Adlerian Therapy
Adlerian Therapy
Adlerian Therapy
Revised 11/11/14
Accepted 12/11/14
DOI: 10.1002/jocc.12069
A
lfred Adler’s theory of individual psychology (IP) suggests that in-
dividuals are not simply a number of parts but holistic beings who
create meaning from the social contexts within which they are actively
involved (Bitter, 2007). Adler’s concept of social interest involves feelings of
belongingness and interest in others’ well-being. This is in stark contrast to
the withdrawal, isolation, and self-absorption that may be immediately present
in the thoughts and behaviors of an individual who recently separated from a
romantic relationship (Gibb, Fergusson, & Horwood, 2011). IP counselors
identify mistaken goals that lead to dysfunctional behavior while fostering
courage and increased self-confidence (J. Carlson, Watts, & Maniacci, 2005).
One group that might seek counseling is women who have experienced a
recent relationship breakup. Although research related to significant romantic
relationship separation exists, less is known about counseling strategies for those
experiencing a breakup. Some researchers (M. R. Miller, 2009) identify romantic
separation experiences as opportunities for positive change, while others note
both positive and negative post-breakup emotions (Monroe, Rohde, Seeley, &
Lewinsohn, 1999; Tashiro & Frazier, 2003), with women having more intense
negative feelings after a relationship ends (Sprecher, Felmlee, Metts, Fehr, &
Vanni, 1998; Tashiro & Frazier, 2003). Using IP in therapeutic treatment with
recently separated women may promote their innate capacity to strive toward
wholeness or completion (Bitter, 2007) while approaching life’s tasks of friendship,
occupation, intimacy, self-care, kinkeeping, spirituality, and change (Sonstegard,
Bitter, & Pelonis, 2004) in a useful manner and with greater confidence. The
purpose of this article is to relate the needs of college-age women who have
recently experienced romantic relationship dissolution to the ideas of Adler, as
represented in the use of IP with these clients.
Alessandra Rhinehart and Melinda M. Gibbons, Department of Educational Psychology and Counseling, University
of Tennessee. Alessandra Rhinehart is now at College of Education and Human Services, Northern Kentucky Uni-
versity. Correspondence concerning this article should be addressed to Alessandra Rhinehart, College of Education
and Human Services, Northern Kentucky University, Nunn Drive, MEP 203E, Highland Heights, KY 41099 (e-mail:
rhineharta1@nku.edu).
New Identity
Individuals who have recently separated from a romantic relationship have greater
success adjusting when they understand how the divorce or separation fits into
IP
Adlerian theory, or IP, is based on three main constructs (Dufrene, 2011).
The first states that all human behavior is purposeful, or goal-oriented. Focus-
ing on purposeful behavior is a key element of IP. This entails exploring the
interpretations of self, others, and life that clients have formulated (Bitter &
Nicoll, 2000). These interpretations make up their worldviews and are helpful
in understanding motivation. Second, individuals possess an innate drive toward
social interest, which involves cooperating with others and making beneficial
contributions to the social environment. Human drive toward social interest
is determined by the early need to rely on others to survive (Sonstegard et
al., 2004). The meaning of life is found in what we contribute to society.
Third, the individual is considered in a holistic manner, with all of the parts
making up a unified whole person (J. D. Carlson & Englar-Carlson, 2008).
Individuals experience the world, or the parts of the whole, within a system
that includes family, school, work, and cultural contexts (Corey, 2009).
As previously mentioned, Alfred Adler (1931/1980) divided human beings’
cooperation with the environment into three life tasks, which were later expanded
by other researchers (Dreikurs & Mosak, 1966/1977a, 1967/1977b; Sonstegard
et al., 2004). Adler proposed the tasks from an understanding of how individuals
respond to or find solutions to circumstances. An individual’s lifestyle informs his
or her approach to managing the life tasks. The three original tasks of occupation,
social, and sexual cooperation link people to one another and to the world in which
they exist (Mansager & Gold, 2000). Researchers later expanded Adler’s list to
Phases of IP
To assess the manner in which an individual approaches the life tasks and,
eventually, to facilitate motivation modification, one must gain an understand-
ing of the four phases of IP (J. Carlson et al., 2005). The three aspects of IP
previously mentioned are governing concepts involved in understanding an
individual. The four phases show how a successful series of sessions progresses.
The first phase involves building a relationship with the client based on
empathy and mutual respect (Ansbacher & Ansbacher, 1956). The counselor
begins therapy before actually meeting the client (Bitter & Nicoll, 2000).
Counselors use information about the client obtained from other sources
to formulate hypotheses. These assumptions provide counselors a starting
point that can be reformulated upon interacting with the client. For example,
counselors can explore the emotional issues and identity changes predicted to
occur following a breakup. Establishing a strong therapeutic alliance is essential
in promoting effective treatment outcomes (Sprouse, Ogletree, Comsudes,
Granville, & Kern, 2005). Bitter and Nicoll (2000) have suggested that in-
formation can be gained even in the simple touch of a handshake. Clients also
gather information about the counselor in these initial moments of therapy.
