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Chapter 5 – Evidence-Based Relationships

Chapter 5 – Evidence-Based Relationships. Chapter 5. This chapter focuses on relationship variables or factors that appear to have a positive influence on counseling or psychotherapy outcomes. Chapter 5. The Great Psychotherapy Debate

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Chapter 5 – Evidence-Based Relationships

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  1. Chapter 5 – Evidence-Based Relationships

  2. Chapter 5 • This chapter focuses on relationship variables or factors that appear to have a positive influence on counseling or psychotherapy outcomes.

  3. Chapter 5 • The Great Psychotherapy Debate • Empirically Supported Techniques or Treatments vs. Evidence-Based Relationships • Where do you find yourself in this debate?

  4. Chapter 5 • Carl Rogers’s Identified three Core Conditions to Therapeutic Change • Congruence • Unconditional Positive Regard • Accurate Empathy

  5. Chapter 5 • Congruence refers to having your thoughts, feelings, and behaviors match. • Rogers believed that therapists should be honest, somewhat spontaneous, and real. • Congruence doesn’t mean interviewers should say whatever they want to say. Some censoring is still needed. • It’s very important to examine your motives when it comes to self-disclosure and touch. • On average, congruence appears to account for about 6% of positive outcomes variance.

  6. Chapter 5 • Unconditional Positive Regard (UPR) involves a warm regard for the other person as a separate individual worthy of respect. • What are some of the ways therapists can communicate congruence? • UPR is conveyed not so much by what you say, but by how you say it. • On average, UPR accounts for a little less than 9% of positive outcomes variance.

  7. Chapter 5 • Accurate Empathy is central to effective interviewing. • It is a complex concept characterized by an effort to see the world from the client’s perspective. • Research suggests that empathy includes: (a) emotional stimulation, (b) perspective-taking, and (c) emotional regulation. • Empathy has a robust effect on treatment outcomes, accounting for nearly 10% of treatment variance.

  8. Chapter 5 • Psychoanalytic and Interpersonal Relationship Concepts • Transference • Countertransference • Working alliance

  9. Chapter 5 • Transference is when your client views you in ways similar to how he or she viewed his or her parents or early caregivers. • Transference feels inappropriate. • It’s like putting an old map on a new terrain. • It’s a way to glimpse a client’s early relationship dynamics. • There’s indirect empirical support for focusing on transference in therapy.

  10. Chapter 5 • Countertransference (CT) is similar to transference, but involves therapists projecting their issues onto clients. • CT is broadly defined as any reaction you may have to your client. • Client transference can trigger interviewer CT. • Freud thought CT was always bad, but contemporary therapists see it as potentially informative. • There’s evidence that not addressing CT can adversely affect treatment outcomes, and addressing it can increase positive outcomes.

  11. Chapter 5 • 5-Minute Reflection • Get with a partner or small group and discuss the concepts of transference and CT. Especially discuss the sort of people who are most likely to trigger your CT reactions. • Report any insights you have back to the class.

  12. Chapter 5 • The Working Alliance (aka: therapeutic relationship) has three main components: • Goal consensus • Collaboration on tasks • Emotional bonding • Evidence strongly supports the positive influence of a positive working alliance on treatment outcomes. • Feedback is also used to enhance the relationship.

  13. Chapter 5 • Role Modeling (aka: Identification and Internalization) • Clients may identify with and internalize traits of their parents, caregivers, and therapists. • Conceptually, these concepts can be viewed from both psychoanalytic and behavioral perspectives.

  14. Chapter 5 • Behavioral and Social Psychologists have emphasized that clients respond best to interviewers who display high levels of: • Expertness (Credibility) • Attractiveness • Trustworthiness

  15. Chapter 5 • Feminist Relationship Concepts include • Mutuality: This refers to sharing power and working collaboratively. • Client as Expert (aka: Empowerment): This concept includes an emphasis on holding the clients’ perspectives as the greatest source of authority re: information.

  16. Chapter 5 • Summary and Conclusions

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