Between Therapist and Client

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Norcross J. C. (2002). Psychotherapy Relationships That Work: Therapist Contributions and Responsiveness to Patients. New York: Oxford University Press [ Google Scholar] Strong S. R. (1968). Counseling: an interpersonal influence process. J. Couns. Psychol. 15, 215–224 10.1037/h0020229 [ CrossRef] [ Google Scholar]

Strupp H. H., Hadley S. W. (1979). Specific versus non specific factors in psychotherapy: a controlled study of outcome. Arch. Gen. Psychiatry 36, 1125–1136 [ PubMed] [ Google Scholar]The patient-therapist relationship is generally representative of the nature of all other relationships you have, and so learning to resolve problems while maintaining connection provides skills that are widely applicable. To experience conflict with a therapist and learn to resolve it is often the path out of depression. Below are examples of helpful practices therapists can implement to optimize the therapeutic process, and a harmful one to avoid. Empathic responding This instrument consists of 50 item belonging to the following dimensions: 15 items compose the Working Alliance scale, 17 items compose the Empathic Resonance scale, and 18 items compose the Mutual Affirmation scale. Altogether, these subscales provide a Global Bond scale. Each item is rated on a 21-point scale.

According to Safran and Segal ( 1990), many therapies are characterized by at least one or more ruptures in the alliance during the course of treatment. Randeau and Wampold ( 1991) analyses the verbal exchanges between therapist and patient pairs in high and low-level alliance situations and find that, in high-level alliance situations, patients responded to the therapist with sentences that reflected a high level of involvement, while in low-level alliance situations, patients adopted avoidance strategies. Although some studies are based on a very limited number of cases, the results appear consistent: the therapist’s focus on the patient’s conflictual behavior patterns and the patient’s involvement rather than avoidance in responding to these challenges, are factors that contribute to improving the therapeutic alliance. Fluctuations in the alliance, especially in the middle phase, thus appear to reflect the re-emergence of the patient’s dysfunctional avoidant strategies and the task of the therapist is to recognize and resolve these conflicts. Fenton L. R., Cecero J. J., Nich C., Frankforter T., Carroll K. (2001). Perspective is everything: The predictive validity of six working alliance instruments. J. Psychother. Pract. Res. 10, 262–268 [ PMC free article] [ PubMed] [ Google Scholar] Di Nuovo et al. ( 1998) propose some methodological changes to increase the utility of research findings, namely, omitting the use of methodological “control” techniques with comparisons between groups, re-evaluating single-case research, reconsidering the use of longitudinal studies, and using systematic replication and meta-analysis to guarantee the generalizability of results, even with single cases. Classic psychodynamic conceptualizations of the alliance as well as Bordin’s ( 1979 integrative model. Specific focus on the affective aspects of the alliance. By combining items taken from other scales (VPPS, VTAS, and HAcs) Marziali and colleagues developed the TARS (Therapeutic Alliance Rating Scale). There are three versions of the TARS according to the rater’s perspectiveA good relationship, the research finds, is essential to helping the client connect with, remain in and get the most from therapy. “It’s primary in the sense of being the horse that comes before the carriage, with the carriage being the interventions,” says Simon Fraser University emeritus professor Adam O. Horvath, PhD, who studies the therapy alliance. Rogers ( 1951) defines what he considered to be the active components in the therapeutic relationship: empathy, congruence, and unconditional positive regard. These were seen as the ideal conditions offered by the therapist but were later shown to be specifically essential for client-centered therapy (Horvath and Greenberg, 1989; Horvath and Luborsky, 1993). While Rogers stressed the therapist’s role in the relationship, other works focused on the theory of the influence of social aspects. The work of Strong ( 1968) was based on the hypothesis that if the patient is convinced of the therapist’s competence and adherence, this will give the latter the necessary influence to bring about changes in the patient. A strong bond is crucial to the success of counselling and psychotherapy. It can be especially valuable to clients who may have struggled to form relationships in their past, and those who experienced traumatic events in their early years, leading them to find it difficult to form relationships in adulthood. Therapy allows clients the chance to explore their relational attachments, bonds and experiences through their relationship with their therapist, which is why this relationship is so important. What makes the therapeutic relationship so different? De Roten Y., Fischer M., Drapeau M., Beretta V., Kramer U., Favre N., Despland J.-N. (2004). Is one assessment enough? Patterns of helping alliance development and outcome. Clin. Psychol. Psychother. 11, 324–331 10.1002/cpp.420 [ CrossRef] [ Google Scholar] Frank A. F., Gunderson J. G. (1990). The role of the therapeutic alliance in the treatment of schizophrenia. Relationship to course and outcome. Arch. Gen. Psychiatry 47, 228–236 [ PubMed] [ Google Scholar]