This is the Chapter 8 of the book The Individual (de Bruin, E., 1st Edition). Which is content for the exam of the Theory component of Module 4 (The Individual) of the University of Twente, in the Netherlands.

Chapter 8:

Building therapeutic relationship

Basic tool therapy: therapist and therapist capacity to engage collaboratively with client

Making sense therapeutic relationship: multiple perspectives

• Relationship as a container: place within which most aiful and destructive feelings client are expressed and acted out --> frame/ structure (edges container) needed so client knows that they are there.
• Authentic meeting:

• Rogers: emphasis individual autonomy/ equality between people --> move beyond performance professional role, seek create authentic encounter

• Authentic presence: engage honest self-exploration, as well as communication appreciation of possibility of intimacy and genuiness in ordinary life settings

• Therapist as coach: supports person in learning new skills, by demonstrating/ modelling these skills, but also reinforcing/ celebrating achievements and success
• Author-editor relationship: freedom/ individuality limited as a consequence of conformity to dominant culture narratives that define way should behave --> writer (client)creates/ imagines story into existence, editor (therapist) helps give it shape

• De-centred relationship: relationship not of interest, aim develop relational connection with people everyday life

• Working alliance: work together in the face of common enemy (problems and symptoms of client)

• Agreement on goals
• Assignment of task
• Development of bond

• Maintaining mutual alignment:

• Directionality: sense intentionality and movement towards future --> client/ therapist need to remain in alignment around trajectories each of them are following, particularly in relation to each other’s goals

• Integrative models:

• The responsive relationship:

• Relational styles: therapist behaviour in respect how they interact with client, in terms directiveness/ supportiveness.

1. High direction/ low support: therapist in charged what is happening
2. High direction/ high support: therapist teaching/ psycho-educational role
3. Low direction/ high support: therapist accompany client engage process of exploration and growth
4. Low direction/ low support: therapist observer client’s progress

• The 5 relationship model: framework for making sense therapeutic relationship

1. Working alliance
2. Transferential/ countertransferential relationship
3. Reparative/ developmentally needed relationship
4. Person-to-person relationship
5. Transpersonal relationship

• Clarkson’s model: developmental movement across these relationship types

• Josselson’s multi-dimensional model: 8 main relationship dimensions

1. Holding: being there for another person/ oneself
2. Attachment: emotional bond/ enduring connection
3. Passionate involvement: aroused in a relationship
4. Eye-to-eye validation: recognition one’s meaning/ value in eye of other
5. Idealisation and identification: admiring other/ using them as model or mentor
6. Mutuality and resources: doing things together
7. Embeddedness: belonging
8. Tending and caring: looking after, being dependent

• Structural analysis of social behaviour: considers reciprocal patterns of behaviour rake place participants in relationship

• Reciprocal patterns: manifestations off interaction between hoe close o other person prefers to be, and preference for being powerful/ dominant

Client’s internalisation of therapist

• Internalisation: voice therapist comes to be added to the voices within inner space --> helps continue therapeutic process after sessions

1. Therapist as “mature mother” object: trusting relationship
2. Therapist as “symbolic mother”: therapies voice attuned to client’s needs/ necer challenges client’s attitudes
3. Therapist as “insufficient mother”: therapist fails accept client’s needs to be accepted/ supported
4. Therapist as “unattainable father”: perceived male therapist as partner always longed for
5. Therapist as “stern demanding father”: image is of a father whose affection/ esteem is struggle to win
6. Therapist as “devalued object”: client does not feel understood or accepted, internally critical of therapist
7. Therapist as “repressed object”: impossible re-create detailed image of therapist
8. Therapist as “unreachable, ideal object”: therapist as omniscient, wise figure

Building therapeutic relationship:

• Alliance in Action (AiA) scale: therapist engage activities that help build collaborative relationship
• Shared language: around use of feelings words and action words
• Metacommunication: pausing ongoing flow of communication to reflect what is happening at that moment (where conversation leading, and checking out state of relationship)

• Effective steps repair therapeutic alliance:

1. Sensitive to the presence of rupture in alliance (confrontation, withdraw or combination of the two) --> therapist, in non-defensive way, acknowledge how they might be contributing to the rupture
2. Encourage client assess primary feelings, and express to the therapist underlying needs/ wishes

Embodiment of therapeutic relationship:

• Transition objects: important tole of objects at crucial stages of transition in child’s life

Boundaried relationship:

• Relationship focused boundaries related to:

• Physical space: how close client/ therapist sit
• Information: what should client know about therapist?
• Intimacy: touching permitted?
• Social roles: therapist/client response meet setting other than therapy
• Shared decision making: to what extent?

The financial relationship:

• Sliding fees: fee should be set that is the maximum affordable by the patient
• Fee guilt: conflict wanting to be perceived as helper/ being involved in a business