case study for adlerian therapy

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Adlerian Theory and the Case of Margarita

A Paper On Case Studies

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Abstract Margarita comes seeking therapy for her propensity to angry outbursts, depression, and social awkwardness. Using the Adlerian theory, this paper will show what the important goals need to be set for Margarita’s treatment as well as the interventions that would best suit her case. Using interviews, subjective and objective, as well as early memory recollection, you will see how Margaritas problems can be successfully addressed and treated with the usage of Adlerian practices. Also, an understanding of the cultural considerations and limitations will be gained. The pros and cons of the Adlerian model of counseling are discussed and it is shown that the pros outweigh the cons of using this method on a Hispanic person.

Adlerian Theory and the Case of Margarita Margarita comes to therapy with presenting concerns of aggression and anger as well as depression and social anxiety. This section of the paper will address Margaritas issues from the view of Adlerian theory. Goals will be establishes for Margarita using this theory and interventions from the Adlerian perspective will be applied as well. Being from Puerto Rico, there are some cultural considerations that come into play in this case and those will be addressed along with any limitations that the Adlerian theory may have in successfully treating Margarita.

Establishing Goals for Margarita The most basic goal of Adlerian therapy is to challenge client’s premises and life goals. “Adlerian Therapy is a growth model. It stresses a positive view of human nature and that we are in control of our own fate and not a victim to it.” (PsyWEB, 2011). By reading Margarita’s case study it is clear that she is in need of growth and a more positive view of herself. She admits to feeling depressed most of the time yet not expressing those feelings outwardly. She states the reason for this is that she has responsibilities and must put on her game face to take care of what she needs to take care of (kids, work, and school). Margarita also admits to having anger issues without being able to pinpoint the cause of her anger. She appears to have isolated herself as she states she has no friends and feels fearful of social situations. Ironically though, Margarita belongs to many organizations and committees where she must take charge and show strength and ability. She admits that in these situations she feels in her element and in control though as far as gaining friends from these experiences, she does not feel worthy of such relationships. Knowing these things allows for goal setting to begin.

In the case of Margarita there are four specific goals that the therapist should work towards; encouraging a view of equality, changing of lifestyle, decreasing feelings of inferiority, and changing faulty thinking and motivations. With the issues in Margarita’s life it is clear that she employs faulty thinking that leads her to feelings of inferiority. “For those of us who strive to be accomplished writers, powerful business people, or influential politicians, it is because of our feelings of inferiority and a strong need to overcome this negative part of us according to Adler.” (Heffner, 2002).

Margarita is striving to become successful in her own right and this is apparent through her work with the community boards and her recent acceptance into law school which is a prestigious honor. Even with these accomplishments Margarita still does not feel equal to her peers or good enough to be where she is in life and this is in part due to faulty thinking patterns. One of the most important goals, however, will be to find ways to overcome her outbursts of anger. By looking into the rest of her issues, the root of these outbursts should become more apparent and therefore targeted for removal and/or control.

Intervention and Techniques During the therapeutic process, various techniques are used in order to help Margarita. One technique that is not special to her case is encouragement. “Encouragement is the most powerful method available for changing a person’s beliefs, for it helps clients build self-confidence and stimulates courage.” (Corey, 2009, pg 105). This is the basis of the relationship that allows the interventions to work for the client. The Adlerian therapeutic process has for phases. The first is the establishing of the relationship between therapist and client. The therapist and client work together in goals and interventions in order to reach success. The types on interventions used with a client stem from the relationship and the types of interventions used depend upon the individual. In the first phase of therapy, “the main techniques are attending and listening with empathy, following the subjective experience of the client as closely as possible, identifying and clarifying goals, and suggesting initial hunches about purpose in client symptoms, actions, and interactions.” (Corey, 2009, pg 109).

The second phase in Adlerian therapy is exploring the client’s psychological dynamics. This is an assessment phase where the counselor gets an understanding of the client’s life. To do this the counselor may conduct interviews with the client. The first interview that Margarita would take part in is the subjective interview where she will be encouraged to tell the story of her life in the most complete, unedited way she can. At the end of this interview the counselor would want Margarita to answer “The Question”. This final question allows the client to show their life without any problems and restraints. For Margarita, “The Question” the counselor would ask her would be “How would your life be different if you did not face these issues? What would you be doing differently that would make your life different then it is now?” The second interview technique is the objective interview. This is a discovery interview where the therapist does information seeking. This includes information about how Margarita’s problems began her social history, and the reasoning behind why she decided to come to therapy at this particular point in time. Once these interviews are complete, the counselor will have a deeper understanding of Margarita and better know what techniques to use with her.

In doing these interviews, the counselor has found that Margarita’s early life events may be at the root of her present issues. Because of this, the early recollection technique is employed. Margarita is asked to make a list of her earliest memories for the counseling session. “From a series of early recollections, it is possible to get a clear sense of our mistaken notions. Present attitudes, social interests, and possible future behavior.” (Corey, 2009, pg 111). Through this technique, the counselor finds that Margarita has a reoccurring theme from her childhood. One memory is at age 4 where her mother is screaming at her father and he is trying to calm her. Another memory at age 5 is of her giving her mother a handmade Christmas gift which was not received as well as the gold ring her older brother gave to her. At age 6, Margarita recalls overhearing her parents talking about what to do with a little girl with so little potential. From this short list the a counselor can see that Margarita learned from an early age that she was not valued and not worthy of love and success.

The counselor now sees where Margarita’s faulty thinking began and now will address this issue. During her sessions, Margarita has used overgeneralizations and applied false goals of security. She is highly fearful of her husband leaving her due to her anger issues and therefore feels that she must be perfect in order to make it so he will never leave her. The reality is that her husband loves her and does not need her to be perfect, just to be in control of her emotions. She over generalizes when she states that while she does important work for the community, no one likes her and she can see why that is true. The counseling must call her out on these things in order to bring them to the front and center so they can be addressed and worked through. The third phase deals with encouraging self-understanding and bringing insight to the client. “When Adlerians speak of insight, they are referring to an understanding of the motivations that operate in a client’s life. Self-understanding is only possible when hidden purposes and goals of behavior are made conscious.” (Corey, 2009, pg 113). During this third phase the counselor will provide interpretation for Margarita. These interpretations come as suggestions. For instance, the counselor may say to Margarita, “It seems to me that you feel insecure about your ability to engage people in meaningful dialogue.” By doing this, the counselor is helping Margarita to understand her own motivations.

The final phase is reorientation and reeducation. This is where the action of the therapy comes into play. “This phase focuses on helping people discover a new and more functional perspective.” (Corey, 2009, pg 113). Margarita will begin her reorientation of her motivations and behaviors. She will be able to find her lighter, happier, more useful side. The counselors place is that of the encourager. Margarita will be encouraged to make decisions and modify their thinking and goals. At this phase the past and present have already been explored. Faulty thinking and behaviors that do not work have been examined. Now it is time for action. Margarita and her counselor will develop a plan that she can follow when she feels that she is veering off track. New goals can be set and Margarita can now see what her possibilities in life are.

Cultural Considerations and Limitations Though Margarita has lived in America for 10 years, her first 16 years were spent in Puerto Rico where the culture differs from that of the United States. In addition to her years spent if Puerto Rico, her parents have not assimilated to their new culture and therefore Margarita was raised in a home in which her original culture reigned supreme. There are some theories of counseling that would not be beneficial for Margarita due to those facts. However, Adlerian therapy would be a good fit. Adler was ahead of his times in respect to social equality and cultural considerations. “Adlerian counseling takes into account the social and cultural values of minority groups, such as social embeddedness, integration of family members, and spirituality into the counseling process.” (Bornsheuer, & Polonyi, 2011). These are the reasons that Adlerian therapy could be a successful fit with Margarita.

Though Adlerian therapy typically does fit will in cross cultural situations there can be limitations as well depending on the client and how deeply rooted their cultural beliefs are. The only limitation that the counselor can see getting in the way of successful treatment of Margarita is that many times Hispanic families can be close-mouthed when it comes to sharing personal information with those outside their family circle. In her case study it states that the only people who see her depression and angry side are her husband and her parents. This tells the counselor that there is a possibility that Margarita’s culture, having taught her to be silent with strangers, may stop her from being completely candid about her life which would stunt the success of her treatment.

Conclusion The emotional and behavioral issues that brought Margarita to therapy can be identified and treated successfully using Adlerian therapy. The goals set forth at the beginning of the therapeutic relationship were taken from her initial presentation, and using the techniques (early memories, interviews, reeducation) that are typical of Adlerian therapy, the counselor was able to show how treatment with this model could be successful for Margarita’s case. While there is a clear limitation due to cultural issues, the counselor feels that Adlerian therapy would be a good match for Margarita.

References Bornsheuer, J., & Polonyi , M.A. (2011). Adlerian counseling with hispanic clients and families. Unpublished manuscript, Counseling, Sam Houston State University, Humble, Texas. Retrieved from http://www.shsu.edu/~piic/AdlerianCounselingwithHispanicClientsandFamilies.htm

Corey, G. (2009). Theory and practice of counseling and psychotherapy. Belmont, CA: Brooks/Cole.

Cosner, L. (2002). Psychography:alfred adler. Retrieved from http://faculty.frostburg.edu/mbradley/psyography/alfredadler.html

Heffner, C.L. (2002). Personality synopsis [Chapter 5 Section 2]. Retrieved from http://allpsych.com/personalitysynopsis/adler.html

PsyWEB, Initials. (2011). Psychotherapy. Retrieved from http://www.psyweb.com/mdisord/MdisordADV/AdvPsych.jsp

Stein, H.T., & Edwards, M.E. (1998). Classical adlerian theory and practice. In P Marcus (Ed.), Psychoanalytic versions of the human condition New York City: New York University Press.

The theory and application of adlerian psychology. (2007).Psychology, Adler Graduate School, Richfield, MN. Retrieved from http://www.alfredadler.edu/overview/adlerian.htm

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22 Most Effective Adlerian Therapy Techniques and Worksheets

Despite their age, Adler’s ideas remain as relevant as ever and in line with modern views that social relationships and self-actualization are crucial to human growth and wellness.

Adlerian therapy identifies human behavior as goal oriented and socially embedded and recognizes the importance of family groups (Sweeney, 2009).

This article explores Adlerian therapy and several techniques and tools that help people move forward in their lives.

Before you continue, we thought you might like to download our three Positive Psychology Exercises for free . These science-based exercises explore fundamental aspects of positive psychology, including strengths, values, and self-compassion, and will give you the tools to enhance the wellbeing of your clients, students, or employees.

This Article Contains:

What is adlerian therapy 10 theoretical principles, 15+ key concepts & goals of adlerian therapy, adlerian therapy in practice: 2 examples, how does it work 10+ techniques and interventions, 9 worksheets, activities, and questions to ask, a look at adlerian group therapy techniques, 6 limitations and strengths of the approach, training in adlerian therapy: 3 opportunities, 3 fascinating books on the topic, resources from positivepsychology.com, a take-home message.

“Along with Freud and Jung, Alfred Adler was a major contributor to the initial development of the psychodynamic approach to therapy” (Corey, 2013, p. 102). After collaborating for 10 years, Adler deviated from Freud’s biological and deterministic point of view (which he believed was excessively narrow) to a social-psychological or goal-oriented view of human nature.

Crucially, “Adler envisioned a psychology of growth, where people could strive to overcome difficulties and actually change their lives” (Carlson & Englar-Carlson, 2017, p. 4).

The following points summarize some of the key theoretical principles of what became Adlerian therapy (modified from Sommers-Flanagan & Sommers-Flanagan, 2015):

• Holism Humans must be treated as a single unit rather than divided into separate parts.
• Superiority striving Despite obstacles, we naturally strive (actively and creatively) toward excellence and task completion.
• Purpose Humans work toward specific goals in life, driven by future hopes rather than past experiences.
• Social interest and community feeling We strive to connect socially at an individual and community level. The absence of community would lead to arrogance and selfishness.
• An idiographic approach While generalizations can be helpful, every human must be considered unique.
• Phenomenology Everyone creates their own reality ; experiences are based on individual perceptions and subjectivity.
• Soft determinism Biology and environment influence, but do not determine, behavior.
• Freedom to choose We are responsible for choosing our behavior from a limited number of options. Yet, we often make poor choices because of a lack of knowledge or education.
• Lifestyle The schemas used for directing ourselves through our lives are established during childhood but can be changed later through education and therapy.
• Optimism Adler was “hopeful that the pull toward social interest and community feeling and the drive toward completeness would help individuals live together peacefully and happily” (Sommers-Flanagan & Sommers-Flanagan, 2015, p. 88).

