Frew, J. (2012). Case Approach to Gestalt Therapy. In G. Corey, Case Approach to
Counseling and Psychotherapy (pp. 110-124). Cengage Learning.
http://students.aiu.edu/submissions/profiles/resources/onlineBook/s5c5Y5_counseling
%20psychology.pdf
Keywords: Gestalt – Awareness – Psychotherapy – Case Study – Here-and-now
Introduction
“The goal of Gestalt therapy is, quite simply, the restoration of awareness” (Frew, 2012, p.
111).
Case Approach to Gestalt Therapy is an article written by Jon Frew and published as the
6th chapter of the book “Case Approach to Counseling and Psychotherapy”, whose 8th edition
was published in 2012 (Corey, 2012). This chapter is intended to help psychotherapists and
psychologists better understand what Gestalt therapy is. Jon Frew has practiced for over 35
years as a consultant in organizations. He also provides supervision and psychotherapy,
consultation to psychotherapists and is a trainer in Gestalt therapy (Jon Frew – Organizational
Consulting, 2018). This book has the particularity of illustrating, throughout the chapters, many
alternative approaches to client care by accompanying a single patient, Ruth Walton. In this
chapter, devoted to Gestalt Therapy, after having developed some concepts of this approach,
Jon Frew illustrates them through the case study of Ruth.
It is interesting to notice that the first publication about Gestalt Therapy was made over
70 years ago, and that today there is a lot of concepts belonging to this field (Hegarty, 2021).
However, Baier and his collaborators (2020) demonstrated in their critical review that the
success of a psychotherapy could be better explained by general factors than by the theoretical
approach used. For example, these authors discovered that therapeutic alliance mediated 70.3
% of therapeutic outcomes in their study. That is why it would be better today to consider that
Gestalt Therapy is just one specific approach among many. Moreover, it is well-known that the
degree of faith that the therapist has concerning his approach, his abilities and his competences
influences the effects of psychotherapy. The more confident the therapist, the better the therapy.
Summary
First of all, Jon Frew introduces the goal of the Gestalt approach. He explains that
Gestalt therapy tends to emphasize the awareness of here-and-now experiencing. He reminds
that this is the client’s movements of awareness lead the therapy. According to him, the role of
the Gestalt therapist is to favor the client’s awareness of his inner conflicts, his unfinished
situations and his own feelings, thoughts, and sensations thanks to role playing, questions and
reformulations. The aim is to allow the client to realize and express what’s happening inside of
him in the present moment. That is why the therapist doesn’t have to make a diagnosis nor a
categorization of what behavior, feelings or thoughts are pathological or not. Furthermore, the
therapist doesn’t try to confirm hypotheses or to achieve a goal concerning his patient.
Then, Jon Frew discusses an essential concept of Gestalt Therapy: the cycle of
experience. Like many others, Jon Frew thinks that someone cannot be apprehended without
considering his environment. According to him, we all experience contact with our
environment, and these contacts occur in several phases. A cycle of experience begins with
physical or emotional sensations, followed by awareness of these sensations leading to
excitement and action resulting in contact with the environment, thus completing the cycle of
experience. Nevertheless, it happens that contact with the environment doesn’t take place
correctly and it can cause suffering. When an individual isn’t aware of an unfinished cycle of
experience, he or she might experience symptoms, repetition of the same unfinished cycle of
experience, and suffering.
To illustrate how a Gestalt therapist can work, several excerpts from interviews
conducted between Dr. Gerald Corey and Ruth Walton have been added. These interviews are
punctuated with useful comments to explain which therapeutic technique was used the therapist
and what was its usefulness.
Ruth expresses some pain from living too much for others.
She says she “give and give until there is little left to give.” (Frew, 2012, p. 113). She seems to have
difficulty taking action. She checks what others expect of her instead of acting on her feelings.
Jon Frew explains that putting the expectations of others before her own allowed Ruth to avoid
conflict and thus be safe. This information about Ruth’s life and the way she relates to the
therapist provides information about the quality of her cycle of experience. Dr. Gerald Corey
describes his goals in this meeting with Ruth Walton. He wishes to help her identify a « “figure”
or an experience that becomes salient for her, to heighten her awareness of that experience, and
to explore how she might make contact with [him] about that figure of interest. » (Frew, 2012,
p. 113).
To increase Ruth’s awareness of her experiences, the therapist invites her to focus on
what she is experiencing in the here and now. For example, Gerald Corey’s speech is designed
to intensify the experience of the here and now. Here are some examples: “What are you aware
of, Ruth, as we begin today?”, “What do you noticing as you tell me this?”, “What are you
experiencing right now?”, “Take a minute and check in with yourself” (Frew, 2012, p. 113).
The goal is to invite Ruth to listen to herself and realize that she rarely attends to her immediate
experience. The therapist will then suggest an experiment to increase her experience cycle. This
experiment will focus on how Ruth carefully observes the therapist. “You are looking at me
very intently. Are you aware of that?” (Frew, 2012, p. 113).
As a result of this awareness, Ruth experiences anxiety and difficulty maintaining gaze with the therapist (“Now I am having trouble looking at you. It’s more comfortable to look out the window.” (Frew, 2012, p. 114).
The therapist then suggests that she alternate between staring at him and looking away, to observe how she feels in both situations. As this experience unfolds, Ruth is invited to refocus on what she is feeling in the here and now. Ruth eventually says, looking at the therapist’s face, “I see a kind face. I see interest, even concern and care. It’s very comfortable for me now to have this eye contact.” (Frew, 2012, p. 115).
