In our work, we focus on behaviors of which clients are quite aware. . Therapy is a relationship between two persons with personal and interpersonal histories .. parental figure links to patterns revealed in the transference, they found it more important to Smith College Studies in Social Work, 56, TRANSFERENCE IN SOCIAL WORK 'Transfer' was introduced into social work In this sense, the therapeutic relationships would be viewed as a We May being complicit to their 'maladaptive' relationship patterns We may. fined as action patterns which are not conscious because they have not become in- tegrated into the Although it has now become common for clinical social workers to use the to the treatment relationship which need to be raised. Now that.
After carefully weighing my response, I stopped him and asked him if he had any thoughts or feelings about therapy on the way to the office. It turned out that he had a bad argument with his girl friend last night, felt like an awful person for expressing so much anger at her and, on the way to see me, had the thought and feeling that I could not possibly like him and would want to get rid of him as a patient. Without my saying anything about my fantasy, we explored what his anger meant to him and how it was used against him when he was a child.
Whenever he was angry he was informed that he was not acceptable. It was not that his expression of anger was not acceptable to his parents but that he was not acceptable.
It is important to remember that therapists are human beings and have thoughts and feelings just the same as the rest of the human race. However, the therapist is trained to absolutely never act upon the counter transference feelings. Under no circumstances is a therapist to act romantically or sexually towards a patient.
When people come into therapy they are placing their trust with this professional mental health worker. Just the same as seeking treatment from a medical doctor or dentist, they expect to be treated with respect and dignity. The expectation of being treated with respect and dignity includes the fact that the therapy office be a completely safe place where people can learn about themselves and learn healthy new behaviors in order that they can move on with their lives.
Unfortunately, there are always a few mental healthy practitioners who lack scruples and honesty. These are people who take advantage of those who have placed their trust with them. I have heard of therapist who will actually try to convince a patient that it will help them the patient to have sexual relations with the therapist. When these unethical people are discovered they are investigated, lose their licenses to practice mental health and even go to jail.
This holds true whether the mental health worker is a psychiatrist, psychologist or clinical social worker. All three professions are licensed and come under specific ethical rules and regulations of their profession and of the state in which they live and practice. Every state licensing board has a list of ethical rules and laws that are publicly available and can be found Online in your state.
This is why it is always important for people looking for psychotherapy to exercise the greatest of care in making a good choice. Here are some guidelines in selecting a therapist: A good starting place for selecting a therapist is taking a recommendation from a friend, family member, family doctor Primary care physicianand from another mental health practitioner.
When you interview a therapist you have the right to ask their professional identity psychiatrist, psychologist, clinical social worker. You also have the right to ask whether or not they are licensed.
In most if not all states, practitioners are expected to have their licenses displayed. Never assume someone is licensed. If they are not, Beware! If they do not have experience in helping people to cope with a particular mental illness or behavioral difficulty you can go elsewhere to find the right professional. If any practitioner refuses to answer these types of questions then it is time to leave and seek someone else. Some patients are "squeamish" about asking questions.
They fear offending the therapist. You have a right to know the person you are placing your trust in. Unlike Kivlighan and Shaughnessy, these authors considered therapies consisting of 8 and 16 sessions, using the ARM to rate the therapeutic bond, partnership, and confidence, disclosure, and patient initiative.
No significant correlation was observed between any of the four patterns and the therapeutic outcome. However, the authors observed a cycle of therapeutic alliance rupture—repair events in all cases: On the basis of this characteristic, the authors hypothesize that the V-shaped alliance patterns may be correlated with positive outcomes.
In particular, Stiles et al. The results of the study by De Roten et al. According to De Roten et al. De Roten et al.
Transference, Countertransference and Finding a Good Therapist
According to Castonguay et al. This has supported the idea that therapeutic alliance may be characterized by a variable pattern over the course of treatment, and led to the establishment of a number of research projects to study this phenomenon. Discussion and Conclusion According to their meta-analysis based on the results of 24 studies, Horvath and Symonds demonstrate the existence of a moderate but reliable association between good therapeutic alliance and positive therapeutic outcome.
More recent meta-analyses of studies examining the linkage between alliance and outcomes in both adult and youth psychotherapy Martin et al. Thus, it is not by chance that in their meta-analysis, Horvath and Luborsky conclude that two main aspects of the alliance were measured by several scales regardless of the theoretical frameworks and the therapeutic models: This accounts for the difficulties associated with the concept of alliance, which is built interactively, and so any assessment must also consider the mutual influence of the participants.
In a helpful contribution, Hentschel points out that the problematic aspect of empirical studies investigating the alliance is their tendency to view the alliance construct as a treatment strategy and a predictor of therapeutic outcome: The use of neutral observers or the creation of counterintuitive studies is therefore recommended.
From this historical excursus, it is clear that research into the assessment of the psychotherapeutic process is alive and well. The development of a dynamic vision of the concept of therapeutic alliance is also apparent. The work of theorists and researchers has contributed toward enriching the definition of therapeutic alliance, first formulated in Research aimed at analyzing the components that make up the alliance continues to flourish and develop.
Numerous rating scales have been designed to analyses and measure the therapeutic alliance, scales that have enabled us to gain a better understanding of the various aspects of the alliance and observe it from different perspectives: Attention has recently turned toward the role of the therapeutic alliance in the various phases of therapy and the relationship between alliance and outcome.
So far, few studies have regarded long-term psychotherapy involving many counseling sessions. This topic, along with a more detailed examination of the relationship between the psychological disorder being treated and the therapeutic alliance, will be the subject of future research projects. Equally important, in our opinion, will be the findings of studies regarding drop-out and therapeutic alliance ruptures, which must necessarily consider the differences between that perceived by the patient and that perceived by the therapist.
Conflict of Interest Statement The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Acknowledgments The authors thank Mauro Adenzato for his valuable comments and suggestions to an earlier version of this article.
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