I have also thought about cotherapy and how it works in the session clients. I remember watching a cotherapy with Object Relation therapists David and Jill Scharff. In my perspective, they did it so effortlessly and it work for the clients. I understand that they have been doing therapy for a long time and Object Relation is their area of expertise but I could not help but wonder how will I function has a co-therapist when I still experience anxiety as the only therapist in the room. To be honest, cotherapy scares me because I feel like I will question my abilities against my counterpart. I will not completely dismiss the idea with cotherapy because with time and practice I may consider it. The two advantages and disadvantages of cotherapy
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My personal theoretical orientation to counseling is Cognitive-Behavioral therapy. Cognitive-Behavioral therapy helps the client to uncover and alter distortions of thought or perceptions which may be causing or prolonging psychological distress. The theoretical foundations of CBT are essentially those of the behavioral and cognitive approaches. CBT leads to a clear, persuasive, and evidence-based description of how normal and abnormal behavior develops and changes (Kramer 293). The term “cognitive-behavioral therapy” or CBT is a term for therapies with many similarities. CBT is not used as a cure and often times used to help with anxiety or depression the most, and may be single or in group settings. There
My role as the clinician is quite important. The primary task is to engage the client in identifying cognitive errors, refuting them, and replacing them with more adaptive thoughts. A sound therapeutic relationship is necessary for effective therapy, but not the focus of the therapy. Many forms of other counseling believe that the main reason people get better in therapy is because of the positive relationship between the therapist and client. Cognitive-behavioral therapists believe it is important to have a good, trusting relationship, but I know that is not nearly enough. We believe that the clients change because they learn how to think differently and they act on that learning. Therefore, CBT tries and focuses on teaching rational self-counseling skills. CBT is the teamwork that exists between the therapist and the client. This form of therapy is used to seek ways of learning what their clients want out of life and then helping their clients achieve those goals. The therapist's role is to listen, teach, and encourage, while the client's roles is to express concerns, learn, and implement that learning (Pucci1).
Firstly, one strength of the counselling relationship which makes it the most important factor is its effectiveness. The counselling relationship allows client and counsellor to agree on tasks and goals (Colin Feltham 2010). Through the relationship the client can become aware of their problems and work with the counsellor to find solutions. The relationship works well in Cognitive Behavioural Therapy (CBT) as it combines interpersonal and technical factors to result in a favourable outcome (Glovozolias 2004). CBT is action orientated therapy used to change faulty thinking patterns to help clients overcome mental disorders such as depression. (Whisman 1993) Discussed five studies that looked at the relationship and CBT in cases of depression; three studies found the therapeutic relationship significant for positive outcome. Unfortunately, in CBT value is placed on technique and therefore there is not much research on the effect of the counselling relationship in this therapy. Although, the relationship is vital in person centred therapy, as it emphasises the importance of the therapeutic relationship between counsellor and client. In person centred therapy the counsellor must find ways of using the relationship to highlight issues in the clients functioning. Person centred therapy was introduced by Carl Rodgers and is one of the most widely used therapies as it focuses on the client's thoughts, feelings, behaviours and needs.
Transference is often manifested as an erotic attraction towards a therapist, but can be seen in many other forms such as rage, hatred, mistrust, prettification, extreme dependence, or even placing the therapist in a god-like or guru status. When Freud initially encountered transference in his therapy with clients, he felt it was an obstacle to treatment success. But what he learned was that the analysis of the transference was actually the work that needed to be done. The focus in psychodynamic psychotherapy is, in large part, the therapist and client recognizing the transference relationship and exploring what the meaning of the relationship is. Because the transference between patient and therapist happens on an unconscious level, psychodynamic therapists who are largely concerned with a patient's unconscious material use the transference to reveal unresolved conflicts patients have with figures from their childhoods. Countertransference is defined as redirection of a therapist's feelings toward a client, or more generally as a therapist's emotional entanglement with a client. A therapist's atonement to his own countertransference is nearly as critical as his understanding of the transference. Not only does this help the therapist regulate his or her own emotions in the therapeutic relationship, but it also gives the therapist valuable insight into
There are a multitude of reasons why an individual may need or want therapy; whether it’s due to learning how to cope with a mental disorder or disability, life happenings such as traumas or abuse, addictions, or even PTSD. Anybody can receive it – individual persons, families, or groups. It isn’t hard to argue that most therapists and psychologists will agree that the therapeutic alliance is one of the most beneficial foundations of a therapy session. Also referred to as the working alliance or working relationship, it represents the bond between therapist and
Allowing for our ethical codes of conduct, if the client is someone we feel we can proceed with, then as always, the first stage would be to develop a good rapport and gain the clients trust to develop an honest and open relationship with them. The client centred approach as always is the best method for this – to put the client at ease in a non-judgemental space where they can express their emotions and explore what it is they want to achieve with therapy. In giving the therapist an
They both have a “positive view of human nature and view the individual as not necessarily being a product of their past experiences, but acknowledge that they are able to determine their own futures” (Holder, 2013). They both attempt to improve their client’s wellbeing by implementing a two-way therapeutic relationship where both client and therapist collaborate to enable the clients coping mechanisms (Holder, 2013). CBT and PCT both instil the three core conditions of empathy, unconditional positive regard and congruence but in CBT it is used mainly in the establishing of the working alliance (Holder, 2013). In both methods, the relationship between client and therapist is congruent and they both use the skills of reflection, paraphrasing and
The dynamics of the client-therapist relationship in cognitive therapy is a collaborative effort. Cognitive therapists elicit patient’s goals at the beginning of treatment. They explain their treatment plan and interventions to help patients understand how they will be able to reach their goals and feel better. At every session, they elicit and help patients solve problems that are of greatest distress. They do so through a structure that seeks to maximize efficiency, learning, and therapeutic change (Robert & Watkins, 2009). Important parts of each session include checking the client’s mood, a connection between sessions, setting an agenda, discussing specific problems and teaching skills in the context of solving these problems, setting of self-help assignments, summary, and feedback (Robert & Watkins, 2009). The status that CBT has with insurers and funding agencies is a result of concrete and measurable goals, goal-focused processes and clear outcomes-based evaluations/results. Therapy is typically conducted in an outpatient setting by trained therapist in cognitive behavioral techniques. Treatment is relatively short in comparison to some other forms of psychotherapy, usually lasting no longer than 16 weeks.
