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Between Therapist and Client

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Strong S. R. (1968). Counseling: an interpersonal influence process. J. Couns. Psychol. 15, 215–224 10.1037/h0020229 [ CrossRef] [ Google Scholar]

Randeau S. G., Wampold B. E. (1991). Relationship of power and involvement to working alliance: a multiple-case sequential-analysis of brief therapy. J. Couns. Psychol. 38, 107–114 10.1037/0022-0167.38.2.107 [ CrossRef] [ Google Scholar] In the initial stage, the patient and therapist make an agreement to devote time and energy to achieve specific goals. In this stage, the perception of the therapist, intensity of client motivation, and compatibility of personality/experiences are important factors.Do they even have life preservers (tools for depression reduction) in the office? Or are their techniques irrelevant to depression treatment?

Freud (1905) was the first to describe transference as the repetition of an old relationship. It occurs when feelings from an old significant object/event create feelings and impulses that are transferred onto the therapist. If there is any answer to these questions that gives you serious pause, then trust your instincts; too much is at stake.• Give yourself time for the project, time to identify problems, to identify patterns of reaction that are nonproductive, to learn and establish new patterns. Bordin (1979) is famous for conceptualizing the working alliance in three parts: tasks, goals, and the bond.Internal consistencies of four scales were all acceptable (alphas ranged from 0.77 to 0.87). The internal consistency of the Client Initiative scale was low (0.55; Agnew et al., 1998). Young J. E., Klosko J., Weishaar M. E. (2003). Schema Therapy: A Practitioner’s Guide. New York: Guilford [ Google Scholar] Some theorists have defined the quality of the alliance as the “quintessential integrative variable” of a therapy (Wolfe and Goldfried, 1988), and in the present state, it seems possible to affirm that the quality of the client–therapist alliance is a consistent predictor of positive clinical outcome independent of the variety of psychotherapy approaches and outcome measures (Horvath and Bedi, 2002; Norcross, 2002). Thus, it is not by chance that in their meta-analysis, Horvath and Luborsky ( 1993) conclude that two main aspects of the alliance were measured by several scales regardless of the theoretical frameworks and the therapeutic models: personal attachments between therapist and patient, and collaboration and desire to invest in the therapeutic process. According to their meta-analysis based on the results of 24 studies, Horvath and Symonds ( 1991) demonstrate the existence of a moderate but reliable association between good therapeutic alliance and positive therapeutic outcome. More recent meta-analyses of studies examining the linkage between alliance and outcomes in both adult and youth psychotherapy (Martin et al., 2000; Shirk and Karver, 2003; Karver et al., 2006) have confirmed these results and also indicated that the quality of the alliance was more predictive of positive outcome than the type of intervention (but for slightly different results in youth psychotherapy see McLeod, 2011). Luborsky’s ( 1976) psychodynamic concept of the two types of helping alliance (i.e., patient’s perception of the therapist as supportive, and representing the collaborative relationship between patient and therapist to overcome the patient’s problems). These scales rate the alliance and consist of the HAcs (Helping Alliance Counting Signs Method), HAr (Helping Alliance Rating Method), and HAq (Helping Alliance Questionnaire Method).

Learning how to connect despite difficulties is healing. Human beings wither when they are not connected with others. When you learn the skills of connecting you create the safety for exploring vulnerabilities.

PositivePsychology.com’s Resources

Recognize that over and above the content of therapy, the client-therapist relationship is itself a therapeutic agent. When you feel like you are drowning in the sea of blues and someone is about to throw you a life preserver, you must be able to trust that they'll be smart and strong enough to pull you out of danger. That requires that you choose a therapist with great care. Some questions to consider in selecting a therapist: Adequate internal consistency and inter-rater reliability (Elvins and Green, 2008; Kolden, 1991). The results show that the patient’s in-session emotional Hartley D. E., Strupp H. H. (1983). “The therapeutic alliance: its relationship to outcome in brief psychotherapy,” in Empirical Studies in Analytic Theories, ed. Masling J. (Hillsdale, NJ: Erlbaum; ), 1–38 [ Google Scholar]

Kivlighan D. M., Shaughnessy P. (1995). Analysis of the development of the working alliance using hierarchical linear modeling. J. Couns. Psychol. 42, 338–349 10.1037/0022-0167.42.3.338 [ CrossRef] [ Google Scholar] Related to mutuality is another strong relationship builder: collaboration, or working together to define and actualize therapy goals, including the direction the therapy relationship is taking.When it’s time to end therapy, research by Norcross and colleagues finds that eight actions tend to promote better patient outcomes: having a mutual discussion about how the therapy went, discussing the patient’s future functioning and coping, helping the patient use new skills beyond therapy, framing personal development as an ongoing process, anticipating post-therapy growth, talking specifically about what it means to end this course of therapy, reflecting on patient gains, and expressing pride in the patient’s progress and in the mutual relationship ( Psychotherapy, Vol. 54, No. 1, 2017). Research examining outcomes of psychotherapy and counseling have found that only 15% of treatment success can be attributed to the type of therapy or the techniques administered (Hubble, Duncan, & Miller, 1999). Horvath A. O., Marx R. W., Kamann A. M. (1990). Thinking about thinking in therapy: an examination of clients’ understanding of their therapists’ intentions. J. Consult. Clin. Psychol. 58, 614–621 10.1037/0022-006X.58.5.614 [ PubMed] [ CrossRef] [ Google Scholar] Norcross J. C. (2002). Psychotherapy Relationships That Work: Therapist Contributions and Responsiveness to Patients. New York: Oxford University Press [ Google Scholar]

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