counseling relationship

8/10/2019 Counseling Relationship

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THE COUNSELLING RELATIONSHIP

Introduction

The actual contact between a counselor and a person who is seeking help lies at the heart of what

counseling is about. Although a counselor may be able to use theory to make sense of the clients

difficulties, and may have a range of techniques at his or her disposal for revealing and

overcoming these difficulties, the fact remains that theory and technique are delivered through

the presence and being of the counselor as a person: the basic tool of counseling is the person of

the counselor. An interest in the nature of the therapeutic relationship represents a common

concern of all therapy practitioners and theorists.

Even if different approaches to counseling make sense of the client therapist relationship in

different ways, they all agree that effective counseling depends on how this kind of relationship

operates, what happens when it goes wrong and how to fi! it. The relationship between a client

and patient and their therapist is probably unique for the ma"ority of people who enter

counseling. Even in short#term counseling, the person is e!posed to a situation in which another

person will listen to him or her for several hours, will make every effort to see issues and

dilemmas from the speakers perspective, will treat what is said with e!treme respect and

confidentiality and will abstain from seeking to gratify any of their own needs during this time.

There is a deep caring, and sense of being $special, that is unusual or even absent from the

e!perience of most people in %estern industrial societies. &f course, such an e!perience may be

hard to accept: can the counselor really be trusted' (s he or she genuinely interested in what ( am

saying' )ow can ( take so much without giving something back'

The intensity with which many therapy clients e!perience their relationship with their therapist is

captured well in a study by *ott +---, who interviewed women around their feelings about

their therapists, and by %achhol/ and 0tuhr +---, who found that, 1 years after the end of

therapy, clients still held vivid memories of their therapist and the qualities of their relationship

with him or her. The importance of the counselor client relationship has been reflected in the

findings of many research studies. 2esearch that has invited clients to describe what has been

helpful or unhelpful for them in counseling has consistently found that clients identify

relationship factors as being more important than the use of therapist techniques. (n the eyes of

the client, it is the quality of their relationship with their therapist that has made the largest

contribution to the value of therapy for them.

3c*eod +--4 has reviewed this research literature. Another line of research has involved

measuring the strength of the client therapist relationship early in therapy, and looking at

whether a strong therapeutic alliance predicts a subsequent good outcome. This research, which

has been reviewed by &rlinsky et al. +--5, repeatedly demonstrates a high positive correlation

between the quality of the therapeutic relationship and the amount the client gains from therapy.

These research findings have been interpreted as providing support for the role of non#specific

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factors in therapy, which were discussed in 6hapter 7: the relationship between client and

therapist is a core non#specific factor e!isting in all forms of therapy +)ubble et al. ---. %hy

is the therapeutic relationship so important' There are several ways of making sense of what

happens in the relationship between a counselor and a client. There are some counselors, often

influenced by the cognitive behavioural tradition, or by ideas about professional client

relationships in occupations such as medicine, teaching or social work, who regard the building

of $rapport to be an initial step in counseling, of significance mainly as a platform from which

structured therapeutic interventions can be made.

(n contrast, there are other counselors, working within the psychoanalytic tradition, who see the

relationship as an arena in which the client acts out dysfunctional relationship patterns, thus

enabling the therapist to observe these patterns and set about remediating them. 8inally, there are

counselors operating within the humanistic tradition who regard authentic contact or encounter

between persons as intrinsically healing. 0ome counselors move between these types of

relationship, depending on the client with whom they are working, or the stage of the work. The

aim of this chapter is to e!amine the different images of the therapeutic relationship that have

been proposed in the counseling and psychotherapy literature, and to e!plore the ways in which

these ideas have been applied in practice.

IMAGES OF THE THERAPEUTIC RELATIONSHIP

(t is useful to think about the different types or style of therapeutic relationship in terms of

images, rather than as lists of attributes or theoretical models. 9y reflecting on images of

relationship, it is possible to consider a wide array of cultural images that lie behind, or may fuse

with, the approach to the counselor client relationship advocated by different theorists. 8or

e!ample, images of the counselor or helper as confessor, priest, healer, shaman or friend are alsopresent in contemporary theory and practice, but are generally referred to in an implicit rather

than e!plicit fashion. The notion of $image also reminds us that the ideas of 8reud, 2ogers and

others arise from their imagination. Any relationship between two people is played out at a

number of levels: social, emotional, linguistic, physical etc. Theories of what goes on between

counselortherapist and client are inevitably a partial representation of the relationship, one

among many possible versions of reality. (t is important to recogni/e that ideas such as

transference and empathy are ways of describing some of what is happening in therapy, rather

than constituting ob"ective truths. 8inally, the idea of $image also reminds us that the intensity

and focus of an image can vary. (n short#term counseling, there may not be time for an intense

relationship to become established. (n longer#term counseling, the relationship may become

stronger and more sharply defined, but may at the same time begin to be overlaid by other

images, as counselor and client get to know each other in different ways.

