Therapeutic Alliance - Essay Example

?Therapeutic Alliance The quality of the therapeutic alliance is a predictor of the treatment’s positive outcomes. This report reflects on and elaborates this concept. First of all, an introduction has been given as to what therapeutic alliance actually is. Its importance in the treatment process has been discussed. Some findings from the past empirical research have been taken into account to support its importance. After that, characteristics of a positive therapeutic alliance have been discussed following which is an illustration about what factors lead to a positive therapeutic alliance. This section discusses the roles of both the counselor and the client working in the alliance. The report is summarized in a concluding paragraph and Harvard referencing has been used properly. 2. Introduction- What is Therapeutic Alliance? Therapeutic Alliance is the term that defines the collaborative nature of the relationship between the counselor (therapist) and the client (patient) in the field of psychotherapy. Safran and Muran (2003:1) consider the quality of the therapeutic alliance as “the most robust predictor of treatment success.” It is normal for therapists to undergo alliance issues with the patients. When both the parties are comfortable with each other, the patients feel engaged in the treatment process and are more responsive which helps in the decision-making about their treatment. The patients recover soon when they are allowed to participate in the treatment process with confidence. Muran and Barber (2010:7) affirm that therapeutic alliance ensures that the work is going well and it “is off-course when our patient seems to be losing interest, becomes silent or angry with us, or seems to feel misunderstood.” This requires the therapists to work out new strategies to enable the patient to regain his interest. Alliance theory has gained much importance in psychotherapy and aims at establishing healthy relationships between the therapist and the patient. This relationship encourages the involvement of the patient’s goals and preferences in the treatment process and makes the therapist outline strategies to achieve these goals. Therapeutic alliance focuses on listening to the patient without the therapist becoming judgmental. It is based on the concept of inclusive practice which involves the clients’ contribution just as well as the counselor is involved in the treatment process. The patients are allowed to participate in the decision-making process and are encouraged to participate and collaborate just as well. They are left free to make their choices and decisions that would affect their lives and their treatment outcomes (Ross 2006). When a patient is listened to and his problems are discussed, he feels relieved and the treatment process fastens. He feels that he is being given importance and that his decisions matter. This not only soothes him but wakes in him a wish to recover. This is the essence of therapeutic alliance. The patients’ participation in the treatment process is also a form of outcome as is considered as important as the treatment itself. The whole process is beneficial enough for the therapist as well because knowledge is being shared by working with patients and thus improved practice is made possible. The patients or those who are using the services bring out their own ideas and innovation and thus the therapist tends to be at a more informed clinical position. The Therapeutic Relationship is the Most Important Ingredient in Successful Therapy (Singer 2011). 3. Past Research and the Findings This section summarizes the findings that have been located by researchers who have been studying the importance of positive therapeutic alliance and the effect it has on the treatment. Researchers have found that when clients are not satisfied with their relationship with the physician, this decreases their chances of fast recovery. Thus, client-rating is important. Positive therapeutic alliance works as a consistent predictor for positive recovery. Sometimes, the alliance serves as a more important part of the treatment than the treatment itself. Researchers also suggest that the intensity of the emotional bond in the alliance does not depend upon the time the services have been availed which means that the bond can be developed in one or two sessions, and if does not have to develop, many sessions will be unable to create an emotional link between the client and the counselor. Counselors should be able to listen to the clients by getting aware of and focusing on their own personal abilities to a certain extent and not too much that the concentration is diverted to their own selves rather than to their patients. Moreover, it is also important for the therapist to make engaging relationships with the client’s family to assist the quality of the alliance with the client. Since, the client’s family will be close to him, hence it is important to involve them in the alliance as well otherwise negative relations with the family may harm the alliance with the client even if it is positive. 4. Characteristics of Positive Therapeutic Alliance Here, we discuss the characteristics of a positive therapeutic alliance which may feel as simple but a constant practice is required to give these characteristics a meaningful implementation. Since, therapeutic alliance is nearly the most important part of the treatment, the clinicians who do not integrate it as part of their practice are doing a great disservice not only to their client but also to the field of therapy itself (Singer 2011). Singer quotes Dr. Carl Rogers who defines the helping relationship between the two parties as “a relationship in which one of the participants intends that there should come about , in one or both parties, more appreciation of, more expression of, more functional use of the latent inner resources of the individual” (1961, cited in Singer). Dr. Carl Rogers (1957) has stated that there some characteristics that are vital for a positive therapeutic alliance. These characteristics include the therapist’s sincerity toward establishing a helping relationship with the client, unconditional positive regard, empathy, shared agreement on goals in therapy, and integration of humor in the relationship. These are some of the many characteristics that a therapeutic alliance should contain in order to be positive. 5. How to Establish Therapeutic Alliance? This section discusses the factors that contribute toward a positive therapeutic alliance. Therapists should undergo proper training regarding learning the strategies that will help them make positive therapeutic alliance with their patients. Positive alliance requires that respect and trust is mutually shared between the therapist and the client. Hope and expectation should be made to bear fruit through positive therapeutic relationship between the two parties. 