Quiet Reflective Listening Analysis

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.

In 1787, our founding fathers sat down to write, what came to be the longest surviving written charter of government, the constitution. Some might argue the constitution was flawless; however it did leave the issue of slavery to be unattended and unresolved until 1820. As tensions rose between the pro-slavery and anti-slavery states, compromises such as the, Missouri Compromise, Compromise of 1850, and the Kansas-Nebraska Act only temporarily settled debates that would eventually send the United States tumbling into Civil War.

Within this model the counselor can employ a wide range of techniques to achieve the behavioural objectives agreed, these include - challenging irrational beliefs, rehearsing different self statements, experimentation of self statements in real situations and systematic desensitization (Mcleod 2008). Behavioural therapist work on changing behaviour and it’s assumed that changes in feeling and thinking will follow.

A therapeutic relationship is a key component in the nursing profession. Without therapeutic relationships, the best possible care can never be provided. The foundation in which trust is built upon is created from the nurse’s ability to truly listen and respond appropriately. Listening creates the base in developing a strong, trusting relationship. Sometimes it is simply hearing what a patient says that makes all the difference, empowering them to open up and become more comfortable with the nurse (Hawkins-Walsh, 2000).

There are many ways of forming a relationship and gaining the trust and respect of the patient and I had to work out the different things that make a good therapeutic relationship. According to Hinchliff et al (2003) there are a number of important elements that make a good therapeutic relationship, but it is important to make clear that a therapeutic relationship is a formal relationship between a medical professional and patient. The Nursing and Midwifery Council (2008) maintains that at all times nursing staff must maintain appropriate professional boundaries in the relationships they have with patients and clients.

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

Therapeutic relationship is defined as the collaboration and attachment between the client and therapist that focuses on meeting the health care needs of the client (Bordin, 1979). In this relationship, the therapist without prejudice shows Empathy, insight, understanding and acceptance of the client. Duan and Hill (1996) defined Empathy as “feeling into” the experience of the client. Over the years, the research evidence keeps piling up, and indicating a high degree of Empathy in a Therapeutic relationship is possibly one of the most potent factors in bringing about positive outcome in the therapy

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).

As important as the bond between a client and therapist is advantageous for therapy, it does not constitute the fullness of the relationship. Clients also bond with

There are many values this writer wishes to incorporate into a counseling relationship. The fundamental values this writer wishes to incorporate are: flexibility, self-awareness, self-regulation, and empathy. The ability to be flexible and alter what one does in order to fit the client’s needs is crucial to establishing and maintaining a therapeutic relationship. Flexibility can be demonstrated in many different ways, such as the way the therapist interacts with the client, the tone of voice that is utilized, down to the way the therapist provides material to the client. In being flexible, treatment is able to remain focused on the client and his or her needs (Egan, 2014).

My client is vulnerable and in need have trust in our therapeutic relationship. Heather is generally not an outspoken person therefore I do not take her openness in my sessions for granted. Heather has expressed how much our sessions have helped her so far and that they have become an important part of her life.

There are many variables that influence the success of therapy for the client, none more so than the therapeutic relationship. The therapeutic relationship is defined as the strength and collaborative relationship between the client and therapist that emphasises mutually agreed goals and tasks within the context of a strong affective bond (Horvath, 1994.) In the therapeutic relationship, the clinician offers care, touch, compassion, presence, and any other act or attitude that would foster healing, and expects nothing in return (Trout, 2013.) Some clinicians believe that the “therapeutic relationship is a precondition of change, others as the fertile soil that permits change, while others see it as the central mechanism of change itself” (Norcross, 2010.) This is not to devalue other variables that impact the success of the therapy such as client involvement and the treatment method.

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

The whole reason for a therapeutic relationship is to facilitate a successful patient outcome. Each person is unique and has different needs.

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