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THE PRACTICALITIES OF RELATIONSHIP COMPETENCE: HOW TO DEVELOP

AN EFFECTIVE THERAPEUTIC ALLIANCE

Although the images of the therapeutic relationship that have been reviewed above offer a

valuable range of different ways of making sense of what happens between a client and a

counselor, they tend to be fairly silent on the question of what a counselor should actually do toestablish a robust alliance with a client. 0ome of the more recent theory and research around the

topic of the therapeutic relationship have focused on identifying and developing practical

strategies that can be applied by counselors to build and maintain constructive relationships with

clients

(t is helpful to reali/e that, on a moment#to#moment basis, congruence can be e!pressed in the

way the counselor talks. 3ost of the time in counseling, both counselor and client talk in a

manner that refers to the topic of the clients $problem. 9y also including talk that refers to the

process and activity of talking, it becomes possible to weave in to the conversation a continual

flow of statements about aspects of the relationship between counselor and client.

This $talking about the process of talking has been discussed by 2ennie +--; as the skill of

metacommunication: $the act of communicating about communication . . . stepping outside the

flow of communication to appraise it.

E!amples of therapist#initiated metacommunication would be when the therapist:

< talks about his or her own plans, strategies, assumptions=

< asks the client to focus on his or her plans, strategies, assumptions=

< shares his or her assumptions about what the client thinks and intends=

< invites the client to share his or her assumptions or fantasies about what the counselor thinks or

intends=

< reviews the relationship in all these ways when stuck, or in a therapy $crisis=

< e!plores the impact of the client on counselor +the feelings, action tendencies and fantasies that

are evoked by the clients behaviour=

< e!plores the impact of the counselor on the client.

Each of these ways of talking opens up a layer of the $unspoken or implicit relationship between

counselor and client, and makes it possible for both participants in that relationship to reflect on

what is happening between them, and if necessary change it. The use of metacommunication

represents the application in therapy of the relationship framework developed by *aing et al.

+->>. &n the whole, counselors do not engage in metacommunication to any great e!tent

within therapy this is a neglected skill. ?iesler +-;; concluded, as a result of his research into

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this topic, that $therapist interventions incorporating metacommunicative feedback have been

almost universally overlooked in the individual psychotherapy literature.

2epairing ruptures in the alliance it is seldom that a therapist and client meet form a good

working relationship and then continue through several sessions of therapy without any

challenge or disruption to the bond between them, or their agreed goals and tasks. This kind of$ideal relationship +in therapy as in any other area of life is a myth. %hat is more usual is for

the relationship, and the therapeutic work, to $hit the buffers now and again. @articipants in

counseling both clients and counselors may report that they have reached an $impasse, or

that there has been a $rupture in the relationship.

(n these circumstances it is necessary for the counselor to be able to call on strategies for

$repairing the relationship. A significant amount of recent theory and research has begun to

address the question of how best a therapist or counselor can repair or retrieve the therapeutic

relationship when it goes through a bad patch. The work of eremy 0afran +0afran --7a, b=

0afran and 3uran -->, 1444a, b, 144 has been at the forefront of attempts to investigate theprocesses and implications of $ruptures in the therapeutic alliance. 8or 0afran, the single most

important strategy for the therapist in such situations is metacommunication it is necessary to

stand back from what is happening, name and discuss the problem, and then negotiate around it.

0afran has identified a series of steps or stages that can be observed in the effective repair of a

therapeutic alliance. 8irst, the therapist needs to be sensitive to the presence of rupture in the

alliance. Typically, a client will e!press confrontation +anger with the therapist or criticism of the

progress of therapy, withdrawal +disengagement from the therapist or the therapeutic process or

a combination of these two responses. The task of the therapist at this point is to draw attention

to what is happening within the here#and#now relationship, for e!ample by asking $%hat are youe!periencing . . . ' or $( have a sense that you are withdrawing from me. Am ( right' The

acknowledgement by both the therapist and the client that there is a difficulty moves the repair

process on to the ne!t stage, which involves helping the client to describe their negative feelings,

or what it is they believe is blocking them or hindering progress. The therapist may need to

acknowledge at this point, in an undefensive way, how he or she might be contributing to the

rupture. The final stage involves encouraging the client to access their primary feelings +typically

anger or sadness, and to e!press to the therapist their underlying needs or wishes. &ne of the

tasks of the therapist at this stage is to affirm the importance of these needs and wishes.

