Counselling & Psychotherapy Theories Applied | Circumstance Study

Case Analysis: Vignette II

Bella. H. T. Lam

Theories & Systems in Counselling & Psychotherapy

My customer Scott, who is a 19 yrs. old male, have lost his father for nine months due to lung cancer. The major problem revealed by his mum was he previously become quite and remained aloof when he's at home. During the previous consultations, he was just looking downward and fidgeting with his figures. Brief email address details are always appeared as i am asking some open up questions. However, he thought he need help and decided to have change while i advised to close the period.

To commence with, I might like to assess a few of his behaviors so as to develop a powerful section for him. From his mom, I recognized that he has become quite and aloof after his dad passed away this maybe one of the action, which he was aiming to avoid his real sense. Also, it might have an opportunity that Scoff will not know how to cope along with his own sense about his father's fatality. Moreover, in between our chat he usually gives me quick answers or sometimes remains silent in bill to the mistrust of people or some energy blockage advised by Gestalt, this proved he will not want to answer question, showing his feeling or he does not learn how to answer. Without attention contact and fidgeting finger were also the gestures related to his mistrust or lose of love and belongingness needs. Therefore, in the coming session I hope to build a trust-worthy romantic relationship with Scott in order to allow him to talk about the real feeling with me. Furthermore, helping Scott to handle, exhibit, aware and deal with his sense are also my targets.

Progressive Muscle Relaxation

I would choose the intensifying muscle relaxation to start with the counselling period. As Scott stated that he received headaches sometimes since his dad was died on the previous session. I think temporary headaches was one of the psychosomatic sign. The procedure of comforting muscle and mental pressure in the intensifying muscle relaxation may help client to cope with long-term pain and the occurrence of migraine problems which is related to the stress or anxiousness. (Ferguson &Sgambati, 2008) Despite, Scott will not feel stress or nervousness, he behaves silent and aloof when he is at home might in account to his stress or anxiousness.

In the section, I may give instructions to Scott to instruct him relax. Then, ask Scott to inhale and exhale deeply and regularly so as to relax his muscle. Make an effort to have the muscle when they are tensioned. Then he'd asked to relax his muscle from the head then neck of the guitar and make to the trunk until the lower limbs. Before relaxation he's asked to try getting rid of the mental problem and have the comparison between relax mode and tension function. He could figure out how to become relax if he keep practicing this action daily. Which would become the habitual tendencies in his lifestyle. Progressive muscle rest could be use with another way easily and can practice daily by the client. This may help Scott to understand how to relax and improve his daily living when he's feeling stress or stress and anxiety. This practice not only soothing his muscle but also his mental. ( Davis, 1980)

Expressive Artwork Therapy

The next stage I'd like to utilize expressive art therapy to be able to help Scott expressing his feeling. Since Scott can only just answer short answer whenever i asked open question I would recommend that he didn't learn how to communicate his owns thing verbally or it could because he didn't aware his owns' problems so he cannot exhibit himself once i am asking him questions. While expressive fine art therapy is available by Natalie Rogers, it uses various artistic varieties, for example, creating motion, writing a journal, playing music as a advertising to help visitors to express his feeling. N, Roger discussed that "This is a multimodal way integrating head, body, emotion and inner spiritual resources. "(N, Rogers, 1993, ) In doing so, expressive art therapy let people to check out its unconscious head and communicate some unknown or new information. "This is also a self-discovery and healing process. " (N, Rogers, 1993)This may allowed Scott expressing his emotion to be able to have significantly more understanding about his unconscious brain.

In this section, I would make some percussion equipment to Scott, allowing him to express his sense by music improvisation. I'd ask him to think about some cases and try to use different instruments to signify or reflect that scenario. This may help him to aware and exhibit his sentiment himself and give me more info about his sentiment. I think this is the right way for Scott as he did not answer a open question easily, by using a different way like participating in music maybe give him another way to express himself. Nevertheless, Person-Centered therapy is the key top features of Expressive Art therapy while they are also emphasis the human relationships between the consumer and therapist. (N, Rogers, 1993) Therefore, I would like to create a trust -suitable romantic relationship with my consumer using the knowledge of Person-centered remedy before I started the Expressive Skill Therapy.

Person-Centred Therapy

Other than being unsure of how to express his own feeling, Scott answering question in an exceedingly brief way may also because he will not want to talk about his real feeling. According to the Carl Roger's Person-centered Remedy, relationship between client and therapist was very significant for the procedure. As if the customers believe that his emotions are comprehended by the counselor might support the clients' desire to improve. (Roger, 1961) The Person-centered Therapy suggested the three main ways to develop a good connections with the client. Including Congruence, Unconditional Positive Regard and Empathic Understanding. (Cain, 2010 ) Being congruence means that the therapist should point out truly along with his emotion, attitudes, thoughts when they are getting together with your client. Providing unconditional positive regard means is caring the client as a true person, as the caring without the criteria or judgments. (Koldon, Klein, Wang, &Austin, 2011) Matching to Rogers's (1961) research, a lot more caring the customers got, the greater success of the remedy would be. While empathic understanding is to talk about the subjective view by the experience's that the client's talked about. After this Scott can identify his own goal by himself.