In summary, Adlerian therapy sees the individual as motivated by social relatedness, purpose, goals, and consciousness (Corey, 2013).

• Building mutual respect
• Performing a lifestyle assessment
• Identifying and disclosing faulty assumptions (mistaken goals) in the client’s lifestyle
• Reorientation of the client toward a more meaningful lifestyle

Adlerian therapy aims to develop “the client’s sense of belonging and to assist in the adoption of behaviors and processes characterized by community feeling and social interest” (Corey, 2013, p. 109).

The client is not considered sick or in need of healing. Instead, the therapist seeks to reeducate them and, where possible, reshape society. For the client to find a way of living with social interest, they must be given a new “cognitive map” – an alternative way of looking at themselves and the world around them.

The goals of Adlerian therapy are therefore educational, helping clients to (modified from Corey, 2013):

• Foster and grow social interest
• Overcome feelings of inferiority and discouragement
• Change their lifestyle by modifying their views and goals
• Challenge faulty motivation
• Recognize equality among people
• Become contributing members of society

Adlerian therapy is not only centered on the individual. Treatment recognizes the demands placed on the client by the world as six interrelated life challenges (Sommers-Flanagan & Sommers-Flanagan, 2015):

• Work or occupation Individuals must be able to work cooperatively through social relationships.
• Social relationships Establishing strong and healthy relationships is a vital outcome of therapy.
• Love and marriage Lifestyle changes, developing empathy, and thinking and acting to benefit relationships are also goals of Adlerian therapy.
• Self Our relationship with ourselves is formed during childhood but can be improved through good self-care and a reasonably positive yet accurate opinion of ourselves.
• Spirituality It is important and helpful to have a good understanding of our relationship with God, religion, and the universe.
• Parenting and family Family and parenting are essential life tasks and extensions of love and marriage.

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Adlerian therapy works with clients facing real problems; they require support and new ways of thinking, along with clearly defined goals (Corey, 2013; Sommers-Flanagan & Sommers-Flanagan, 2015).

Case example 1: Spoiled rich kid

Sommers-Flanagan and Sommers-Flanagan (2015, p. 102) used an image to challenge a 15-year-old boy who persistently criticized his mother’s wealth while complaining he had an insufficient allowance: “I had an image of a closet spoiled rich kid. You want money […], but you’re uncomfortable with your friends seeing you as rich.”

The new insights offered by the image helped the boy connect and share his inner conflicts and beliefs about money and his lifestyle, benefitting his treatment.

Case example 2: Stan

In another case, the therapist resisted choosing his client’s (Stan) goals and instead adopted a more collaborative approach (Corey, 2013). The therapist began by using an assessment to explore his relationships, roles, and feelings about himself. The results, along with ongoing conversations, uncovered that Stan felt he would get hurt if he got close to people and would only be acknowledged if he became perfect.

During the reorientation phase, the client and therapist reflected on alternative beliefs, attitudes, and actions. Stan was helped to accept that he needn’t remain a victim and could, instead, take control of life.

Through collaboration, the therapist can help the client (Sweeney, 2009):

• Learn about mistake goals
• Find the motivation to change
• Replace unhelpful private logic with common sense
• Develop more social interest as they change
• Feel a sense of belonging and equality with others
• Become brave enough to take risks

Typically, Adlerian therapy is broken down into several stages, with appropriate techniques and interventions for each one (Sommers-Flanagan & Sommers-Flanagan, 2015):

Forming the therapeutic relationship

The therapeutic relationship is formed through effective listening and caring. The therapist is eager to “foster collaboration and communicate interest in the client as a person” (Sommers-Flanagan & Sommers-Flanagan, 2015, p. 93).

Goal alignment

The therapist works hard to identify and understand the client, their needs, and their goals for therapy.

Focusing on positives and avoiding pathologizing

The therapist must focus on strengths and problems equally, showing interest in the whole person rather than someone who needs to be “cured.”

Lifestyle assessment and analysis

An evaluation of the client’s lifestyle is an important part of treatment, typically using one of the following three interview formats (Sommers-Flanagan & Sommers-Flanagan, 2015):

• Family constellation interview Used to find out relevant information about childhood experiences, including describing family members, their interactions, and childbirth order.
• ‘The Question’ Used to uncover the purpose of the client’s symptoms, such as “How might your life differ if you were well?”
• Earliest recollections Rather than reflecting on the past, the “earliest recollections” questions are there to forecast the future. For example, “Is the individual giving or taking? Alone or with others? What emotion do they use?”

Interpretation and insight

Therapy must uncover the connections between insight, motivation, and action. Adlerian therapists work collaboratively with the client, asking questions (such as, “Could this be true?”) to deepen their understanding.

Reorientation

Insight gives way to action through directly applying specific techniques to facilitate change; for example:

• The future autobiography The client is asked to write a story about how the rest of their life might look.
• Creating new images Analyzing the client’s early recollections and basic mistakes makes it possible to produce a new visual positive image to replace a more negative one.
• Acting as if Clients may wish for traits they don’t currently possess. The therapist can prompt them to act as if they do have them by asking clients, “How would it look if you had X?” (for example, more confidence or assertiveness).

Understanding the client’s past can help predict their future (Sommers-Flanagan & Sommers-Flanagan, 2015).

The following worksheets and therapy questions are helpful.

Understanding Siblings

The Understanding Siblings worksheet helps gain insight into the family relationships formed during childhood and an understanding of how birth order may have affected beliefs and behavior (Sommers-Flanagan & Sommers-Flanagan, 2015).

Follow-up questions dig a little deeper, such as:

Who took care of each other? Who played with each other? Who was most like you? Who was least like you?

Catching Oneself

The Catching Oneself worksheet is used for reflection purposes to help the client recognize when they act or think in ways that lead to angry outbursts or a loss of control (Sommers-Flanagan & Sommers-Flanagan, 2015).

Ask the client to think of times over the last week when they became angry or had an outburst.

When was it? What happened? Has this happened before? What typically triggers this sort of outburst? What could you do to reduce the likelihood of it happening or its severity?

By better identifying when outbursts occur and why, they will become more able to avoid the situation or control their feelings.

Reflecting As If

The Reflecting As If intervention can help change behaviors (Sommers-Flanagan & Sommers-Flanagan, 2015).

The client is asked:

• How would it look if you were watching yourself on video acting in the way you would like to?
• What would be the first signs that you had begun to act in that way?

Sample Adlerian questions

The following six questions are typical ones used in Adlerian therapy (modified from Carlson et al., 2006):

What brings you to see me today? What kind of person would you like to be in six months? How would you like things to be in a year? What would your life be like if you didn’t have this problem? Of the problems you have shared today, which is most upsetting or troubling for you? What would need to happen for the work to be nearing completion?

However, as with all group therapy, there are a few points that deserve early consideration, including (Sonstegard & Bitter, 2004):

• How many people can the therapist be fully engaged with for an hour or more?
• Find a well-lit, private space, free from distractions that comfortably fits the size of the group.
• What is the balance of gender, age, and culture?

The following three Adlerian techniques have proven successful in group settings:

• Group agreements Having introduced one another, it is helpful for group members to determine a set of guidelines regarding what is acceptable; this may include how long to meet and how to ensure psychological and personal safety.
• “The question” Asking questions, such as, “What would you be doing if these symptoms or problems were removed?” can open up discussion and dialogue in the group. Hearing other members’ successes (even imagined ones), difficulties, and concerns can create a safe space.
• Family constellation The clients discuss the major influences in their life and how they shaped their interpretation of life and society.

The Adlerian approach has had a profound and long-term effect on therapy and has both strengths and limitations (Corey, 2013; Sommers-Flanagan & Sommers-Flanagan, 2015).

• Adlerian therapy is typically sensitive to the needs of the client but requires rigorous training.
• The belief that clients are not psychologically sick but need help with mistaken beliefs is in line with many modern therapeutic approaches.
• Therapy techniques offer therapists considerable freedom in working with clients.
• Changing the autonomous self may be culturally at odds with some clients and their beliefs.
• Clients from some cultures may not be interested in exploring their past as a child and wish to see the counselor as the “expert.”
• Clients may find it difficult or even inappropriate to share family struggles.

While there may be challenges, “the therapeutic approach allows for the use of a variety of relational, cognitive, behavioral, emotive, and experiential techniques” (Corey, 2013, p. 127).

While there are many face-to-face and online training options, we have chosen to share three below.

Adler Graduate School

Academic study is teamed with counseling internships for experiential learning.

Positive Discipline Association

While they don’t come with a certification for practicing psychotherapy , the four sessions offer useful insight into its underlying principles.

Bucks Adlerian Training

This UK-based training offers a diploma in Adlerian counseling as part of its advanced certificate in the theory of individual psychology and Adlerian counseling skills and includes 100–120 hours of supervised client counseling.

While many therapy books introduce Adlerian therapy techniques (among other therapeutic approaches), the following three books are dedicated to the topic.

1. Learning and Practicing Adlerian Therapy – Len Sperry and Vassilia Binensztok

The authors offer a substantial review of conventional Adlerian therapy and introduce a more contemporary version – Adlerian pattern-focused therapy.

This is an ideal resource for future clinicians to gain a theoretical and practical understanding of the benefits of Adlerian therapy.

Find the book on Amazon .

2. Adlerian Counseling and Psychotherapy: A Practitioner’s Wellness Approach Therapy – Thomas Sweeney

Now in its sixth edition, this book from Thomas Sweeney takes the reader through a scholarly and thought-provoking analysis of Adlerian therapy.

The book’s clear and engaging style provides a solid explanation of theory and practice in a user-friendly format.

3. Adlerian Psychotherapy – Jon Carlson and Matt Englar-Carlson

This introduction to the theory, history, and practice of Adlerian psychotherapy brings the importance of Adler’s approaches into the reader’s view.

It is a valuable book for those wishing to understand the importance and far-reaching impact of Adlerian therapy and its potential in short-term therapeutic approaches.

We have many resources available for mental health professionals providing support to clients seeking help in therapy sessions.

Free resources include:

• Setting Valued Goals Reflect on personal values and why they matter to determine your most important goals.
• What I See in You Practice performing positive self-appraisal in a group setting.
• Positive Memories of Childhood Reflect on positive memories and emotions from childhood.

More extensive versions of the following tools are available with a subscription to the Positive Psychology Toolkit© , but they are described briefly below:

• The Self-Compassion Miracle Question Clients are asked to imagine that they no longer talk to themselves in a negative, self-critical way; instead, they treat themselves with kindness and compassion.
• Step one – Understand the client’s current situation.
• Step two – Perform the readiness to change assessment.
• Step three – Identify the stage of change.

This provides a helpful model for recognizing where the client is with their change and what may be needed to move them forward.

If you’re looking for more science-based ways to help others enhance their wellbeing, check out this signature collection of 17 validated positive psychology tools for practitioners. Use them to help others flourish and thrive.

17 Top-Rated Positive Psychology Exercises for Practitioners

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Alfred Adler recognized that no one exists outside of the society they find themselves in and the importance of social relations (Sweeney, 2009). Indeed, “he valued the role of cooperation with and connectedness to the world around each person,” including their families (Carlson & Englar-Carlson, 2017, p. 3).

Rather than focusing on the past, Adlerian therapy highlights the importance of goals for positively influencing behavior. Treatment recognizes that the future is built on the now.

Equally importantly, humans are treated as a whole, rather than separate parts, as they strive toward goals and excellence. Each person must be seen as unique; their subjectivity is their own, and they have the freedom to choose how they live.

Adlerian therapy can help clients who become stuck by disclosing unhelpful assumptions and reorienting the client toward more meaningful styles of living.

While Adlerian therapy is less commonplace now, its legacy lives on in the therapeutic techniques that followed. As a result, lessons are still to be learned from this and other early approaches to psychotherapy.

We hope you enjoyed reading this article. Don’t forget to download our three Positive Psychology Exercises for free .

