Evidence suggests that the quality of the relationship between the counsellor and client, or ‘therapeutic alliance’, is the single greatest predictor of therapy success. Though the skill of the counsellor is an important factor for predicting change, research indicates that the relationship between client and counsellor is even more important than the treatment style and techniques used. Therefore, if you are seeking assistance from a counsellor, it is important to select one with whom you can relate to easily. It is common for clients to see a number of different counsellors before finding the right one for them.
The following factors are generally considered to be important aspects of the therapeutic alliance that should be considered by both clients and therapists during the early stages of counselling.
The counsellor’s interpersonal qualities
Evidence suggests that the experience of empathy, understanding, genuineness and unconditional acceptance is more likely to produce psychological growth. Therefore, when selecting a counsellor, it is important to find someone whom you feel possesses these qualities. Additionally, you must feel that they are trustworthy, reliable and safe.
It is likely that you will feel most comfortable with a counsellor who has a similar interpersonal style to you and who meets your expectations regarding counselling. For example, if you expect and value a high level of expertise and professionalism, a counsellor with a more formal communication style, office setup, dress code and therapeutic style, would be more likely to benefit you than a counsellor with a more friendly and informal approach.
Often people who seek counselling have had past experiences and traumas that make it difficult for them to trust and feel safe around others. Additionally, for various reasons, they may have had an experience that gives them little faith in counselling as a vehicle towards change. If you fit either or both of these profiles, it is understandable that you may be reluctant to engage in counselling. This is likely to interfere with your ability to achieve change in therapy, as it will impact significantly on the relationship between you and your counsellor.
Therefore it is important to voice your concerns up front and examine how you feel about your counsellor’s responses to your concerns. For those with a high degree of distrust and skepticism, it is of high importance that they find a counsellor with whom they can relate to, but that they also examine their concerns critically and achieve some flexibility and willingness to attempt to engage with a new counsellor.
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Shared understanding of problems
Clients usually come to counselling with preconceived ideas about the nature and reasons behind their problems, as well as the type of assistance a counsellor is likely to provide. Effective counselling occurs when your views are similar to those of the counsellor’s on the above issues. When there are differences, a good counsellor should openly acknowledge and discuss them with you, and you are also encouraged to raise any issues you notice.
The main goal in the early stages of counselling is to arrive at a ‘case conceptualisation’, or a shared understanding of the reasons a client’s problems have developed and persist. This enables the counsellor to determine how to best intervene. A case conceptualisation should incorporate your perspective and the counsellor’s experience and expertise.
If you cannot arrive at a shared understanding of your issues, the decision may be made to refer you to another counsellor whose conceptualisation is more acceptable to you. Therefore it is important for you to voice any concerns you have regarding how the counsellor is interpreting your problems and situation, as the necessary adjustments cannot be made if the counsellor is not aware that you do not see their ideas as accurate.
Commonalities between client and counsellor
Both clients and therapists bring to the counselling relationship tendencies to interpret, feel and act towards others, which are influenced by their backgrounds and past experiences. These tendencies have a profound influence on the quality of the therapeutic alliance. Therefore, whilst it is perfectly feasible to have a high quality relationship with a counsellor of a different gender or ethnic background to you, the gender and racial composition of the client-counsellor pairing must be considered when selecting a counsellor. Engaging in counselling is challenging and therefore needs to be done on a solid foundation of understanding.
Shared goals are also important – the counsellor’s goal should be to help you achieve your goals. Therefore, goals for counselling sessions should be achievable, measurable and in your best interests (e.g. if you have anorexia, the therapy goal should not be to lose weight, even if you want to). They should also be up to date with where you are at in life and may change throughout therapy, so counsellors should continually check with you regarding this.
The client-counsellor relationship is affected when the therapist and client have different goals in mind, whether consciously or subconsciously. If you notice that your counsellor’s goals for your treatment appear to be different from yours, this should be raised for discussion. Often therapists set goals with more of a long-term, relapse-prevention focus, seeing the client’s goals as too short-term and transient. These differences need to be discussed openly.
Tasks undertaken during the course of counselling
Tasks carried out by the client and counsellor in service of therapy goals also influence the therapeutic alliance. Before undertaking a task, whether in session or at home, you should understand the nature of the task, what it involves and why it needs to be done (its value and contribution to achieving therapy goals). You should also be equipped with the knowledge, skills, confidence and practical ability to carry the tasks out.
Though it is common for counsellors to ask clients to undertake challenging tasks in service of their goals and values, if you find that your counsellor is asking you to undertake tasks that are simply impossible for you to complete, this issue should be raised with them in therapy. Continued failure to complete tasks set in therapy will not empower you or contribute to progress in therapy.
Finding assistance
If you live in Canberra and feel that you may benefit from counselling, you can contact Strategic Psychology to arrange an appointment. We can assist you to identify the psychologist or service that is most likely to benefit you.
No referral is required in order to see one of our psychologists, however, you can contact your GP for a referral under Medicare (if eligible) to receive a rebate on services provided.
Reference:
Dryden, W. (2009). The therapeutic alliance as an integrating framework. In W. Dryden, & A. Reeves (Ed.), Key Issues for Counselling in Action (pp. 1-17) (2nd ed.) UK: Sage Publications Ltd.