Chairwork and the therapeutic relationship: Can the cart join the horse?

Abstract

Chairwork" is a collection of experiential methods that utilize movement between chairs and dialogue with parts of the self to bring about change. Because of their emotionally intense nature, therapists often assume that a robust therapeutic relationship is a prerequisite for these tasks.However, it could be said that chairwork also supports the development and strengthening of the alliance. This article presents a single-session, chairwork-centered treatment with an individual experiencing social anxiety. Verbatim extracts and post-intervention feedback illustrate the reciprocal and reinforcing roles of client participation, therapist facilitation, and the therapeutic bond during chairwork. Moreover, the case demonstrates that relationship and technique are intimately bound when using experiential methods, suggesting that therapists do not always need to privilege the former to implement the latter.

The interplay between therapeutic relationship and therapeutic technique: “It takes two to tango”

“…In the first paper "Chairwork and the therapeutic relationship: Can the cart join the horse? ", Pugh et al (2022) present a single-session chairwork-centred treatment with a woman experiencing social anxiety. The article explores chairwork as a medium for practising psychotherapy and not solely a powerful therapeutic method, and outlines a four-component "pillars" model describing the central principles, processes, procedures, and facilitative process skills of chairwork.…”

The interplay between therapeutic relationship and therapeutic technique: The whole is more than the sum of its parts

“…According to Wampold's (2015) contextual model of psychotherapy, the initial therapeutic relationship is essential before therapy can truly begin. This was evidenced in the Pugh and colleagues (2022) article, whose single‐session, chairwork‐centered treatment was made possible by initial communication and relationship building before the session. Goldman and Goldstein (2022) too emphasized the need to begin with a safe relational environment within which therapy can proceed.…”

“…First, taking a detailed look at a single‐session, chairwork‐centered treatment of a woman with social anxiety, Pugh et al (2022) offered anecdotal evidence from verbatim client statements and postintervention feedback to demonstrate the way in which therapeutic relationship and therapeutic technique can have reciprocal and bidirectional reinforcing roles. Defining “chairwork” as “a collection of therapeutic interventions that utilize movement between chairs and dialogue with parts of the self to bring about change,” Pugh et al (2022) made the point that, while therapists often assume that a strong therapeutic relationship is required as a precursor to a technique like chairwork, it may be that relationship and technique reinforce each other.…”

“…First, taking a detailed look at a single‐session, chairwork‐centered treatment of a woman with social anxiety, Pugh et al (2022) offered anecdotal evidence from verbatim client statements and postintervention feedback to demonstrate the way in which therapeutic relationship and therapeutic technique can have reciprocal and bidirectional reinforcing roles. Defining “chairwork” as “a collection of therapeutic interventions that utilize movement between chairs and dialogue with parts of the self to bring about change,” Pugh et al (2022) made the point that, while therapists often assume that a strong therapeutic relationship is required as a precursor to a technique like chairwork, it may be that relationship and technique reinforce each other. With good establishment of the treatment rationale and an agreement regarding treatment methods before or early on in session, as well as a carrying out of the technique itself in an expected and effective way, the therapeutic relationship is further enhanced, encouraging the patient to participate fully in the technique, increasing the likelihood of positive treatment outcomes.…”

Bringing the Inside Out and the Outside in: The Therapeutic Relationship in Compassion Focused Therapy Chairwork

“…In contrast, Pugh [23] has developed single-session chairwork, wherein chairwork is offered at the first and only meeting with the client, without the pre-emptory establishment of the working alliance. In a case study of this format, Pugh et al [24] suggest a cyclical and mutually reinforcing interaction between the therapeutic relationship and practice of chairwork: i.e., the bond created in the heat of the experiential intervention appears to further both the therapeutic relationship and the reach of the technique.…”