Understanding Independence and Autonomy in a Therapeutic Setting

By Ojasvi Kaul

Addressing a growing concern of intermixing words with similar meanings

especially in the setting of mental health, we have started to use the words
independence and autonomy in a way that has left so many of us in confusion.
Sure, on the surface they sound the same - making decisions on our own - but
when you look closely, the meaning is different and they are used in different
contexts.

Independence can be understood as the absence of external control, influence,

or support. It implies the ability to make decisions and take actions without being
unduly influenced or constrained by others. The connotation is often associated
with overcoming challenges and asserting one's identity.

Autonomy on the other hand, talks about the ability to self-direct within an
established framework. Here, the perspective changes and we take the internal
force as the guiding power behind our decision-making. The connotation is often
associated with empowerment, control, and the ability to make meaningful
choices.

This difference may not seem huge, but in psychology, the implication is big. Let
us make this simple with the help of a few examples, especially in a therapeutic
setting.
Independence is seen when therapists work with clients to develop self-
reliance, confidence, and a sense of personal agency.
- Developing personal coping skills - Radhika worked on her stress and
anxiety, by handling challenging situations by using mindfulness and
relaxation techniques.
- Building emotional resilience - Geeta was struggling with low self-esteem
and with therapy started to recognize and challenge the negative self-talk,
which helped her have a more positive self-image.
- Overcoming dependency on approval - Nitesh wishes to work on his need
for external validation by challenging his beliefs and thought patterns and
building internal sources of validation.
 Autonomy is observed when therapists foster a collaborative relationship with
the client by providing them with information and acknowledging the client’s
expertise in their own lives.
- Collaborative goal setting - Preeti wants help with anger management, so
the therapist helps her identify her specific triggers and what coping
mechanisms she uses.
- Medication management - Rahul, who was previously addicted to alcohol,
works with his therapist and psychiatrist on his medication options after
recovering from a major surgery.
- Assertiveness Training - Sahil is facing difficulty in making himself heard at
his place of work. The therapist helps him communicate more effectively,
among other things which empower him to advocate for himself.

In the end, both ideas support personal agency, self-direction, and the capacity
to overcome obstacles in life, all of which enhance individual well-being. While
autonomy fosters a sense of control and purpose and allows people to make
meaningful decisions that are in line with their beliefs and aspirations,
independence builds resilience and the fortitude to live without depending on
someone else. Collectively, they establish a basis for individual development and
contentment.