therapy model that would be used just for Sarah and Robert would be the attachment theory family therapy approach. This model would be used because they both detached themselves from each other, they didn’t use their sibling relationship as a support instead the avoid each other. When working with them outside of residential home it would be important to create a schedule that has flexibility, because it will give them some control and may help to make them more open to the process. An example of this that was effective can be found in Foroughe and Muller’s article about attachment-based intervention strategies.
The foundation of therapy starts by building rapport with the client and applying strategies when necessary to overcome a variety of barriers. It is imperative to have rapport with a client and to be aware of barriers to facilitate a good treatment outcome. This will take practice and the use of methods and strategies ready to be implemented when needed. There are many components to building a good client rapport such as: intimacy, vulnerability, exploration of inner challenges, self-awareness, staying present; inner resiliency, empathy, anxiety management, and self-integration, and relationship acceptance. The two types of barriers are internal and external and this is for both the client and the therapist. The common barriers to rapport are countertransference and transference. Strategies for overcoming barriers are: Pause Moment and self-awareness. It also requires skills such as being genuine, sensitive, open, and
Research has shown that a strong therapeutic alliance is necessary for establishing a beneficial contact between the therapist and the client. If the therapist does not encourage the creation of a reliable therapeutic alliance from the beginning of the treatment, it will be hard to develop a constructive relationship with the client later. Establishing the therapeutic alliance will increase the chances of achieving the goal of the treatment because the clients will be willing to cooperate if they trust and respect the therapist. Clients are not likely to cooperate with therapists who impose their authority aggressively. Instead of imposing their authority on the patient, therapists should develop work with their patients by
By examining the bond between a therapist and his client we can further understand how important the role of therapeutic alliance is in treatment outcome. The authors point out that therapeutic alliance plays a major positive impact on the outcome of therapy. Individuals who build good therapeutic alliances with their therapists experience more productive and effective therapy than individuals who do not.
At my current placement I take on the role of a case manager, providing individual and family therapy to a mandated teen and his parent. Although transference and countertransference are often seen as disruptive to the therapeutic alliance and in general as an extremely bad things as a professional I believe that counter transference and transference can be important tools to working with resistant clients. I do not stand alone in this thinking many of Social Work founding theorist actually suggest that all therapeutic relationships need a degree of transference to have successful interventions. Freud is one of those founding fathers who used transference and countertransference to create the foundation for social work principles and methods we still use today (Klein, M., 1952). Although I believe that Freud both used transference and countertransference unethically, I can state with certainty that during my work with my current client and his family I experienced counter transference that benefited the therapeutic alliance and helped further our work together.
This way I could direct the thought process to discovery of what fears are associated with the mistrust. I would ensure the goals were within my, as therapist, obtainable. If I availed myself to the client between the hours of 8-5 everyday, then I would have to be ready to talk to or be available to the client between those hours. If I do not, I start to build doubt. P.S. The client will test this availability. As the therapist, I would have to set and ensure the client understands some ground
If the client feels “safe” in the session, this can be very powerful for them. As sessions occur, the client will feel more comfortable in trusting the clinician with their feelings, attitudes and emotions. The client is able to present their needs and problems in ways that only they can express. Another factor that may resonate in the sessions may include transference and counter-transference. Transference is when the client’s attitudes, feelings and emotional conflicts from past events begin to be directed to the therapist, while Countertransference is exactly the opposite, when the therapist’s attitudes, feelings, and emotional conflicts from the past are directed towards the client (Transference and Countertransference, 2011). There are not too many positive factors with Countertransference, except being able to recognize it, when it exists, and be able to work out any conflict. A client’s experiences can affect their feelings, emotions, and behaviors towards their therapist. If the therapist remains their professionalism, and sets the proper limits and boundaries, a client can work through past experiences that are affecting their functioning. In a lecture, it is the role of the counselor to recognize the client’s experience; reflect and process the client’s emotional state, as well as process their own emotional reactions to clients and their issues. When clients can work through their problems from past