So concerning provide these three conditions, I'd like to chat with Scott with more caring, sometimes give some restatements of what he just thought to show my empathic understanding, point out my true sense and attitude whenever we are chatting. Also, giving a feeling to him that I'd support him no matter what he decide or think. Following this kind of discussion I might build a better or trust-worthy romantic relationship with Scott and present the love and belongingness needs that allow him to talk about his real sense if you ask me and he will notify me more somewhat than simply answer me a brief answer or refuses to answer me. In addition, the rarely eyes connection with counselor may package to his unsafety sense. In this Personal centered remedy, I would provide him a protected climate which can let him feel safe and inclined to have eye contact with other and less fidgeting. The ultimate goal of this treatment is to permit him to express himself, trust himself by giving him matter and care, I could become a facilitator to allow him to be unbiased and integration that leads him able to cope along with his life's issue like the dilemma of his father's loss of life. Furthermore, this therapy is suitable for people who's open and ready for change since Scott agree to start to see the counselor and accepted he need helps reveal that he's ready and open to involve some changes. (Corey, 2013) However, Person-centered therapy was an unstructured therapy which is difficult to estimate the length of time needs because of this treatment. The only path is to recognize how the client's know about himself and assisting him to create his own plan. Therefore I'd like to spend additional time in this treatment before moving to the next part.

Gestalt Therapy

The next treatment I'd like to make use of is the Gestalt remedy. Although we've used the Expressive Art therapy in order to talk about Scott understanding to himself, it could insufficient because the art therapy more targets expressing the emotion and feeling. To help expand talk about his knowing of his own sense I would like to aid him to realize greater awareness which include knowing the environment, oneself also speak to their awareness by using the Gestalt remedy. (Ploster &Ploster, 1973) Aside from expressing his feelings, aware and face his own feelings is also my matter. In Gestalt therapy, it mainly targets where in fact the energy used or blocked, the here and today which allow client to fully experience the "now" also the unfinished business that your body is lined inside the bottom and not completely fixed and include some unexpressed feeling. (Ploster, 1973) While blocking energy is another form of security behavior suggested by Gestalt. In Scott conditions, looking from counselor when they are chatting, point out just a few is also the patterns of blocking energy. (Corey, 2013)When Scott residing at home silently and aloof are types of that he cannot communicate his own feeling and cause unfinished business. His father has died for nine weeks but he altered his behavior started from his dad death to now that represent Scott continues to be struggling with days gone by activities as Gestalt therapist recognized that the past would come to the present's instant is usually the lack of completion of days gone by experience. (Corey, 2013 )

While in this treatment I would encourage Scott to experiences his own blocking energy gesture and allow him to know very well what is he struggling and accept it. Also seeking to bring his feeling from the past to present and know that he is able to make a big change of situation. I'd choose the Reversal exercise and Exaggeration exercise for Scott. For reversal exercise, I'd ask him try to take a look at me and stop fidgeting along with his figure for one minute whenever we are chatting, to let him to accept what he is doing. After that, I would ask him to stay silent for longer time which to exaggerate his tendencies. (Feder & Frew, 2008) From this behavior he is able to make an effort to interpret his interior feeling when he is keeping silent. The gestalt remedy have much description about the importance human's gesture and vocabulary which would be ideal for Scott which have more gesture and less words to aware his sense via body dialects.


In this session there might be used four treatment, The intensifying muscle leisure, Person-centred therapy, Expressive art remedy and the Gestalt remedy. The progressive muscle relaxation might want to help your client improve his psychosomatic health issues like headache. While the person-centred remedy is target at building a trust-worthy relationship with your client in order to let him to share me more with his own's sentiment and my caring may let him to identify his own goal and the eager of changes. Expressive art work therapy may like to cope with his complications of expressing his own feeling once i am requesting some available question. Furthermore, the gestalt remedy wish to help client to aware with his gesture like refuse having eye contact with other so as to relate his gesture to his sense and let him to focus on.


Cain, D. (2010). Person-centered psychotherapies. Washington, DC: North american Psychological Association.

Corey, G. (2013). Theory and practice of counseling and psychotherapy (9th ed. ). Belmont, CA: Cengage.

Davis, J. (1980). Progressive Muscle Rest. In The consequences of progressive muscle relaxation after breathing and panic in patients with serious obstructive pulmonary disease. Madison: University of Wisconsin.

Feder, B. , & Frew, J. (Eds. ). (2008). Beyond the hot seat revisited: Gestalt approaches to group. New Orleans: Gestalt institute Press.

Ferguson, K. E. , &Sgambati, R. E. (2008) Rest. In W. O'Donohue &J. E. Fisher (Eds. ), Cognitive behavior therapy: Making use of empirically backed techniques in your practice(2nd ed. , pp. 434-444). Hoboken, NJ: Wiley.

Koldon, G. G. , Klein, M. H. , Wang, C. , & Austin, S. B. (2011). Congruence/genuineness. In J. C. Norcross (Ed. ), Psychotherapy associations that work: Evidence-based responsiveness (2nd ed. , pp. 187-202). New York: Oxford College or university Press.

Polster, E. , & Polster, M. (1973). Gestalt remedy integrated: Curves of theory and practice. NY : Brunner/Mazel.

Rogers, C. (1961). A therapist's view of psychotherapy. In On learning to be a person. Boston: Houghton Mifflin.

Rogers, N. (1993). The creative interconnection. INSIDE THE creative connection: Expressive arts as treatment. Palo Alto, Calif. : Knowledge & Behavior Catalogs.

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