The case about to be studied is about Lonely Tom he is about 30 years of age and is suffering from mental disturbance caused by his past family treatment towards him. He is the middle child of five siblings he has two brothers Lebron who is seven years older and Albert who is 6 years younger than himself, two sisters Tamika who is three years older and whom he has had a very close relationship with and Mary who is 22 years of age of whom he speaks very ill of.

The mother is a senior vice president of a marketing company where she has been working before the time Tom was born. The father works for the New York City Sanitation Department; he has odd working hours so the possibility of spending quality time with the children is ruled out.

Tom feels very insecure about the fact that no one is there for him, he comes to this conclusions by the fact that whenever he has some dispute to settle with his younger sister Mary who is an asthmatic patient the mother rushes to the aid of Mary and gives full attention and support to her.

The mother plays a very significant role in the family; and is a very outspoken person. Tom usually has battles with Mary, she constantly accuses Tom for violent actions, which he has never done. Since Mary is the favorite child in the family the parents would side her and end up putting the blame on Tom, she would sometimes make up stories that Tom hit her. He is always being compare with his older brother Lebron. Lebron is 37 years of age and was a very athletic child and maintained high grades in school, whereas Tom was an average student in school he was apart of the school band.

The ability to please his father was something that he thought was impossible to do. Whenever he had accomplished something good he would seldom get praise to appreciate his efforts. The only thing that seemed to make his father happy was the fact that he never got into trouble at school.

At the age of 37 Tom still feels anger for Mary for all the things that she has done to him at family reunions he avoids her at all costs. He has a bitter feeling towards her He also feels very sorry for himself. Towards the opposite sex he has a very fearful. Approach to them he is sensitive of the idea of “Closeness”.

In his work life he is very much delighted and content as an administrator for a hospital, but the feeling of having an empty slot in his life is still very apparent. He gets tired for no apparent reason and gets dreams of carrying a bag of bricks to his room. Tom does enjoy a long vacation and playing the piano he fulfills the later by volunteering to play every Saturday morning at a deaf and blind organization.

From the above case we come to the conclusions that Tom is a very touched person, he can feel love and affection to somebody for the smallest detail and can be their friend forever on the other hand he can hate a person also and never would want to speak to them.

The parents are not really interested in the child’s daily affairs but that does not mean that they don’t like him as mentioned above his mother and father due to the tight work schedule that they have seldom have the time to communicate with Tom. Since Tom has not got the much needed time and attention he has become aggressive in nature. This kind of attitude from the parents puts us at the conclusion that the interest showed by the father in Tom’s academic life and his accomplishments were not really important if he succeeded or not. This does not mean that the father did not care for him as most people would some under the impression, but the lack of time and devotion to be spent with each child individually. This meant that Tom did not really feel the love and appreciation, in which these emotions of being left out made Tom feel very insecure about himself.

The mother on the hand is a very controlling and a demanding person; this is the description Tom has given. He feels very insecure about them, as his word is never taken into consideration and the lack of parental love that is missing from his life due to the work conditions that the parents go through each day. The affectionate hug and some “fun” time that he would like to spend with his family do not take place in his childhood.

To fully understand what the major focus of therapy or counseling would be in this case we need to fully understand the different kind of therapies, Six known therapies are explained

 Adlerian Therapy: - Adlerain is a growth model. It stresses on a positive view of the human nature and that we are control of our own fate and not a victim to it. The therapist in this case will gather as much as family background as possible. Once this has been gathered the therapist will set goals for his client (Tom), this will enable the therapist to learn more about Tom. This procedure helps the therapist to make goals that are not too high or not too low. The goal of this therapy is to challenge and encourage Tom. These goals are usually something that can help the client socially, goals such as parenting skills, martial skills, ending substance abuse and almost anything else that is applicable to the client. The therapist will try and focus on the Tom’s lifestyle and begin to have a mutual respect for each other. They will then mutually set goals and the therapist will offer the encouragement.

The therapy can also be assigning homework and setting up contract between him and to make suggestion on how to make reach his goals. In this therapy Tom will be asked to meet the therapist maybe twice a week in which the therapist and himself have a one on one talk in which they would discuss about Tom’s social life. He will be given goals to achieve. Some of them could be to meet a new woman friend whom he does not know and share the experiences with the therapist.

 Behavior Therapy: - In this therapy Tom would learn about specific behavioral problems that are related to him. The therapy believes that all the behaviors that we inherit are all learned and we are the product of our environment

. The focus of the therapy would be on the present and overt behavior of Tom. The therapy believes that reinforcement and imitation teaches normal behavior and that abnormal behavior is a direct result of defective learning.

Therapy will be based on learning theory. The therapist includes a treatment plan and the goals of the treatment will be laid out up front, with the outcome expected from the therapy will also be set and be produced to Tom, straightforward. To eliminate unwanted behaviors Tom needs to learn new behaviors. This may include assertion, behavioral rehearsal, coaching, cognitive restructuring, desensitization, modeling, reinforcement, relaxation methods, self-management, or new social skills. Both Tom and the therapist need to take an active role in learning the more desired behavior. Behavior therapy is well suited to deal with depression, disorders in children's behavior, phobias, sexual disorders of any type, and stammering.

