Adlerian Therapy against Depression

Overview

Adlerian psychotherapy was founded by Alfred Adler (an ex-associate of Freud who rejected Freud's notion that sex is the root of all psychological problems.) It takes a positive view of human nature: We are all goal-oriented creatures who are striving for social connectedness, and we are in control of our destiny. Many personal difficulties, Adler believed, stem from feelings of inferiority-he in fact coined the term "inferiority complex."

An Adlerian therapist will identify, explore, and challenge a client's current beliefs about their life goals. He or she will gather family history and will use information about a client's behavior patterns to help the client set new, socially satisfying, and attainable goals. These could relate to any realm of life and could include developing parenting or marital skills, or ending substance abuse. Once these healthier objectives are set, the therapist may also assign homework, set up contracts with the client, and make suggestions on how the client can reach his or her new goals.

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Probably, the most influential contribution Adler has made was his emphasis on birth order and sibling relationships. This emphasis propelled him to focus his therapeutic approach in family relationships. This approach was labeled “family constellation”, which gathers information on the client’s immediate family member, such as parents, brothers and/or sisters, and others living in their house. A summary and interpretation of this information portrays how the client interacts with the social world.

The Adlerian therapy focuses on spotting concerns or issues revolving around unrealistic ambitions or lack of confidence. The therapist also discovers the successes and failures the client has gone through and how these experiences have affected him or her. The diagnostic tool of early recollections is also practiced. With this method, the client narrates early childhood incidents that keep on happening again and again. According to Adler, these recollections describe how an individual sees himself or herself and what he or she envisions for the future. After gathering this information, the therapist then develops a lifestyle assessment, or the main targets of therapy.

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It is a guideline for Adlerian therapists to guide the client in exploring his or her strength, rather than revealing his or her weaknesses. Therapists use an objective interview that inquires about the beginning of the client’s problems, the client’s medical history, the client’s purpose for engaging in therapy, and the person’s coping mechanisms. Indeed, based on this approach, therapists or counsellors are “lifestyle investigators”.

Questions about family environment have likewise been included in the techniques. The family issues include the client’s similarity or dissimilarity with the parents and other siblings, parents’ treatment of the children and discipline in the home. Early recollections are also practiced, commonly starting with the line, “Tell me something that happened one time.” This narration is further interpreted by the therapist, according to the client’s perception of the event. Personality priorities are also interpreted based on the four behavioral patterns of superiority, control, comfort, and aim to please.

Adlerian Therapy Focus for Depression Treatment
- Emphasis is placed on the importance of the feelings of self that arise from conflicts and interactions
- The sense of self being the central core of personality is also stressed
- The relationship of ego being the core personality of a person is another focus of the therapy
- It starts from psychoanalysis
- Great emphasis is placed on motivation and social interaction 

How Adlerian Therapy works?
The goal of Adlerian Therapy is to challenge and encourage the clients' premises and goals, to encourage goals that are useful socially and to help them feel equal. These goals may be from any component of life including, parenting skills, marital skills, ending substance abuse, and most anything else.

The Adlerian therapist provides a supportive, accepting environment that can help you build trust, hope and confidence. This can be achieved in a non-judgmental, non-labeling context where the client is stimulated (or irritated) into thoughts and actions which strive for a positive, balanced, connected, competent and creative approach to self and others. The therapists may also assign homework, setup contracts between them and the client, and make suggestions on how the client can reach their goals.

Adlerian Play Therapy
Adlerian Play Therapy is a component of the complete program of Adlerian Therapy. Although Adlerian Play Therapy may work a little different because it is geared to appeal to children, the concept is the same. In Adlerian Therapy sessions, the therapist will focus on and examine the lifestyle of the client and try to form a mutual respect and trust with the client. They will then mutually set goals as the therapist provides encouragement and makes suggestions on how the client can reach those goals. The therapist will also provide the encouragement for the client to make the changes that will assist him or her in attaining the goals that have been set.  

In the case of children, they are not always perceptive to opening up and talking about their feelings, and without this very important part of lives being revealed, it’s difficult for a therapist to help solve the problem that may be plaguing the child. As a result, a systematic approach to therapy was developed called Adlerian Play Therapy and is used in combination with the Adlerian Therapy. Children, being as they are, do not like the idea of anyone trying to find out why they act a certain way, or what happened to make them the way they are. They are very timid little creatures when it comes to the way they feel inside and why they feel that way. I am sure many parents have heard their children say, “I’m not saying anything. I don’t like talking to strangers.” It becomes difficult for a parent who is trying to get to the root a problem with her child’s behavior or the way her child thinks. 

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What is the solution and how do you help a child who refuses to open up? That’s where the concept of Adlerian Play Therapy steps in. Your child doesn’t want to talk to a stranger, and no matter what you do, he or she just won’t open up and talk. With the Adlerian Play Therapy concept, the child is “fooled” into opening up because the session is conducted during a course of playtime with the therapist. By playing together and developing a sense of being on the child’s level, he or she opens up without even realizing it.

