Dr George Varvatsouliasgeorge.varvatsoulias@newham.ac.uk

Quality of relationship-Therapeutic outcome Client’s participation in therapy a strong

prerequisite for the effectiveness of therapy Skills the client can learn from the

therapeutic relationship Working alliance features (Bordin, 1979):a. Agreement of task (process, activities,

techniques)b. Agreement on therapy goals (Short/long-term

goals; Therapist/Client cooperation and contribution

c. Positive therapist-client bond (mutual liking, respect, trust, commitment)

Interpersonal effectiveness through Socratic questioning (empathy, collaboration)

Open-minded curiosity Respect of the client’s beliefs, emotions, behaviours Practical and Academic (knowing models and protocols in

CBT) Wright and Davis’ (1994) model of how clients would like

their therapists:a. Confidentialityb. Concernc. Seriousnessd. Prioritisatione. Competencef. Practical suggestions for life improvementg. Let the client decide on the therapeutic steps to be takenh. Flexibility in communicationi. Revisiting therapeutic outcomesj. At ease and tolerant

Careful listeningTaking time to set a shared agendaFeeding back (feeding and being fed

back)Establishing SMART goals to clients

needs

Clients may:Not carrying out homeworkBe scepticalExpress emotions

Dealing with such ruptures (Watson & Greenberg, 1995):

1.Goals or tasks of therapy2.The client-therapist bond

Explaining to the client from the first session that:

1.He/she can feel safe2.He/she should trust the therapist is

working towards his/her best interests3.Should feel free anything that relates to

his/her problem to share it with the therapist

4.Confidence is of utmost importance for the success of therapy

Explaining the client that the therapist:1.Refrains from self-seeking or personal

gratification2.Confidentiality is kept unless issues of

personal harm or harm to others is involved

3.Seeks to increase the client’s autonomy4.Does not express personal opinion to

client’s understanding of oneself, but offers interpretations which are valid and useful to the client’s effort.

Therapeutic relationship is non-reciprocal:1.The client refers to issues he/she feels

bothered by2.The client learns to be emotional ready

to learn, but his/her emotional readiness is not referred to the therapist’s emotional needs

3.The client is taught ways in dealing with difficulties arising from his/her faulty cognitive apparaisals

Dual relationships: The therapist and the client are known to each other, e.g. They are working together at the same setting

Self-disclosure: The client refers to personal experience, but the therapist listens without referring to one’s own experiences in return

Non-sexual physical contact: Therapists should be very careful in interpreting clients’ feelings if those feelings come with a sexual or more friendly content

Sexual relationships between therapists and clients: Most harmful kinds of boundary violation which totally damage the therapeutic relationship