Week 2: Counselling Relationship Flashcards
(32 cards)
The Counselling Relationship (Gladding & Alderson, 2011) (2+3)
Largest amount attributed to outcome variance (outside client characteristics) is the emergent therapeutic relationship and individual therapist differences (Henry, 1998)*
According to Gelso & Carter (1985), as cited in Gladding & Alderson (2011) the counselling relationship is comprised of:
a) the working alliance
b) the real relationship
c) transference and countertransference
The Working Alliance (4) (Gladding & Alderson, 2011)
Also known as: the therapeutic alliance, the ego alliance, the counselling alliance or helping alliance
- It is ‘the quality and strength of the reciprocal relationship between a client and counsellor and includes both the affective elements and the collaborative working elements of this reciprocal relationship’ (Bedi, Davis & Arvay, 2005 as cited in Gladding & Alderson).
Authors, such as Horvath (2005), state that this bond is arguably the best predictor of treatment outcome.
He further states the best indicator of a positive alliance is ‘enthusiastic collaboration.’*
The Real Relationship (4)
(Gladding & Alderson, 2011)
- It is reality oriented, appropriate and undistorted
- Counsellors are real and genuine and encourage clients to be as well
- Clients engage in the realness of the relationship by being realistic, authentic
- The counsellor/client relationship can deepen as the counselling progresses
Transference (1) and its use (3)
(Gladding & Alderson, 2011)
A client’s projection of past or present feelings, attitudes or desires onto the counsellor.
- Origins in psychoanalytic theory.
It can help counsellors understand client better*.
- Five frequently appearing patterns for how the client sees the counsellor: as ideal, as seer, a nurturer, a frustrator, or a nonentity.
- Working through the transference can offer insight, resolve distorted perceptions, increase trust and confidence in the counsellor.
Countertransference (3+2)
(Gladding & Alderson, 2011)
The counsellor’s projected emotional reaction to or behaviour toward the client.
The reaction may be irrational, stressful, neurotic and emanating from counsellor’s unresolved issues.
May involve treating the client like another person in their life or the counsellor may over-identify with the client.
- Over-identification
- Disidentification
Over-identification
is when the counsellor loses the ability to have emotional distance* and can take the form of being overprotective, or benign.
Disidentification
involves being emotionally removed from the client, such as being rejecting and hostile
Common Types of Countertransference (5)
(Corey et al in Gladding & Alderson, 2011)
Five common forms:
Feeling a constant desire to please the client
Identifying with the problems too closely so that there is little objectivity
Developing sexual feelings for a client
Giving advice compulsively
Wanting to develop a social relationship with the client
Factors that Influence the Counselling Process (5)(Gladding & Alderson, 2011)
1) Seriousness of the Presenting Problem
2) Structure
3) Initiative
4) Client Qualities
5) Counsellor Qualities
Factors that Influence the Counselling Process: Seriousness of the Presenting Problem (3+2)
Clients reporting higher distress initially take longer to report clinically significant improvement.
- Largest gains in improvement occur early in treatment.
- Clients with a higher degree of coping/functioning tend to improve the most from counselling.*
Some conditions, such as schizophrenia or antisocial personality may not improve through traditional talk therapy.
50% of clients with anxiety/depression noticed improvement between sessions 8-13 and 85% improved over one year (Leibert, 2006)
Factors that Influence the Counselling Process: Structure (6)
‘A joint understanding between the counsellor and client regarding characteristics, conditions, procedures and parameters of counselling.’
- It provides direction, clarification of roles, protects rights, roles and obligations.
Often, clients enter counselling with hesitance, reluctance.
- Guidelines for limits on: time, roles, actions, procedures, fees*
- Based on theoretical orientation, client personality and presenting problems.
- Some flexibility is necessary in order to meet the needs of various clients as well as individual needs.
Factors that Influence the Counselling Process: Initiative (4)
The motivation to change.*
- Can be negatively affected by the stigma of seeking help.
A reluctant client
- is one who has been referred by someone else such as a parent bringing a child, or court-referred.
A resistant client
- is one who is unwilling, unready or opposed to change.
Factors that Influence the Counselling Process: Client Qualities (2+1)
Counsellors typically enjoy working with clients who:
- think they have the potential to change.
Clients who have
- insight into their psychological functioning tend to expect more from counselling.
The importance of observing and understanding (in context) the nonverbal communication of clients.
Factors that Influence the Counselling Process: Counsellor Qualities (1+5)
The counsellors’ personal qualities and style and level of functioning are inter-related.
5 qualities are believed to be important*:
- Self-awareness
- Honesty
- Perceived expertness
- Approachableness
- trustworthiness
Attending Behaviour (5)
(Sommers-Flanagan & Sommers-Flanagan, 2012)
Attending behaviour is the foundation of interviewing (Ivey & Ivey, 1999)
It is primarily non-verbal
Much of our communication is considered to be non-verbal; Hall (1966) felt 90% was and others, such as Birdwhistell (1970), felt 65% was non-verbal
- There is unilateral agreement across all theoretical orientations that listening well and paying close attention is essential
Attending behaviour allows for open communication and free expression
Positive Attending Behaviour
(Sommers-Flanagan & Sommers-Flanagan, 2012)
Eye contact* ~
Body language ~
Vocal qualities ~
Verbal tracking ~
Positive Attending Behaviour: Eye contact* ~
Find the right balance
Culture consideration plays a part
How long are we making eye contact for?
Show that we are engaged
Positive Attending Behaviour: Body language ~
Lean forward slightly to show interest
Relaxed body
calm
Positive Attending Behaviour: Vocal qualities
Pay attention to voice loudness
Pitch
Rate
Fluency
Positive Attending Behaviour: Verbal tracking
Paraphrasing
Summarising
Negative Attending Behaviours (7)
(Sommers-Flanagan & Sommers-Flanagan 2012)
- Making infrequent eye contact
- Turning 45 degrees or more away from client
- Leaning back from waist up
- Crossing legs away from client
- Folding arms across the chest*
- Interrupting
- Head nods, saying un huh, too much eye contact or repetition of client phrases
Empathy (4)
One of the most vital elements in counselling.
Subjective: counsellors can momentarily sense what it is like to be the client.
Interpersonal : feeling the client’s experience from his/her perspective.
Objective: having knowledge about the client’s problem from reputable sources.
Brene Brown on empathy (3)
1) Perspective taking
2) Staying out of judgement
3) Recognising emotion in others and communicating that recognition with others
Connect with something that relates to yourself
“I don’t know what to say, but im glad that you told me”
- What makes sth better is connection
Self-Disclosure (2+3kinds+3)
Each client-counsellor relationship must be looked at individually in regard to self-disclosure.
Yalom (2002) describes 3 kinds:
- about the therapy,
- about the ‘here and now’ relationship,
- and personal details about the counsellor
Egan (2007) emphasizes that any self-disclosure must be:
- Brief and focused
- Should not add to the client’s problem
- Should not be used frequently