Here there is a resolution of Ruth’s suffering by closing her experience cycle. Ruth expresses relief after becoming aware of what she is feeling. By expressing different aspects of her Being thanks to the therapist, Ruth liberated a part of her suffering. She released space to experience a new way to solve her problems and to live her own life more fully by taking in account the differents facets of her being. Of course, this exercise alone is not enough to accompany Ruth through the multiple objects of her suffering. Thus, as Jon Frew points out, “as that figure reached completion, another emerged.” (Frew, 2012, p. 116).
The critical evaluation
According to us, the main quality of this article is its conciseness. On the one hand, this
book chapter is simple and doesn’t need to have a solid basis in Gestalt therapy, because the
vocabulary used is accessible. On the other hand, even if the article is brief, Jon Frew addresses
clearly some essential concepts of Gestalt therapy and makes links with his experience thanks
to the case study presented.
Another quality of this article is related to the book structure. In fact, a lot of different
approaches of psychotherapy are developed into the different chapters of this book. A total of
twelve approaches are presented in the book. These approaches are all illustrated with Ruth’s
case. The comments related to the case study enable the reader to create links with his
experience and allows him to understand the concrete differences between these approaches.
The book’s lead author, Gerald Corey, explains that this book reflects his “increasing
emphasis on the use of demonstrations and the case approach method to bridge the gap between
the theory and practice of counseling.” (Corey, 2012, p. 19). One of the goals of this book is to
provide learning by analyzing a therapeutic approach in action. Therapeutic processes are
illustrated concretely and the therapist’s interventions are commented on. Questions for
reflection are presented at the end of the chapter. They allowed us to make links with our
personal life and with the other chapters of the book. This allows the reader to more easily
integrate each approach with each other. As psychology students, reading the chapter on Gestalt
therapy made us feel like we were sitting next to Gerald and Ruth, much like what we might
experience in our internship experiences. This was a very stimulating read. We were also
pleasantly surprised to find that this book is available for free on the Atlantic International
University (AIU) website (Corey, 2012).
Although this article has many qualities, it also has some flaws. First of all, this chapter
is from 2012. Therefore, it cannot take account of more recent knowledge about Gestalt therapy.
Furthermore, some important concepts of Gestalt therapy are not covered in the chapter, and
the explanations of the concepts presented are quite basics. This chapter isn’t enough to fully
understand this approach. That is why additional books should be consulted in order to have a
more complete understanding of Gestalt therapy. In the same way, this article emphasizes the
merits of Gestalt therapy unilaterally, without paying attention to the limitations of this
approach. For example, it doesn’t explain how to work with psychotic disorders, suicidal crisis
or in the urgency. Finally, it would also have been judicious to take a step back in order to recall
what are beneficial factors for the smooth running of psychotherapy and to put Gestalt therapy
in a historical perspective to better understand the different authors, theories and philosophical
fields having influenced the Gestalt approach.
Although the encounters with Ruth may reflect real-life situations, they are only
fictional and written to illustrate each approach. We question the method of writing Ruth’s
clinical case when the approach under study does not seem to advocate for anticipating client
behaviors. Necessarily, the writing had to be guided by the representations and expectations of
the writer, playing the role of therapist. To what extent do Ruth’s behaviors highlight what is
really going on in Gestalt Therapy? Ruth’s behavior thus seems to be delimited only by the
writer’ thoughts. Although the character of Ruth is only fictional, she seems to be an object here
and not a subject, making any clinical approach presented in this work difficult.
Even though there is no doubt that Gerald Corey is a great counselling specialist, he is
the only therapist who illustrates the 12 therapeutic approaches in action. We question this
choice. Why choose a single therapist for 12 approaches and not different therapists
specializing in each? An attempt to answer this question could be that it allows us to keep a
certain continuity in the reading of the book and thus to help the reader.
Conclusion
This book chapter was an interesting introduction to study different possible approaches
to practice psychotherapy. We particularly appreciated reading case studies with related
comments that enable us to learn about concrete example of therapeutic strategies but also about
the patient’s subjective experience of Gestalt therapy. Moreover, it was also very instructive to
compare case studies of this chapter with the other case studies of the book. The entire book
isn’t a sufficient support to acquire in-depth knowledge of psychotherapy, but it still remains a
very attractive publication for those who want to learn more about psychotherapy without
having much knowledge in this field. This book should be considered as a general introduction
to psychotherapy with specific examples of application. Overall, the form of the book is as
interesting as the contents for the readers.
Words we have learned
1 – Here-and-now : l’ici et maintenant
2 – The faith : la foi
3 – To mediate ; pas d’équivalent en français, le sens de ce terme se rapproche de « explique
», « influence », « module »,« interfère dans »…
4 – « smooth running of psychotherapy » : le bon déroulement de la psychothérapie
5 – To advocate : préconiser
References
Baier, A. L., Kline, A. C., & Feeny, N. C. (2020). Therapeutic alliance as a mediator of
change: A systematic review and evaluation of research. Clinical Psychology Review,
82. https://doi.org/10.1016/j.cpr.2020.101921
Corey, G. (2012). Case Approach to Counseling and Psychotherapy (8th ed.). Cengage
Learning.
http://students.aiu.edu/submissions/profiles/resources/onlineBook/s5c5Y5_counseling
%20psychology.pdf
Frew, J. (2012). Case Approach to Gestalt Therapy. In G. Corey, Case Approach to
Counseling and Psychotherapy (pp. 110-124). Cengage Learning.
http://students.aiu.edu/submissions/profiles/resources/onlineBook/s5c5Y5_counseling
%20psychology.pdf
Hegarty, D. (2021). Gestalt therapy: An exploration of its relevance today. Inside Out, 93, 27-
36.
Jon Frew – Organizational Consulting. (2018). Retrieved December 18, 2022, from
https://jonfrew.com/