• Carlson, J., Watts, R. E., & Maniacci, M. P. (2006). Adlerian therapy: Theory and practice . APA Books.
• Carlson, J., & Englar-Carlson, M. (2017). Adlerian psychotherapy . American Psychological Association.
• Corey, G. (2013). Theory and practice of counseling and psychotherapy . Cengage.
• Sonstegard, M. A., & Bitter, J. R. (2004). Adlerian group counselling and therapy: Step by step . Routledge.
• Sommers-Flanagan, J., & Sommers-Flanagan, R. (2015). Study guide for counseling and psychotherapy theories in context and practice: Skills, strategies, and techniques (2nd ed.). Wiley.
• Sperry, L., & Binensztok, V. (2018). Learning and practicing Adlerian therapy. Cognella Academic Publishing.
• Sweeney, T. J. (2009). Adlerian counseling and psychotherapy: A practitioner’s approach . Routledge.

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Adlerian Therapy: Key Concepts & Techniques

Riley Hoffman

Lab Manager at Yale University

B.A., Psychology, Harvard University

Riley Hoffman is the Lab Manager for the Emotion, Health, and Psychophysiology Lab at Yale University. She graduated from Harvard University in May 2023 with a B.A. in Psychology. In the future, Riley plans to pursue a Ph.D. in Psychology and/or law school. Her research interests lie at the intersection of psychology, health, and society.

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Saul Mcleod, PhD., is a qualified psychology teacher with over 18 years of experience in further and higher education. He has been published in peer-reviewed journals, including the Journal of Clinical Psychology.

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Adlerian therapy focuses on understanding an individual’s lifestyle and social interests, examining past experiences and family dynamics, and encouraging goal-setting and positive behavior changes to overcome perceived barriers and foster a sense of belonging and purpose.

Adlerian Therapy Techniques

Adlerian theory, formulated by Alfred Adler, is rooted in individual psychology . It emphasizes understanding the whole person within their social context and highlights the importance of feelings of belonging, significance, and contribution to society.

The techniques used in Adlerian therapy aim to provide insight into an individual’s lifestyle, challenge and reorient unhealthy beliefs, and encourage socially beneficial behaviors.

Adlerian therapy’s techniques emphasize collaboration, insight, self-awareness, and encouragement. By understanding and reorienting deep-seated beliefs and patterns, individuals are empowered to live more purposeful and socially connected lives.

Here’s a breakdown of the key techniques in Adlerian therapy:

• Engagement and Relationship Building : Establishing a strong therapeutic alliance is vital. The therapist creates an atmosphere of trust, respect, and collaboration. The individual should feel understood, encouraged, and accepted for therapy to be effective.
• Lifestyle Assessment : This is a hallmark of Adlerian therapy. The therapist collects data about the client’s early childhood memories, family constellation (birth order, siblings, parental relationships), and major life events. These provide insights into the client’s core beliefs, values, goals, and strategies for dealing with life’s challenges.
• Early Recollections (ER) : The therapist asks the client to recall earliest memories. ERs are not viewed for their factual content but for the subjective meaning the individual assigns to them. These recollections offer clues about the client’s beliefs, coping strategies, and worldview.
• Encouragement : Adler believed that encouragement is more effective than praise. Encouragement helps people see possibilities and believe in their abilities to overcome challenges. Therapists use this technique to motivate clients, boost their self-efficacy, and foster a positive outlook.
• Acting “As If” : This technique involves asking the client to act “as if” they were already the person they wish to become or “as if” they had already overcome a specific challenge. This allows clients to experience different behaviors, emotions, and outcomes, facilitating change.
• Paradoxical Intention : This technique is used for clients stuck in a behavior pattern. The therapist might instruct them to intensify or deliberately engage in the undesired behavior. The intent is for the client to become more aware of the behavior’s absurdity or irrationality, leading them to challenge and change it.
• Catching Oneself : Clients are taught to recognize and catch themselves when they fall into habitual, counterproductive patterns. By recognizing these patterns as they occur, clients can choose to redirect their actions or thoughts in more constructive directions.
• Spitting in the Soup : This metaphorical technique makes the client’s self-defeating behaviors unpalatable by highlighting the negative consequences. For instance, if a client procrastinates, the therapist might underscore the anxiety, missed opportunities, or disappointments that arise from this behavior.
• Push Button Technique : This technique is used to highlight how individuals have control over their reactions and feelings. Clients are encouraged to visualize having two buttons: a negative (e.g., anger) and a positive (e.g., calm). Through practice, they learn to “press” the positive button in situations where they typically might react negatively.
• Task Setting and Goal Orientation : Adlerian therapists often set tasks or homework for clients to carry out between sessions. These tasks encourage self-awareness, provide opportunities to practice new behaviors, and guide individuals towards their goals.
• Role Playing : By acting out specific situations, clients can explore emotions, behaviors, and alternative responses. It’s an effective way to practice new strategies and behaviors before applying them in real life.
• Guided Imagery : Therapists guide clients through vividly imagined experiences. This can help individuals confront fears, visualize successful outcomes, or experience situations from a new perspective.
• Feedback and Interpretation : As the therapy progresses, therapists provide feedback and interpretations that help clients understand their behaviors, beliefs, and feelings. This insight can pave the way for change.
• Mirror Technique : Clients are asked to talk about themselves in the third person, as if they were talking about someone else. This distancing can allow for a more objective self-assessment and give insight into self-defeating patterns.

Stages of Adlerian Therapy

The following section summarizes the six stages of Adlerian psychotherapy developed by Stein and Edwards (2002).

These stages serve as a guide since every individual’s journey will have a slightly different path.

As Adler (2013a) put it, “Just as one cannot find two leaves of a tree absolutely identical, so one cannot find two human beings absolutely alike” (p. 102).

Since in Adlerian psychology, the goal is for the patient to feel competent and connected, the overarching goal of Adlerian psychotherapy is to help the patient overcome feelings of inferiority.

This process has three subgoals:

• To reduce the inferiority complex of exaggerated feelings of inferiority to a normal and helpful size, where the patient strives for significance but is not overridden;
• To reduce and banish the superiority complex of constant striving for superiority over others; and
• To promote feelings of community and equality.

Adlerian therapy focuses on understanding an individual’s lifestyle and social context. Beginning with establishing a therapeutic relationship, it proceeds to explore the client’s life history, assessing their private logic and lifestyle patterns.

Interventions aim to foster insight, challenge maladaptive beliefs, and encourage new behaviors. The goal is to empower the client to move towards a more socially oriented and purposeful life.

Phase 1: Establishing the Therapeutic Relationship

For psychotherapy to be effective, it is essential that the therapist and the client commence with a healthy working relationship. There must be a “warm, empathetic bond” which opens the door for gradual progress.

This bond is created by genuine warmth and compassion expressed by the therapist, in addition to the trust of the client in the relationship.

Phase 2: Assessment

The therapist must conduct a thorough assessment of the client in order to develop an effective therapeutic process. The analysis must identify at least the following elements:

• Feelings of inferiority
• Fictive goal, defined as “an imagined, compensatory, self-ideal created to inspire permanent and total relief, in the future, from the primary inferiority feeling”
• Psychological movement, defined as “the thinking, feeling, and behavioral motions a person makes in response to a situation or task”
• Feeling of community
• Level and radius of activity
• Scheme of apperception
• Attitude toward occupation; love and sex; and other people

These assessments are done through various methods, including the projective use of early memories in addition to intelligence, career, and psychological testing.

Phase 3: Encouragement and Clarification

The process of encouraging the client helps them reduce feelings of inferiority. The therapist can start by acknowledging courage that the client has already shown, and continue by discussing small steps the client can take towards getting to a more confident place.

For instance, if the client has a limited radius of activity, the client and the therapist might discuss ways to broaden their activity.

The second crucial aspect of this phase is to clarify the client’s core feelings and beliefs regarding the self, others, and life in general. This is done using Socratic questioning.

Through this method, the therapist challenges the clients’ private logic and focuses on psychological movement around his fictive goal.

Phase 4: Interpretation

Once the therapy has reached the point where the client has made some progress, and he and the therapist have examined the meaning of his movement in relation to his goals, the therapy is ready to begin interpreting the client’s style of life.

This must only be done when the client is encouraged sufficiently, and this must be done with significant care.

Discussing and recognizing topics such as the inferiority complex can be difficult for the client, but new insight can be transformative.

Phase 5: Style of Life Redirection

Now that the client and the therapist have recognized the issues with the client’s style of life, the task becomes to redirect the style of life towards life satisfaction.

This involves reducing and productively utilizing feelings of inferiority, changing the fictive final goal, and increasing feelings of community.

This is accomplished using different methods, depending on the client’s specific needs.

Phase 6: Meta-therapy

Finally, some clients may wish to seek further personal development, towards higher values such as truth, beauty, and justice.

Towards this end, the therapist can provide stimulation for the client to become the best version of himself.

This process is challenging and requires a deep understanding of the client.

Key Concepts

Adlerian therapy, rooted in the individual psychology of Alfred Adler, centers on understanding individuals within their social contexts.

By understanding and working with these concepts, Adlerian therapy aims to foster insight, challenge unhelpful beliefs, and empower individuals to lead more fulfilling, socially integrated lives.

• Holism : View the person as an integrated whole, emphasizing the interconnectedness of thoughts, emotions, and behaviors.
• Social Interest : A person’s innate potential and desire to cooperate with others and contribute positively to the community.
• Lifestyle : An individual’s core beliefs, strategies, and patterns of behavior developed early in life, which shape how they approach life’s challenges.
• Inferiority and Superiority : Feelings of inferiority can drive an individual to strive for superiority or perfection. Healthy striving benefits society, while compensatory behaviors can be maladaptive.
• Birth Order : The position of a child in the family (first-born, middle child, youngest, etc.) influences personality and behavior.
• Early Recollections : Whether accurate or not, early memories provide insights into a person’s beliefs and worldview.
• Private Logic : An individual’s personal reasoning system, often developed in childhood, which may or may not align with common sense or societal norms.
• Encouragement vs. Praise : Encouragement fosters self-efficacy and resilience, while praise can be contingent on performance.
• Goal Orientation : Recognizing that behavior is purposeful and directed towards achieving personal goals, often formed in response to feelings of inferiority.
• Safeguarding Strategies : Defensive behaviors and justifications individuals use to protect their self-esteem and maintain their current lifestyle, even if it’s dysfunctional.

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What to Know About Adlerian Theory

A theory that suggests people need to feel a sense of belonging.

Kendra Cherry, MS, is a psychosocial rehabilitation specialist, psychology educator, and author of the "Everything Psychology Book."

Daniel B. Block, MD, is an award-winning, board-certified psychiatrist who operates a private practice in Pennsylvania.

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• Effectiveness
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Adlerian theory is a holistic approach to psychology that emphasizes the importance of overcoming feelings of inferiority and gaining a sense of belonging in order to achieve success and happiness .

This theory also focuses on the importance of social interactions and community involvement in order to promote individual growth.

This approach to therapy is based on the theories of Alfred Adler , an Austrian psychiatrist and one-time colleague of the psychoanalyst Sigmund Freud. While once part of Freud's psychoanalytic circle, Adler eventually parted from Freud to establish his own theory of psychology, which he referred to as individual psychology.

His approach emphasized each individual's need for connection, belonging, and striving to overcome feelings of inferiority.

Adler's theory also stressed the importance of understanding how individuals are influenced by their social context. This approach suggests that people are driven by a need to feel that they are significant and that they belong. 

This article discusses how Adlerian theory works, how it is used, and its benefits. It also covers some of the things you should consider if you want to try this type of therapy.

Techniques of Adlerian Theory

Adlerian therapy is positive, humanistic , and integrative that can be adapted for the specific needs of the individual. One of the key concepts of Adlerian theory is that human behavior is goal-oriented.

People who are experiencing problems work with a therapist to gain insights into their problems and behaviors. Once they have developed a deeper understanding of themselves, people can then work on learning new skills and behaviors that will help them overcome these problems. 

Adlerian theory emphasizes techniques that promote growth and resilience . Some techniques that are used in this type of therapy include:

• Providing encouragement : Therapists show that they care for clients by listening and showing empathy . This also involves helping people learn how to recognize their own strengths and gain confidence in their ability to succeed.
• Creating expectations : Therapists may ask people to consider how they would act if they were already the person that they strive to be. This allows the client to visualize success, overcome resistance to change, and establish the expectation that the individual will succeed. 
• Examining the purpose for behavior : As people explore their behaviors, a therapist might ask the client to reflect on the purpose of these behaviors. Often, understanding the purpose that some of these maladaptive behaviors serve can help people develop healthier coping strategies.
• Examining memories : Looking at past moments can serve as a way to gain insight into past patterns of behavior that might contribute to current problems. After exploring several memories, therapists can look for certain themes that may emerge.

