Balancing Humanistic and Solution-Focused Therapy Approaches

Introduction

While it may seem like common sense, balance is critical in treating any patient. In striving to become a well-balanced therapist, this author seeks to combine the humanistic-existentialist and solution-focused approaches in a more subtle way. By leading first with the humanistic-existentialist approach and then tactically shifting to the solution-focused approach at the right moment in an intervention, the full effects of both can be realized. Only when the client is fully drawn out and has exposed their inner self can the therapeutic "pivot" be executed with full effect.

While the war-fighting analogy may seem out of place, therapists are in some ways like generals — planning tactics and strategy methodically to conduct the intervention on the most favorable terms, so that the full effectiveness of their treatments can be realized.

Analysis of the Therapy Session

In the video reviewed, the therapist gives the client signs of empathy, unconditional positive regard, congruency, and genuine relatability. This includes unwavering eye contact. Notably, she uses the children's names frequently, which is a positive technique. However, stepping back from the therapist's role for a moment, she used Max's name only once. Dale Carnegie's approach, which this author found instructive, emphasizes the strategic use of a person's name at the right time as a key relational tool. While this may seem like an unrelated comparison, Carnegie identified what is now widely understood: people enjoy hearing their own name and feeling seen, which facilitates connection (Carnegie, 1981, p. 76). Using Max's name more often would likely have encouraged him to open up more quickly.

Even though Max's stated goal was to help his children and his marriage, the deeper driver — the conflict going on inside of him due to his marital problems — remained underexplored. While it may seem unusual to draw a parallel with a sales context, therapists are in a sense purveyors of emotional understanding. The more quickly and smoothly a therapist reaches a client's core concerns, the more value the client will derive from the initial intake and the more motivated they will be to continue. For this reason, this author would have focused more attention on Max himself, rather than predominantly on the children.

This author would also have pressed the question of why Max believes that withdrawing from the situation will benefit his children. He appears to be living in a counterfactual fantasy. If his account of events is accurate — which any good therapist would want to verify objectively — it would be worth exploring the pattern of his consistently deferring to his wife. That behavior may be sustainable for him personally, but his children did not choose their circumstances and deserve a peaceful environment in which to grow.

The Humanistic-Existentialist Framework

Carl Rogers maintained a holistic approach to human existence that depended on thorough and complete investigations of values, meaning, freedom, personal responsibility, tragedy, spirituality, human potential, and personal self-actualization. The term humanist implies the belief that people are inherently good. Humanistic psychology looks beyond the purely medical model of psychology to open up a non-patronizing view of a person. In this approach, the therapist deliberately downplays the pathological aspects of a client's life and highlights the healthy dimensions instead.

One key element of this approach is the initial meeting — especially the intake session — between the client and the therapist, which establishes the foundation for genuine dialogue. The mission of humanistic therapy is to help clients approach their own situation with a stronger and healthier sense of themselves, moving toward self-actualization. This is part of humanistic psychology's broader aim to be a science of human experience while remaining focused on the experiential level of the client's life. In other words, the therapist must set aside the scientist's hat and engage with the client on a personal level. As Rogers argued, the therapist must connect with the client's real feelings in order to treat the person effectively (Rogers, 1974, pp. 33–34). In this author's view, at least in cases such as this one, there is no purely clinical formula. We have to connect on a humanistic level because the person is not a specimen in a laboratory — they are a complex being who must be seen in the totality of their existence.

This striving for balance calls to mind the philosopher Maimonides' concept of the golden middle path (Rosenfeld, 2007). Tracy Knight, in her article on person-centered psychotherapy, also writes about this balance while acknowledging its limitations. She cautions against being excessively centered on the client's inner processes at the expense of their social perceptions:

"Being primarily concerned with individuals' inner processes and a nondirective therapist approach, the person-centered framework does not address the frequent centrality of clients' social perceptions and expectations as they apply to the therapy situation, that is, their conceptions of the therapy enterprise and the ideal roles each participant is to assume within that context. The ultimate 'truth' of the person-centered perspective is largely irrelevant if clients perceive the therapist as behaving in an inattentive, elusive manner" (Knight, 2007, p. 113).

It is appropriate that the therapist in the video connects with Max about his family — he does respond, but almost in a textbook manner. If he did not respond when asked about his children, that would itself be a clinical concern. The key to Rogers' approach is to enter the person's psyche and draw out what lies beneath. After all, regardless of external circumstances, it is what is happening in a client's mind that matters most and that will affect everyone around them. It is this inner life that must be fully engaged before it can be constructively confronted in a therapeutic manner. Connecting with Max's psychological core would accomplish this more quickly and more subtly than the indirect approach visible in the video.

Conclusion

A well-balanced therapist should have the expertise to combine the humanistic-existentialist and solution-focused approaches in a nuanced and strategic way. By beginning with the humanistic-existentialist approach, the therapist can assess whether this framework alone is sufficient, whether the client would benefit more from a solution-focused approach, or whether elements of both are necessary. In the particular situation examined here, this author would have sought to determine whether the client would benefit from family therapy or cognitive behavioral therapy. A client-centered approach that analyzes the depth of the client's psychological layers will allow the therapist to calibrate the strenuousness of the intervention appropriately.

References

Carnegie, D. (1981). How to win friends and influence people (Rev. ed.). New York: Simon and Schuster.

Knight, T. (2007). Showing clients the doors: Active problem-solving in person-centered psychotherapy. Journal of Psychotherapy Integration, 17(1), 111–124.

Rogers, C. R. (1957). The necessary and sufficient conditions of therapeutic personality change. Journal of Consulting Psychology, 21, 95–103.

Rosenfeld, D. (2007). Maimonides on life. Retrieved from http://www.torah.org/learning/mlife/ch2law2b.html

Watson, J. C. (2006). A reflection on the blending of person-centered therapy and solution-focused therapy. Psychotherapy: Theory, Research, Practice, Training, 43(1), 13–15.