5.1. The Counselor’s Role Counselor’s characteristics that can lead to a positive relationship with the client include: 5.1.1. Non-possessive Warmth The counselor should be able to establish an emotional link with the client so that the latter feels free to convey his feelings to the former without feeling that the former is an all-knowing person with authority. This is important to give the relationship a warm and cozy touch which breaks the cold ice between the two parties. 5.1.2. Friendliness There should be a touch of humor in the relationship so that the client is able to be in a talk-it-all-out position. Without the counselor’s friendliness, the client would remain reserved and this may lead to his hiding of many facts that may be necessary for the treatment process. 5.1.3. Therapist’s Genuineness The clinician needs to be aware of his capabilities and should be himself. He should not be egoistic and should not consider himself as a super power that has all the control over the client and his treatment decisions. His genuineness and sincerity toward the client will make the later wish to participate in the decision making process thus fastening up the recovery. 5.1.4. Respect Despite the friendliness, it is important that the therapist show deep respect toward the client to make him feel comfortable and honored. This involves an acceptance of all features of the client’s nature regardless of who they are and how they behave. The clinician should treat the client as a whole and not a certain aspect of his, and this begins with respecting him as an individual being. 5.1.5. Empathy The clinicians should not be judgmental about the clients’ aspects but should be understanding and compassionate toward their feelings, emotions and decision (Feller & Cottone 2003). Empathy is an important factor that builds a positive therapeutic alliance as the client feels that his problems are being understood, not judged. The clinician should be able to make the client disclose his private affairs without having him feel that he is being judged. 5.1.6. Mutual agreement of goals and preferences The treatment process can only proceed with positive outcomes if there is mutual agreement on goals, objectives and preferences from both the sides. The counselor should listen to the client and give importance to his preferences regarding his therapy so that a shared agreement is made possible. The client should be made to understand the goals rather than having the goals imposed on him. This way he will show more compassion to work out to achieve those goals and participate actively. 5.1.7. Advice The clinician should not hurry up in giving direct advice to the client until asked. This is because the client will feel that he is not being listened to and the clinician has already judged him and giving advice. This weakens the therapeutic alliance. Thus, it is important that the client is entered into a discussion to reveal the facts so that he himself reaches the conclusion and picks up the advice, not having the clinician let him know what he should do. 5.2. The Client’s Role It is usual for the client to be emotionally distant from the therapist in the start of the treatment process. Clients can also be ailed enough to develop helping relationship with the therapist, or they may be frustrated enough to develop any kind of association with or trust upon the clinician. In any case, when the client chooses to get a treatment that is the beginning of his recovery from the psychiatric or psychological disorders that he is having. Thus, it is also important to create awareness in the client what therapeutic relationship is and how it would affect his recovery process. Once he knows about the advantages of the alliance, he will show enough eagerness so as to actively engage with the therapist in making decisions about himself. Thus, the client should be able to make himself comfortable with the therapist and should consider him his best friend for the time being. He should know that he needs the therapist much more than he needs anybody else at that crucial time and should confide in him his private affairs and things that have been upsetting him for long. Only that way the therapist will be able to touch the root cause of the problem and help the client make choices and decisions about the treatment. The client should also listen to what the therapist tells him to do and should take the words seriously while not feeling that the therapist is being judgmental. The client should let the therapist ask all kinds of questions that are a part of the psychoanalysis procedure and should not feel insecure while talking about his past emotional experiences. 6. Conclusion Therapeutic alliance is the concept that has gained much importance in the field of psychotherapy because of the positive outcomes witnessed by the researchers when the counselors and the clients engaged in a helping relationship. A positive therapeutic alliance throws more responsibilities on the shoulders of the clinicians if they want their clients to fasten up the recovery process. When the alliance involves warmth, empathy, compassion, genuineness, active listening, trust, and emotional bondage, it results in the client showing energy and strength to make their own decisions that are according to the goals and objectives defined by the counselor who gives importance to clients’ preferences and designs out the treatment process accordingly. Developing a positive therapeutic alliance is an art that the therapist will learn through consistent practice and willingness. The willingness is also important on the client’s part because the alliance will only be successful if the client is also willing to form the bond with his therapist. References Feller, CP & Cottone, RR 2003, ‘The importance of empathy in the therapeutic alliance’, Journal of Humanistic Counseling, Education and Development, viewed 21 January 2011, Muran, JC & Barber, JP 2010, ‘Alliance theory and measurement’, The Therapeutic Alliance: An Evidence-Based Guide to Practice, illustrated edn, Guilford Press, New York. Rogers, CR 1957, ‘The necessary and sufficient conditions of therapeutic personality change’, Journal of Consulting Psychology, vol. 21, pp. 95-103. Ross, I 2006, Inclusive Practice, viewed 15 January 2011, Safran, JD & Muran, C 2003, ‘The therapeutic alliance reconsidered’, Negotiating the Therapeutic Alliance: A Relational Treatment Guide, illustrated edn, Guilford Press, New York. Singer, RA 2011, ‘The therapeutic relationship is the most important ingredient in successful therapy’, SelfGrowth.com, viewed 21 January 2011, Read More