Adlerian theory suggests that people are always trying to satisfy certain desires and reach specific goals. How those goals are reached can vary greatly from person to person depending on their personalities and environments.

Therapists who utilize Adlerian therapy use a variety of techniques to learn more about how people typically behave in order to help them gain insight. Analyzing these behaviors can help people understand patterns that might be holding them back and seek out newer, more effective solutions.

Stages of Adlerian Therapy

Adlerian theory is often used in counseling and psychotherapy. Using this approach, therapists help people develop a better understanding of their goals and motivations. An important goal of this process is to overcome any feelings of inferiority in order to achieve a more fulfilling life. The process takes place over four stages:

This stage focuses on establishing a therapeutic alliance between the therapist and the individual in therapy. A therapeutic alliance is a cooperative, collaborative relationship between a therapist and a client. This involves the ability to get along, communicate, share, and work together.

Research suggests that this therapeutic alliance is one of the most important factors affecting the outcome of psychotherapy. An American Psychological Association (APA) task force concluded that the therapeutic alliance mattered more than the type of therapy itself.

At this stage, the therapist works to learn more about the individual in therapy. This includes taking a history, learning about past experiences, and using psychological assessments. This often includes exploring early memories, talking about family dynamics, and looking at how the individual thinks about these events.

To learn more about these goals, Adlerian therapists may administer assessments as a way of determining what goals a person is trying to achieve and how they normally go about reaching them.

This stage focuses on helping the individual learn more about their situation and gain insight into their own behavior. A therapist might offer interpretations of events and suggest that certain patterns may exist. While a therapist might make observations, it is essential for the person in treatment to gain a sense of personal insight into their own beliefs and behaviors.

Reorientation

Now that the individual has acquired new insights, the therapist works with them to develop new habits, behaviors, and skills that will support their growth going forward. This process may involve strategies such as reframing old experiences while also developing new patterns.

Adlerian therapy occurs in four stages that focus on forming a therapeutic relationship, gathering information, gaining insight, and developing new skills. 

What Adlerian Theory Can Help With

Research suggests that Adlerian therapy can be helpful for treating a number of mental health conditions. Some of the problems this type of therapy may be used to treat include:

• Adjustment issues
• Eating disorders
• Personality disorders
• Schizophrenia
• Substance abuse problems

Applying Adlerian theory to therapy can be helpful for people who are struggling with problems related to low self-esteem , loneliness , or negative thinking . By affirming the individual and rebuilding social relationships, people are able to gain confidence and empowerment that allows them to pursue their goals and make healthy choices.

Benefits of Adlerian Theory

People often find treatments based on Adlerian theory helpful because it emphasizes the importance of community involvement and social interactions in order to promote individual growth.

Because it is a holistic approach, people are able to gain a greater awareness of different aspects of themselves as well as a greater understanding of how they fit in within their social world. 

Another benefit of the Adlerian approach is that it avoids pathologizing people. Instead, it emphasizes how people can experience difficulties and discouragement during life, which then contributes to psychological problems.

By addressing the feelings of inferiority that play a role in social disconnection, Adlerian therapy helps people regain their sense of self, adjust better to changes, and find the social support they need to thrive.

Effectiveness of Adlerian Theory

Studies have also supported Adler's belief in the importance of the therapeutic relationship. The therapeutic alliance has been shown to affect treatment outcomes across a range of conditions, therapeutic modalities, and contexts.

One study found that an Adlerian group counseling intervention was helpful for improving feelings of authenticity among university students.

Research also suggests that there is neurobiological support for some of Adler's key ideas. For example, one study found that eudemonia , or happiness rooted in meaningfulness, is linked to decreased inflammation and healthier genetic expression.

In other words, a greater sense of social connectedness rooted in caring for others, connecting with the community, and finding a sense of purpose is linked to improved mental health and well-being.

Things to Consider With Adlerian Theory

While the Adlerian approach can be helpful for many people, that doesn't mean that it is the best choice for everyone. Because Adlerian theory focuses on how early memories shape current problems, it involves exploring and confronting memories that can sometimes be painful or upsetting. This can be difficult for some people, so it is important to consider whether you are ready and willing to do a deep dive into your past.

It is also important to remember that being open to change is essential for success. In order to overcome problems, you have to be willing to critically assess how your current behaviors are playing a role in keeping you from reaching your goals. Just identifying them isn’t enough, however. You have to be ready to actively work to change those behavior patterns. 

How to Get Started With Adlerian Theory

If you are interested in this approach to psychotherapy, start by looking for a mental health professional who has training and experience with Adlerian theory. An online therapist directory can be a great tool for finding professionals in your area who practice Adlerian therapy. You might also ask a doctor or healthcare provider for a referral to a therapist in your area.

Spend some time talking to a therapist before you decide if it is the right fit for you. Remember that Adlerian theory suggests that the therapeutic alliance is critical for success, so make sure that you feel comfortable and safe working with your therapist.

Even if you don’t specifically seek out this type of therapy, chances are your treatment may have been influenced by Adlerian theory. Adler’s ideas had an influence on other types of therapy including existential therapy, rational emotive behavior therapy , logotherapy , strategic therapy, family therapy , and person-centered therapy .

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Stubbe DE. The therapeutic alliance: the fundamental element of psychotherapy . Focus (Am Psychiatr Publ) . 2018;16(4):402-403. doi:10.1176/appi.focus.20180022

Ergüner-Tekinalp B. The effectiveness of Adlerian-based encouragement group counseling with college students in turkey . The Journal of Individual Psychology . 2017;73(1):54-69. doi:10.1353/jip.2017.0004

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By Kendra Cherry, MSEd Kendra Cherry, MS, is a psychosocial rehabilitation specialist, psychology educator, and author of the "Everything Psychology Book."

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The Case of Sally with Adlerian Therapy

Sally’s predominant reason for coming to counseling is to alleviate a number of somatic complaints such as panic, anxiety, and possibly depression. Her physical symptoms have included: hot flashes, cold sweats, shortness of breath, tremors, fainting, heart racing, fears dying of heart attack, shakes, hot flashes, and cold sweats. Although there was no stated medical causes, hot flashes could be the beginnings of peri-menopause due to her age being 39 years old and although early, hormonal changes could be contributing to her distress.

I chose an Adlerian approach because Sally needs immediate help as panic can be debilitating and frightening and an Adlerian therapist can get to the core issues quicker than could a psychoanalytic approach. I would be concerned that an existential approach could exacerbate her problems and cause her to look elsewhere for therapy. An Adlerian therapist would look beyond Sally’s symptoms to the causes which could include the following: transitioning to mid-life and her role of parenting coming to a close, dissatisfaction with her marriage, feeling stuck about actually getting a job as a teacher, and feeling overweight.

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Although she takes pride in her role of homemaker, mother and wife, she is aware that she has lived for others and wants to become more motivated and assertive about her own life goals. That is, Adlerian therapy never places the counselor in a ‘superior’ position with respect to truth, or express disrespect, condescension or lack of empathy.

Sally is feeling very inferior and and needs to know that the therapist will provide the support to find encouragement and hope again. An Adlerian therapist would work to build respect, confidence, equality, and cooperation with Sally.

Sally reports a number of fear based thoughts that the therapist should take note of such as: her husband will leave her if she makes any changes in herself, she might go to hell for not believing the same dogmatic beliefs as her parents, and she is afraid of taking the initiative to work outside the home. Her reasons for most of these issues are losing the approval of her family, husband, and children.

She does not report that she has friendships or social contacts other than attending a church.

Since childhood she has always felt socially awkward, constantly being worried about what others have thought of her. Finally, she has concerns about death and dying and evidence supports that panic attacks can certainly perpetuate that notion in a client with high anxiety. It seems appropriate that Sally is questioning life right now and she does show some insight into her issues already as she previously questioned the dogmatic beliefs she was raised with enough to attend a different church than her parents.

And yet this too has caused consternation as well because of her fear of going to hell and losing parental love and approval. Even though her life is consistent and stable, she considers it boring and stale and wants help from therapy to push her out of this and yet fears that therapy could make her even worse.

According to Adler, all behavior is purposeful and for Sally to be this anxious and panicky has hidden goals. The therapist would work with Sally to help her assume responsibility for finding her life beyond her role of only a mother and wife.

An Adlerian therapist would say that Sally is unconsciously avoiding meeting life tasks. Although her problems are manifesting somatically, her issues would best be solved if viewed through a social context and life tasks: building friendships, establishing intimacy, and contributing to society. Sally has not worked through friendships, she has contributed to society by raising her children but that role is coming to a close and she has not fulfilled her task to become a teacher, and she is in a marriage but she’s not experiencing intimacy. So all three universal tasks are not developed and an Adlerian would be concerned with all three areas.

According to Corey (2009) there are four processes in Adlerian psychotherapy:

• forming a relationship
• investigating the client’s life style through assessment and interviews both subjective and objective,
• interpreting the data to the client and
• helping the client to reorient towards a more prosocial stance by modifying certain convictions held by the client that aren’t helpful and promoting courage, optimism and finding meaning in life.

Another area of focus would be Sally’s early recollections and especially her being the oldest child and how she feels affected by that. First born children tend to be rule bound, dependable, hard-working and take on a pseudo-parenting role. Because of her birth order, Sally is most likely resistant to new ideas and has a habit of being right thing oriented. Sally could talk about her feelings about being an oldest and the pressure involved.

Sally could explore how that early role of taking care of others is not necessarily the only way she has to define herself.

How can taking care of yourself help your marriage and your relationship with your children? What kind of role model does this give to your children? Is the goal of creating dependency in others really the healthiest aim? The following are some possible issues a therapist could go over in terms of Sally’s “private logic” or mistaken beliefs:

• I should adhere to my parents’ morals and rules and not my own.
• If I find out who I really am, I’ll not only find nothing or I could be worse off than before.
• I am socially awkward and weird and noone will want to be my friend.
• My purpose in life is to take care of others.
• I believe I should share my parents religious beliefs or I might go to hell or lose their approval.
• My husband will leave me if I make changes in myself, such as work outside the home.
• Life is boring and should not be fun, not even sexually fun.
• I am afraid of confrontation and not doing the right thing.
• The world is a scary place.

The goal of the second phase with Sally would be to utilize her autobiography, and the Life Style Assessment and interview which includes information regarding family constellation, early recollections, and birth order.

By utilizing a Life Style Assessment, the therapist works on modifying Sally’s mistaken attitudes, and not just eliminating symptoms. At this point the therapist can make use of what Dreikurs (1997) calls “The Question. ” The therapist would ask Sally, “If I could wave a magic wand and your symptoms would go away, how would your life be different and what would you be doing differently? ” After a relationship is established and the client has a comfort level, the counselor would discuss client goals for therapy.

Although not required in Adlerian therapy, a contract or plan would promote better focus. Sally and her therapist should begin to formulate a plan or contract detailing what she wants, how she plans to get it and what is preventing her from successfully attaining her goal, how can she change nonproductive behavior into constructive behavior, and how can she make full use of her assets in achieving her purpose. In Sally’s case there was no information offered about her dreams but an Adlerian therapist could use this as another way to interpret her issues.

Adlerians view dreams as rehearsals for possible future courses of action. There are so many different techniques that an Adlerian therapist can apply. The therapist could remind Sally and celebrate the reality that she already done the hard work of going back to school and getting a teaching degree. An Adlerian could help Sally explore her fears about stepping into the workplace and what the worst case would be. Is the fear of failure holding her back from making any attempts at all? We already know that Sally’s birth order contributed to her fear of change and fear of failure.

The therapist could also help Sally with the technique of “as if”. Sally is already acting “as if” she might not get hired or “as if” there are no new roles for her. Would her family really fall apart? Can she teach her children to be less dependent on her so they become healthy as well? It would be helpful for Sally to see that her own lack of activity is causing her more stress. She knows she wants to find herself and take some risks and what would be the worst case if she failed in her job? What would the best case look like?

Because of Sally’s case and my choice for Adlerian therapy, I researched Adler’s beliefs about women in the workplace and found he was a man ahead of his time. In Chandler’s article, she states “it is not easy in our culture for a girl to have self-confidence and courage. From an early age girls are told through various social modalities that they are incapable and are suitable for only subordinate work.

