The Essential Aspects of Building a Therapeutic Relationship

What makes a patient and their therapist click? Since its advent, clinical psychology has been faced with one key question- what is it that makes therapy successful? What elements can one encourage, promote and learn in order to be as helpful to a patient as a therapist can be? Clinicians from all schools of thought continue to contest new, novel and improved ways to help those in need and these techniques vary in theory, assumptions and even in their execution. However, even though the techniques and underlying assumptions vary depending on the school of thought, one aspect remains constant to therapy - the contact between a therapist and a patient. The relationship, better known as the therapeutic relationship or working alliance between a patient and therapist, defined by Clara Hill, are the feelings and attitudes that the people in session have towards one another and how those sentiments are expressed. The therapeutic relationship is extremely important for two reasons. One, the therapeutic relationship acts as a microcosm that enables a therapist to peek into the patients' outside world. The microcosm acts as a meeting point of different perspectives, and ideas. The strength of the relationship will then determine how well a course of action is take.And second, the therapeutic relationship is one aspect of therapy that transcends all different forms of therapy. It is therefore logical to assume that one would come across a range of data that provides specific guidelines for building a therapeutic relationship. However, this does not seem to be the case. During my research for this paper, I came across Carl Rogers, The Necessary and Sufficient Conditions of Therapeutic Personality Change and found that many scientists have drawn from his work. Carl Rogers most celebrated aspect from that paper is his postulation of unconditional positive regard and empathy. He postulates that a therapist must always maintain unconditional positive regard for their patients. In looking further, I found that it is not merely empathy and unconditional positive regard that sustains a relationship, in fact many other aspects contribute to and play a key role in building a therapeutic relationship.Providing a holistic overview of all the key aspects of the therapeutic relationship is beyond the scope of this paper and hence I have limited myself to a few concerns. In order to uncover the essential aspects ofbuilding a relationships, it was vital to look into whether the therapeutic relationship was a function of the individual therapist or whether there seemed to be some underlying patterns within experts. Next, I contested how much the relationship contributed to the outcomes versus the techniques used within therapy. I then, gauged the extent of the effect of the variables and finally, the client's role in the various aspects of the therapeutic relationship.One point of contention when talking about the therapeutic relationship is the idea of whether the model of therapy dictates the therapeutic relationship or whether an 'ideal therapeutic relationship' exists and whether experts try to attain that idea. To test the rationale to see if the therapeutic relationship was be a function of the model of therapy or the therapist's expertness in the field, Fiedler (1950) compared the therapeutic relationship of therapists who believe in different forms of therapy-psychoanalytic, nondirective and Adlerian therapy. In this experiment he tested for three hypothesis. First, was that expert therapists would be more likely to achieve an ideal therapeutic relationship than a non-expert therapist. The second hypothesis was that the relationship between the therapist and patient was more a result of the therapists themselves and not the school of thought that they believed in. And the third, was that experts would be better at communication and at understanding their patients than non-experts. To do so, Fiedler used ten electronically recorded sessions in the early therapeutic relationship. …