Methodology

Adler taught that a client’s life-style can be viewed as a personal mythology. These mythologies are true for the individual and so the individual acts accordingly. These mythologies are “truths” and “partial truths,” but they can also be myths that one confuses for truths. Adler calls these basic mistakes. Look at common overgeneralizations, such as “people are hostile”, “life is dangerous” as well as misperceptions of life, “life doesn’t give me any breaks”, are all myths that one confuses for truth. These mythologies or life-styles are expressed in the client’s physical behavior, language, dreams, interpretations, etc. The intervention in Adlerian therapy is reeducation and reorientation of the client to myths that work “better”.

Concept of Change/Development According to Adler's theory of change, the therapist uses a variety of strategies that help the client to identify his specific needs. The client is unique; therefore, the technique used must fit the situation of the client. Thinking, feeling, emotion and behavior can only be understood as subordinated to the individual's style of life, or consistent pattern of dealing with life. The individual is not internally divided or the battleground of conflicting forces. Adler believed that humans possess the freedom to act, determine our fate, determine our personality, and affect our style of life.

The goal of the therapy is to stimulate cognitive, affective and behavior change. Although the individual is not always fully aware of their specific goal, through analysis of birth order, repeated coping patterns and earliest memories, the psychotherapist infers the goal as a working hypothesis. The client approaches control of feelings and emotions. First, the client recognizes what kind of feeling he or she is having (angriness, sadness, frustration, etc). Once the client sees and knows the feeling; then he or she will try to imagine or think of something pleasant that had happened to him or her, replacing the bad feeling for a good one. By doing this, the client is in control of his or her emotions and can change the mood only by thinking differently. It is believed by Adlerians that thinking different thoughts can effectively change mood states.

The client is helped by the therapist to see life from another perspective. The client tries to put him or herself into another role. Change occurs when the client is able to see his or her problem from another view, so he or she can explore and practice new behavior. As the therapist explores the thinking, feeling and acting of the client, he or she directs the client into a new philosophy of life. Thus, the client is able to think about a new philosophy of life. He or she makes decisions and conclusions about his or her own life.

Adlerian psychotherapy can be broken down into three basic phases: 1) Understanding he specific style of life of the patient, 2) Explaining the patient on himself or herself, and 3) Strengthening the social interest in the patient. It attempts to bring each individual to an optimal level of personal, interpersonal, and occupational functioning. The objective of therapy is to replace exaggerated self-protection, self-enhancement, and self-indulgence with courageous social contribution.

Tools and Techniques Once the initial analysis has been completed and goals for treatment have been set, Adlerians employ a variety of techniques to encourage individuals to move forward and elicit change. Most of the techniques are action-oriented, focusing on facilitating life-style changes while working to help the individual learn to counteract discouragement, enhancing self-efficacy and increasing self-esteem. Treatment may occur in the form of multiple psychotherapy (whereby several therapists treat a single patient), individual psychotherapy, and/or group therapy.

Within the therapeutic relationship, the therapist is said to represent values the patient may attempt to imitate. In serving as models for their patients, Adlerian therapists therefore characterize themselves as “being for real”- genuine, fallible, and able to laugh at themselves. An emphasis on humor as an important asset is frequently utilized in treatment since “if one can occasionally joke, things cannot be so bad”. Other verbal techniques include giving advice while taking care to discourage dependency; frequent use of encouragement and support; and utilizing language that avoids moralizing by referring to behaviors as “useful” and “useless” as opposed to “good” and “bad”.

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Some of the more action-oriented techniques include creative and dramatic approaches to treatment such as role-play, the empty-chair, acting “As if”, and psychodrama. Other techniques include task setting, creating images, catching oneself, and the Push-Button Technique. Dramatic techniques such as Role-play, the Empty Chair, and Acting “as if”, are all utilized to help the patient practice useful skills and behaviors as they “try on” new roles and styles of living. While these techniques provide valuable opportunities for patients to rehearse new life-skills, they also allow for the patient to make choices as to which roles they wish to discard, and which they wish to use in their everyday life. Psychodrama is technique that occurs exclusively in a group setting, whereby the internal struggles of a single patient (or “protagonist”) are worked though dramatically. The process occurs with the active participation (and support) of other members of the group who are employed by the protagonist to represent challenging aspects of his or her inner life, while he or she attempts to move “successfully” through it.

Creating images is another technique utilized by Adlerians in eliciting change. Based on the premise that “one picture is worth a thousand words”, patients are given (or generate) images to describe themselves. Use of this technique maintains that remembering this image, the patient can remember goals, and in later stages, can learn to use the image to laugh at oneself.

The Push-Button Technique also utilizes the patients’ own imagination in service of therapeutic goals. After being instructed to call upon two specific life experiences- one pleasant experience and one unpleasant experience- patients are encouraged to focus on the feelings each of these incidents evoke. This process is utilized to teach patients that they can create whatever feeling they wish by deciding what they think about. As a result, the patient finds that he is the creator, not the victim of his emotions, and the power of self-determination is enhanced.


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