0uccessfully resolving a rupture in a therapeutic alliance can have a number of benefits for theclient. 6learly, it strengthens the relationship, and makes it possible to continue therapy in a

productive direction. 9ut it also gives the client an opportunity to learn about how to sort out

relationship difficulties in general, and how to askdemand what they need in a relationship.

8inally, for people who may be more familiar with rivalrous conflict#ridden relationships, it

provides a model of collaborative, give#and#take relatedness

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The concept of boundary may be an useful way to begin to make sense of the relationship

between a therapist and client is to consider the way in which the boundary between the two

participants is created and maintained. Although the concept of boundary was not used by any of

the $founders of therapy +e.g. 8reud, ung, 2ogers, it has become widely used in recent years as

a means of describing important aspects of the therapeutic relationship. (n common#sense terms,

a boundary marks the limits of a territory, and the line where one territory or space ends and

another one begins. (n counseling and psychotherapy, the concept of $boundary is clearly a

metaphor there are no actual boundary posts, markers or lines laid out in a therapy room.

(n a therapy situation, boundaries can be identified in reference to a range of different

dimensions of the relationship. 8or e!ample, boundaries can be defined around:

< Time. The beginning and end of a therapy session.

< @hysical space. )ow close +or far apart should the client and counselor sit= how e!tensive is

each participants $personal space'

< (nformation. )ow much should the client know about the counselor'

< (ntimacy. )ow emotionally close should the counselor and client be' Boes the level of intimacy

within the relationship e!tend to touching, or even to se!ual contact'

< 0ocial roles. )ow does the counselor acknowledge the client if they meet in another setting'

)ow should the counselor respond to a clients request to form a relationship outside of the

therapy room' The idea of boundary also allows other significant aspects of the therapeutic

relationship to be discussed. 9oundaries can be rigid or permeable.

6ounselors differ in the personal style, with some favoring strictly regulated boundaries, and

others being more fle!ible. 0ome counselors may $loosen their boundary in the later stages of

therapy with a client. 3any different forms of behavior +the client being late or $forgetting to

pay the fee= the counselor touching the client can be interpreted as boundary $violations or

$transgressions, and links can be made with other boundary issues reported by the client in his

or her everyday life.

The concept of boundary has been particularly widely used within contemporary psychodynamic

and psychoanalytic thinking. The psychoanalytic psychotherapist 2obert *angs +-;; has been

prominent in arguing for the strict imposition of clearly defined boundaries in therapy as a core

principle of therapy. *angs believes that definite boundaries create a strong therapeutic frame

within which the client will be safe to e!plore painful and threatening personal material. 3any

humanistically oriented counselors and psychotherapists have had reservations about the way in

which the idea of $boundary is used within therapy as a "ustification for a distanced, detached

stance in relation to the client. 8or e!ample, )ermansson +--C: 7D has argued that $the very

nature of the counseling process demands a measure of boundary crossing . . . counselor

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aloofness, often promoted by boundary rigidity, is in itself potentially abusive. ordan

+1444:4D acknowledges that she has: $trouble with aF Gboundary languageH . . . anchored in

aF view of separation as safety.

CONCLUSIONS: THE COMPLEXITY OF THE THERAPEUTIC RELATIONSHIP

The theory and research discussed in this chapter reflects the importance of the client counselor

relationship in all approaches to therapy. (t is clear that counselors trained in the use of different

theoretical models employ quite different ways of understanding the therapeutic relationship. (t

also seems clear, however, that there are fundamental $truths about the client counselor

relationship, relevant for all approaches to counseling, captured in the ideas of 2ogers +-DC and

9ordin +-C-, and in 8reuds concepts of transference and counter#transference. (t also seems

likely that some clients respond better to some types of relationship than others, depending on

their own personal history and needs. The therapeutic relationship makes a difference in

counseling the quality of the relationship has been shown to contribute significantly to the

eventual outcome of counseling, and to the ability to help distressed people to stay in counseling.(t is essential, therefore, for any counselor to be aware of where his or her strengths lie, in term

of making and maintaining helpful ways of relating to clients, and also to keep striving to

become more responsive to the endless variety of relationship patterns that may be presented by

clients. Therapeutic relationships are comple!, and operate at a number of different levels at the

same time. (t is difficult to $decentre sufficiently from ones own viewpoint to develop an

accurate understanding of how one behaves in relationships. 8or any counselor, building an

understanding of how he or she engages in relationship with clients is greatly facilitated by the

use of opportunities, such as training groups, or supervision, which provide feedback and

challenge on his or her way of being with others.

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counseling relationship

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