Obviously a girl who is unable to examine such judgment s for their correctness will regard female inability as woman’s inevitable fate, and will ultimately herself believe in her own inability.

Sally shared with the therapist at the start that she likes to be “in control. ” Sally could be helped to see that the only people who have difficulties with fears are those that have to be in control. We can choose to be afraid of a lot of things because so many things can go wrong. But is living in fear and paralysis really good living? According to Adler, Sally is lacking courage, the courage to take a risk which would be to interview and get a job. Sally’s symptoms could indicate her faulty belief that she has to be perfect, have love and approval and that she cannot make mistakes and fail.

Her anxiety and panic keep her immobilized from finding out that she can succeed or even that maybe she would fail but is that worse than sitting home with panic? Life changed for her because her children grew up and she can’t control that. Life is never a constant and we are better off if we change with it and find new purpose. If Sally disagrees with the client that she is in control by manifesting panic and anxiety and being immobilized then the Adlerian that would refute her rationalizations that she is “out of control” is called “spitting in the soup. ” She may still feel out of control about her anxiety but it won’t taste good.

The therapist would want to find out if Sally is afraid of getting a job because she won’t “need” her husband anymore and work with her on her new job bringing a source of joy to her that will help her marriage.

It seems that Sally’s courage was undermined by her father’s harshness and rigidity and also by her husband’s lack of promoting her efforts to work outside the home. The therapist would teach Sally that she can’t change her mind about working if she doesn’t know her own mind. It makes sense that she is not working because her mom didn’t work and because she has never wanted to challenge her father and now husband.

Is Sally also holding back because she still continues to feel awkward in the presence of others like she did as a child? Also, if Sally sought her children to be her friends and now that they are growing up and leaving, this could be causing anxiety. It sounds like Sally was never really allowed to have a teenage life with a boyfriend as well as girlfriends so she missed important years for developing this aspect of her life.

If she finds that she does not get support and make friends at her job, she can always look for another job.

Or she can stay in that job and work through her friendship skills with the help of a counselor. And not everyone always has a friend at their job. Sometimes we benefit from just the work experience itself but either way, working helps us to learn more about ourselves, especially socially where Sally is lacking confidence. Another technique to be used is the paradoxical intention which would involve having Sally exaggerate her stuck thoughts and behaviors, go with their resistance, rather than against it and become aware of her behavior and her responsibility for its consequences.

A therapist would use disclosure and well-timed interpretations such as “It seems to me that……or Could it be that…….

Or this is how it appears to me. ” Sally would never be led to defend herself and she would be free to discuss and even argue with the counselor any hunches and impressions. According to Hilary Silver in her article Reflections on Alfred Adler, she states that “In turn, dignity bestows well-being: job satisfaction, a livable pace of work, creativity, meaning, and fulfillment. Dignity may be inherent in being human, but people also earn dignity through their actions.

Work is not only a way to earn a living it is also a way of being useful. ” In the reorientation phase of therapy, Sally and her therapist could consider alternative attitudes, beliefs and actions.

Hopefully, Sally will no longer be locked into the past pattern of avoiding and she feels more encourage and powerful enough to make the changes she needs. Sally will have learned that its not enough to gain insight but that we have to become action-oriented. Sally could be given some tasks and homework such as calling some school districts, and putting in some applications.

The therapist could role play the interview process with Sally to give her a comfort level. Also Sally could role-play talking with her husband and working through her perceived resistance about her working outside the home. The therapist could switch roles and be Sally and Sally could be her husband.

To sum up, Adler believed that our answers can be found by looking at life through a social context. We find our highest ideals by by incorporating such traits as caring for others, the courage to be imperfect, and contribution to the common welfare.

If Sally goes on to get a job she will see and recognize her importance in society and not just to her family. This will increase her confidence in herself and allow for more intimacy in the family, not a one down position to her husband. By learning more assertiveness in herself, she can take more risks, become more active and courageous, and less in control.

When this occurs she will lose the panic feelings and anxiety, and feel confident and positive about her new life as a teacher, as a lover and spouse, and friend to those in the community.

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Case approach to adlerian therapy: an adlerian therapist's perspective on ruth.

James Bitter , East Tennessee State University Follow

Document Type

Publication date, description.

Book Summary: A central client, Ruth, becomes the focus for the application of nine therapeutic techniques: psychoanalytic, Adlerian, existential, person-centered, Gestalt, behavior, cognitive-behavior, and reality therapies - and, new to this edition, family systems therapy. You'll deal with Ruth (and clients from other case studies) as active counselors, participating in a variety of role-play situations. In the process, you'll develop an understanding of the counseling process and of the complex professional and personal issues that are triggered in the counseling relationship.

Citation Information

Bitter, James. 1996. Case Approach to Adlerian Therapy: An Adlerian Therapist's Perspective on Ruth. Case Approaches to Counseling and Psychotherapy . 4th. Gerald Corey, Eds. Pacific Grove, California: Brooks/Cole. 68-100. ISBN: 9780134240220

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StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-.

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Adlerian therapy.

Rommy Cedeno ; Tyler J. Torrico .

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Last Update: January 11, 2024 .

• Introduction

Adlerian Therapy, introduced by Alfred Adler (1870-1937), is a constructivist and encouragement-based counseling technique concentrating on prevention rather than remediation. His advising method progressed to a combination of purposeful, cognitive, and psychodynamic views. He valued the role of cooperation and connectedness among individuals in the world. [1] His ideology emphasizes the influence of personal choice, the fundamental nature of human beings, the significance of an idealistic and motivating life focus, the elimination of social inequality, and the prioritization of social relationships. [2]

Historical Context

Born in Vienna, Austria, to Hungarian parents, Alfred Adler was the third child and the second son in a family of 7 children. He was a frail boy, developing rickets during his early years before being struck by a near-fatal bout of pneumonia at age 5. These severe health conditions and his rivalry with his older sibling made him feel inferior during his youth. Adler believed these early life experiences were the major factors that drove him to become a doctor. Adler began his foray into the medical profession in the field of ophthalmology. His philosophical orientation was toward the betterment of the human condition. [3]

In the early 1900s, Adler became an imperative figure in the history of psychotherapy. He was an initial supporter and fellow of Sigmund Freud, who invited Adler to collaborate with the Vienna Psychoanalytic Society, where he served as leader and co-editor. During this time, his work focused on abnormal human behavior and appeared psychoanalytic. After some time, Adler elaborated his hypotheses on the nature of humankind, which caused significant theoretical disagreement with Freud. Following his ideology, he disclosed a novel doctrine and practice of counseling that emerged as a unification of cognitive, existential-humanistic, systemic, and psychodynamic viewpoints. He reaffirmed his theories during World War I by serving his country as a military doctor. This experience profoundly affected him. [1] As a result, Adler became more interested in standard human behavior, allowing him to establish several child guidance clinics in Vienna. For this reason, he developed a relatively small but significant following. His therapeutic methods became more encouragement-focused after the war, emphasizing human strengths and abilities. This postwar advisory technique was the fundamental basis of Adlerian psychotherapy. In 1935, Adler sought refuge in the United States with a hypothesis about a community of social equals. Although he taught and lectured extensively in the United States, his followers found substantial resistance from those who adopted Freud's psychoanalysis. [4]

Individual Psychology 

Adler established the psychological concept of Individual Psychology, often misinterpreted as focusing predominantly on individuals. However, Adler selected this denomination from the Latin "individuum," which means indivisible. This theory suggests that individuals are better comprehended as a whole, not as a collection of parts, rejecting reductionism and accepting holism. Adlerian therapy aims to discern how someone proceeds in life as a whole. Consequently, it seeks to understand an individual's lifestyle, uniqueness, and personality structure to understand each person better. [3]

Adler's View of Human Nature

Adler believed that behavior is socially embedded from birth because no one functions autonomously. The behavior of seeking to belong and having a place or role in human groups is universal. Adler viewed that the fundamental essence of people is being social. Consequently, their conduct is comprehended only in a social context where they must belong to a social system and participate in valuable activities. Every individual is born in an environment where he or she must engage in reciprocal relationships. Correspondingly, everyone is a social being, not in isolation. Adler also concluded that all individuals have one fundamental desire and purpose: to belong and feel significant. Throughout one's life, the goal of belonging is fundamental to human nature. Each individual chooses to decide which group is essential and seeks acceptance. Suppose someone is unaccepted or has a feeling of not belonging; problems and fears can affect an individual's mental health. Another example is when someone cannot score or perform at a job, that individual may fear rejection. As a result, the sense of belonging will remain unfilled, and that person may eventually become anxious or depressed. [5]

Adler's concept of people's nature is ample and founded on certain assumptions that differ notoriously from the Freudian psychoanalytic view. Adler and Freud developed simultaneously and in a similar environment, but their differences were so significant that they eventually became antagonists. Freudian Psychoanalysis is biologically established and focuses on psychosexual development, the dynamics of the mind, and instincts. On the other hand, Adlerian Theory is socially based, interpersonal, and subjective. According to his foundational tenets, human beings function as units in all aspects of personality, such as cognition, affect, and conduct. Adler also highlighted egalitarianism, leading advocates for the rights of women, children, and other groups marginalized by social context. [5]

Adler's Theory of Personality

Alder's doctrine supports the hypothesis that personality development begins at a young age and is a consequence of experiences during infancy. Adler claimed that one's personality is a comprehensive unification, which is the foundation of holism. According to the Adlerian conception, nine principal aspects are essential for the occurrence of this phenomenon: (1) Social Interest, (2) Lifestyle, (3) Goal-directed and Purposeful Conduct, (4) Inferiority Complex, (5) Striving for Superiority, (6) Masculine Protest, (7) Fictional Finalism, (8) Family Constellation, and (9) Birth Order. [5]

Social Interest

Social interest, also known as Gemeinschaftsgefühl, is a German word that means "community feeling." Adler suggested this concept as a "sense of direction to living collectively with others and a lifestyle that esteems the commonwealth beyond one's interests and desires." Social interest is attributed to an individual's feeling of being part of the community and their approach toward others. No one can avoid connecting with other individuals because society involves interaction, which is a part of survival. Therefore, people work together to communicate their social interests. Individuals cooperate and assist the community by acknowledging their personal and collective goals. Individuals develop character and emotions from childhood when they find their places in society. This search fosters a sense of belonging, empathy, and acceptance, leading to cooperation for the greater good. Subsequently, these individuals cultivate a feeling of social belongingness as a collective. [6]

Adler acknowledged that associating with others was the first social task encountered. Our capacity to get along with others becomes a part of our lifestyle and consequently influences how well or poorly we will face life crises. When social involvement develops adequately, we can find solutions to these difficulties. However, it is pathogenic when a person is not involved with his community or is not interested in the welfare of the rest. Pathological lifestyles demonstrate egocentric, exploitive, demanding, detached, or combative actions. Criminal behavior frequently develops from a pathological lifestyle. Thus, developing social interests is critical in preventing antisocial conduct. Adler suggested that community feeling is the answer to overcoming antisocial and criminal behaviors. Additionally, social interest provides an optimistic perspective on life and an impetus to develop the welfare of others. [6]

Lifestyle 

Lifestyle or style of life, the Adlerian terminology for personality, is a personal metanarrative that involves an individual's particular beliefs, purposes, and principles for dealing with the adversities of living. This life plan is distinctive for each person and emerges early in life, approximately when the individual reaches 6 years of age. Lifestyle consists of our comprehension of events rather than the events themselves, profoundly influencing our personalities. This notion includes self-concept, self-ideals, views of the world, and ethical convictions. Later, this cognitive orientation is molded within the initial social setting of the family constellation. The family constellation consists of family atmosphere, values, and gender lines. [7] These aspects influence an individual's lifestyle and determine how we act, think, perceive, or live. We select methods for enduring life challenges and cues from developing lifestyles. According to the Adlerian theory, humans are proactive and creative in developing their lifestyle, functioning as playwrights and actors while constructing their personalities within a socially embedded context. Adler outlined 4 basic lifestyles: the socially useful, the ruling type, the getting type, and the avoiding type. [8] The "socially useful" is also described as a responsible lifestyle. This category includes individuals who are the healthiest, most complete, and most cheerful typology. They possess a strong sense of social responsibility and strive daily to improve themselves, overcome their worries, build resilience, and eliminate greed. Socially useful individuals tend to be mature, optimistic, well-adjusted, polite, and respectful of others. They do not aim for superiority but to solve adversities in ways that are cognizant of others. [9] The "ruling type" is also described as a selfish lifestyle. Individuals with limited social interests attempt to demonstrate authority and seek dominance over others. These people tend to be confrontational and possess harsh energy that subjugates anyone who gets in their way. They adopt an antisocial approach to society. The most energetic of these are intimidators and sadists. Meanwhile, less active individuals turn their power inward and hurt themselves, such as individuals with substance use disorders and suicidal ideation. [9] The "getting type" is also known as a dependent lifestyle. These individuals conduct their existence in one direction: obtaining reinforcements from others. They usually want to receive everything from others without any effort or struggle. They have low social interests and non-reciprocity. The main explanation for their behavior is that they have not overcome their feelings of inferiority. Consequently, they develop relationships of dependence and absolute submission. [9] The "avoiding type" is also recognized as an escapist lifestyle. These people try to dodge duties, evade responsibilities, and cannot maintain relationships. They display childish behaviors, pursue an easy life, and experience immediate satisfaction. They tend to have the lowest energy and prefer unrealistic daydreaming and being fanciful instead of facing reality. Additionally, individuals of this type demonstrate little social contact because of fear of rejection, evading life in general and others in particular. [9]

