The Therapeutic Alliance Is A Key Component Of Psychological Treatment

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In the literature, the therapeutic alliance is labelled in several ways; therapeutic alliance, working alliance, therapeutic bond and helping alliance, (Horvath & Luborsky, 1993). Whilst the labelling may be varied, three common themes, based on the Alliance Model (Bordin, 1979), are evident: 1. An agreement between the patient and therapist on goals and tasks 2. The bond existing between the patient and therapist 3. Based on a collaborative relationship (Horvath & Luborsky, 1993; Martin, Garske, & Davis, 2000). This essay will examine the historical origins of the therapeutic alliance, the arguments supporting, or not supporting, the notion that the therapeutic alliance is a key component of psychological treatment, how this works without visual or auditory contact with a therapist, and then will investigate this in relation to the treatment of unipolar depressive disorders. It is evident that unipolar depressive disorders are a worldwide problem with an estimated 400 million people globally suffering depression, unipolar depression occurring in around 7% of the global elderly population (“WHO | Mental health and older adults,” 2013); 16.2% lifetime prevalence estimates in the US (Kessler et al., 2014), 2.9% prevalence estimates in Japan - which may not seem comparative but taking into account Japans population (102 million in 2005, equating to 2.95 million people with unipolar depression), this is extremely prevalent. Major Depressive Disorder (MMD) is the largest mental health category in Japan (Kawakami, Takeshima, & Ono, 2005). The World Health Organization Global Burden of Disease Survey predicted that by 2030, unipolar depression will become the leading global burden disease, only preceded by heart disease (World He... ... middle of paper ... ...2013), males are more likely to complete suicide compared to females (although the risk of suicide is the most consistently reported risk factor amongst all with MDD) (American Psychiatric Association, 2013). In order to receive a diagnosis of MDD, at least five of the following symptoms have to be evident over a two week period and these symptoms should equate to a difference in the person’s previous functioning; depressed mood, reduced interest in most/all activities that were previously enjoyed, significant change in weight (either loss or gain), insomnia or hypersomnia, fatigue or loss of energy, feeling worthless or inappropriate feelings of guilt, suicidal ideations, and/or a reduced ability to concentrate (American Psychiatric Association, 2013). These symptoms cause the person significant impairment in their social, work or day to day areas of functioning.
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