by Reg Watson

How would you define or describe a helping relationship? What are some of the key elements of a helping relationship? What is “therapeutic alliance?

The working relationship that develops between the client and the counselor The working relationship that develops between the client and the counselor A key element for successful helping relationships A key element for successful helping relationships Importance of therapeutic alliance Importance of therapeutic alliance Core conditions: Core conditions: Trust Trust Respect Respect

Stage 1—Attending Stage 2—Exploration Stage 5—Termination Stage 4—Action Stage 3—Understanding Between stage 1 and stage 2 a decision may be made by the client or counselor The client may choose to terminate or the counselor may choose to refer Stages are fluid, dynamic and often overlapping

Essential in first stage Building trust Building trust Establishing rapport Establishing rapport Demonstrating openness Demonstrating openness Therapist role Observe Observe Listen Listen Accept Accept

Attending skills Listening Listening Respect (positive regard) Respect (positive regard) Genuineness Genuineness Engender hope Engender hope Encouragers Encouragers Silence Silence Decision point: continue, terminate or refer

Use of more substantive interventions Empathy Empathy Clarifying Clarifying Paraphrasing Paraphrasing Reflecting meaning Reflecting meaning Summarizing Summarizing Self-disclosure Self-disclosure

Client increases depth of exploration depth of exploration self disclosure self disclosure Presenting problem may be phased out as real issues/concerns emerge may be phased out as real issues/concerns emerge Decision point: continue, terminate, or refer

Therapist provides Encouragement Encouragement Support Support Positive reinforcement Positive reinforcementSkills/interventions Interpretation Interpretation Summarization Summarization

Advanced therapeutic skills Advanced empathy Self-disclosure Self-disclosure Confrontation Confrontation Immediacy Immediacy Interpretation Interpretation Probes and questions (direct/indirect) Probes and questions (direct/indirect)

Client begins to recognize personal involvement needed for change Client becomes more congruent with feelings, attitudes, thoughts and behaviors resulting in a increased sense of self Fosters insight and awareness that result in action steps

Therapeutic focus shifts from problem identification to action implementation Therapist helps client examine options and solutions helps client examine options and solutions encourages client to implement plan encourages client to implement planClient begins to practice healthier strategies begins to practice healthier strategies

Client and therapist Evaluate outcomes action taken Evaluate outcomes action taken Outcomes (successful or unsuccessful) discussed, evaluated and revised for subsequent steps Outcomes (successful or unsuccessful) discussed, evaluated and revised for subsequent steps Decision point: move into other issue(s) or terminate.

Therapeutic action skills Problem solving Problem solving Advising Advising Directives Directives Homework assignments Homework assignmentsbibliotherapyjournaling “trying on” new behaviors

Termination stage characterized by Summarizing salient points of therapy Summarizing salient points of therapy Wrapping up unfinished business Wrapping up unfinished business Saying goodbye Saying goodbye Therapist helps client Prepare for ending (timing) Prepare for ending (timing) Make transition into larger social context Make transition into larger social context Explore loss and accompanying feelings Explore loss and accompanying feelings Address unfinished business Address unfinished business

Resistance internal resistance internal resistance external resistance external resistanceTransference Counter transference

Egan, Gerard (2010). The skilled helper (9 th ed.) Belmont, CA: Brooks/Cole. Egan, Gerard (2010). Exercises in helping skills from Egan’s skilled helper (9 th ed.) Belmont, CA: Brooks Cole. Peterson, V. and Nisenholz, B. (1998). Orientation to counseling (4 th ed.) Needham Heights, MA: Simon and Schuster.