisor who provided me with necessary skills to perform psychotherapy.

The Second Session

In the second session, Ita arrived in time because she was eager to have her depression relieved. Ita described her condition as total misery because she lived a lonely life, suffered from inoperable breast cancer, was diabetic, and experienced a host of other social issues in her life. In this session, I had to identify and classify her problems as well as examine possible solutions to each of the problems.

An important step in psychotherapy is the identification of the presenting problem and then contextualising it (Shulman 2011, p.76). Hence, I discovered that Ita’s problems emanated from social and health aspects. From here, I could formulate hypotheses about possible interventions that might help her recover from depression and live a normal life.

At the beginning of the session, Ita viewed her life with lots of complications without any possible intervention. She cited that she lived “a solitary life” where nobody was willing to help her. Moreover, she said that her inoperable cancer and diabetic conditions contributed to her depression.

At first, I too perceived these conditions as very complex for I could not figure our possible interventions that could help Ita overcome her depression.

However, after taking her through the process of identifying possible interventions using different hypotheses, she became convinced that her life would change for the better. Hence, at the end of the second session, Ita was longing to proceed to the next session and have her problems solved.

According to my experience, the second session was somehow easy to handle since we had created a good rapport in the first session. Nevertheless, I experienced a challenge in identifying the problems and formulating possible solutions. Given that Ita viewed her condition as irredeemable, it was challenging to convince her that the hypotheses that we set would work effectively.

Barlow (2007) asserts, “A therapist can facilitate the transition to a more active and structured approach by maintaining a problem-oriented stance” (p.268). In this view, I made sure that Ita transitioned from having pessimistic attitude to having optimistic attitude for her to internalise the possible interventions.

At the beginning of the second session, Ita viewed me as a friend who would perform a miracle to get her out of her condition. As the session progressed, Ita gained an insight of her condition and possible interventions. Ita expected me to come up with interventions and make them work to improve her life.

However, with time, she realised that interventions emanated from our interaction. Therefore, at the start, Ita viewed me as a helping friend, but at the end of the first session, she recognised me as a partner who wanted to help her overcome her miserable life.

The second session gave me great insights of how clients perceive their problems. Moreover, I learned how to identify and classify problems so that I could formulate possible interventions. I noted that formulation of interventions is the hardest part in the process of psychotherapy.

Clark (2006) argues, “In constructing the model of a patient, the therapist is often able to activate affective and imaginative processes that provide an empathic understanding of a patient’s experiential state” (p.117). I realised that involvement of the Ita in the formulation of possible interventions is central in psychotherapy. Therefore, the second session gave me an invaluable experience of formulating possible interventions with Ita.

Given that I experienced some challenges in the first session, I had to consult my supervisor on what to expect on the second session, lest I would experience similar challenges.

My supervisor helped me a lot because he provided me with reading materials that enabled me to prepare well. Without my supervisor, I could not have managed to counsel Ita during the second session. Hence, I attribute my success in the second session to my supervisor’s guidance and instruction.

The Third Session

The third session started well as Ita arrived on time as usual for the therapy. Since the Rogerian psychotherapy is non-directive, I commenced the therapy by letting Ita recollect what we did during the previous session to see whether she could remember anything. The non-directive approach to counselling is effective because it enables a client to take charge of the counselling process (Barlow 2007, p.268).

The aim of the third session was to formulate feasible goals that Ita could achieve at the end of the counselling process. Therefore, in the session, I did ask her to state goals that she sought to achieve at the end of the counselling.

During the third session, Ita made significant progress that encouraged me. At the beginning of the counselling, Ita was reluctant. She did not want to play an active role in the counselling process because she believed that I was the one to guide her through the process of counselling and recovery. However, using non-directive skills of the Rogerian psychotherapy, I managed to convince her to become active.

Clark (2006) argues, “…a therapist’s attitudinal stance of congruence is fundamental to the quality of therapeutic relationships” (Clark 2006, p.68). For me to probe Ita well, I had to be congruent and attentive to her needs. Eventually, Ita trusted me and started becoming active throughout the counselling process.

