Thursday, February 5, 2009
Let's discuss "The Therapeutic Relationship"
I read an article by Richard A. Singer Jr,. M.A, CAC
The article is called: The Therapeutic Relationship is the Most Important Ingredient in Successful Therapy
I couldn’t agree more *nodding head*.
Some key points in the article:
Any successful therapy is grounded in a continuous strong, genuine therapeutic relationship – or as Carl Rogers says, “Helping Relationship”.
CHARACTERISTICS OF THE THERAPEUTIC RELATIONSHIP
Why is this important? Because the therapeutic relationship forms the foundation for treatment as well as successful outcome of treatment. Without the “relationship being the number one priority in the treatment process, clinicians are doing a major disservice to clients.
Carl Rogers presented 3 characteristics that are essential and sufficient for therapeutic change:
Therapist’s genuineness within the helping relationship.
1. ALL façades should be left out of the therapeutic environment-the therapist should be a REAL human being with REAL thoughts, REAL feelings, and REAL problems. This will foster trust.
2. Unconditional positive regard. Clinicians need to treat the individual NOT a diagnostic label. Diagnoses are not real entities, PEOPLE ARE.
3. Empathy. It is ESSENTIAL to have the ability to enter the clients ‘private world’ and understand their thoughts and feelings WITHOUT judgment.
(the author of the article adds 2 more)
1. Shared agreement in goals in therapy. When clinicians have their own agenda and do not cooperate with the client, this can cause resistance and a separation in the helping relationship. Therapists should think of their own personal lives- if FORCED to work on something you have no interest in, how much passion or energy will you put into it, and how much respect will you have for the person doing the coercing.
2. Integrate humor in the relationship.
Therapists should also ask themselves these questions BEFORE entering into a helping relationship:
* Can I be in some way which will be perceived by the client as TRUSTWORTHY, dependable, or CONSISTENT in some deep sense?
* Can I be real? Clinicians must accept themselves before they can be real and accepted by clients.
* Can I let myself experience positive attitudes toward my client (warmth, caring, RESPECT) without fearing these?
* Can I give the client freedom to be who they are?
* Can I receive this client as she is? Accept her completely and COMMUNICATE This acceptable?
In 1994, Orlinsky, Grave, and Parks conducted a study and identified variables and behaviors that consistently demonstrated to have a positive impact on treatment outcome…. These include:
affirmation of the client
ability to engage the client and focus on the client’s issues and emotions
In 1996, Constaquay, Goldfried, Wiser, Raue, and Hayes stated, “It is imperative that clinicians remember that decades of research consistently demonstrates that RELATIONSHIP factors correlate MORE HIGHLY with client outcome than do specialized treatment techniques.”
GEE, I WONDER WHAT MARSHA LINEHAN WOULD HAVE TO SAY ABOUT THAT?
The author challenges all therapists to ask themselves how they would like to be treated if they were the client.
I personally, have some questions I would like to ask my ‘dear therapist’
~ How would YOU feel if you called your therapist and she did not call you back?
~ How would YOU feel if you sent an email to your therapist laying your soul bare, only to have it ‘brushed away’ with no response, or with some ‘come clinical’ response signed: Sincerely, DT. (Sincerely? Do we not know each other at all????)
~ How would YOU feel if your DT stated she would call you back, but DIDN’T?
~ How would YOU feel if your DT changed her boundaries, but would not explain what the NEW boundaries were, and when directly asked about it, replied, “I have my reasons.”
~ How would YOU feel if you caught your DT in a lie?
~ How would YOU feel if your DT was a completely different fucking person than the one you saw 2 years ago, and it was the SAME PERSON!!!!!!
Tell me, DT, how does that make YOU feel????
Because I can tell you how it has made me FEEL:
It has validated my belief that people cannot be trusted. It has made me terrified to ever let myself be vulnerable to another person. EVER AGAIN! It has confirmed my decision to walk away from the mental health program for good this time! It has made me question why I ever trusted you in the first place.
It has made me wonder why the hell you chose to fuck up my life even more?
Was it not enough to be physically and sexually abused for 10 years as a child?
Was it not enough to be hated by my own mother?
Was it not enough to be raped repeatedly?
Was it not enough to have nightmares and intrusive memories and flashbacks and get NO help from you?
Was it not enough to be so filled with self hate that I could see no other way out than to want to die, to cut my own flesh?
Was it not enough to be so filled with shame and badness that I had to vomit repeatedly every night to try to get it out of me?
Was it not enough?
Did you really have to fuck me too? (in the mental - mindfuck kind of way).
Why? What was your motive?
Oh, "I'm sure you have your "REASONS"