The essence of the therapeutic relationship: congruence, unconditional positive regard, and empathy

What are the very basics to counseling?  What helps you build rapport with your clients?According to Seligman (2010), Rogers theoretical perspective places huge significance on facilitative conditions that he believed created a positive client-clinician relationship that promotes the clients’ self-awareness and ability to direct their lives in positive ways.  Congruence, unconditional positive regard, and empathy were the most important of these conditions.  Congruence speaks to the client’s ability to be genuine and authentic, well-integrated, and aware of themselves and how they are perceived by others.  People who are congruent send messages that are clear and understandable, in Roger’s words, the clinician is “transparent.”  The inside feelings match the outer self.  It is about the ability to understand a person’s frame of reference with accuracy.  They may get that look on their face like, “wow, she gets me!”  Or you may hear them say after a reflection of feeling or paraphrase, “yes, that is right,” then they go even deeper into their sharing.

Unconditional positive regard is caring about, respecting, liking and accepting people for who they are – without placing any requirements on them to act, feel or think in certain ways to please their clinician.  This view holds an appreciation for the client that they are simply doing the best they can at the present time.  Unconditional positive regard helps people believe they are worthy and can trust their own thoughts and feelings, it can work to devalue negative messages clients may have received throughout their life.  It also allows them to see that they can change

Empathy is the counselor’s ability to feel with the client and convey back to them understanding.  It is to perceive a person’s internal frame of reference.  Empathy is all about active listening.

According to Corey (2009), the provision of an empathetically attuned and respectful relationship provides the support necessary for clients to allow themselves to experience a range of feelings that they might otherwise block, which then allows them to modify their patterns of thinking and acting.  In my experience with clients when I create an environment that is similar to a person-centered approach, I am able to experience the client in a way that makes a difference for them.  For example, I met with a client that had experienced an unimaginable amount of trauma in her short life of 21 years.  At first, she was very standoffish and disapproving of even meeting with me for an assessment.  I was very open with her about what the session would include.  I did not push her too far in directions that she did not want to go, I reflected feelings, I kept great eye contact, I normalized her experience.  As our session went on, she began to share more and more with me.  When she smiled I smiled, when she was serious I was serious, when she shared a story that affected her deeply, I shared that feeling.  I left the session feeling like we had covered much ground, and she was smiling as she left.  If I had rushed through things, or stayed on my own agenda, I know for certain she would not have opened up to me.

One of my professors stated that when clients experience the counselor as being genuine and interested in their well-being in a non-judgmental way they are more motivated, they are more willing to do homework assignments, they are more likely to continue counseling, and they are more likely to believe that counseling will be helpful for them.  Additionally, he stated that without a strong therapeutic alliance “you don’t have anything,” that what has to come before any other intervention is Roger’s facilitative conditions.  In this way, all counseling models are linked to person-centered counseling because of the focus on trust and safety that is created by using these conditions.

I find it important to mention the fact of dealing with our own feelings.  Corey warns of the need to be able to manage your own emotions.  How can you expect a client to manage theirs if we can not role model this skill?  Corey asks an interesting question, “If you are afraid to cry or lose control, how can you expect to deal with clients who keep their tears inside lest they get out of control?”  Corey goes on to say that if your emotions frighten you, chances are that you will find some way to divert your clients’ attention away from intense feelings.  If a client is afraid of becoming engulfed in depression and you are running from depression, how can you therapeutically engage this individual?”  I make sure to debrief with peers and my supervisor when I have an emotional experience with a client so that I can move past it.  I also have worked very diligently in the past several years to get a better understanding of who I am and how my life has affected me, that way I can keep my wits about me and be useful to the people I am trying to help and support.

One other thing to consider for those non-counselors out there…these skills can be learned and honed to establish deeper, more meaningful relationships with your loved ones.  I have definately used these skills with my husband, and sometimes he will ask a question or reflect a message back to me, and I am blown away!  How would it feel to have a conversation with your spouse/boyfriend/girlfriend, and feel like they were really listening?  Like they get you?  One way to start this type of communication is to engage in it yourself.  The more you illustrate these listening skills to others, and role-model good communication skills, the easier it is for those you communicate with regularly to pick up on this new form of cummunication.

What tips can you share on the therapeutic relationship?

Books referred to in post:

Theories of Counseling and Psychotherapy: Systems, Strategies, and Skills (2nd Edition)The Art of Integrative Counseling

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