The Importance of the Relationship in Counseling and Psychotherapy
This summer, I have the pleasure of teaching an undergraduate course in basic counseling skills. While many counseling courses focus on the various theories of counseling (think cognitive-behavioral, existential, family systems, etc.), this course is tantalizingly different.
It's not that I don't appreciate the many theories of counseling and psychotherapy - in fact, the first two I listed above were cognitive-behavioral and existential because those are my personal favorites. But I think that new students of the helping profession need to learn first about the fundamental importance of the therapeutic relationship to achieving meaningful results in counseling and psychotherapy.
Did you know that there are somewhere between 100 and 500 theories of counseling and psychotherapy, depending on how you classify them? Whew! That's a lot of theories to learn. The truth is that therapists don't have to learn all of them in order to be good at what they do. Time and again, research has shown that a handful of common factors cut across all of these theories to determine effectiveness in helping people:
- Sustaining a strong relationship between the helper and client
- Increasing the client's enthusiasm and expectations that help is possible
- Augmenting the client's sense of capableness
- Providing new learning experiences for the client
- Regulating emotional arousal and expression
- Providing occasions to practice new behaviors
Regardless of the specific techniques therapists decide to use, they must nurture these six conditions. I think this all starts by building a strong, trusting therapeutic relationship. According to Carl Rogers, one of the most prolific scholars in the art and science and psychotherapy, a therapist can achieve this by exhibiting three conditions:
- Congruence. This is basically being genuine and consistent in one's thoughts, feelings, and actions when interacting with a client. In other words, the therapist should be real.
- Positive regard. This doesn't mean that therapists have to like every client the same way they like and want to spend time with their friends and family. Instead, the therapist should respect and accept every client in all of his or her humanness, even if the therapist does not agree with all of the client's actions.
- Empathy. This is not the same as sympathy, which implies pity. Instead, empathy is a true appreciation and effort to understand what the client is experiencing, particularly regarding the client's feelings and worldview.
What do you think? Are these conditions sufficient to establish a therapeutic relationship effective enough to facilitate change? Share your thoughts and experiences by leaving a comment below.
Young, M. E. (2013). Learning the art of helping: Building blocks and techniques (5th ed.). Boston, MA: Pearson.