How can an effective therapeutic relationship contribute to facilitating change in therapy? To answer this question, you need to relate the fundamentals of a good therapeutic relationship to the change process, applying theories and concepts discussed so far in the subject.
This essay will define an effective therapeutic relationship and discuss its role in producing positive therapeutic outcomes. For this purpose the fundamental core qualities as conceptualized by Rogers and Bordin needed to form a therapeutic alliance will be identified and discussed and linked to positive therapeutic outcomes. Drawing together these discussions and other identified fundamental qualities leads me to the hypothesis that therapeutic outcomes rely heavily on the therapist’s commitment to their own internal work and subsequently their ability to integrate this depth of awareness into real contact with clients in order to facilitate change.
What is an effective therapeutic relationship?
The therapeutic relationship is fundamentally the relationship between the therapist and client specifically defined by the purpose of supporting the client to find a more satisfying way of living (McLeaod & McLeaod, 2011). Contained within the relationship is the internal view of both the therapist and client regarding their connection, its effectiveness therefore relies on the nature of these views and their ability to support positive outcomes (Priebe and McCabe, 2008; and Norcoss & Wampold, 2011). The importance of the therapeutic relationship is shown in Lamberts (1992) four factor model of change which identifies the therapeutic relationship as being the largest therapist associated component affecting therapeutic outcomes (Sprenkle & Blow, 2001).
Bordin (1979) first conceptualized the therapeutic alliance as containing three factors; the emotional bond between the therapist and client, the agreement of treatment goals and understanding of tasks needed to accomplish those goals. Bordin further hypothesized that the strength of the relationship is the greatest prediction of therapeutic outcomes rather than the type of relationship (ibid).
How does a counsellor develop an effective therapeutic relationship that facilitates the change process?
Extensive research highlights the therapist’s ability to embody fundamental qualities as crucial in developing a facilitative environment that allows for deep contact with the client and therapeutic change (Corey, 2009; Sprenkle & Blow, 2001; and Norcross & Wampold, 2011). Rogers first conceptualized these qualities as congruence, unconditional positive regard and empathic understanding and linked there efficacy in facilitating positive therapeutic outcomes (Corey, 2009; and Rogers, 1957).
Congruence as an interpersonal skill implies authenticity on the therapist’s behalf, the action of attending to the therapy process with an intention to be present and genuine in the interests of building a trusting connection and environment for change (Greenberg & Geller, 2001). When applied to Hills (2004) three step model of change, congruence in the exploration stage of the therapeutic process does not stand alone but rather influences the nature of the therapist’s interaction (McLeod & McLeod, 2011). For example Hill identifies the following skills needed to establish rapport; questioning, attending, listening, silence and reflection, congruence in this example is the shell that contains these skills and influences their ability to yield therapeutic outcomes (ibid). With the therapist’s congruence, also referred to as a grounded presence, the client learns to trust in the relationship, is modelled healthy relational dynamics, which in turn supports their internal understanding, acceptance and healthy expression of their own values, attitudes and beliefs (Mann, 2001; and Greenberg & Geller, 2001).