I had prepared well for the third session, but when I started counselling Ita, I realised that she was quite different. Although she arrived as usual, she looked disinterested with the discussion. I too felt uneasy as I did not know how and where to begin the session. From expressions, she looked more depressed than previous sessions. She uttered some words saying, “life is unfair because my misery has no end.”

These words compelled me to encourage and comfort Ita because she said them while crying. I empathised with her while encouraging her to face the reality. The situation seemed tough, but I eventually managed to contain her and progress with counselling.

The counselling relationships in the third session evolved from a therapist-centred to client-centred. At the beginning of the third session, Ita assumed that I had the overall responsibility of directing her in the process of counselling. She believed that a therapist performs everything, while the client simply receives the therapy.

However, continued discussions on her condition allowed her to discover that she had a noble role to play in the counselling process. In the end, Ita formulated feasible goals that she wanted to achieve. Hence, the counselling process started from a therapist-centred and ended as a client-centred process.

Before the third session, I was quite aware that employing non-directive approach in counselling is difficult. As the Rogerian psychotherapy entails using non-directive strategy, it was challenging to transform Ita from playing a passive role to an active one.

According to Shulman (2011), non-directive strategy involves “reinforcing and encouraging positive statements to enable client become active in the counselling process” (p.67). The application of non-directive strategy helped me in transforming Ita’s attitude. Although she was reluctant to participate, my constant probing prompted her to open up for the session.

After opening up, Ita became active in formulating the goals that she expected to achieve at the end of the counselling process. Ultimately, I realised that non-directive approach is critical in counselling because it enables a client to own the counselling process.

Since I knew the third session was more complex than previous sessions, I consulted my supervisor regarding the probable challenges that I would face. My supervisor cautioned me to be ready for any relapse that could happen since Ita was vulnerable to depression.

Thus, the caution helped me when I found that Ita was not in the mood to continue with the counselling process because the depression overwhelmed her. In this view, my supervisor gave invaluable advice that I applied in the third session.

The Fourth Session

At the fourth session, we focused on formulating interventions to the problems that we had examined in previous sessions and aligned them to the goals we had made. Ita’s problems constituted health and social aspects. Hence, we started by formulating interventions to social problems that she had faced in life.

In the social interventions, we agreed that Ita should forgive her family and daughter for not giving her the support she deserved. In addition, we concluded that Ita should begin engaging her family members in a friendly manner. Concerning the medical issues of diabetes and inoperable breast cancer, we agreed that she would seek medical attention on management interventions, as well as live a positive life.

According to the Rogerian psychotherapy, “by adapting cognitive behavioural intervention to the individual client’s background, life history, and experiences, psychotherapist is helping a client to attain a state where there is meaningfulness in life” (Thyer 2008, p.126). During the counselling, I helped Ita to find meaning in life and uplift her spirit.

In the fourth session, Ita made considerable improvement because as we started the session, she was in depression due the conditions in her life and left when she was a bit happier. When she arrived at the counselling room, Ita confessed that her troubles were weighing her down and she was tired of facing another day. She cried saying, “I am desolate and wretched without anyone caring about me”.

As she cried, I comforted her to regain strength and live a positive life. After a lengthy discussion of issues affecting her and formulation of possible interventions, Ita improved for she went home hoping the interventions could work in her life.

I perceived the fourth session as a bit technical, for I had to formulate interventions that seemed feasible enough for Ita to accept and apply them in life. I knew that, for an intervention to be effective, Ita must accept it wholeheartedly.

Thus, I was quite careful in formulating interventions and describing the expected outcomes to Ita. Since the depression at times overwhelmed Ita making her unapproachable and bitter about life, it required a tactful approach to convince her. For that reason, I had to formulate workable interventions that suited her condition.

During the fourth session, our relationship changed as we progressed with the counselling session. At first, Ita perceived me as a therapist who wanted to impose unreasonable interventions that would not work in her life. However, as counselling progressed, she realised that interventions emanate from the available resources.

After examining several interventions, we had a privilege of choosing the most appropriate ones among them. Hence, at the end of the session, Ita had entrusted me with her life since I was sensitive and did show great concern towards her attitude and feelings.

