In the case of Josiah, a young man in his twenties who probably feels that he is somewhat invincible when it comes to contracting an STD, I feel that having a conversation with Josiah that has a casual, non-finger pointing feel, more of a Carl Rogers humanistic style, seems to be the most effective method. As Rogerian style emphasizes unconditional positive regard, not judging, and letting the client be in control, I feel that this would work well for Josiah .
However, I would also mix some Cognitive Behavioral Therapy techniques into our session, the technique of Vertical Descent something that would probably also help Josiah change his negative sexual behavior into something more positive. Vertical descent helps one get to the root of why one really feels about something or is engaging in a certain type of behavior. The counselor keeps asking questions until the client hopefully gains some insight .
Use your promo and get a custom paper on
"Helping Clients Make Informed Decisions".
Sample Conversation with Josiah:
Counselor (C): So, Josiah, tell me how you decide if you are interested in somebody sexually.
Josiah (J): If they look good and there seems to be an attraction, then I go for it. Life is all about having fun, man.
C: What does having fun mean to you?
J: You know, living on the edge, feeling carefree. Not worrying about things a lot.
C: I can understand that. Tell me more about “living on the edge.”
J: (pauses) Not worrying about the consequences of behavior. Doing what feels good. Being a little bit wild. Hey, I work all week and need some relaxation.
C: So, what I am hearing you say is that what “feels good” and “relaxation” is fun.
J: Well, yeah. That’s fun.
C: It sounds like you are also saying that sex is fun.
J: Yeah, it should be.
C: Lets get back to this “Living in the edge.” Do you think that not using protection during sex could be living on the edge?
J: Maybe.
C: What are some other ways to live on the edge?
J: I don’t know. Maybe sky diving, rock climbing, drinking.
C: Yes, I agree. Perhaps, it would be harder to set up sex with somebody if you were not drinking.
J: Probably would. It helps me relax.
C: Do you ever think about getting an STD or getting a girl pregnant during sex?
J: Sometimes I do.
C: How would life change if you got an STD or became a father?
J: It would suck, but condoms do not feel good.
From here, I would help Josiah discuss the negative side of not using condoms and try to get him to see that he may need to change his behavior by limiting his sexual partners and using condoms. It is my goal to let him see that his health and future are more important than short-term pleasure and gratification.