Goal-directed and Purposeful Behavior

As reported by Adler, human conduct is not exclusively specified by heredity and the environment. Instead, individuals can analyze, impact, set goals, and act purposefully. All decisions and conduct become unified with every person's ambition, purposes, current circumstances, and paths in which the person moves. While individuals could or could not be aware of their motivation for a specific action, their behaviors are still purposeful and goal-directed. From an Adlerian perspective, every individual establishes objectives that provide security and give them a place in life. Establishing objectives depends on individual "private logic," a subjective and personal ideology that helps individuals achieve goals. Private logic is the reasoning an individual invents to stimulate and justify a style of life. When humans become familiar with their unique private philosophy, they develop a healthy view of the world. This phenomenon indicates that each person perceives a situation from a unique perspective. Every person lives and operates as if their idea of the world is accurate or correct. When society distorts an individual's perspective, their emotions become destructive and distorted. Consequently, this person could develop inappropriate behaviors. [5]

Feelings of Inferiority 

This statement in Adlerian psychology refers to the pervasive impression that one's capabilities are inferior to those of others. Equivalently, this hypothesis states that all individuals experience feelings of inadequacy. Because this condition is typical for all individuals, it is not a symptom of defects or aberrations. Individuals' feelings of inferiority stem from a perceived sense of inadequacy which they strive to overcome. These feelings of inferiority originate partly from infancy's helplessness and inability to handle meaningful life situations. The main reason for its origin is because the child's parents and most others are physically older, more sophisticated, and more skilled than them. However, this sentiment becomes more evident during infancy. In this phase, a sense of inadequacy emerges from 3 origins in childhood: organic inferiority, spoiling, and neglect. [10]

This inevitable sensation of inadequacy encourages individuals to strive for achievement. According to Adler, most children overpower this perception of incapacity through 3 different mechanisms: dreaming of becoming adults, creating other areas of strength, or establishing a superiority complex. All of these illustrate the methods of overcompensation. This term attributes camouflaging inefficiencies, feelings of weakness, and incompetence in a particular area by outshining in a different area and gaining fulfillment. According to Adler, the same principle applies to survival because our innate perception of inadequacy allows humans to survive. These sentiments motivate growth and development, whereas non-human species become extinct. [11]

Even though sensations of inefficiency are universal, it is crucial to differentiate inferiority feelings and complexes. An inferiority complex arises when people cannot compensate for their disadvantages, or immediately they cannot overpower their life adversities. By definition, an inferiority complex is a pervasive feeling that one's abilities and characteristics are inferior to those of others. Exaggerated feelings of inferiority and insecurity lead to maladjusted behavior. [10] Whereas inferiority feelings are normal, an inferiority complex is abnormal. Individuals who are at the highest risk of developing an inferiority complex comprise those who show evidence of poor self-esteem, low socioeconomic status, or a history of depressive symptoms. [11]

Striving for Superiority

As proposed by Adler, each person navigates life with perceived physical inadequacies, culminating in a perception of inferiority. To counterbalance the aforementioned sentiments, perseverance for excellence is the principal motivation. Striving for superiority means an individual's effort to become competent by definition. Aiming for superiority brings up a particular idea in which people are encouraged by a supreme initiative to realize their full potential. As a result, this motivation aids individuals in accomplishing self-centered purposes. Individuals aim to master external factors and acquire power and status, not only for themselves but also for the common good of humanity. Adler stated, "Striving is useless if it does not favor other people; it is healthy if it proceeds in the direction of social interest." It is closely related to the community because individuals live in realism with their social world and, as a result, build a better life. When feelings of inadequacy result in an inferiority complex, the awareness of such thoughts can be overwhelming. As a result, they can develop into a "distinctive delusion" that Adler reported as a superiority complex. Nevertheless, aiming for preeminence is not equivalent to the denomination superiority complex. [12]

A superiority complex arises immediately when individuals overestimate their qualities and capacities, displaying an impression of being more competent than others, intended to conquer sentiments of worthlessness. A false feeling of power and security invariably conceals an underlying inferior complex. It is not an extension of the traditional approach of persevering for dominance. A superiority complex develops from an attempt to evade one's problems rather than face them. These individuals are commonly described as "impertinent, supercilious, and disdainful" towards the rest, negatively impacting society. The complexity of the superiority complex and its origin of inadequacy can be seen not only in mental diseases but also in criminal conduct. On the other hand, healthy individuals' endeavors for preeminence do not evolve into arrogance to camouflage the perception of mediocrity. Aiming for preeminence assists with the advancement of society since it encourages us to contribute positively to science, technology, and the arts. [12]

Masculine Protest

Concerning this hypothesis, Adler stated the existence of gender polarity amid masculinity and femininity. However, Adler highlighted that the feminist point is devaluated in culture and related to vulnerability. Females are typically devaluated compared with men in many areas of society. Also, children of both genders are considered powerless and propelled to occupy the feminine position. As a result, women reject a feminine identity so they can be valued and compensated like men. Adler was an advocate of women's rights. He claimed that if females had the same opportunities as men, they could deal successfully with feelings of worthlessness. As a result of his dedication to equal rights, Adler developed the idea of masculine protest as the desire to be a "real man," such as being superior or striving to be perfect. This principle is not exclusive to women; it can similarly apply to men. Male individuals tend to carefully suppress their feminine traits by having excessive masculine wishes and efforts. Likewise, men who suffer from masculine protests tend to develop pathological fantasies, grandiose behaviors, and feelings of being powerful and more important than others. Quite the opposite, masculine protest among females consists of pursuing prestige in male-dominated fields or adopting typical features associated with masculinity, such as combativeness or male mannerisms. [13]

Fictional Finalism and Creative Self

Alder proposed that every individual has an aim and inspiration. This hypothesis states that people modify their behavior in consonance with their personal goals also known as 'Subjective final goal' or 'guiding self-idea.' Human conduct is guided when someone tries to achieve a complete goal that correlates to their self-ideal. By classification, it is an imagined final goal for one's life and behavior. Nevertheless, this final goal develops an individual's personality and is ample for explaining anything the individual does, thinks, strives, or feels. The goal does not have to be based on reality but instead describes the person's thoughts. Hence, according to Adler, human beings constantly aim for the fictive, essential goal of perfection, which decreases the distress of feelings of inferiority. [14]

During childhood, the individual develops a fictional ideal of success that satisfies the child's unbearable feelings of inferiority. As the individual grows, the goal continues to guide fiction in any current situation. It directs the person's movement while redirecting to new forms of concretization for adult life's purposes. People typically demonstrate a vague and imprecise notion of fictional finalism. This purpose is partially known and relatively unknown. The unknown portion of this purpose comprises the unconscious. Throughout life, the prevailing direction of striving continues, but the precise comprehension of the objective may vary. Whereas a healthy individual adjusts the plan, on the contrary, pathology may display as an immovable ideal where conduct is not adaptative. In other words, fictional ideas or ideals affect personal conduct because they are unconsciously encouraged by plans, purposes, and forthcoming. This belief does not focus on childhood experiences. The philosopher Hans Vaihinger impacted Adler, stating that all individuals live with many fictional ideals that have no relationship with reality. Fictionalism develops during childhood and can help us to deal more efficiently with reality. For example, if we believe that heaven and hell exist, such ideas will impact our way of living. In the view of fictional finalism, Adler admits that the past is meaningful but assumes that what matters is the future. The important thing is not what individuals have done but what they will do with their creative selves because the ultimate goal is to explain human behavior. [14]

Family Constellation and Birth Order

The standing in which an individual enters the family at birth is that person's birth order. This hypothesis suggests that an individual's standing in his family constellation is a significant factor in his development, explaining the dynamic relationship between siblings in a family and the different constituents of the family group. Adler proposed that one's rank would impact diverse personality traits, including responsibility, ambition, sociability, and willingness to break the rules. [15]

The family constellation is the structure of the family system, which includes such elements as birth order, the person's perception of self, and sibling and parental relationships. It moderates the difference between the genetic and constitutional factors the child brings and the cultural factors the child learns from the family. He also declared birth order is meaningful regarding how adults interrelate with others and develop their personality traits. There are 5 ordinal positions within a family constellation: (1) firstborn, (2) secondborn, (3) middle child, (4) youngest child, and (5) only child. Adler stated that individuals with specific birth order standings usually reflect a behavior pattern consistent with lifestyle configurations. It is not the child's rank in the hierarchy of successive births that impacts his character, but the circumstances in which he is born and how he interprets it. The psychological position, as perceived by the individual, is of tremendous importance more than the birth order itself. Favorable or unfavorable consequences may exist depending on the birth order position. Our birth order presents us with particular challenges and encourages us to create complex rivalries and alliances with our family members. [16]

Research on Adlerian birth order theory is mixed. Although Adler claimed that the secondborn was the highest achiever, research has been inconclusive. Birth order research has helped psychologists understand why siblings are no more similar in personality than those from different families. [16] The family is not a shared environment but a set of niches that provide siblings with different outlooks on life. The siblings' personalities vary within the same family because they adopt different strategies to achieve parental favor. [17]  

The Firstborn

The oldest children are the foremost and undisputed rulers of the household, who receive undivided attention, the cause of glad tidings, and happily the center of attention. Many parents spend considerable time caring for their first child. As a result, the child may have a secure standing within the family. With the arrival of a second child, parents must split their time with the new arrival. That child will build dissatisfaction, and the battle will begin to regain the parent's complete awareness. [18]

Adler hypothesized that all firstborns mourn the loss of their privileged positions. However, those whose parents spoiled them felt great resentment, discouragement, and hostility toward the new sibling. The new arrival causes high pressure and standards of commitment and cooperation on the eldest child. Consequently, the firstborn is ready to meet adult expectations and strive for perfection as a guiding fictive goal. Firstborns tend to become conservative, highly organized, responsible, moral, and disproportionally interested in maintaining the status quo. However, when these individuals lack social interest, they tend to be insecure, distrustful, and hostile toward society. Meanwhile, younger children assume social commitment and design appropriate ways of coping with life's tasks. [19]

The Second and Middle Children

The second offspring arrives to discover that somebody is already preceding them. While the firstborn has a period when the parent's attention is full-time, the second will always have to split the attention. The second born was born in distinctive circumstances from the first. The second child typically pursues the opposite way to find their place compared to the older child. They can be less accountable, more autonomous, and more curious in whatever the eldest does not pursue to conquer. Adler considered that the second child might react competitively, seeing the first child as a pacesetter. The second child usually seeks to be number one. The competition, frequently known as sibling rivalry, can be extreme in families that motivate comparisons between relatives. Every so often, the second offspring is victorious in the competition, but multiple second children behave as if the competition never happened. This ongoing competition influences each child's lifestyle. When a family has two children, the older child is often considered more dominant. Consequently, the second child can feel discouraged and respond differently in similar situations to reduce the discouragement that may arise with direct competition. [20]

When a third child arrives, the second becomes a middle child. Middle children commonly feel stressed and pressured in families of three. They recognize themselves as disadvantaged and defeated by their siblings. Such situations can make them sensitive to criticism and easily outraged. Consequently, they may become more independent, rebellious, judgmental, or overthinkers. However, they also have assets, especially in larger families where they can learn from others' mistakes. [20]

