The therapeutic alliance refers to the relationship that exists between a psychotherapist and their client or patient. By establishing an excellent connection, the therapist aims to provide patient-centred care in which they only act as an enabler for the patient to achieve their objectives. The patient is encouraged to participate in their treatment for them to face and address the psychosocial impacts of pain. Traditional methods have always overlooked this aspect of treatment and adopted unidirectional patient-therapist relationships. The implementation of this new way is essential as research, and recent studies have shown that addressing the physical issues of treatment cannot fully bring the improvement of a patient's condition. Thus, this essay endeavors to discuss the merits and demerits of the establishment of the therapeutic relationship, its risks and benefits and the effective practice of professional therapeutic relationships.
Merits of Therapeutic Relationships
Establishing a relationship based on mutual trust with patients has some benefits for both the patient and the psychotherapist. The patient feels that the therapist is warm and cordial which will make them open and trust which eventually makes the process of treatment more relaxed and fun. The patient feels that the therapist is helping them without acknowledging their effort in the process (Bedics, Atkins, Harned & Linehan, 2015). They are likely to say things such as "the last session made me feel much better." Every psychotherapist desires that their input brings about a change of attitude from the patient. The primary objective of every session is to ensure that the patient can feel changed and an improvement in their condition. This can be quantified by aspects such as a decrease in episodes of anxiety or fear.
Therapeutic alliance creates a rapport between the therapist and the patient as they feel understood, accepted and not misjudged. This union is vital in addressing underlying issues that would not come up in the absence of trust. Making the patient comfortable enough to fully open up is critical in identifying and responding to concerns, small as they may appear, that would have otherwise affected the healing and recovery process. The patient felt valued and respected thereby making them also be receptive to the solutions that the therapist offers.
The difficulties faced by the patient can be overcome if they believe in the treatment being administered. This alliance not only fosters an understanding of sorts, but it also provides a platform for acceptance and belief in the solutions being offered. The treatment is a joint collaborative effort between the patient and the therapist, and the former feels like part of the solution (Bedics, Atkins, Harned & Linehan, 2015. The patients accept the concepts governing the aetiology of his predicaments thereby giving the therapist an assurance that goes a long way in administering the right treatment. It is difficult to handle a patient who refuses to acknowledge the underlying issues and who is not receptive to the solutions being offered. This stubbornness may hinder the rate of recovery or prevent it entirely.
Demerits and Risks of Therapeutic Relationships
Sometimes, due to misunderstanding or loss of trust, the relationship between the therapist and the patient may break down. This conflict is what is referred to as alliance rupture. These strains may be severe to the extent that the patient entirely loses their trust and confidence in the therapist and the treatment. They may leave never to return for treatment, or they may be mild and subtle in which case there is a sense of things that are not working as they should, but both parties choose to ignore this anyway. According to Jeremy (2018), these ruptures are common to all types of therapy, and more often than not, the patients who harbour ill feelings, or mistrust of their therapist are usually unwilling to disclose this. It is even worse when the therapist fails to identify the discord that exists.
Benefits of Therapeutic Relationships
Family therapy, especially in cases of child abuse, is often a very innovative and effective way of administering treatment. Establishing a therapeutic alliance in couples or family therapy is a central element in addressing the issues that are at stake. This alliance differs to that, that is present in individual psychotherapy session in that the therapist must establish multiple partnerships with all parties involved. They must develop a conceptual framework that recognizes the numerous and complex relationships that exist between the family (Rait, 2007). This model should establish the mode of operation between the psychotherapist, the individual family members, and the family as a whole.
Professional Therapy and Family Relationships
The therapist must be skilled to balance their relationship with each family member. They must maintain proximity to each family member while striving to stay out of the transference by remaining objective and differentiating their position as that of the family coach from the other individuals in the sessions. They must at all time be the non-anxious party that is not affected by the family emotion process (Rait, 2007). These sessions can be very constructive in solving perennial psychological and behavioural issues that plague the family. Individuals within this unit feel safer and more understood since the family problems are addressed. It is said that a family that counsels together stays together.
Impasses may occur at family therapies. While they may be divisive and demoralizing, they more often than not provide a learning opportunity for the family and the therapist. Some of the standard indicators of this rupture of the alliance may be in the form of hostility towards the therapist and other individual family members, passive aggressiveness, expressions filled with negativity, noncompliance of individuals and disagreements (Urech et al., 2018). These challenges may be due to mistakes by therapist for example if they appear to side with one individual or it may also come from the family members. The therapist must develop strong leadership, and they must also ensure that the family is part of the solution to overcome these difficulties.
Combining the therapist system and the client system into treatment is touted as one of the best strategies of therapy. The support of the patient is critical in their recovery process as it underlines their commitment to the solutions offered. However, too much of overdependence on their corporation may mislead the therapist into giving too much control to the patient who may not have a professional and technical knowledge required (Urech et al., 2018). In the case of pauses, the therapy session might not be of great help to the patient.
To sum up, it is not surprising that therapeutic alliance has gained huge admiration from psychotherapists. It has proven to be an effective model that has had positive impacts in many cases. The relationship between a therapist and a client is often the key to quick recovery. Great insights and opportunities to learn for all parties have been noted, leading to better mental and psychological states. Through adequate interventions and professionalism, ruptures and misunderstandings can be addressed as soon as they have the potential of occurring. Nevertheless, the benefits of therapeutic relationships are established as the patients have a high probability of recovering. On the other hand, imbalanced therapeutic relationships are detrimental to the timely recovery of the patients and the overall management of the client system.
Bedics, J. D., Atkins, D. C., Harned, M. S., & Linehan, M. M. (2015). The therapeutic alliance as a predictor of outcome in dialectical behaviour therapy versus nonbehavioral psychotherapy by experts for borderline personality disorder. Psychotherapy, 52(1), 67.
Rait, D. S. (2000). The therapeutic alliance in couples and family therapy. Journal of clinical psychology, 56(2), 211-224.
Safran, J. (2018). Therapeutic Alliance Ruptures. Psychology Today. Retrieved 22 February 2018, from https://www.psychologytoday.com/blog/straight-talk/201801/therapeutic-alliance-ruptures
Urech, A., Krieger, T., Moseneder, L., Biaggi, A., Vincent, A., Poppe, C., ... & Berger, T. (2018). A patient posts hoc perspective on advantages and disadvantages of blended cognitive behaviour therapy for depression: A qualitative content analysis. Psychotherapy Research, 1-13.
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