Adlerian Therapy

Adlerian therapy refers to counseling and psychotherapeutic interventions that are associated with the individual psychology of Alfred Adler (1870-1937), a Viennese psychologist and contemporary of Sigmund Freud. Individual psychology emphasizes an examination of the individual’s social and cultural embeddedness, a holistic view of personality, taking personal responsibility, striving to achieve life goals, growth towards a sense of completion and belonging, and a practical approach to meeting life’s challenges. Because these values are so universally shared, a wide variety of mental health professionals use classical and contemporary expressions of Adlerian therapy in their work.

Theoretical Basis of Adlerian Therapy

Adler believed that people’s pursuit of their overarching life goals pulled them from positions of inferiority, inactivity, and inertness to positions of mastery and completion. Many factors affect the nature of people’s life goals and the manner in which they pursue them, including heredity, pre- and perinatal influences, socioeconomic and cultural contexts, health, the family emotional environment, and school experiences. In the process of negotiating these goals, Adler contended, all people must address three tasks: how to find a productive work role in life, how to establish and maintain an emotionally close relationship with a life partner and family members, and how to contribute meaningfully to the community of humankind.

Adlerian therapists believe that social interest leads to and is a marker of psychological health. The essence of social interest involves striving to achieve one’s life goals while meeting life’s tasks in a socially responsible and supportive manner. Some individuals, however, strive so single-mindedly after particular goals, which offer only a fleeting sense of efficacy or esteem, that life tasks go unmet and other people are viewed as obstacles that must be manipulated, mastered, or vanquished. This approach is the antithesis of healthy mental functioning.

Adler believed that the roots of unhealthy goal striving developed during childhood from a confluence of variables such as dysfunctional family environments that were discouraging and disempowering, undiagnosed or untreated psychological or medical conditions, and lack of encouragement. Such conditions overwhelm the child’s ability to develop a healthy lifestyle and a sense of belonging. Rudolf Dreikurs, an Adlerian scholar, observed that under these circumstances children may act out or misbehave as a means of seeking attention, becoming more powerful, exacting revenge, or withdrawing from a task or interaction. Adults also may develop self-defeating life goals that give rise to physical or psychological symptoms and to interpersonal difficulties. Adlerian therapy seeks to determine the early-in-life causes of unhealthy, self-defeating life goals, and to reorient the individual toward a healthy style of life.

Processes of Adlerian Therapy

Dreikurs identified four phases that characterize Adlerian therapy. The initial phase involves establishing the therapeutic relationship. This is done by enlisting the client’s cooperation, addressing and resolving immediate crises, understanding the presenting problem, and identifying possible goals for the therapy.

The second phase of therapy involves the use of semistructured interview and standardized measures to assess the client’s lifestyle (i.e., personality). The lifestyle assessment process provides the clinician with essential information and creates an experience of self-discovery for the client. A successful lifestyle assessment will reveal the client’s private logic (i.e., the reasons underlying the client’s thoughts, emotions, and behaviors). Adlerian therapists sometimes use genograms to explore the structure and emotional atmosphere of the client’s family of origin and to understand the client’s early goals and sense of belonging. The client’s perceived position in his or her family may provide an indication of how he or she relates to others. Early recollections of childhood events and the analysis of dreams can reveal the client’s implicit life goals. Knowledge of the client’s goal striving provides an overarching framework for understanding the finer details of the client’s life.

The insight phase of Adlerian therapy involves helping clients build a deeper, intuitively-based awareness of their private logic so that behavior change can be implemented. Adlerian therapists use a variety of techniques at this stage of therapy, including challenge, confrontation, prescribing the use or display of a client’s symptom, and “spitting in the soup” (i.e., making a preferred but dysfunctional goal or behavior less palatable to the client and thus making it less salient for dealing with life challenges). This phase culminates with the client’s understanding how his or her life goals and subsidiary behaviors lead to problems and dysfunctional relationships.

The objective of the final phase of Adlerian therapy is to help clients reorient themselves from dysfunctional positions in life to individually healthy and meaningful life goals that embody social interest. A variety of techniques are used to help clients achieve this objective. For instance, Harold Mosak’s pushbutton technique helps clients see that they have a choice about the particular thoughts they entertain, along with the ensuing emotions and behaviors that stem from them. Clients also can be taught to “catch oneself” and to change course when they realize they are pursuing a goal or enacting a behavior that has been identified as dysfunctional. Clients can experiment with new modes of being and new life roles by “living as-if” in progressively wider settings outside of therapy. Adlerian therapy concludes when presenting problems have been resolved and the client is able to derive the positive psychological benefits of pursuing healthy and meaningful life goals.

