In the assigned chapter, Bohart and Tallman (2010) discussed clients and their effect on therapy. They argued that client and extratherapeutic influences are the single most important factor in determining therapy outcome. In fact, up to 87% of the variance in therapeutic outcome is attributable to the client, factors that occur outside therapy, and unexplained variance (Bohart & Tallman, 2010, p. 84). Bohart and Tallman further argued that approximately 40% of variance can be ascribed to client factors while only 13% can be accounted for by treatment (e.g., the therapeutic relationship, interventions, therapist, model of therapy). Unfortunately, traditional conceptualizations of psychotherapy have largely ignored these client factors (Bohart & Tallman, 2010, pp. 92-84). Instead, the focus has been on the therapeutic process, the therapist, and his or her interventions, which do not contribute as much to therapeutic outcome as client factors. According to Bohart and Tallman, it is clear that more attention must be given to the critical effect clients have on the outcome of therapy (pp. 94-95).
Evaluation
First, Bohart and Tallman (2010) discussed the role of the medical model in psychotherapy (pp. 92-94). The medical model focuses on diagnosis and specific treatment based on that diagnosis. Bohart and Tallman said that the medical model of psychotherapy is not supported by research. They said that research shows that “all bona fide therapeutic approaches work about equally well, regardless of diagnosis… Research also challenges the importance of technique” (Bohart & Tallman, 2010, p. 92). They also discussed the inconsistent findings regarding professional training and therapeutic outcome. Last, they pointed out tha...
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... Bohart and Tallman (2010) make some valid points, there is the possibility that their line of reasoning will be taken too far. If taken too far, their arguments can be used to say, “Therapy is always unnecessary.” It can also lead some therapists to under-train because of an underlying message that says, “Therapists do not need to do that much in therapy because the client will do all the work.” Balance is needed where therapist training and expertise is valued, but so are the invaluable contributions that the client can make toward his or her progress in therapy.
Works Cited
Bohart, A. C., & Tallman, K. (2010). Clients: The neglected common factor. In B. L.
Duncan, S. D. Miller, B. E. Wampold, & M. A. Hubble (Eds.), The heart and soul of
change: Delivering what works in therapy (2nd ed., pp. 83-111). Washington, DC:
American Psychological Association.
Heitler, Susan. Ph.D. “8 Reasons to Cheer for Psychotherapy and to Broaden Its Availability.” Psychology Today. N.p. 10 Aug. 2012. Web. 11 Nov. 2013
Current research implies that an empathetic clinician-client relationship and interrelated ecosystems play the majority role in the success of therapy (Kilpatrick & Holland, 2009). The clinician’s ability to be present and actively perceive what the client is experiencing is of utmost importance in creating a therapeutic alliance. It is imperative that the clinician gains positive regard towards the client and their environment displaying honest acceptance towards the client no matter what issues are presented in session. This closely relates to a sincere presentation of genuineness that instills a feeling of honesty within the client and clinician (Kilpatrick & Holland, 2009). An experienced clinician builds upon the therapeutic
Roth, A., Fonagy, P. (2005). What works for Whom? A Critical Review of Psychotherapy Research. US: Guilford Press.
...ate with their therapists. “A systematic relationship between the therapists' personal reactions to the patient and the quality of their communication, diagnostic impressions, and treatment plans” (Horvath & Greenberg, ). While positive attitudes from the therapists are more likely to result in a successful treatment, negative attitudes will not develop the necessary cooperation from the clients side to successfully reach the goal of the therapy.
Therapeutic relationship is an essential part of nursing; it is the foundation of nursing (CNO, 2009). The National Competency Standard for Registered Nurses state that nurses are responsible for “establishing, sustaining and concluding professional relationship with individuals/groups.” Throughout this essay the importance of forming a therapeutic relationships will be explained. The process of building a therapeutic relationship begins from prior to time of contact with a patient, the interpersonal skills of the nurse; then the process includes skills required by the nurse to communicate effectively, including respect, trust, non-judgment and empathy. The way to portray these skills can be via verbal or non-verbal cues that are important to understand how they influence a person. The process and skills listed below are all relevant to nurses working in the contemporary hospital environment today.
In conclusion, Anderson et al. (2010) discussed the relationship between therapeutic models and the techniques utilized by them. However, the contextual model that they posit in this article is built upon a postmodern philosophy and has numerous flaws. As a result, I reject many of their arguments, at least as they are presented. Despite this, there was some information (albeit modified) from this article that I can incorporate into my own practice as a therapist.
Prochaska, J.O. and Norcross, J.C (2003) Systems of Psychotherapy: a transtheoretical analysis, 5th edition, Pacific Grove, California: Brooks/ Cole.
Corey, G. (2013). Theory and practice of counseling and psychotherapy (9th Edition). Belmont, CA: Brooks/Cole Publishing.
Furthermore, my goal is to let client fix their problems on their own through insight and guidance from the therapist. I envision a successful therapeutic process being when a client follows their goals and achieves positive outcomes in their lives. I seek to gain a therapeutic process with my clients by building rapport, trust, and helping them gain insight. When my clients are stuck and need motivation, I plan to remind them about their goals and the positive things that will come with change. If family is important to a client, informing the client about their family and their happiness may help motivate them to continue to
Wampold, B. E. (2001). The great psychotherapy debate: Models, methods, and findings. Mahwah, NJ: Erlbaum.
...ential impediment to postmodern and CBT interventions is practitioner incompetence. Psychological harm to clients is a potential danger of interventions implemented by untrained or inexperienced therapists. Likewise, the attitude and professional maturity of the practitioner are crucial to the value of the therapeutic process. In both approaches, whether taking on the role of teacher or collaborator, the therapist’s stance is one of positive regard, caring, and being with the client. While techniques and therapeutic styles may vary between and within the postmodern and CBT counseling approaches, they both enlist the client’s diligent participation and collaboration throughout the stages of therapy to accomplish positive therapeutic outcomes.
It is considered to be inevitable that therapists will evaluate and judge problems through the lens of their own worldview, due to the fact that it is impossible to be entirely value neutral if a therapist is being active in the role of therapy (Aponte & Winter, 2000). From this perspective, the therapist has the responsibility of not only learning their clinical techniques and models from the academic institution they are being trained at, but also of examining the self of the therapist and working to be aware of their own personal biases and issues which have the potential to influence their work. The therapeutic relationship is considered to be one major component of...
Corey, G. (2011). Theory and practice of counseling and psychotherapy. (ninth ed., pp. 291-301). Belmont, CA: Brooks/Cole.
Najavits, L., &Strupp, H. (1994). Differences in the Effectiveness of Psychodynamic Therapists: A process-outcome study. Psychotherapy, 31, 114-123.