I use an integrative approach utilizing humanistic, psychoanalytic, and social constructivist perspective frameworks to understand my clients’ concerns and help them understand themselves. At the beginning of a client relationship, I use Gestalt therapy techniques to focus on their present concerns. I inform clients new to counseling that the field has come a long way from Freud’s free associations and “tell me about your mom.” Focusing on current concerns helps build trust and an understanding that I am not in the session to judge or demean, but to support and accept the client as they gain an understanding of how their present environment is affecting their initial concerns for seeking counseling.
My approach with a client is very non-directive. Clients of all ages, 4-80, respond very well to it. Clients bring themselves to sessions and I accept what they bring. Together we explore what has been causing stress, pain, or heartbreak, but we also celebrate successes, changes, and hope. I do not always have a plan when entering a session and if I set up an intervention with a client in the previous session, I’ll perform a check to see if that intervention is still viewed as necessary or wanted. A non-directive approach teaches confidence and allows the client to be in control. What is felt during a session will hopefully be felt and experienced outside of a session.
I am a huge proponent of journaling and the use of paradoxical change as means for the client to explore different aspects of their identity. By writing out scenarios and then rewriting them with different actions and outcomes the client begins to see these “self-fan fiction” journal entries as a guideline to work towards connecting with aspects of themselves they either wish others could see or would like to be more present. If the client does not want to write they have discussed those changes in sessions. I don’t focus on negating behaviors, but increasing the presence of behaviors the client already shows a tendency towards. The result is an increased level of confidence in the traits they wish to explore.
Using gestalt “here and now” techniques helps to illuminate themes of one’s past and how they are perpetuated to the present. This helps to eliminate the self-destructive patterns and guides the client to more healthy relationships. Clients have found it beneficial when exploring something unrelated to their initial concern for coming to therapy to have connections made in the form of these patterns. Once a pattern is recognizable, steps can be placed to notice when that pattern is starting over and how to observe it while it’s taking place or leave the situation, if necessary. This has been beneficial for undesired relationships as well as work- and school-related concerns. The patterns are not posed by myself but are questioned and given back to the client for reflection.
I have used empty chair-like journals and in-session work to help with troubling relationships and grief. The difficult part is letting the client feel comfortable in expressing those emotions. In these scenarios, working with self-acceptance and encouraging the client to give permission to themselves usually works over a period of time along with control and confidence that is learned through non-directive sessions. I have had a decent success rate of having clients use the empty chair-like techniques, mostly in journal entries away from sessions. When they do it’s often helpful in some cathartic sense of being able to say what they wanted to say or wished they could have said. These moments are often reflected as a stepping stone on a roadmap with the eventual end point being able to feel or use what was in the intervention in their life.
In terms of psychoanalysis, I focus heavily on one’s identity and helping the client meet or adjust their identity to their preferred concept of themselves. This is heavily based on my exposure and works with Erikson and Marcia’s concepts of identity moratorium and how it ties into one’s well-being and wellness. In this regard, words matter. I help the client identify the terms they use to describe themselves, the motivations those words imply, and how those terms may be outdated expressions that no longer match their current needs. An example I often use is that of a college “athletic performer” who loses the motivation to work out because they will not be performing. Helping the client change that descriptor of the identity to “fitness trainer” encourages them to train simply for the purpose of remaining fit. This improves comfort and acceptance of their new roles and identities and allows for an improved sense of wellness. It is my working belief and is supported through research that identity development does not stop, but is an ongoing lifelong process. As such, I have seen success with this type of work with teenagers and adults alike.
Finally, I use concepts from social constructivist perspective theories as a means to guide my understanding and acceptance and to help the client to put together their life as plot points in a story. As I am only getting snapshots of a client’s life, it tends to read like a story to me, with a series of conflicts, climaxes, and resolutions (or lack of resolutions). Reframing this concept back to clients helps them to see their life as a story and shows them how they can construct their resolutions while empowering them to take control of the story or narrative. Using this concept helps a client and myself understand the factors that the client has control over, which factors are affecting the client, and plan a way forward.
It has been recently brought to my attention that I am working with narrative therapy concepts; so I am currently exploring Narrative Therapy and its current and future application to how I practice. I know that after graduation, I am only beginning my education in mental health counseling and fully intend to keep learning and adjusting my framework in ways that make me proud to be a mental health counselor, but also better benefits my clients.