Tom will be asked to describe how he felt when he was young and how does he feel now when he thinks about any particular event in his life that caused him the problems that he faces today. The therapist will tell him how deceptive his thoughts were and how to overcome these emotions. They will ask him to think about the ways in which he reacted to a certain event in his life. For e.g., the way he treated his sister and that he never spoke to her, he would be asked to think if he acted in another way what would the outcome have been. (Alfred R. Mele, 1997)

 Person-centered Therapy: -

This therapy will hands over the whole responsibility to Tom and will view his nature in a very positive fashion. The therapist will make Tom self aware of the problems that he is going through and will help to experience previous feelings that he feels missed out on.

The therapist will teach Tom to trust in himself and to use this trust to find his direction in life. The person-centered therapist makes them aware of their problems and then guide him to a means of resolve them. The therapist and Tom must have faith that he (Tom) can and will find self-direction. The therapist focus on the here and how. The therapist will motivate Tom in experiencing and expressing feelings. The person-centered therapist believes that good mental health is a balance between the ideal self and real self. This is where the problem lies, the result of difference between what we are and what we wish to be causes maladjusted behavior.

In this therapy Tom would be asked to trust himself and to know that nothing in his life that he has ever done was bad. To overcome these emotions the therapist will ask him about what feelings did he miss out when he was a kid and how would he feel if he had received those emotions. He will then focus on his problems and try to help him overcome them one by one and one step at a time. (Alman, Brian M., &Lambrou, Peter, 1992)

 Existential Therapy: This therapy will ask Tom to be responsible for his actions and his fate once he realizes them he will have to shape up his life. This therapy entirely focuses on the present and the future of Tom. So the counseling therapist would ask him to see the future and the present in a very different and positive way. S/he will encourage Tom to recognize the fact that he was responsible for his own faults. Tom at the end of the therapy would benefit by the fact that he would now be able to make good choices or dealing with situations that life throws at him.

With this therapy Tom will be made to realize that all that ever happened was because of his own actions and deeds and that he is free to change him instead of him crying about it and feel sorry for himself. Once Tom realizes this fact then he is made to think about his future and how would he like his future to be.

 Gestalt Therapy: - This therapy deals by facing the problems faced by Tom in his past and will tell him how these have affected him in the present and if he does not correct them what could happen to him in the future. Integration of behaving, feelings and thinking is the main goal in Gestalt therapy. He will have the ability to recognize how earlier situations in his life have affected his life. Then Tom will be made aware of personal responsibility, how to avoid problems, to finish unfinished matters, to experience thing in a positive light, and in the awareness of now.

It is up to the therapist to help lead Tom to awareness of moment-by-moment experiencing of life. Then to challenge Tom to accept the responsibility of taking care of himself rather then excepting others to do it. The therapist may use confrontation, dream analysis, dialogue with polarities, or role-playing to reach his goals. This may include treatment of crisis intervention, marital / family therapy, problem in children's behavior, psychosomatic disorders, or the training of mental health professionals.

 Cognitive –Therapy: - Rational-emotive therapy is a highly action-oriented and deals with Tom’s cognitive and moral state. This therapy stresses Tom to think on his own and in his ability to change. The rational-emotive therapist believes that we are born with the ability of rational thinking but that my fall victim to irrational thinking .

They will stress Tom’s ability to think, in making good judgments, and in taking action. The therapist will use directed therapy. The therapist believes that a neurosis is a result of irrational behavior and irrational thinking. The Rational-emotive and Cognitive-behavioral therapists believe that Tom’s problems are rooted in childhood and in their belief system, that was formed in childhood.

Therapy will include method in solving and dealing with emotional or behavior problems. The therapist will help Tom to eliminate any self-defeating outlooks they may have and to view life in a rational way. The therapist will never have a personal relationship with Tom. The therapist will think Tom as a student and themselves as the teacher.

In the above therapies the need to find one suitable for Tom which would be very useful for in my perspective would be the Cognitive –Therapy because the therapy mentioned in there will help him as the therapist will believe that his problems are rooted in his past and they need top be recognized and that any irrational thoughts or actions would not prove to do any good.

The therapist will help recognize the fact that the bad treatment received from his parents were due to the fact that the work overload and the fact that the daughter (Mary) was an asthma patient required special needs, the therapist could ask Tom to be in his mother shoes for a while and try and analyze the situation from her point of view (his love for children may prove to help him see this fact) that his mother did not meant to do any harm or neither the fact that she had any ill thoughts about him.

Where the question about the daughter comes into being that could be explained in a number of theories as the possibilities could be numerous. Some of the possibilities could be that she like teasing her older brother and liked the fun of seeing her older brother getting into trouble because of her, another reason could be that since he did not like her and never communicated to her well enough this could have been a communication method that she wanted to try out but which proved to be a disastrous for Tom, in the event of failure kept on blaming and accusing him for things that he never did. As far as the woman problem that Tom faces the therapist could ask that a female partner to be brought in so that he could talk and relate to her. This could release some pressures and which could change his perception about woman.

Since he has a love for children he could be made to recognize the fact that in order for his children not lead a life that he led he will have to have a suitable female partner in which the essence of caring and sharing need to be the main ingredient in their daily life. This solution could also help him solve the problems of being lonely in life he could be asked to meet people to gain the confidence that is needed by him the most. His talent in playing the piano could be used as bait to attract like minded people to become acquainted with him hanging around with them and going to places of mutual interests and gaining the confidence that one would get from having friends around oneself.