Client-centred therapy for severe childhood abuse: A case study

Abstract

Aims: This case study demonstrates the experience of client change in non-directive client-centred therapy for a client ('Mac') who had experienced severe and repeated childhood abuse within an institutional care setting and shows how complex posttraumatic stress involving difficulties in identity, problems forming and maintaining non-abusive interpersonal relationships were encountered within the therapy. Method: The data were taken from the detailed notes of 160 sessions of client-centred therapy. Following detailed reading and re-reading a phenomenological analysis of the data produced four emergent themes. Results: The four themes were labelled: post-traumatic distress, acceptance and understanding, new meaning-accurate symbolisation and growth and relationship. Conclusion: The findings suggest that following severe trauma the experience of being in a client-centred therapeutic relationship was related to a reduction in post-traumatic distress. In turn, new meaning was created through accurate symbolisation of previously denied and/or distorted traumatic experience. Additionally, the client displayed growth in the development of a small number of non-abusive relationships that improved his quality of life. It is proposed that client-centred therapy can help client adjustment to the consequences of severe and traumatic childhood abuse.