Forms of Adlerian Therapy

Adlerian therapy is widely used in the treatment of adults, children, couples, families, and groups. Although many variations of Adlerian therapy exist, they differ primarily with respect to the duration of therapy, the focus and scope of treatment goals, and the strategies and techniques that are afforded by the therapeutic modality. Adlerian therapy has traditionally been long term and comprehensive in focus, but clinicians have successfully adapted the approach for short-term and brief therapy.

Adlerian therapy with couples emphasizes how complementarity (i.e., compatibility) in the life goals and lifestyle of the partners can perpetuate relational discord. Therapy with couples is aimed at increasing the partners’ awareness of the way in which their choices lead to disagreements and unhappiness instead of goal alignment, mutual support, and encouragement.

Adlerian therapy with families emphasizes the importance of a democratic and supportive family atmosphere, the role of the parents as leaders and caregivers, the individual responsibility of each family member, and the necessity for each person to contribute meaningfully within the family system. Adlerian therapists often include the Systematic Training for Effective Parenting (STEP) model that was created by Don Dinkmeyer, Sr., Gary McKay, and Don Dinkmeyer, Jr. as an important component in primary and secondary prevention efforts with families.

Adlerian therapy with children uses a variety of play and other nonverbal techniques to examine the sources of a child’s symptoms and goals. In addition to resolving symptoms (e. g., school refusal or aggressiveness), Adlerian therapy emphasizes the importance of orienting children toward cooperation (versus competition), and of encouraging them to become socially interested (versus self-interested). Adlerian interventions with children frequently involve parents and family members.

Adlerian group therapy, with suitably-screened clients, provides an active therapeutic forum in which the social manifestations of client’s problems (e.g., goals for dominating others, hesitating lifestyle tendencies) can be explored and changed. Adlerian groups accentuate the client’s social embeddedness, the interpersonal nature of problems, and ways in which social interest can be cultivated.

Current Status and Future Trends

The breadth of Adlerian therapy makes it conceptually and clinically resonant with classic therapeutic approaches (e.g., those of Karen Horney, George Kelly, Abraham Maslow), with modern cognitive-behavioral approaches (e.g., those of Albert Ellis, Aaron Beck) and with the newer postmodern and constructivist perspectives on therapy (e.g., that of Robert Neimeyer). The latter group has found Adlerian therapy of particular interest because of a shared epistemological heritage in the work of Hans Vaihinger’s Philosophy of the As-If.

Mental health professionals continue to find Adlerian therapy and individual psychology highly useful to their work. The Journal of Individual Psychology is the primary forum for disseminating the conceptual and clinical scholarship of the field. Books summarizing the Adlerian literature or focusing upon specific topics continue to appear regularly. For example, Henry Stein and his associates have undertaken a comprehensive project to translate Adler’s papers on theory and practice from their original German into English. The North American Society for Adlerian Psychology organizes an annual international convention dedicated to the advancement of Adlerian theory and therapy. The International Committee for Adlerian Summer Schools and Institutes (ICASSI, www.icassi.net) provides training in Adlerian methods and offers a framework for advocating positive social change in accordance with the work of Adler and Dreikurs. A number of local Adlerian societies and training institutes exist throughout the world.

References:

  1. Adler, A. (1927). Understanding human nature. Garden City, NY: Garden City Publishing.
  2. Ansbacher, H. L., & Ansbacher, R. R. (1956). The individual psychology of Alfred Adler. New York: Basic Books.
  3. Carlson, J., Watts, R. E., & Maniacci, M. (2005). Adlerian therapy: Theory and practice. Washington, DC: American Psychological Association.
  4. Dreikurs, R., & Soltz, V. (1964). Children: The challenge. New York: Hawthorn Books.
  5. Kottman, T. (1995). Partners in play: An Adlerian approach to play therapy. Alexandria, VA: American Counseling Association.
  6. Mosak, H. (1999). Primer of Adlerian psychology: The analytic-behavioural-cognitive psychology of Alfred Adler. Philadelphia: Brunner-Mazel.
  7. Oberst, U. E., & Stewart, A. E. (2003). Adlerian psychotherapy: An advanced approach to individual psychology. London: Brunner-Routledge.
  8. Rule, W. R., & Bishop, M. (2006). Adlerian lifestyle counseling: Practice and research. New York: Routledge.
  9. Shulman, B. H., & Mosak, H. H. (1988). Manual for lifestyle assessment. Muncie, IN: Accelerated Development.
  10. Sonstegard, M. A., Bitter, J. R., & Pelonis, P. (2004). Adlerian group counseling and therapy: Step-by-step. New York: Brunner-Routledge.
  11. Sweeney, T. (1998). Adlerian counseling: A practitioner’s approach. Philadelphia: Accelerated Development.

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