Dr George Varvatsoulias george.varvatsoulias@newham.ac.

uk

Quality of relationship-Therapeutic outcome Clients 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)

 a. b. c. d. e. f. g. h. i. j.

Interpersonal effectiveness through Socratic questioning (empathy, collaboration) Open-minded curiosity Respect of the clients beliefs, emotions, behaviours Practical and Academic (knowing models and protocols in CBT) Wright and Davis (1994) model of how clients would like their therapists: Confidentiality Concern Seriousness Prioritisation Competence Practical suggestions for life improvement Let the client decide on the therapeutic steps to be taken Flexibility in communication Revisiting therapeutic outcomes At ease and tolerant

Careful listening Taking time to set a shared agenda Feeding back (feeding and being fed back) Establishing SMART goals to clients needs

Clients may: Not carrying out homework Be sceptical Express emotions Dealing with such ruptures (Watson & Greenberg, 1995): 1. Goals or tasks of therapy 2. The client-therapist bond

Explaining to the client from the first session that: 1. He/she can feel safe 2. He/she should trust the therapist is working towards his/her best interests 3. 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 gratification 2. Confidentiality is kept unless issues of personal harm or harm to others is involved 3. Seeks to increase the clients autonomy 4. Does not express personal opinion to clients understanding of oneself, but offers interpretations which are valid and useful to the clients effort.

Therapeutic relationship is non-reciprocal: 1. The client refers to issues he/she feels bothered by 2. The client learns to be emotional ready to learn, but his/her emotional readiness is not referred to the therapists 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 ones 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