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Introduction for an essay on the therapeutic alliance
The importance of therapeutic alliance essay
Therapeutic alliance research
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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 …show more content…
In 2008, a meta-analysis of measures named thirty-two different measurement tools (Elvins & Green, 2008). An example of a measurement tool is the Working Alliance Inventory (WAI), devised by Horvath and Greenberg (1989), and is based upon Bordin’s Alliance Model (Hatcher & Gillaspy, 2006). The WAI involves a thirty-six item questionnaire that is made up of twelve questions for each of the three dimensions; bond, task and goals. This was shortened to a twelve item questionnaire; four questions for each of the three dimensions and has become the most commonly used measurement tool (Hatcher & Gillaspy, 2006). With such a varied number of measurement tools, it is very difficult to compare like for like when looking at the results of different studies. Elvins and Green (2008) argued that in order to fully appreciate the influence the therapeutic alliance has on therapeutic outcomes, more stringent measures need to be
...the patient’s feeling it and knowing it.” In other words, the therapist must attend to both the client’s core affective experience and what makes that experience frightening or painful. This stance is informed by the affective phenomena of empathy, affect contagion, affective attunement and resonance, and the reaching of a coordinated affective state. Ultimately, the therapist’s affective response to the client’s experience serves to amplify the client’s affective state. The therapist must come alongside the client, allowing the client to feel deeply understood and as though someone is offering to help. The client no longer feels an unwanted experience of aloneness and the anxiety that accompanies it. This stance effectively eliminates resistance on the client’s part, and the patient finds him or her self naturally wanting to share even the hidden parts of the self.
Psychotherapy is a verbal communication between a therapist and a patient that is intended to help the patient. It is designed to help the patient in many ways such as finding relief from emotional distress. The patient becomes less anxious, fearful, or depressed. Psychotherapy can also help to seek solutions to problems in the patient’s live. It helps with dealing with disappointment, grief, family issues, and job or career dissatisfaction. It also helps to modify ways of thinking and acting that are preventing the patient from working productively and enjoying personal relationships. Talking with a psychotherapist is different from talking with a friend in three respects that increase its likelihood of being helpful. Friends may be able and willing to listen and give advice, but qualified and duly licensed psychotherapists are trained professionals with specialized education and experience in understanding psychological problems. Second, friendships are typically mutual relationships. People take turns being helpful to each other. Psychotherapy is devoted entirely to the patient’s welfare and focused solely on the patient’s needs for symptom relief, problem solutions, or lifestyle changes. Lastly, psychotherapy involves a formal commitment to meet regularly at a designated time. They talk only about the patient’s concerns. They continue meeting as long as doing so serves the patient’s best interests. This is in contrast to the mutuality,
Creating the therapeutic alliance and sustaining it is vital for the client to be able to trust and rely on the clinician for help. “An early and strong therapeutic alliance is critical to successful treatment.”...
Stickley, T. & Freshwater, D. (2006). “The Art of Listening to the Therapeutic Relationship” Journal of Mental health Practice. 9 (5) pp12 - 18.
The therapeutic aspect is focussed on the care received, and how it creates a positive outcome for the service user, this includes good communication, building strong relationships, person centred planning and the choices available to the person in receipt of care. (Miller, J, 2015) (Gibb and Miller, 2007)
...ocation often using a two-way mirror. This gives the Milan team a unique collaborative aspect to therapy. Often the therapists meet beforehand at a pre-session meeting to discuss the clients. Then the session takes place and then there is an intersession where the therapists collaborate on an intervention for the clients. That intervention is then introduced to the client’s in therapy, After the conclusion of therapy the therapists meet again to discuss how the therapy session went and what could be improved upon in the future. The Milan team also puts a positive spin in client’s symptoms, often a simple reframing. The Milan Team also employs circular thinking or questioning. This is designed to throw off the clients thinking by orienting those towards seeing themselves in a relational context. This often gives new light to the circular nature of familial problems.
Hersoug, A. G., Høglend, P., Monsen, J. T., & Havik, O. E., (2001). Quality of working alliance in psychotherapy: Therapist variables and patient/therapist similarity as predictors. Journal of Psychotherapy Practice and Research, 10, 205-216.
Watson, J.C., & Gellar, S.M. (2005). The relation among the relationship conditions, working alliance, and outcome in both process-experiential and cognitive-behavioral psychotherapy. Psychotherapy Research 15(1-2), 25-33.
Ruddy, N. B., Borresen, D. A., & Gunn Jr., W. B. (2008). Colocating with medical professionals: A new model of integrated care. In The collaborative psychotherapist: Creating reciprocal relationships with medical professionals (pp.115–133). Washington, DC: American Psychological Association.
It was also made very evident that individuals are connected to everybody else in the world in some way even when the connection is not made fully aware of. Jung stated that we are all connected through repetitive events in which we find meaningful. Research is starting to focus more on synchronicity, thus changing the way individuals view it when it comes to psychotherapy. Walt Whitman as well as Jung believe that once synchronicity is established in therapy, those experiences are then able to build off of each other. Overall, relational therapy might need to involve receptivity and sustained attention awareness in order to aide in the healing process while shifting through the therapeutic process. It was made very clear in this article that client-patient understanding is a very important concept of psychotherapy due to the fact that if the therapist cannot communicate with their patient, the problems in which the patient is suffering from cannot be solved. In addition, when therapists have a close connection with their patients, they are able to understand their feelings more than if not, therefore, they will be able to identify problems and find solutions to those problems. Synchronicity is strongly encouraged to be incorporated in psychotherapy due to the fact that such
Smith, T. B., Rodríguez, M. D., & Bernal, G. (2011). Culture. In J. C. Norcross (Ed.), Psychotherapy relationships that work (2nd ed.). New York: Oxford University Press.
Assuredly though, Kevin’s family is supportive of him, and this is a valuable basis for an on-going alliance. Furthermore, the learned problem-solving and communication strategies equip each individual to navigate through potential future conflicts, reducing the need for repeat-therapy. Lastly, though it is unknown whether Kevin is medicated for his depressive disorder, young people have an improved outcome with a combined treatment approach of pharmacotherapy and either CBT or systemic family therapy (A. Hall, personal communication, 17 April 2014; March, 2006; The Werry Centre, 2010; Nayar, 2012). All safety and appropriateness considered, this approach would improve Kevin’s mood and ability to engage in therapy and as a consequence, also improve his other social relationships (Nayar, 2012).
Stickley,T. & Freshwater, D. (2006). “The Art of Listening to the Therapeutic Relationship” Journal of Mental health Practice. 9 (5) pp12 - 18.
Therapy has long been thought of as taboo. In this paper, I will discuss the major forms of therapy and their characteristics along with the strategies that are also used. This essay will also cover examples of each disorder and show which therapeutic method is best used in caring for individual(s).
“Integration is a method of utilising more than one theory in the belief that by combining or integrating these theories the chance of a successful outcome for the client is increased.”