1. CHAPTER 3: The Therapeutic Relationship
Learning the Art of Helping:
Building Blocks and Techniques
Fifth Edition
Mark E. Young
Updated by:
Tracy S. Hutchinson, University of Central Florida

2. Chapter Outline
Importance of the Therapeutic Relationship and Change How to Create a Therapeutic Relationship Other Factors that Help or Strain the Relationship

3. Therapeutic Relationship
Research shows relationship is more important than any technique (e.g. think about professionals, doctors).
Achieving goals is more likely when a positive working relationship exists.
Assists with preventing attrition
Uncomfortable with helper
Not liking helper
Helper is incapable of helping
Relationship needed to move through the helping stages

4. Therapeutic Relationship
Drop out rates often due to
Being uncomfortable with helper
Not liking helper
Deciding that the helper is incapable of helping
Establishing a strong, cooperative relationship early on supports all other stages and instills hope

5. Six Common Therapeutic Factors
Enhancing
Efficacy
And
Self-Esteem
Maintaining a
Strong Helper/
Client Relationship
Providing
New Learning
Experiences
Activating Client
Expectations, Hope, and Motivation
Lowering
and Raising
Emotional
Arousal
Practicing
New
Behaviors

6. What helps establish the therapeutic relationship?
Helper is nonjudgmental
Helper’s self-disclosure
Validation of feelings
Normalization of feelings
Helper’s commitment to help
Helper’s use of humor
Helper’s listening skills and nonverbal behavior
Client’s choice

7. What Clients Say
The helper taught me a technique such as making a list of goals. The helper showed good non-verbal's such as eye contact and leaning forward The helper showed good listening behaviors: remembering what was said and paraphrasing The helper self disclosed that he or she had had a similar experience. Encouraged me by making comments including pointing out strengths

8. What Clients Say
Emphasized that it was my choice and that I knew myself best. Was open to my criticism about the structure of the sessions or what he or she said. He or she validated my feelings and gave me support. The helper greeted me, introduced himself or herself and said goodbye. I had a positive first impression.

9. What Clients Say
The helper used humor. The helper’s office environment helped to enhance the relationship (including relevant books). I liked some personal characteristics of the helper (well groomed, similar background).

10. What Clients Say
The helper normalized my the feelings I was having. The helper came highly recommended. The helper was honest and frank. The helper explained how therapy would work. The helper went beyond a business relationship and made extra efforts to help.

11. Most helpful Things Labeling and expressing feelings.
The relationship as a non-judgmental space where they could open up to a supportive person.
Becoming more aware of themselves through self-exploration
Finding new ways of relating to people because of their experience in the therapeutic relationship.
Having therapists ask question to help them find patterns in their lives

12. Characteristics of a Therapeutic Relationship
Mutual liking or respect
Purpose of relationship is resolution of client’s issues
Sense of teamwork while working towards agreed-upon goals
Contractual relationship may terminate at any time
Compensation
Disclosure
Professional boundaries
Termination

13. Relationship Enhancers
NON VERBAL SKILLS
(empathy, expertness, self-disclosure)
leads to
RELATIONSHIP COMPONENTS
(liking, respect and trust)
RELATIONSHIP CONSEQUENCES
(communication, openness, persuasion)
CHANGE

14. Question? What is the difference between EMPATHY and SYMPATHY ?
Sympathy is equal to the notion of Pity. “ahh poor you”. Pity, can suggest that the sufferer is less than the person who is giving the sympathy. Nietzche suggest that this could create and power imbalance.
Can you understand me?

15. Empathy vs. Sympathy
How do you know, that someone is really understanding you? How do you feel, when someone is sympathizing with you?

16. Relationship Enhancers
Empathy
Conveying understanding of client’s subjective experience
Not agreement with behaviors or taking sides
Helpers should not “own” the problem
Non-judgmental
Helper as learner
Sincerity
Consistency
Helper must communicate understanding of facts, feelings, and meaning of client’s story
Learn from the client when situation is different from your own (tutorial stance)
“I wonder what this must feel like”. Can empathize, without taking sides.

17. Empathy is not…
Simply agreeing with the client Pretending to understand Taking on the client’s problems Sympathy A one-time event

18. Empathy and Expertness
Watch for client’s overestimation, idealizing, or attributing therapeutic success to the helper “Ascribed” vs. “Achieved” Credibility

19. Self-Disclosure
What to share with the client? Conveys honesty and openness Modeling behavior for clients Attractiveness of helper Trust Deepens client self-disclosure Self-disclosing vs. self-involving statements

20. Self-Disclosure
What to share with the client? Self-disclosing vs. self-involving statements Watch timing and extent!

21. Self-Disclosure Mistakes
Self-disclosure is…
too deep
poorly timed
not matching client’s experience
Which factors may be difficult to avoid?

22. Roadblocks to Communication
Ordering, directing, commanding Moralizing, preaching, imploring Advising, giving suggestions or solutions Judging, criticizing, disagreeing, blaming Interpreting, analyzing, diagnosing Reassuring, sympathizing, consoling, supporting Probing, questioning, interrogating Distracting, diverting, kidding

23. Transference & Countertransference
Residue from other relationships
Personal needs impinging on relationship
Problematic or Therapeutic?

24. Transference
Carry-over feelings from the past influences the current relationship Can be a source of therapeutic material Can be positive or negative The therapeutic relationship as a model

25. Transference Counselor as ideal Counselor as seer
Major transference patterns:
Counselor as ideal
Counselor as seer
Counselor as nurturer
Counselor as frustrator
Counselor as nonentity

26. Dealing with Client Transference
Convey acceptance of client’s remarks - do not retaliate
Explore client’s feelings
Use self-involving statements to disclose your genuine thoughts and emotions about the client’s behaviors
Use transference to help client find different ways to express feelings and meet needs

27. Countertransference
Helper’s strong emotional reactions to client Anger is the most common Supervision is the key! Do NOT disclose feelings unless it will benefit the client

28. Common Patterns of Countertransference
Paternal/maternal nurturing
Fear of client’s anger
Disgust, disapproval
Need for reassurance, liking

29. Common Patterns of Countertransference
Anxiety Insecurity Feelings of identification Sexual / Romantic Frustration / Anger

30. Exercise
Barriers to Communication