The Therapeutic Relationship

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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... ... middle of paper ... ... 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.

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