A Case Illustration of Client-Centered Therapy
The following case example illustrates some of the
features of client-centered counseling that have been
discussed. The client is a 20-year-old sophomore who
was being seen in a university counseling center. His
initial complaint involved a generalized feeling of
unworthiness. As the sessions moved along, he began
to focus specifically on his feelings of intellectual
inadequacy. Even though his college grade point
average in a demanding curriculum was 3.3, he was
constantly absorbed by a sense of inferiority. He fre-
quently compared himself (always unfavorably) to an
older brother who had recently completed medical
school and was the source of much parental pride.
The following exchange took place during the 15th
session.
Client:Well, it happened again yesterday. I got back
that exam in American Lit.
Therapist:I see.
Client:Just like before. I got an“A”all right—me and
eight others. But on the third question the
instructor wrote a comment that I could have
been a little clearer or else could have given more
detail. The same old crap. I got an“A”all right,
but it’s pretty damn clear that I’m like a machine
that can generate correct answers without ever
understanding. That’s it. I memorize, but there’s
no spark, no creativity. Boy!
Therapist:What else can you tell me about the
exam?
Client:Well, it was like we talked about before. I’m
doing OK, but I just don’t feel like I really measure
up. I remember my brother bringing home a
paper in high school. It was a“C,”but the
instructor said John had real potential. I just don’t
think I’ve got it.
Therapist:Even though you got an“A”you are not
satisfied.
Client:That’s right. Never satisfied. I could get 42“A+s”
and never feel good. I hate myself!
Therapist:M-hm.
Client:Sometimes I’m so ridiculous.
Therapist:You feel silly because of the way you react. Is
that right?
Client:I should put it aside, think about other things.
But I don’t, and then I feel silly when I don’t.
Therapist:You’re silly because you feel dissatisfied and
silly because you don’t just forget it.
Client:I know I should be satisfied with an“A.”Other
guys would be. They’d be glad to get an“A.”
Therapist:M-hm.
Client:But I can’t. No wonder the folks are so proud
of John. He got decent grades, and he was
satisfied—not like me. It’s a wonder they don’t get
fed up with my moping around.
Therapist:So even with good grades your unhappiness
is enough to turn people off.
Client:Sure. But somehow I’ve got to get rid of this
defeatist attitude. I’ve got to think about the
good side.
Therapist:M-hm.
Client:A lot of times I’ve tried to forget my lack of
potential. Just go on and plug along.
Therapist:Yeah. I guess you really felt people put you
down because of this lack of potential?
Client:Boy, did they! Especially my folks. They never
really said so, but I could tell from the way they
acted.
Therapist:M-hm.
Client:They’d say that John really has a head on his
shoulders, or (pause)...he can think his way out
of anything.
Therapist:And this made you feel sort of worthless—
not hearing things like that about yourself.
Client:That’s right.
Therapist:M-hm.
Intense feelings were expressed in this
session. The client felt worthless and inferior to his
brother. Despite an outstanding college record,
hecontinuedtofindwaystoprovethathewas
intellectually unacceptable. The therapist did not
attempt to contradict him or to prove him wrong; nor
did he make reassuring comments. Rather, he
accepted the client’s statements and the feelings they
conveyed.PSYCHOTHERAPY: PHENOMENOLOGICAL AND HUMANISTIC-EXISTENTIAL PERSPECTIVES 377