Using the Existential Approach with Patrick, Client Profile 3
The existential approach will help Patrick integrate his painful emotional experiences into his life, develop self-acceptance, and discover purpose and meaning in his life (Corey, 2009). Developing Patrick's self-acceptance will lead to increased self-esteem and a decrease in his self-imposed isolation as he learns to engage in meaningful relationships with others (Laureate Education, Inc., 2006). This therapy will respect Patrick's life journey and emphasize his growth and development in spite of the arduous challenges he has experienced (Corey, 2009).
An existential approach may not directly address Patrick's acute symptoms of anxiety, hyper-vigilance, and stress-related distress. Additionally, existential therapy may not provide enough structure and direction for Patrick's issues (Corey, 2009). In the cultural context of his profession, values emphasized in the existential approach may conflict with those of his comrades. For example, the idea of self-actualization self-reflection, self-awareness, and self-appreciation might seem effeminate or self-indulgent to a group of male firefighters. This could cause internal conflict with regard to the significance of the therapy.
It may be helpful to gather more information about his parents' foundational belief systems and the values central to his childhood. These may have contributed to his low self-esteem. His marriage disintegrated before the September 11th crisis, so some issues began prior to that traumatic experience (Laureate Education, Inc., 2006). An additional consideration is the male dominant culture of firemen with which he associates, and from where he receives at least some affirmation of roles related to manhood (Laureate Education, Inc., 2006). Within this culture, he may have developed inappropriate measures of success for male roles, and these measures should be addressed, especially since Patrick appears insecure and lacks self-esteem.
Ethical or Legal Issues to Address
Patrick's depression should be assessed in the initial meeting with the therapist (Corey, 2009). If Patrick reports suicidal thoughts or appears to be a danger to himself, this would need to be addressed immediately. Another issue that requires immediate assessment is Patrick's use of alcohol. It is important to determine the extent of his use because of the critical nature of his work and the danger it poses to others if he drinks during work hours.
Overall Therapeutic Goal
One of the overall goals in existential therapy is to integrate one's life experiences and accept them as a natural condition of being human (Corey, 2009). In an existential approach, clients learn to find "a balance between recognizing the limits and tragic dimensions of human existence on one hand and the possibilities and opportunities of human life on the other hand" (Corey, 2009, p. 139). In Patrick's case, this will mean accepting the reality of the pain and loss he has suffered during the September 11th crisis and integrating these and other experiences into his life. Existential therapy will help Patrick discover meaning through his experiences, which will give him a greater sense of well-being (Diener & Seligman, 2004; Frankl, 1963).
The Therapeutic Process
The therapist will use a client-centered approach to develop trust in the relationship, and convey acceptance, respect, and appreciation to Patrick through careful and deliberate self-disclosure (Laureate Education, Inc., 2006). Creating an environment in which Patrick perceives the therapist as a caring comrade will help Patrick explore his emotional experiences. The therapist will demonstrate unwavering acceptance toward Patrick and will engage with him authentically. Additionally, using the I/Thou relationship will reflect a "direct, mutual, and present interaction" (Corey, 2009, p. 150). Developing such a caring and intimate relationship is central to existential therapy and crucial to strengthening Patrick's ability to trust others and decrease his social isolation (Laureate Education, Inc., 2006).
Goals of Therapy
Goals of Patrick's therapy would include increasing his self-awareness to understand more accurately his emotional life experiences exacerbated by the September 11th crisis. An equally crucial goal is to decrease his need for alcohol consumption and his tendency toward social isolation. Patrick will begin to question and develop personal meaning in his life (Corey, 2009). His experiences with the September 11th crisis left him in despair and a state of emptiness and meaninglessness, but with encouragement, he will find meaning, not only despite his experiences, but because of them.
Specific Strategies and Techniques
Although existential therapy lacks techniques and strategies, the therapist may borrow from other approaches appropriate for the client (Corey, 2009). In Patrick's case, using a person-centered approach will help to establish trust between Patrick and the therapist. Through this relationship, the therapist will encourage self-awareness and reflection to help Patrick gain self-esteem and find purpose and meaning in his struggle (Corey, 2009). Borrowing from Gestalt therapy, the therapist will use the empty chair technique by which Patrick has an opportunity to express his emotions to his lost comrades and others with whom he has unfinished business (Corey, 2009; Laureate Education, Inc., 2006).
Corey, G. (2009). Theory and practice of counseling and psychotherapy (8th ed.). Belmont, CA: Thompson Brooks/Cole.
Diener, E., & Seligman, M. E. P. (2004). Beyond money: Toward an economy of well-being.
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Frankl, V.E. (1963). Man's search for meaning: an introduction to logotherapy. New York:
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Laureate Education, Inc. (Producer). (2006). Case Study: A Humanistic/Person- centered Perspective [Streaming Video]. Baltimore: Author.