The Youngest Child

The youngest child is frequently the most pampered and overindulged within the family constellation. They typically evolve as the center of attention and are often portrayed as cute, charming, and the family's baby. In addition to parents, they have older siblings to entertain and provide nurture. Some youngest children develop a competitive orientation and become high achievers, but mostly become spoiled, expecting others to take care of them. When they reach adulthood, they may find adult responsibilities too much to handle or gain independence, sometimes using their charm and manipulative ways to get others to fulfill their needs. They can be great entertainers and comfortable before an audience, whereas many hate public speaking. One favorable consequence of being the youngest child is the opportunity to compete. A possible unfavorable outcome is that one feels insufficient to everyone. They typically perceive inferiority because everyone in the family is older and seen as superior. Adler also mentioned that when the youngest offspring is unwanted, they feel neglected, disdained, and disregarded. [20]

The Only Child

Only children might have the perceptions of the oldest, and they get pampered as the youngest child. An outstanding exception from the others is that they never feel dethroned and are less likely to feel the pressure of a close competitor. Likewise, they develop rich imaginations because they spend much time alone. The only child usually lacks models or competitors, so they seldom learn to share or compete for attention. However, they may be perceived as mature for their age, comfortable with adults, responsible, cooperative, and developing mastery of cognitive skills. However, they may have little or no intimate give-and-take with other children, unlike their peers. These characteristics can make early school experiences more difficult for these children as they begin coping with new life situations involving peer groups. [21]

In line with his interest in the social determinants of personality, Adler observed that the personalities of a family's oldest, middle, and youngest children were variable. He attributed these differences to the distinctive experiences of each child as a member of the social group. [22] Alder hypothesized that neurotics, criminals, and drunkards have characteristics usually displayed in the firstborn child. He also proposed that the youngest child in the family is most likely to become the problem child and later a maladjusted adult. Adler saw the second or middle child as ambitious, striving to surpass the older sibling, and well-adjusted, although tending to be rebellious and envious. [23]

• Issues of Concern

Goals of Adlerian Therapy

The fundamental goal of Adlerian psychotherapy is to aid patients in participating and incorporating techniques that are discrepant with existing cognitive structures or lifestyles. Hence, patients can correspondingly design perceptual alternatives and adjust or substitute growth-inhibiting beliefs or personal narratives with growth-enhancing ones, thereby overpowering feelings of inadequacy and disheartenment. The primary purpose of therapy is to conceive the patient's sense of belonging and to aid in adopting behaviors denoted by community feeling and social interest. This is achieved by raising the patient's self-awareness and adjusting their constitutional beliefs and life goals. The Adlerian model does not view patients as ill but acknowledges the need to re-educate individuals and reshape society. Adler contended that patients are often discouraged instead of having a disease. Its approach concentrates on supplying knowledge, instruction, advising, and motivating dispirited individuals. [8]  

Encouragement is proposed as the most powerful strategy for modifying a person's assumptions. It allows patients to build self-confidence and promotes courage. Courage is the willingness to perform even when fearful in ways compatible with social interest. Fear and bravery go hand in hand; without dread, boldness would not be necessary—the loss of courage or despondency develops maladjusted conduct. Discouraged individuals do not serve in line with social interests. Adlerian therapists allow patients to view things differently, but it's up to them to accept or decline the alternative perspective. Adler assisted his patients in reaching their defined self-goals. [8]  

Contemporary Adlerian counseling and psychotherapy integrates supportive, cognitive, constructivist, existential-humanistic, systemic, and psychodynamic perspectives. A primary goal of Adlerian therapy is to motivate patients to believe that change is achievable by helping them experience and assimilate new information that is discrepant with existing cognitive structures or lifestyles. Adlerian therapists also motivate their patients to use their talents to assist others. In this way, individuals develop a social interest. Thus, patients can create perceptual alternatives and modify or replace growth-inhibiting beliefs or personal narratives with growth-enhancing ones, overcoming overwhelming feelings of worthlessness and discouragement. [24]

Adlerian therapists use several techniques in working with their patients. They maintain a time limit of 30 minutes for children and 45 to 50 minutes for adults. Near the end of the session, therapists do not introduce new techniques. Instead, they summarize the interview with the patient's assistance, and at the end of the therapy session, they assign homework. Some popular techniques include offering encouragement, style of life analysis, the question, hypothesis interpretation, acting as if, catching oneself, the pushbutton technique, and others. [25]

1) Offering Encouragement

Encouragement is a principle and method that pervades all Adlerian therapy; it is essential when working with children. It strengthens the ability to deal with life tasks. Adler asserted that motivation is necessary to develop healthily, combat discouragement, and work toward personal goals. Children become what they are encouraged to become. Encouragement skills or techniques enclose the following: [25]  

• Valuing patients as they are.
• Demonstrating consideration for patients through active listening, respect, and empathy.
• Focusing on the patient's strengths, assets, and abilities, including identifying past successes and communicating confidence.
• Helping patients generate perceptual alternatives for discouraging fictional beliefs and oppressing narratives.
• Helping patients distinguish between what they do and who they are.
• Focusing on the patient's efforts and progress.
• Communicating affirmation and appreciation to patients.
• Assisting patients in seeing the humor in life. [25]   

2) Asking "The Question"

In using the question technique, therapists ask a variation of the question that Adler developed: "How would your life be distinct if you no longer had this issue?" Such questions help patients understand what they want to see changed in their lives. As a result, patients cannot necessarily ignore symptoms, or they will feel motivated because they begin to comprehend that they have the resources and abilities to overcome the problem. Typically, patients get asked this question at the beginning of counseling. Solution-focused therapists relabeled this method as the "miracle question." [25]   

3) Acting "As If"

In the traditional approach, "as if" is a therapeutic technique in which the clinician asks the patient to act "as if" there were no barriers to achieving his or her goal. They are instructed to behave "as if" they possess a particular conduct and are encouraged to try new demeanors and roles. This approach aims to sidestep the possible modification resistance by counteracting some perceived risks. [25]  

4) Using Pushbutton Technique

Most of the time, patients are unaware of their unpleasant feelings. This technique aims to help patients become aware of their role in maintaining or creating unpleasant feelings. The push button technique has 3 phases. In the first phase, Adler asked patients to imagine a pushing button. Then, he directed them to close their eyes and recall a pleasant experience in as much detail and vividness as possible. Next, Adler requested patients to make notes of that pleasant memory. As a second phase, Adler would give similar directions, but this time asking patients to imagine a negative experience in as much detail as feasible. In phase 3, Adler asked patients to retrieve another pleasant memory or return to the one in phase 1. Again, they should recall the memory in detail and focus on the positive feelings. After they relived the pleasant memory and positive feelings, Adler instructed them to open their eyes. Finally, patients reflect on what they learned, and they usually make a connection between beliefs and feelings. Typically, they mention that their thoughts produced certain feelings. Occasionally, however, patients are unable to make a connection between beliefs and feelings. [1]

After ensuring the patient established this connection, Adler gave 2 pushbuttons to take for a homework assignment. When patients press the positive push button, they create pleasant images that positively affect their feelings. Likewise, when they press the negative push button, it negatively affects their feelings. These pushbuttons affirm that feelings or behavior are typically a choice. When they return for the next counseling session, the discussion with the therapist can focus on which button patients have been pushing and the purpose of choice. [1]

5) Catching Oneself

Catching oneself aids patients in being aware of their self-destructive behaviors or thoughts without feeling guilty. This technique involves encouraging patients to catch themselves in the act of performing the presenting problem. The intent is to help patients change maladaptive old habits. With proper training, patients can learn to anticipate situations, identify when their thoughts and perceptions are becoming self-defeating, and take steps to modify their thinking and behavior. Catching oneself involves assisting patients in identifying the signals or triggers associated with one's problematic behavior or emotions. When patients identify their triggers, they can make decisions that hasten overwhelming symptoms. [26]

6) Style-of-Life Analysis

This technique typically includes an interview that leads to a formulation or summary of the patient's style of life. Based on patients' memories of their family of origin, these interviews give the therapist information about the patient's perceived ordinal position, family constellation, and family atmosphere. Then, the Adlerian therapist asks about the patient's childhood physical development, school experience, and sexual and social development. Adler also used to ask about the patient's local community and socioeconomic status to help determine their view of themselves and the family's position in the larger world. [8]

The final phase of the interview is the collection of early childhood recollections. These remembrances are not coincidences; they are usually projections. Having gathered all the previously mentioned data, the Adlerian therapist has all the information necessary to create a tentative hypothesis about a patient's lifestyle. This lifestyle includes patterns of behavior and ways of viewing themselves and the world around them. [8]

7) Hypothesis Interpretation

The purpose of hypothesis interpretation is to explain to the patient when more than one justification exists for his or her behavior. For example, after the style of life analysis, the therapist can ask the patient, "Could it be that?". This technique will help the therapist know if his or her interpretations are correct. [8]

8) Task Setting

Adlerian therapists give task assignments so patients can practice a different manner of conducting themselves, which can lead to a distinct perspective. Using this technique, the patient finds threatening situations less and less frightening. Adler suggested giving a depressed patient the task of doing something enjoyable each day on a "pleasant day" schedule. Moreover, to promote the patient's social interest, Adler proposed to assign community service to his patients, such as volunteering at a homeless shelter. These concepts are fundamental to modern-day behavioral activation therapy. [1]

9) Brainstorming

After helping the patient identify misconceptions in thinking, Adlerian therapists brainstorm with the patient's alternative hypotheses and beliefs. Instead of saying, "I never get what I want," a patient can substitute with "Sometimes I get what I want." The last conviction promotes healthy development. [1]

The 4 Phases of Adlerian Psychotherapy 

The fundamental purpose of Adlerian psychoanalysis is to aid patients in dismissing discouraging style-of-life convictions, experiencing and assimilating new information, and engaging in behavior modification consistent with additional supportive and encouraging perspectives. The final objective of Adlerians is developing and expanding the patient's social interest or community feeling. Adlerian psychotherapy typically proceeds in a succession of logical steps. The 4 phases include relationship, analysis/assessment, insight/interpretation, and reorientation/reeducation. [27]

• Phase 1 of Adlerian Therapy: Establishing the Therapeutic Relationship

At the beginning of psychotherapy, Adlerian therapists initiate a comfortable therapeutic alliance by using humor and small talk to institute an equalitarian partnership. This therapeutic relationship shall be encouraging and respectful. This stage is the first and most meaningful. Adlerian psychotherapists sit facing the patient with their chairs at the same level. The principal goal of Adlerian Psychotherapy is to motivate patients and permit them to perceive that transformation is feasible. The therapeutic process should be a harmonious partnership established on respect and trust. As a final goal, this sort of psychotherapy helps individuals to eliminate mistaken thoughts about themselves. The objective mentioned above can be reached by understanding each individual's unique private beliefs and approaches. With that understanding, Alder motivated his patients to create wholesome lifestyles and overpower feelings of inadequacy. The 3 entrance gates to an individual's mental life: (1) his/her birth order position in the family of origin, (2) his/her first childhood memory, and (3) his/her dreams. [28]

Despite the egalitarian focus, Adlerian psychotherapy also takes on a psychoeducational atmosphere because it inspires patients to use their talents to assist others in developing a social interest. Adler used to believe their patients were discouraged when they began psychotherapy. Consequently, Adlerian therapists strive to create a supportive and encouraging therapeutic alliance. Adlerian therapists are empathic and caring, but they confront patients with their basic errors, misplaced objectives, and self-defeating conduct. Such confrontations help patients deal with the contradictions in their lives and replace mistaken pursuits. [28]  

• Phase 2 of Adlerian Therapy: Uncovering the Patients' Dynamics or Assessment

The second stage is the psychological inquiry of the process. This methodology will vary according to the nature of the problem, psychological inventories, tests, case histories, and family. It gets divided into the patient's lifestyle and early recollections. First, the Adlerian psychotherapist assesses the patient's lifestyle. After obtaining a summary of their patient's early recollection and lifestyle, they examine their basic mistakes. Usually, individuals acquire these fundamental mistakes during childhood when they construct reasons and principles regarding their experiences. These experiences may be purely or partially fictional. [29]

