Within The Therapist Lies The Key

| March 4, 2019
Therapeutic alliance

“The establishment of a therapeutic alliance can be a daunting task, even for those therapists who are generally successful…”

For some time now, it has been well-established that the alliance between the therapist and the client plays a significant role in predicting successful therapeutic outcomes. A strong alliance is predictive of successfully achieving therapeutic goals, whereas a poor alliance is seen as resulting in increased dropouts and missed sessions. It should be obvious to everyone that missing therapeutic sessions and dropping out of therapy are not optimal strategies for obtaining successful outcomes.

Although therapist characteristics are seen as essential for establishing a strong therapeutic alliance, attempts to understand the alliance are generally focused on the client and the client’s perception. Of course, this only makes sense given that the perception of a therapeutic alliance or lack thereof begins and ends with the client. It is the role of the therapist to reach out to the client and engage in activities that will create and strengthen a bond between the therapist and the client. However, It is only the client who knows whether that outreach has been successful or not. A smiling client does not necessarily translate into a trusting client. And without the trust resulting from a strong therapeutic alliance, work toward achieving the client’s therapeutic goals will be compromised.

The establishment of a therapeutic alliance can be a daunting task, even for those therapists who are generally successful in creating rapport with their clients. After all, each client is unique and, thus, all clients won’t respond equally to all therapist alliance-building behaviors. Most therapists would adjust their strategies for creating a therapeutic alliance if needed. The trick is knowing if such adjustments are necessary. Although the key to building therapeutic alliances lies within the therapist, the therapist needs some insight into the client’s perceptions of their relationship in order to determine if they are using the right key. In an ideal universe, the therapist could simply ask the client. Unfortunately, “seeing” the client’s perceptions is more complex. Luckily, it isn’t necessary to use complex tools to solve the problem of the client communicating their perceptions.

The Session Rating Scale (SRS) is a conceptually simple, easy-to-use tool that measures the client’s perception of the therapeutic alliance. One of two powerful tools offered by MyOutcomes, the web-based application of the Partners for Change Outcome Management System (PCOMS), the SRS takes seconds to administer at the end of each session and informs the therapist of the strength of the therapeutic alliance and whether the alliance is deteriorating. The insight provided by the SRS enables the therapist to identify any challenges and to make adjustments accordingly. The key to strong therapeutic alliances may lie within the therapist, but it is MyOutcomes that has the power in assisting the therapist to unlock that key.

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Category: Therapeutic alliance

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