From the experience of the fourth session, I learned that winning the trust of a client is a critical factor in the counselling process. Trust is important in collaborating with patient, “because collaboration requires that the patient trusts the therapist; we emphasise those interpersonal qualities that contribute to trust” (Barlow 2007, p.380). Trust enabled me to engage Ita in the formulation of feasible interventions.

Although the interventions seemed obvious, the trust that Ita had developed enabled her to understand the feasibility of the interventions. Overall, I have learned that a therapist must first develop trust before engaging a client in the development of possible interventions.

My supervisor helped me in the formulation and development of possible interventions that suited the case of Ita. Before the fourth session, we discussed with my supervisor various interventions, which gave me an insight into psychological interventions. During the counselling session, I applied the interventions because they suited Ita’s situation.

The Fifth Session

Given that we had formulated interventions to achieve set goals in the previous sessions, the fifth session sought to find out if Ita had applied the interventions and made any significant changes. When Ita arrived at the counselling room, I welcomed and asked her how she had progressed after applying the interventions we had set in the previous session.

She responded, “there is no difference because I was so depressed last night”. Though she looked fine that morning, her statement indicated that she needed extensive counselling to allow the needed change. Corsini and Wedding (2010) argue, “More individuals seek therapy because of concerns about the purpose in life than often therapists often realise” (p.313).

Since Ita was willing to go for therapy, I realised that she was determined to have a purpose in life. Hence, in the fifth session we re-examined the goals and interventions that we had established and planned to re-apply objectively.

During the session, Ita progressed well since we started the session after she had experienced mild depression, and at the end of the session, she reported that she felt much better than when she came for the therapy.

Her progress during the fifth session indicates that she had not only made significant achievement, but also the Rogerian psychotherapy had effectively changed her condition. Her determination made her apply the interventions that we had formulated. Moreover, the trust we had developed enabled her to communicate freely and follow my instructions to the letter.

When Ita responded that the therapy had not done much to her, I thought I had employed the wrong intervention in the counselling process. Since her problems revolved around social and medical aspects, I made sure that the formulated interventions addressed all the problems for Ita to recover well from the depression that had weighed her down.

Corsini and Wedding (2010) assert, “More and more patients come to therapy with vague complaints about loss of purpose or meaning in life” (p.311). Therefore, I began questioning whether the non-directive approach in the formulation of goals did not target the problem well. Eventually, I re-examined the process of counselling and reapplied the strategies while having conviction that they would work well.

Throughout the fifth session, our relationship remained relatively constant except that she entrusted me with her life because she thought that I was the only person who would make a difference in her life. In this case, I was like a family member who had the responsibility of taking care of her in times of distress and need.

At the end of the session, Ita felt much better and could not help thanking me about the therapy she had received. As she moved out of the counselling room, she smiled and told me that, “you have brightened my day, I am now better with great hopes”. Such a response encouraged me because I knew my intervention had made her life more tolerable.

As usual, I consulted my supervisor before I started the fifth session. Since I was worried about the effectiveness of the intervention, I inquired from my supervisor whether I could change the intervention in the middle of the counselling process.

My supervisor told me that relapses are common occurrences in the counselling process, and I should be ready to tackle them whenever they occur without necessarily changing the intervention used. Therefore, by the time Ita showed signs of relapse, it was not strange to me. Hence, I handled the situation well and encouraged her to continue with the therapy.

The Sixth Session

The sixth session involved assessment and termination of the counselling process. As a therapist, I had to ensure that my intervention had worked well and empowered the client. Since engagement of the client is important when starting a therapy, disengagement is also essential in termination of the counselling process.

“Under normal circumstances, after a client has made progress in reaching therapeutic goals, it is the therapist’s responsibility to explore what the client thinks and feels about ending the therapy” (Mozdzierz 2009, p.427). In this case, when Ita came for the sixth session, I observed that she had progressed well, and she even confirmed the same verbally.

Afterwards, I proposed that the therapy might end at the sixth session and she did not object it. She only asked that I allow her to see me whenever she wanted because we had become great friends. Thus, we recapped the interventions that we had agreed upon and scheduled to meet after a month or any day that she deemed fit to see me.

In the sixth session, Ita seemed quite happy because she believed that the therapy had helped her to live a better life that is free from depression. Despite her conditions, Ita promised that she would live a positive life with a meaning and full of hope.

