Reaction paper

  • Category:
    Psychology
  • Document type:
    Case Study
  • Level:
    Masters
  • Page:
    3
  • Words:
    1936

Question 1

One characteristic of a therapeutic relationship is the development of a working alliance. The alliance entails developing a mutual understanding between the client and the therapist by agreeing on the goals for change, the tasks to be undertaken to attain the goals and the establishment of a bond that can maintain the parties to work together (Bordin, 1979). The second characteristic is transference of relationship which entails transferring the attitudes, behavior and feeling of client to the therapist. The third attribute is the real relationship which involves genuine reactions and perceptions of both participants towards each other which can lead to the formation of an alliance which further creates a safe environment for the client react and respond (Horvath and Greenberg, 1994).

Question 2

A therapeutic relationship might rupture due to the following factors

  • Relationship problems that arise if the therapist experiments with his or her own cultural competencies. For instance; trying to integrate culture in therapy by discussing cultural and racial differences and similarities during therapy, may be embraced negatively by the client (Elkind, 2002).

  • When the client is not ready to respond to the intervention of the therapist. Most of the reported raptures arise from repletion of a previous problem in the therapist- client relationship which arises from the inability of the client to respond to therapeutic intervention (Prout and Wadkins, 2014).

  • Differing views between the therapist and the client concerning the goals of treatment. Mozdzierz, et al (2014) highlights that if the therapist does not effectively assess the client’s treatment goals and needs then rapture is bound to occur. This is because the client will have a different opinion about his/ her goals of treatment while the therapist holds other views.

  • Misunderstanding from both sides. Clients may sometimes feel criticized or misunderstood by the therapist in certain moments. Concurrently, the therapist may develop a feeling of being misunderstood or frustrated by the client.

Strategies to prevent ruptures in therapeutic relationships

  • Making clarification on misunderstanding at the surface level. In the event that a therapist identifies that the client seems withdrawn, frustrated and criticized , the therapist should act in a non-defensive manner and acknowledge that she/ he has noticed how the patient feels (Safran and Muran,2011).

  • Changing the goals and task through modification of behavior in a manner that is meaningful to the patient (Safran and Muran, 2011).

  • Encouraging the client to get in touch with unresolved and underlying feelings such as anger (Vicki,et al, 2012).

Question 3

How and why Mark’s therapeutic relationship with you (the Counsellor) ruptured. Explain ways this relationship could be repaired.

The therapeutic relationship between Mark and I ruptured due to his lack response to intervention of the therapist. In the beginning the relationship between Mark and I was good. He attended the first two sessions punctually. However his response to questions begins to decline. This is a clear indication that a rupture has occurred. Hill and Knox (2009) highlight that raptures may sometimes occur when clients encounter new issues or experiences from their pasts that still trouble them. Such experiences may trouble their thinking patterns and further affect their response to the intervention of the therapist. Mark recalled his past experience of being bullied during high school. The encounter with this particular experience may have influenced his slow response to my questions indicating a lack of response to my intervention as his therapist.

Also it can be stated that the therapeutic relationship between Mark and I raptured due to relationship problems which arose due to my efforts as a therapist to intensify Marks emotional arousal which disrupted our therapeutic alliance. I asked Mark about how he feels concerning his experience with high school bullying and how this had affected him long term, he then become defensive. By asking Mark this question, his emotions were aroused, thus leading to the rapture of our therapeutic relationship. Elliott et al (1993) highlight that; a therapist can intensify the emotional arousal of a client through deepening their inner experience concerning a certain issue. This may influence the client to reject engagement in activities that the therapist suggests. The question concerning how bullying made Mark feel deepened his inner emotions making him defensive and unwilling to reply to my questions effectively. He even begins to come late for the sessions.

In order to repair the relationship between Mark and me, I need to change the goal or tasks. Hatcher (2010) proposes that rather than focusing or concentrating on the goal or task that brings about disagreement or bring negative emotions to the client, the therapist needs to work on goals or tasks that are meaningful to the client.

Also in order to repair the relationship between Mark and me, I will develop an empathetic environment. This will make Mark feel that I understand him and that I can relate to his experience with bullying. The practice of empathy by a therapist is basically a useful way healing a rapture indirectly (Safran, et al, 2007). Empathy also greatly instigates the rebuilding of the alliance bond (Swank, 2010).

Question 4

The notion that counselors are more effective if they have experienced problems similar to those faced by their clients can be argued as true. This is due to the fact that if a counselor has undergone a similar experience as the client they are able to empathize with the client which gives them the competency of how to handle the client. Empathy which entails putting yourself in another person’s shoes is basically the foundation of good therapy. Naturally many counselors are usually empathetic nevertheless is the counselor has experienced what the client has gone through they are definitely bound to be more empathetic. By practicing empathy, the client will feel more understood, safer and finally develop the feeling that their situation can actually change (Rockville, 2000).