Second, the psychotherapist assesses and interprets the patient's early memories, a projective assessment whereby patients share remembrances of specific childhood events. According to Adler, we select remembrances that concur with our fundamental inferences about ourselves and the rest of the world. It makes little difference whether or not these memories are actual events or fantasies. Our adult lives revolve around what we perceive as having happened. Our earliest memories provide the therapist with a comprehension of our mistaken assumptions, social interests, and future actions. Adler alleged that dreams were a form of dealing with insecurities. Our goals help us to try out strategies for overcoming our limitations, or they may portray a type of desire fulfillment. Dreams can operate as a bridge to what we want. From his perspective, our striving for perfection and need for control drives us. Moreover, dreams prepare individuals to solve their current problems or overcome their present circumstances by rehearsing for future actions. [29]

• Phase 3 of Adlerian Therapy: Patient Insight and Self-Understanding

The third phase, the Adlerian interpretation process, involves insight and self-understanding, a core principle of modern psychodynamic therapy. Insight represents the patient's understanding of the purposive nature of their behavior and the mistaken beliefs that sustained it. Adlerian therapists promote patient insight through standard communication, dreams, fantasies, behavior, symptoms, or patient-clinician interactions. During interpretations, the emphasis is on discovering the purpose rather than the cause of the patient's conduct. A proper interpretation provides clues regarding the purpose of a patient's behavior. From his perspective, insight alone was insufficient for successful therapy. [30]

• Phase 4 of Adlerian Therapy: Reorientation

The final stage of an Adlerian intervention depends on the patient's desire to institute a change. It is also known as reorientation. The reorientation phase of therapy aims to help the patient recover the courage to confront life's challenges. As a result, the patient decides what behaviors stay to reach unique purposes and what behaviors get discarded. During reorientation, the therapist encourages the patient to develop more social interests. Throughout this phase of psychotherapy, the dominant technique used is motivation. [29]

Adler and Parenting Style

The theory of personality and therapy had a crucial impact on developing good parenting skills. Adler acknowledged that the finest fortune for a child was the development of personal courage to cope with life by allowing them to experience the natural consequences of their acts without fear. Adler identified two parenting styles: Pampering and Neglect. Pampering refers to overprotecting children, giving them too much attention, and protecting them from the harsh difficulties of life. This results in children who are poorly prepared to deal with the realities of everyday living and a high level of dependence. They approach life, work, and marriage from a self-centered orientation with unrealistic demands. [31]

On the other hand, the neglected child is the one who receives very little support. As an adult grows up fearing the world, distrusting others, and experiencing difficulty forming close interpersonal relationships. When parents fail to provide sufficient love and care for their children, the net result is that such children view adults negatively. Their inadequacy is manifested by suspicious behavior, isolation, and maliciousness. Although both the pampered and neglected child receive different types of parental treatment, the final results of the treatment may be the same: feelings of inadequacy. Many of Adler's ideas about good parenting techniques include:

• Mutual respect between themselves and others.
• Encouragement: faith and consideration for children as they are rather than as we want them to be. 
• Natural and logical consequences: this allows kids to experience and learn from the results of their behavior.
• Setting freedom and limits for children. [31]   

Adler's Theory of Life Tasks

Adler considered the desire to experience a heightened sense of belongingness with other people as a universal drive. Our drive for belongingness motivates us to become involved in life tasks prominent for our psychological development and mental health. Those 3 fundamental life tasks are work, social, and love-marriage or intimacy. Modern theorists have suggested additional areas to master: self, spiritual, parenting, and family. Work or occupational tasks should be meaningful, satisfying, and contributing to the community. Adler acknowledged that our life is made possible by the work of others. This task includes all forms of obligation and responsibility, not just money. For students, it corresponds to school; meanwhile, for adults, it corresponds to their career and job satisfaction. [32]

The social task is learning to build gratifying friendships with others and ourselves. Adler emphasized that each person needs to find a place among others that allows them to cooperate. He also highlighted that belonging to a social group and fitting in with others are basic needs. The negative consequences of "not belonging" are decreased cognitive functioning, increased cortisol and stress levels, and increased preoccupation with social stimuli. Love-marriage or intimacy tasks should be addressed by learning to love oneself and another. The love task begins for children in the intimacy of breastfeeding, which Adler noted is the child's first experience of cooperation. During childhood, the child unconsciously constructs ideas about relationships based on their parents and consciously follows other models of love and marriage. The child can receive educational guidance and meet the challenges of adolescence and sexuality with common sense and courage. Alternatively, the child can be overburdened and discouraged to overcome inevitable feelings of inferiority. This child will have a hesitating attitude and be compulsive or hostile toward others. [33]

Self-task describes the relationship with oneself, and it develops during childhood. It has 4 dimensions: self-survival, body image, opinion, and evaluation. This task allows the individual to accurately perceive their care and expectations of their physical appearance, psychological, and social self. Spirituality tasks encompass community feeling, social interest, and cooperation. It comprehends the relationship with religious beliefs, the universe, the meaning of life, and metaphysical controversies such as heaven, hell, reincarnation, karma, and salvation. Parenting and family tasks involve giving birth, raising children, and functioning as a family. Therapy goals should help individuals modify their lifestyles, accomplish life tasks, and face life challenges. [33]

Adler's Healthy Mental Development and Development of Maladaptive Behavior or Psychopathology

Alder proposed that the seeds for psychopathology germinate early in life, especially within the family and within our sibling relationships. Developing adequate social interest is critical to individuals' positive mental health. Adler believed that if an individual cannot find their place in life, they will become discouraged and may engage in disturbing behavior to find their place. According to Adler, an individual's underdeveloped social interest is the one factor that underlies psychological maladjustments. They are often at risk for depression, frustration, anger, and social alienation. [34]

Individuals develop maladjusted or disordered conduct primarily because (1) they have increased feelings of inferiority and (2) they develop inappropriate compensatory responses to offset their deep-seated feelings of inferiority. Although the average and maladjusted person manifests feelings of inferiority, these feelings are exaggerated in the maladjusted individual. Adler believed that poor mental health results when people behave as if they are inferior. From his perspective, the mother is the primary person for teaching children social interests because she demonstrates nurture, cooperation, and social welfare. [34]  

• Clinical Significance

The world of counseling and psychotherapy has evolved considerably compared to when Adler developed his theories. Adler has influenced contemporary psychotherapy practices in many ways. His theory of Individual Psychology has acquired popularity; this could be attributed to the fact that many writers have adopted the original theory. It has also been employed in various other applications and settings, such as schools, organizations, and medical settings. One of the ways that Alder's proposals have remained contemporary is by recognizing the aspects of Adler's original model, which are theoretically consistent with modern psychotherapy. In many ways, this model has moved away from allegiance to single theories of personality and has readily adopted integrative theoretical models. [35]  Alderian concepts are fundamental to modern supportive psychotherapy, psychodynamic therapy, and cognitive behavioral therapies, including behavioral activation. Adler developed his original theories and model when campaigning for the social equality of women, contributing to the understanding of gender issues, speaking out for the rights of working-class and poor people, and addressing the rights of minority groups. Within that context, many practitioners of Adlerian therapy were addressing social equality and using a contextual framework for understanding people. Multiculturalism and respect for diversity are now recognized as essential components of psychotherapy. [36]

Adlerian psychotherapy is relevant for working with culturally diverse populations in contemporary society because it addresses various multicultural issues, including culture, ethnicity, gender, racism, sexual orientation, and social equality. A rapidly growing dimension of multiculturalism includes attention and appreciation for religion or spirituality in patients' lives. Historically, most systems of psychology have had either a neutral or negative position toward religion and spirituality. However, Adlerian therapy addresses religious and spiritual issues. Researchers have studied several patient populations that commonly benefit from Adlerian Therapy concepts, such as individuals struggling with anxiety, depression, schizophrenia, eating disorders, substance abuse, family education, gender equality, and personality disorders. [35]

From an Adlerian perspective, when someone develops anxiety, this individual demonstrates excessive uneasiness and excessive self-consciousness. As a result, the individual will believe that he or she does not have the required skills to cope with a threat. From an Adlerian perspective, the anxious patient fears not belonging and may start believing that they are losing control. In Adlerian theory, all behavior is viewed as serving a purpose; anxiety indicates the fear of failure and lack of belongingness. 

Family Therapy

Adlerian Family Therapy is a method that enables individuals to let go of negative and futile emotions and behaviors that serve as barriers to developing positive relationships with self and others. This type of therapy may be used with individuals, couples, and families. It aims to improve family dynamics and offer perspectives and learnings about where individuals "fit in" or belong within the family unit, community, and society. The family therapist questions the influences of birth order, family atmosphere, lifestyle, and priorities. Individuals are viewed as indivisible, social, decision-making beings whose actions and movements have a purpose. [37]  

Techniques that improve family members' interactions with each other are outlined:

(1) Understand a person's beliefs and perceptions, which shape their goals and sense of belonging and impact their emotions.

(2) Establish ground rules for family communication.

(3) Focus on the real issue, not the issue at the surface.

(4) Align the goals between the family and therapist.

(5) Stimulate social interest.

(6) Encourage by listening, being empathic, understanding meaning, understanding the system, and identifying and affirming assets and resources.

(7) Confront each family member's private logic and mistaken beliefs and perceptions.

(8) Intervene by sharing a tentative hypothesis.

(9) Use paradoxical intention (i.e., encourage the family to do the very things it claims it wants to stop doing). [38]  

Research has demonstrated that family therapy will change patient perspectives, increase the family's overall sense of humor, and increase the functioning of the family. [39]

Eating Disorders

Adlerian theorists propose that people generally strive for significance and superiority, and they acknowledge that eating disorders can be a pathological way to cope with inferiority issues. Alderian theorists suggest that individuals with eating disorders use food and eating to communicate their sense of inadequacy symbolically in the face of life's requirements. This sense of inadequacy stems from their failure to master those skills essential to living effectively and healthily with others. [40]  A controlled clinical trial evaluated the outcome of Adlerian Parental Counseling (APC) on individuals affected by an eating disorder. This research showed that individuals with eating disorders significantly improved after APC compared to the baseline and the placebo groups. Parents reported a subjective improvement in psychopathology scales and refinement of their perception of family dynamics. [41]

• Other Issues

As the North American Society of Adlerian Psychology (NASAP) requires, Adlerian therapists must earn a minimum of a master's degree to satisfy entry-level qualifications. Advanced graduate studies include 90 hours of Adlerian Focused Study, with at least 8 years of application. Certified personnel must complete 4 Adlerian-based programs or seminars at a NASAP Conference and 2 Adlerian-oriented publications and have at least 3 years of leadership in local, national, or international Adlerian activities or organizations. [42]

• Enhancing Healthcare Team Outcomes

Adlerian therapy has an essential influence on modern psychotherapies. Although Adlerian therapy is not commonly utilized as a first-line treatment, the influence of Alfred Alder's doctrine has had a significant influence on many common first-line psychotherapies. This includes psychodynamic therapy, behavioral activation, cognitive behavioral therapies, and supportive psychotherapy. Applying these principles can have a meaningful impact on psychiatric symptoms and should be considered for application in patients who may benefit from them. Although psychiatrists and psychologists commonly utilize Adlerian techniques, other interprofessional team members can also implement them to enhance patient care. This includes nursing and support staff applying principles of supportive psychotherapy and mental health professionals using more advanced techniques with appropriate training.

Furthermore, social workers and case managers can refer patients to the proper therapeutic resources. Collaboration with an interprofessional team and exploring the patient's perspectives on goals of care ultimately enhances the benefit of Alderian therapy.

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Disclosure: Tyler Torrico declares no relevant financial relationships with ineligible companies.

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• The Journal of Individual Psychology

Trauma-Informed Adlerian Play Therapy: A Case Study

• Courtney Evans
• University of Texas Press
• Volume 77, Number 3, Fall 2021
• pp. 362-373
• 10.1353/jip.2021.0025
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According to Adlerian theory, early life influences, such as potentially traumatic events, can have an impact on an individual's lifestyle (his or her general orientation to life). For counselors working with children who have experienced traumatic events, it is important to have a modality to conceptualize and to provide efficacious interventions. This case study shows how one child's symptoms of post-traumatic stress disorder following chronic sexual abuse were significantly decreased after trauma-informed Adlerian play therapy (AdPT) participation. In fact, the child's symptoms, post-counseling, no longer met diagnostic criteria for PTSD at all. Through the use of trauma-informed AdPT, the client's parent reported complete symptom alleviation, making a compelling case for the use of AdPT in work with this population.

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