Counselor’s name: Sophie Young Setting: Private Practice

Client’s name: Bob Client’s age: 26 years old

Estimated # of sessions required: 10 Theoretical Perspective: Person-Centered

Client History

Bob struggles with frequent anxiety attacks and depression. He has a positive relationship

with his mother but does not visit or communicate with his father or two brothers. He was shy in

high school and became a “follower” in college by partying with large groups of people. He has

difficulty keeping a job, is currently unemployed, and lives with his girlfriend despite their

frequent communication issues. Bob stated that he has come to therapy as a last resort.

Presenting concerns

Bob’s presenting concerns are recurrent anxiety attacks that he claims are due to a single

use of LSD in college. He reports often feeling sad or angry, though he does not recognize a

current issue that would have instigated these emotions. He states that he hates his father, was

bullied by his brothers as a child, and in college was pressured by them to do well academically.

Bob is currently unemployed and claims to be too weary to find work. Additionally, he disclosed

his unhealthy communication cycle between him and his cohabitating girlfriend.

Actual or core issues

It appears that Bob lacks congruence between his self-concept and ideal self (Murdock,

2017). His unemployment and relationship complications likely contribute to the negative

feelings he possesses about himself. These issues are hindering Bob from his self-actualizing

tendency, an innate desire that all humans have (Murdock, 2017). Bob is having trouble

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distinguishing between events that help or hinder this growth. By experiencing more accurately,

Bob could begin to lean towards self-actualization (Murdock, 2017). Genetically, Bob has the

potential for success, as seen by his successful brothers and father. Bob’s self-concept can be

altered through unconditional positive regard in counseling to facilitate an awareness of his

inherent potential. One study by Farber and Doolin (2011) found that positive regard has a

moderate association with therapy outcomes and can have many benefits for the client, such as

strengthening their ego, involving them in an effective relationship, and empowering the client

towards their innate tendency to grow. A non-conditional, accepting self-concept will help give

Bob the tools he seeks to live a full life.

Course of treatment and interventions utilized

In the first two sessions, the counselor-client relationship was established through

empathetic listening, unconditional positive regard, and treating Bob as an equal. The therapeutic

relationship was established immediately because it is one of the most necessary and sufficient

aspects of counseling (Murdock, 2017). After gaining Bob’s trust, the following sessions focused

on determining how his self-concept is similar to or different from his ideal self. When Bob

discussed his frustration with anxiety and depression, he was empathetically told “it sounds like

you are dealing with a lot of painful emotions. It takes a lot of strength to come and work on

those”. A 2011 study by Elliot, Bohart, Watson, and Greenberg indicated that therapy outcomes

have a moderately strong association with counselor empathy. They also note that it is

imperative for therapists to accurately understand and respond to what the client is saying for

empathy to be perceived well. When Bob discussed his relationships with his brothers and father,

he was told “I’m hearing you say that you don’t think you will ever be as successful as them.”

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This nondirective statement allowed Bob to disclose his belief that a stable job and a high

income equals success.

Bob currently has an external locus of evaluation about his present circumstances,

making him feel unsure of how to help himself (Murdock, 2017). He mentioned that he values a

career and that “working gives people purpose”. We discussed his undergraduate grades and how

he could be seen as a desirable employee in the chemistry field. After helping Bob realize this,

his self-talk became less defensive and more accepting. He said, “I want to apply for a chemical

analyst job, and I think I might have a good shot at it.” This sense of hope was unlike his usual

self-deprecating responses. We are currently on our fifth weekly session out of the ten that are

anticipated. In the following sessions, it is expected that Bob will continue to see his potential

towards living the life he wants. He will continue reporting one accomplishment that he is proud

of each week, an exercise that aids in boosting his self-concept.

Counseling goals

Bob’s short term goals are to shift his self-talk to a more positive tone. It is probable that

this will alleviate many of his anxious and depressive symptoms. Bob has been encouraged to

apply for the chemical analyst position and to updated me on his progress. If he were to obtain

this job, he would likely be more willing to speak with his father and brothers due to his

perceived success. Bob’s long term goals are to see himself as a person who is capable of

reaching his full potential (i.e. fulfilling career, relationship, and mental health goals). As Bob’s

time in therapy concludes, he will be empowered to use his gained insight to make intuitive

decisions about his future life choices.

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Anticipated outcomes of counseling

By holding a positive self-concept that aligns with his ideal self, Bob will experience less

incongruence (namely, anxiety and depression) and will feel motivated to continue the work he

has done in counseling. Bob’s gained independence and intuition will help him to distinguish

what life events are helpful and harmful regarding his self-growth (Murdock, 2017). Obtaining

the chemical analyst job will boost Bob’s confidence and inspire him to seek growth in other

areas of life, such as in his romantic and familial relationships. Because of his dedication to our

sessions, Bob has the ability to continue transitioning from a dysfunctional, incongruent state to

one of healthy congruence, which is the ultimate goal of our time together (Murdock, 2017).

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 References

Elliot, R., Bohart, A. C., Watson, J. C., & Greenberg, L. S. (2011). Empathy. Psychotherapy,

48(1), 43-49. https://doi:10.1037/a0022187

Farber, B. A., & Doolin, E. M. (2011). Positive regard. Psychotherapy, 48(1), 58-64.

https://doi:10.1037/a0022141

Murdock, N. L. (2017). Theories of counseling and psychotherapy: A case approach (4). Boston:

Pearson.