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michellekrethlow@gmail.com |
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The Therapeutic Relationship. |
From my own experiences as a therapist one of the most important factors in a client's recovery is the therapeutic relationship, and actually one of the most difficult aspects of therapy to pin down in words. When a client comes to therapy they do so in their subjective present with a pressing and enveloping concern, a place from which they feel they need help to emerge. This feeling is of considerable significance because it is what has brought the client to therapy usually after some considerable thought and effort; for example, it can take a good deal of courage for some people just to pick up the phone and contact someone for help. The skills of the therapist in immediately establishing a trusting, welcoming and non judgemental environment is therefore essential in order for the healing process to occur. For me as a therapist, Carl Rogers' so called ‘ core conditions' form the basis of my approach to the therapeutic relationship. Carl Rogers' therapeutic approach was based around the concept that all human beings have an inbuilt capacity to grow and achieve their full potential. This is called self actualization and is the standpoint of most humanistic approaches to therapy. In moving toward self actualization Carl Rogers advocated that the therapist in working with the client's present should endeavour to build a therapeutic relationship by being; non judgemental, genuine and empathic. So what lies behind these core conditions? Firstly ‘being genuine', Frankland and Sanders (2006) describe being genuine or congruence as; ‘being real to oneself and open to experiences of all types'. That in communicating with a client and receiving communication we should, as therapists not try to ‘ hide behind a mask' but be real to who we are. This is quite a difficult feat to accomplish. It takes experience and a good deal of self knowledge to be freely ourselves and yet not compromise the client/therapist relationship. A good therapist is able to be in the world of the client with a genuine sense of non possessive warmth for that person without pulling into that relationship for example, elements of self disclosure. By this I mean talking to the client about their own experiences and even giving advice, this is strictly a role for friends, relatives etc not therapists. Secondly being non judgemental or displaying unconditional positive regard means from a therapist's perspective accepting the client's worth as a human and demonstrating that acceptance. Rogers teaches that this non judgemental context is fundamental to the process of change and that essentially in communicating UPR you do not need to approve of the clients actions. For me recognising and understanding my own values and personal standards is an essential part of becoming a therapist. It is extremely important when being with a client to know what your personal limitations are and truthfully acknowledging those subject areas you would find it difficult to work with for whatever reason. This is a question of being totally honest, if you are not as a therapist prepared to work with a client totally none judgmentally about detailed sexual matters or child abuse for example, then this level of honesty should be communicated to that client either at the initial request or as a sensitive referral during the process. Finally empathy, in describing empathy again we must turn to Carl Rogers. Rogers explains empathy in the therapeutic context as trying to understand the client as the client sees himself or from his internal frame of reference; it is essentially a willingness to see someone's world as they experience it through their eyes. To elaborate; the therapist as part of the healing relationship needs to be able to communicate that they understand the client in a sensitive way, remaining objective rather than becoming entangled in the client's world. There are many skills involved in this process including those of listening and questioning as well as the ability to read body language. Indeed any search on Google will reveal plenty of additional information. In my own experience client's often say the simple fact of being truly listened to by someone has been of enormous value therapeutically. It is also important not to confuse sympathy with empathy, sympathy can be described as responding to the distress of another by sharing those feelings, focussing that response toward the well being of that person, for example finding yourself crying when faced with someone doing the same thing. Empathy in contrast can be described as reaching an understanding of the thoughts and feelings of another person without reference to the self, a ‘getting alongside' without personal immersion. Establishing empathy with a client is in fact the cornerstone of the therapeutic relationship helping the client to feel they can explore very difficult thoughts and feelings in an accepting and safe environment. A therapist who is able to achieve a high level of empathy with a client is therefore achieving one of the most esteemed qualities of the therapeutic process. Michelle Krethlow Shaw November 2012
Frankland, Alan and Sanders, Pete. Next Steps in Counselling. PCCS, 2006. If you would like to research further here are some great books. Gilbert, Paul. Psychotherapy and Counselling for Depression. Sage, 2007. Rogers, Carl R. Client Centred Therapy. Constable, 2003.
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