In a profession where the timeliness and cost-effectiveness of treatment are pro-
moted, Bitter and Nicoll (2000) have suggested that Adlerian therapists should
use brief therapy in practice. The theoretical framework for Adlerian brief therapy
(ABT) is essentially identical to classical IP. The differences are found in timeframe
and an intentional focus on the flow of the therapy session or sessions. Counselors
using ABT introduce a contract outlining the time limitations of treatment to
inform and motivate clients. Providing this contract at the beginning of therapy
allows clients to develop an optimistic outlook on the effectiveness of treatment.
The second phase is a psychological investigation in which the counselor as-
sesses the client’s lifestyle (Powers & Griffith, 2012) utilizing subjective and
objective interviews. The counselor uses empathic connection to help clients
explain what brought them to counseling. For example, the counselor would
elicit the breakup story and how the dissolution affected the client’s well-being.
Following the telling of the client’s story, the counselor poses what Adler
(1929/1964) called the question. Dreikurs’s (1997) form of the question asks
clients what they would be doing if they did not have the presenting problem,
an intervention used to determine if the cause of the problem is physiological
or psychological. If the problem is physiological, the client might insist the
problem would simply be gone, that nothing else would change. However, if
the problem is not physiological, clients will often answer with the very out-
come they are avoiding. This aids the counselor in understanding motivation
and challenges with life tasks.
The objective interview takes place following the psychological investigation.
Apart from the presenting problem, the counselor uses a lifestyle assessment to
Case Illustration
Given the Adlerian concept that all problems faced by individuals are socially
based, we present a case study using Adlerian therapy with a young woman who
has recently experienced separation from a romantic relationship. The counselor
uses the four phases of Adlerian counseling in working with Katherine, a fictional
client who is a composite of actual cases. We will explore her presenting problems
from the vantage point of a counselor using Adlerian therapy as a framework.
Katherine is a 20-year-old college student who has recently experienced a
breakup after a 1-year relationship. She is experiencing feelings of depression
related to the breakup, along with recent weight gain. She is also troubled
with anxiety regarding her ability to succeed in her classes. She reports that the
breakup was mutual but mentions that her ex-boyfriend, Daniel, was emotionally
abusive, often calling her names and telling her she was worthless, throughout
the relationship. She decided to seek help from her college counseling center.
When the counselor meets Katherine, she immediately begins processing appar-
ent information about her. Katherine is well-dressed, slightly overweight, and fails
to make eye contact when timidly shaking the counselor’s hand. The counselor
Implications
There are many similarities between the identified needs of women who have
experienced the end of a romantic relationship and the goals of IP. The most
notable concept of IP to relate to the challenges these women face is the concept
of addressing the tasks of life, including friendship, occupation, intimacy, self-
care, kinkeeping, spirituality, and change (Sonstegard et al., 2004). Evidence
for the positive impact of social support in the loss of a romantic relationship
in the work of Ben-Zur (2012) speaks to the appropriateness of using Adlerian
therapy with this population.
As previously mentioned, the timely stage model of ABT (Bitter & Nicoll, 2000) is
consistent with college counseling centers’ needs to employ brief treatment methods
and implement session limits (Lacour & Carter, 2002). The ability of college counselors
to assess the effectiveness of IP with their clients and to document therapeutic gains
is a necessary condition for adopting this method. Outcome studies have specifically
identified the effectiveness of Adlerian therapy with children (Weisz, Hawley, &
Jensen-Doss, 2004) and adults (Grawe, Donati, & Bernauer, 1998). Nikelly (2005)
noted the relationship between social interest and improved physical health, reduced
stress, and increased social capital, all of which relate to academic success. Relevant to
the use of Adlerian therapy with college-age women, Crandall (1980) demonstrated a
correlation between social interest and optimism, adjustment, and well-being. When
applying ABT with this population, college counselors may document therapeutic
gains by focusing on the reorientation phase (Bitter & Nicoll, 2000) and reporting
evidence of insight and change. Insight may be demonstrated by clients’ recognition
of past experiences affecting their current behaviors. Change may be evidenced by
movements toward social interest and confidence, activities in which clients engage
in social contact for support and academic success, as well as strategies for coping
with depression, anxiety, and adjustment.
During the case study, the counselor helped Katherine process her breakup by
assessing her depression and anxiety and by discussing detrimental aspects of the
relationship, including social isolation and dependency. The counselor helped
Katherine discover a link between her motivations within the relationship and the
worldview she developed within her family of origin. Katherine gained insight by
reflecting upon her role as the youngest child and from memories of her father
berating her mother while she hid in her room. She realized the feelings of inad-
equacy and fear that defined her existence as a child left her feeling stuck in current
situations in her life. By reviewing a client’s family-of-origin issues, connecting
these with current concerns, and providing a safe space anchored by empathy
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