What is a therapeutic relationship?

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Therapeutic relationship is “the extent to which a client and therapist work collaboratively and purposefully and connect emotionally, and is conceptualized as a common, or generic, factor in that it is believed to cut across various treatment approaches” (Gellhaus -Thomas, Werner-Wilson, & Murphy 2005,p.1) .The therapeutic relationship is the bond that develops between the psychologist and client. It is a safe and close relationship based on trust that provides space to express feelings, be heard, valued, understood and enables to practice behaviours and newly acquired aptitudes. A good therapeutic relationship is a necessary and crucial factor that influences the success of the therapy. Each relationship is different but there are common characteristics and themes that build it.

What are the characteristics of the therapeutic relationship?

Genuineness

The psychologist and the client need to feel free to be themselves and genuinely relate to each other. This strengthens the relationship .A therapy session should be  a time in which social facades are not used. Genuineness can be seen in non verbal communications like keeping eye contact, nodding that matches the expressed words or emotions and even in spontaneous reactions and humor. The therapist genuineness is seen in being aware, present, involved, attentive ,responsive and expressive.

Trusting and a non-judgmental attitude

Exploring painful emotions, distressing thoughts and being vulnerable, as well as, motivated and engaging can occur if the client has trust and confidence that there is no threat of rejection , judgment and the  belief that the psychologist has his/her best interest at heart. There is a show of mutual respect.  Clients, who perceive the therapeutic relationship as trustworthy are less likely to be resistant to confront their fears and are open to exploration, new perspectives and change. There is a stronger sense of connection and dedication to the therapeutically process. Trust also nourishes hope ,positive feelings  in addition to feeling respected and valued, which  strengthens the client’s self- esteem.

Empathy and care

 Clients need to see and feel that their psychologist really hears them, values and understands their needs and intentions. Empathy enables the psychologist to do that and thus make the therapeutic environment feel warm, attentive, compassionate and caring. Empathy can be expressed non verbally and verbally by validating responses  and by  being inquisitive and asking relevant questions to better understand the client’s background and perspectives. When the client feels that s/he is the focus of attention and is being engaged in the conversation, it helps and grows a secure and trusted basis of the therapeutic relationships. It promotes analyzation,  reflection, meaning creation,insights and supports clients’ active self-healing efforts.

 Insight and experience

The therapeutic relationship is also a collaborative relationship regarding goals, purpose and tasks.It puts the client in a position of shaping their own treatment plan.  Being that therapy is interactive and each session is different than each session essentially becomes a mutual meeting of the minds, an opportunity of growth and learning for both,the clients and the psychologist. Therapy can thus be a rewarding experience for both sides.

Do you recognize these factors in your own therapeutic relationships?

Do you feel comfortable and can you talk freely with your psychologist?

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Ackerman, S., & Hilsenroth, M. (2003). A review of therapist characteristics and techniques positively impacting the therapeutic alliance. Clinical Psychology Review, 23, 1-33.

Black, S., Hardy, G., Turpin, G., & Parry, G. (2005). Self-reported attachment styles and therapeutic orientation of therapists and their relationship with reported general alliance quality and problems in therapy. Psychology & Psychotherapy: Theory, Research & Practice, 78, 363-377.

Gellhaus-Thomas, S.E., Werner-Wilson, R., & Murphy, M.J. (2005). Influence of therapist and client behaviors on therapy alliance. Contemporary Family Therapy, 27,1,19-35.

Lambert, M., J. & Barley, D. E., (2001). Research Summary on the therapeutic relationship and psychotherapy outcome. Psychotherapy, 38, 4, 357-361.

Martin, D., Garske, J., &Davis, M. (2000). Relation of the therapeutic alliance with other outcome and other variables: a meta-analytic review. Journal of Consulting and Clinical Psychology, 68, 438-450.

Schnellbacher, J., & Leijssen, M. (2009). The significance of therapist genuineness from the client’s perspective. Journal of Humanistic Psychology, 49,2,207-228.

Sharpley, C.F., Jeffrey, A.M., & Mcmah, T. (2006). Counsellor facial expression and client-perceived rapport. Counselling Psychology Quarterly, 19,4, 343-356.

Sullivan, M., Skovholt, T., & Jennings, L. (2005). Master therapists’ construction of the therapy relationship. Journal of Mental Health Counseling, 27, 48-70.

 

3 strategies to boost your self- esteem

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A  healthy level of self- esteem is comprised of a balanced and realistic evaluation of the whole self, which involves awareness, recognition and acceptance of both positive and negative aspects of the self. Needless to say challenging your beliefs about yourself, adjusting unhelpful behaviors and adapting helpful ones will heighten your self- esteem the most. The following, however, are 3 DIY strategies that could help too.

1. Make a distinction between who you are and what you do/have done-when we criticize ourselves for making a mistake, failing, not living up to our expectations or being imperfect, we tend to label ourselves and that label influences how we value ourselves. Firstly always question if you deserve that label.

Realize that, for example, making a stupid and inappropriate remark does not mean you are stupid. Your IQ did not change from what it was before that remark was made, did it not? It is a behavior choice at a specific moment not the definition of who you are. Similarly can be said in situations in which you might have failed to reach a goal… Does that mean you are failure as you might label yourself? Will you always fail in the future? Have you had no successes before? And what is your definition of failure, does it truly define your whole self or is it specific to this goal?

When you are able to make that distinction, you are not letting situational and changeable factors diminish your self- esteem. Learning your lesson and improving the next time will strengthen  your self-esteem, as well as, your skills and capacities.

2. Focus on yourself not on comparing yourself with others-  Comparing ourselves to others is usually done by focusing only on that which we lack/ our flaws , which magnify them and by ignoring our strengths and assets,  while in the comparison  over-exaggerating  others’ assets, even putting them on a pedestal as the ideal standard and minimizing or ignoring others’ flaws and struggles. Both are unrealistic and the consequences are harmful to your self -esteem.

Redirect your focus on your own strengths, assets and fortunes instead. Appreciating and valuing your true self starts by acknowledging and celebrating all the positive points of your inner beauty( your values, virtues, inner strengths, characteristics, abilities, talents etc.) You can write them down and also mention why you are grateful for them, which will solidify your positive points. Think about being a better version of yourself by developing your own strengths and skills further, growing the positive characteristics and virtues in you even more, rather than aiming at becoming or achieving a biased and imagined perceived standard that you see in others.

Motivate and encourage yourself by looking at your achievements, who you are right now and how you can realistically become a better version of the present you, rather than only criticizing yourself for not being who you think you should be more like and changing yourself to be like others. Be accepting and kinder to yourself, as well as, pat yourself on the back when you deserve it. It will help you boost your self -esteem as you will see yourself in a more positive and imperfectly human light.

Be aware of your needs and nurture yourself – Being aware of what you need, be it psychological, emotional, social, physical needs etc ( e.g. emotional support,  time to relax or heal, delegate your duties, alone time, further develop your knowledge,  pamper yourself, taking a nap) and fulfilling these needs is telling yourself I matter. I value myself and I am worthy of giving myself the love, care, attention and personal growth that I require now. I am worthy of investing time and effort in myself at least I as do in others (who you probably unquestionably are attuned to and attend more easily to their needs). When you do that you validate yourself and thereby strengthen your self- esteem.

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