A study conducted by Knox, et al (1997) through a qualitative analysis of client perceptions of the effects of helpful therapist self-disclosure in long-term therapy, supports the fact that counselors are more effective if they have experienced problems similar to those faced by their clients. The study involved a sample of thirteen adult psychotherapy clients, who were undertaking long term therapy. The clients were interviewed twice concerning their experiences with instances when the therapist did self – disclosure. The findings of the study revealed that self-disclosure by the therapist brought various positive outcomes to the client. One of the benefits was that self –disclosure by the therapist was useful in reassuring the clients that they can also overcome their existing conditions. Another benefit was that clients were more able to discuss their personal experiences more openly. Also the self-disclosure by the therapist influenced the clients to have a new view points for change and also equalized or improved the therapeutic relationship.

Also counselors are more effective if they have experienced similar problems as their clients due to the development of a positive attitude which can influence change for the clients. When a counselor has a similar experience as the client, they tend to develop genuine and deep care for the client. This is basically because they have been through the same situation before. Although the therapist may not support some of the actions performed by the client, they tend to have an attitude of accepting the client even when they are disappointed by the client. The existence of such a positive attitude can influence change for the client (McLeod, 2008).

The cognitive behavioral theory also supports the notion that counselors are more effective if they have experienced problems similar to those of their clients. This can mainly be achieved if the counselor discloses their experience (Goldfried, 2003). One of the proponents of the behavioral theory, Lazaurous (1994) argues that there a significant contribution to the therapeutic relationship when a counselor answers the questions asked by the client appropriately instead of asking a client questions. For instance, when a counselor asks a client‘’ can you explain to me why you want know’’, this implies that the counselor is asking the client another question as opposed to answering the question. Nevertheless, if a counselor has a similar experience as that of the client they would definitely find it easier to answer the questions asked by the client.

If counselors have experienced similar problems as the clients they can be more effective essentially when it comes to eliminating therapeutic raptures. Raptures occur when clients are not ready to share their experience. As indicated in the case, Mike was not ready to disclose his feelings concerning bullying to me. However, I believe that if I may have experienced bullying in my past and then disclosed it to him. I definitely know that Mike would have been more responsive to my questions.

A counselor with a similar experience as the client can also assist clients with different challenges. For instance; clients who display tendencies of fear tend to avoid close involvement due to fear of rejection. Thus disclosing their issues to the counselor is usually difficult. Nevertheless if a therapist discloses their experience to the client, the fear might sub-side leading to an effective therapeutic relationship.

Counselors are more effective if they have experienced similar problems as their clients based on the fact that their experience can validate the truth to the clients and thus influencing their chances of changing their current situation. If clients are made aware that what they are experiencing a problem that has taken place before and that the situation can actually be effectively dealt with, then the client will be encouraged and be willing to work with the counselor in order to overcome the existing challenge (Norcross, 2002).

References

Bordin, S.(1979). The generalizability of the psychoanalytic concept of the working alliance. Psychotherapy , Theory Research and Practice . 16, p252-260.

Elliott, R, Watson, J, Goldman, R and Greenberg, L. (2004).Learning emotion-focused therapy: The process-experiential approach to change. Washington, DC: American Psychological Association.

Elkind, N.(2002). Resolving Impasses in Therapeutic Relationships. Guilford Press.

Goldfried, M, Carter, E and Burckell L. A. (2003). Therapist self-disclosure in cognitive– behavior therapy. Journal of Clinical Psychology, 59, 555–568

Hill, C and Knox, S. ( 2009). Processing the Therapeutic Relationship. Psychotherapy Research. 19(1). p 1-15.

Hatcher,T.(2010). The Alliance, the Relational Turn, and Rupture and Repair Processes in the Therapeutic Relationship. The Capa Quarterly.

Horvath, A, and Greenberg, L. (1994). The Working Alliance: Theory, Research, and Practice.
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Knox, S, Shirley A, Petersen, D, Hill, C.(1997). A qualitative analysis of client perceptions of the effects of helpful therapist self-disclosure in long-term therapy, Journal of Counseling Psychology, Vol 44(3), p 274-283

Lazarus, A. (1994). How certain boundaries and ethics diminish therapeutic effectiveness. Ethics and Behavior. 4, 255–261.

Mozdzierz, G, Peluso, R and Lisiecki, J.(2014). Principles of Counseling and Psychotherapy: Learning the Essential Domains. Routledge.

McLeod, S.(2008). Person Centered Therapy. Simply Psychology .

Norcross, C.(2002). Psychotherapy Relationships that Work : Therapist Contributions and Responsiveness to Patients: Therapist Contributions and Responsiveness to Patients.
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Prout, T and Wadkins, M. ( 2014). Essential Interviewing and Counseling Skills: An Integrated Approach to Practice. Springer Publishing Company.

Safran, J and Muran, C. (2011). Repairing Alliance Ruptures. Psychotherapy. 48( 1),p 80 – 87.

Safran, J , Muran,C and Rothman, M.(2007). A relational Approach to Supervision: Addressing Raptures in the Alliance. American Psychological Association. p 137-135.

Swank, E.(2010). Repairing alliance raptures in emotionally focused therapy. Sage.

Rockville , MD. (2000). Treatment Improvement Protocol . Center for Substance Abuse Treatment.

Vicki, S, Patrizia, C and Bayne, R. (2012). Key Concepts In Counseling And Psychotherapy: A Critical A-Z Guide To Theory: A critical A-Z guide to theory. McGraw-Hill International.