The counselling process has been good to her in that she was unwilling to terminate our relationship for we had established a strong bond between us. Eventually, Ita ended the counselling process with a considerable progress for her to manage depression and accept reality of life.

The sixth session was quite enriching for both of us. It is inspiring to interact with a client, share problems, and eventually reach a successful conclusion.

The counselling process started with sorrow and misery, but through various psychological interventions, it ended with fulfilling happiness that gave us a sense of achievement. Thus, the sixth session enabled me to assess the achievements I had made through the process of counselling and gave me a reason to terminate the process.

During the sixth session, our relationship evolved from a client-therapist association to great friends with common experiences.

The experiences we shared made us one. In the Rogerian psychotherapy, “there is a considerable amount of emphasis on the working relationships between the client and therapist” (Carducci 2009. p.215). The working relationships made us friends because at the end of the session, Ita was willing to meet me again on a friendly level.

The sixth session made me understand the essence of engagement and disengagement with clients. As the Rogerian psychotherapy is client-centred, therapists should engage a client in the process of counselling, and when the client has achieved considerable progress, there should be a process of disengagement.

The process of disengagement is very important because it determines the effectiveness of interventions employed during counselling. According to Mozdzierz, psychotherapist must try as much as possible to end counselling process on a positive note (2009, p.427). In this view, I disengaged Ita smoothly from the counselling process to protect her from relapsing.

Prior to the last session, I did not know what to do because I deeply empathised with Ita. The condition of her life required someone to support her throughout her life.

Since I did not want to terminate the counselling process abruptly, I consulted my supervisor who informed me about the process of termination and disengagement of a client and when I applied the skills, I was successful. Therefore, my supervisor guided me through the counselling process from the first to the last session.

Conclusion

From Ita’s case, I can conclude that the Rogerian model of psychotherapy is effective in counselling a person with depression due to a combination of social and health issues. The Rogerian psychotherapy entails the use of skills that are client-centred. The non-directive approach is another attribute of the Rogerian psychotherapy for it allows a client to be active in the formulation of his/her goals and interventions.

The main objective of the Rogerian psychotherapy is to help the client accept and face reality in life. Since I applied the Rogerian model of therapy in the case study, it was effective despite the fact that it was my first experience. The process of counselling was quite successful as I managed to apply the Rogerian psychotherapy in counselling Ita to recover from depression.

The process of psychotherapy was interesting because it was my first experience to counsel a client. Moreover, the experience of interacting with a client at a personal level was quite inspiring as I managed to win Ita’s trust.

In the course of the counselling process, I noted that relationships change according to the progress of the client. As Ita progressed, I also advanced because I had to keep abreast with any developments that occurred in each session. At the end of the counselling process, I was happy to have achieved the objectives that we had set with Ita during the counselling.

The experience of counselling Ita has enhanced my knowledge and skills. Firstly, I have understood how to apply the Rogerian psychotherapy in counselling a client with depression. Secondly, I have known how to engage a client into psychotherapy, utilise various skills in the counselling process, and eventually disengage a client from the process of counselling.

Thirdly, I have learned how to create a rapport that provides room for growth and progression in psychotherapy. I managed to learn all these skills with the help of my supervisor whom I consulted throughout the process of counselling Ita.

References

Barlow, D 2007, Clinical Handbook of psychological disorder: A step-by-step treatment Manual, Guilford Press, London.

Carducci, B 2009, The psychology of personality: Viewpoints, research, and Applications, John Wiley & Sons, New York.

Clark, A 2006, Empathy in counselling and psychotherapy: Perspectives and practices, Routledge, New York.

Corsini, R & Wedding, D 2010, Current psychotherapies, Cengage Learning, New York.

Glassman, W & Hadad, M 2008, Approaches to psychology, McGraw-Hill International, London.

Mozdzierz, G 2009, Principles of counselling and psychotherapy: Learning the essential domains and nonlinear thinking of master practitioners, CRC press, Florida.

Shulman, L 2011, The skills of helping individuals, families, groups, and communities, Cengage Learning, New York.

Thyer, B 2008, Comprehensive handbook of social work and social welfare, human behaviour in the social environment, John Wiley & Sons, New York.

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