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ClientTherapist Relationship: What Are the Boundaries?
The client-therapist relationship is a privileged relationship where therapists are obliged to maintain the secrecy and privacy of their clients. This relationship entirely works on trust. If there is no trust, no therapy will be successful
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What is the Meaning of Client-Therapist Relationship?
A therapeutic alliance is emotionally intimate relationship in which the client discloses all those things about which they never discussed with anybody else. Despite the nature of the relationship, there are some boundaries to be maintained by the therapist as a facilitator of that alliance. For any intervention plan to be successful, the client and the therapist should have a trustworthy relationship, which is fundamental for a success treatment.
Components of Client-Therapist Relationship
There are certain components of therapy that form the base of any rapport, and these components are confidentiality, professional intimacy, respect and trust, empathy
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Phases of the Therapeutic Alliance
A therapeutic alliance is formed in stages. No one is ready in the initial sessions to share every bit of their life till then. So, everything in therapy is built brick by brick. In the initial phase, therapy is based on the client's perception of the therapist's support and empathy. In the later stage, there is a sense of responsibility in achieving the mutually decided goal. So the stages of the alliance, according to Rivera (1992), are:
Commitment: In this stage, the therapist and the client decide the common goal of the therapy, and the client learns about how they would be taking the whole therapy process. The therapist in this phase tries to figure out how they would proceed towards the goal, and there is a sense of collaboration.
Process: In this stage, the client starts talking and sharing their issues. Here, the therapist uses active listening skills, paraphrasing, and looking out for triggers. This stage's main agenda is to gather more information about the issue at hand.
Change: In this stage, the intervention plan is decided and implemented. As they progress with the intervention plan, every success and failure is noted, and changes are made. This is the phase where the application is made.
Termination: After the issue is solved, the therapist and client wind up the therapy on mutually agreed term. The therapist and client recognize each other as autonomous and independent individuals, and the client is taught to look for further triggers and how to deal with them on their own.
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Characteristics of Therapeutic Alliance
There are three most essential features of any therapeutic relationship: Emotional bond of trust, caring, and respect; Agreement on therapy goals, and collaboration in the work of the treatment
The most important part of the therapy in the initial phase is the rapport formation, how well a therapist builds a communication channel between them, and this form the basis of the therapeutic alliance. In therapy, not only the relationships between the client and the therapist, are essential but it is also important that how the therapist personally behaves with his/her client's also affects the whole case. This is why the client's environment impacts any such treatment
There should be a bond built on trust, caring, and respect where the environment is non-judgmental and empathetic. There should be respect for the client's choices and decisions
Agreement on therapy goals means that they should be mutually decided, and the client's perspectives on his/her problems should be cared
In any such treatment, collaboration is an essential element; the therapist can make the client understand and accept what they need. Both need to work hand in hand for the attainment of the goals
Ethics to be Followed in an Alliance
Within a therapeutic relationship, it is not unusual or abnormal for the client to feel attracted towards their therapist, who has treated them with care, attention, and empathy. However, it is the therapist's responsibility not to engage in such a social relationship outside the practice. If a therapist pursues such a relationship, it might be seen as against the professional ethics. They should not engage in any manner apart from professional with the client, their family, or their known ones, as this will jeopardize the legitimacy of the therapy.
What if the client expresses "romantic feelings" towards the therapist? As a therapist, how are you bound to respond?
If there is any such scenario, the therapist must keep in mind the professional ethics. They have to follow and deal with that revelation so that it does not harm the client's self-esteem. The client might feel rejected and humiliated by not accepting their feelings; so, therapist must deal such sensitive relationship with due care and should take the best decision needed for the moment.
How to Build a Good Therapeutic Relationship?
If there is not a good relationship, then there are high chances that the client will terminate the therapy soon. Sometimes things get stuck, but a therapist should know how to deal with these situations and reflect on them. Here are some ways that therapists can use−
Make the client more comfortable with the process of therapy. Make sure that the environment is calm and that they feel comfortable
Manage your emotions. Plan your sessions ahead of time and manage how you react to their revelations
Ask different questions. Try to frame questions that help to probe more into the issue. Getting stuck while asking questions is common, but this should not discourage a therapist
Focus on the client's needs. As a therapist, it is normal to feel negative emotions as, at the end, they are also humans. If a therapist feels their problems interfere with the sessions, he/she should consult to his/her supervisor
Refer to another therapist. If the therapist feels he/she is not well-equipped to handle such mental health disorders, then he/she must refer the client to a senior therapist
Success of a therapy depends on the therapeutic alliance. If the base is not strong, no matter how much effort the client and therapist put in, it will not succeed. As a budding therapist, one should know how to form a rapport and continue progressing even after facing setbacks. Therefore, before starting an independent therapy practice, every therapist must complete a proper training session and then for a few months, must work under a senior therapist.
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