Clarkson worked out a comprehensive integrative model which can be applied to the therapeutic process regardless of the modality or approach used. She believed that the systematic use of the relationship between the therapist and client can be the key to achieve changes in clients’ feelings, thoughts and behaviour. In earlier centuries the individual found these healing relationships in the family and the community. However, in the 20th century this was not the case any more, that is why the need for psychotherapy emerged.
According to Clarkson there are 5 forms of therapeutic relationship and they are all valid. The first one is the working alliance, the client and the counsellor enters a contracted relationship, which is the foundation of the work done together. The first session is a great opportunity to negotiate all aspects of the contract including confidentiality and its limits, ethical considerations, limits of competence, potential need of referral, course of action in case of risk of harm to self or others, payment methods and setting boundaries. It also involves negotiating goals. In addition, the contract needs to be reviewed and renegotiated throughout the counselling relationship, e.g. the number of sessions can change especially if there is a shift in focus.
The second form includes transference and countertransference. The counsellor might provoke emotional reactions from a past relationship of the client. This is called transference and the counsellor’s provoked emotions in response to this is called countertransference. Managing transference and countertransference is crucial and the counsellor should discuss these feelings with the supervisor. In other words, Freud said that the therapist should control this urge for closeness and hold back.
The next form is the reparative relationship. When the client’s original parenting was not appropriate, e.g. overprotective or abusive, as a result the client can be in distress. The counsellor should be willing to demonstrate what the client’s fantasy needs, e.g. a parent and by the end of therapy the client will internalise this emotional regulation by overriding the old harmful or damaging ways of relating to self. The therapist can provide the nurturing, praise and affirmation the client may have never had.
The 4th component is the ”I-YOU” relationship as opposed to “I-IT” The counsellor is genuine in the relationship, giving his/her real self in the here and now. He/she is also emotionally involved with the client and committed, there’s a sense of mutuality. Appropriate self-disclosure and immediacy can enhance this process. The counsellor’s self awareness is also crucial in this respect, finding the balance and not making the mistake of fulfilling his own emotional needs and keeping the focus on the client’s agenda. By communicating the core conditions the counsellor facilitates human growth and development.
The 5th element is the transpersonal relationship which means a feeling of connectedness. It can be a deeper level of connection between the counsellor and the client or even a feeling of being part of humanity or the wider world.
Bibliography:
The Therapeutic Relationship, Petruska Clarkson Whurr Publishers, 1995
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