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The Therapeutic Relationship

The Therapeutic Relationship

Description:

This lesson will discuss the therapeutic relationship between the client and therapist.  

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Tutorial

What's Covered

In this lesson, we'll discuss what psychotherapy is, as well as what constitutes a therapeutic relationship.

The particular areas of focus include:

  1. The Psychotherapy Profession
  2. Forms of Psychotherapy
  3. Aspects of the Therapeutic Alliance
    1. Professionalism
    2. Suspension of Judgment
    3. Focus on Client
  4. Placebo effect

1. THE PSYCHOTHERAPY PROFESSION

As you learned in a previous lesson, therapy is generally considered to be the most recognized of the psychological professions; over half of psychologists are engaged in some form of psychotherapy.

Psychotherapy is any psychological technique that's used to facilitate positive changes in a person's personality, behavior, or adjustment.

In other words, it's the treatment of some kind of psychological problem. The goal of psychotherapy is to improve the mental health of its patients.

As you've probably seen, there are different professions in psychotherapy; namely, there are psychologists and psychiatrists.

The difference between those two professions is that a psychiatrist is a medical professional, whereas a psychologist is engaged specifically in psychology.

A psychiatrist can prescribe drugs, although some psychologists in different states are able to do that as well.

The main difference to remember is that psychiatrists are medical professionals. They have to go to medical school, whereas psychologists are engaged in counseling more specifically.

Term to Know

    • Therapy
    • Intervention designed to improve client's state of mind through changing beliefs, understanding the etiology of their difficulties, finding new ways to act and react.

2. FORMS OF PSYCHOTHERAPY

There are different levels of therapy within psychotherapy as well. There is clinical psychology, which tends to refer to the treatment of severe mental disorders.

Whereas the treatment for more everyday problems, such as depression or anxiety occurring on a smaller level, might simply be referred to as counseling.

However, it's important to note though that all of these different levels fall under the umbrella category of psychotherapy.

When engaging in the process of psychotherapy, a psychologist or psychiatrist will generally start by having a patient take a series of tests.

This series can involve written inventories, like a personality inventory that asks the patient to go through and check either yes or no, or how much or to what degree he or she feels a certain way.

There might be an oral test, which could involve the patient giving a family medical history, or even pictorial tests, such as a thematic aptitude test or a Rorschach test, which you may have heard of.

The Rorschach test is also called an inkblot test, and it involves a person talking about what he or she sees within a somewhat ambiguous picture.

Once these tests are done, the person engages in the actual psychotherapy. There are different schools of thought around this process, such as psychoanalytical psychotherapy, and humanist or cognitive behavioral therapy, which will be covered in some detail later on in future lessons.


3. ASPECTS OF THE THERAPEUTIC ALLIANCE

The important thing to remember is that in all of these different forms of psychotherapy, the main way that people are treated is through conversation.

Patients speak with their therapists in a back and forth question and answer format. Because conversation is at the heart of psychotherapy, it's important to establish a strong relationship between the therapist and the patient.

In other words, the patient really has to trust his or her therapist in order to be able to discuss things with that person.

This is called a therapeutic alliance, or the relationship between a therapist and client in which they can both work together to affect some kind of positive change -- regarding either mental process or behaviors -- in the client. There are certain aspects of this therapeutic alliance that make it unique from other types of relationships that a person has.

Term to Know

    • Therapeutic Alliance
    • A caring and collaborative union of the therapist and the client to resolve the client's problem.

a. Professionalism

Firstly, this relationship is professional, meaning that it's the therapist's job to help the patients.

Also, the therapist expects nothing other than payment in return from the patient; the patient can thus feel a bit more comfortable opening up to that person.

b. Suspension of Judgment

The therapist suspends any kind of expectations or judgments that he or she may have about that person.

This way, the person feels more open and apt to discuss things that might be a bit more sensitive.

c. Focus on Client

The focus in the therapeutic relationship is supposed to be on the clients. Therapists often don't reveal any opinions or even much information about themselves.

They generally ask questions and interpret either verbal or nonverbal responses, but will usually not add any additional information except when giving interpretations.

This can be different depending on the theoretical perspective that a particular therapist is employing, but it's generally assumed that this is the case.

Term to Know

    • Therapeutic Relationship
    • Helping relationship aimed at resolving problems and improving the client's life.

4. PLACEBO EFFECT

To be effective, psychotherapy also relies on a concept referred to as the placebo effect. This is something that you might have heard of before, and it will definitely be discussed in more detail in a later lesson on experimental psychology.

For now, the important thing to know is that the therapy placebo effect is a change in a condition or a behavior that's due to the patient's expectation that the treatment will have an effect even though that treatment might not actually have any kind of effect.

As you will hear in the experimental context, the placebo effect is when you give somebody a sugar pill, and say that it's actually medicine that will make him or her better.

If the placebo effect works, the person will still get better because he or she expects to when taking the medicine. In other words, the effect is essentially psychological in its basis.

A therapist may use certain techniques in psychotherapy, but what underlies all of them is this expectation that the patient will get better. The saying that "it's all in your head" is in fact the point of this area of psychology.

Establishing this expectation that the patient is going to get better will again fall back on the therapeutic alliance; there needs to be the feeling that the psychotherapist is competent and also somebody that cares for and wants to cure the patient.

Term to Know

    • Therapy Placebo Effect
    • Using the expectations, motivation and perceptions of the client (and therapist) to aid in changing the client's life.

Summary

    In this lesson, you learned that as a profession, psychotherapy is a form of intervention in which the therapist aims to better the client's life by affecting change in the client's mental processes or behavior. There are many forms of psychotherapy, but this goal is at the center of all of them.
    You now understand that in order for psychotherapy to work, there needs to be a therapeutic alliance between the therapist and the patient. The specific aspects of the therapeutic alliance involve professionalism, suspension of judgment, and a focus on the client. Psychotherapy also relies on the placebo effect, meaning that a patient's belief that he or she will get better will actually help that patient's condition to improve.

Good Luck!


Source: Adapted from Sophia tutorial by Erick Taggart.

TERMS TO KNOW
  • Therapy Placebo Effect

    Using the expectations, motivation and perceptions of the client (and therapist) to aid in changing the client's life.

  • Therapeutic Alliance

    A caring and collaborative union of the therapist and the client to resolve the client's problem.

  • Therapy

    Intervention designed to improve client's state of mind through changing beliefs, understanding the etiology of their difficulties, finding new ways to act and react.

  • Therapeutic Relationship

    Helping relationship aimed at resolving problems and improving the client's life.