Client critical incidents in the process of early alliance development: A positive emotion–exploration spiral

Fitzpatrick, Marilyn; Janzen, Jennifer; Chamodraka, Martha; Park, Jeeseon

doi:10.1080/10503300500485391

Cited by 42 publications

(49 citation statements)

References 26 publications

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“…Indeed, prior research supports the idea that positive regard promotes the development of the therapeutic alliance (Ackerman & Hilsenroth, 2003;Crits-Christoph et al, 2006;Najavits & Strupp, 1994;Thomas et al, 2005). It may also be that communicating positive regard elicits positive feelings in clients, which, as Fitzpatrick et al (2006) found, may then lead to enhancement of the therapeutic alliance.…”

Section: Discussionmentioning

confidence: 84%

“…The remaining 11 predictor variables (after exclusion of the four non-correlated predictors) belonged to either the category of validation or of presentation/body language (see Bedi, 2006, for a description of these categories). Based on prior research (i.e., Ackerman & Hilsenroth, 2003;Bedi, 2006;Bedi & Duff, 2008;Crits-Christoph, Connoly Gibbons, & Hearon, 2006;Fitzpatrick et al, 2006;Horvath & Bedi, 2002;Najavits & Strupp, 1994), variables related to validation were strongly expected to predict alliance scores. Therefore, the first block (step one) contained all variables closely related to validation.…”

Section: Correlational Analysesmentioning

confidence: 99%

“…While some research has begun to focus on practitioner characteristics that contribute to alliance development (e.g., Ackerman & Hilsenroth, 2003;Thomas et al, 2005;Watson & McMullen, 2005) and on the client's perspective of the alliance (e.g., Bachelor, 1995;Bedi, 2006;Bedi, Davis, & Arvay, 2005;Bedi, Davis, & Williams, 2005;Bedi & Duff, 2008, 2009Duncan et al, 2003;Fitzpatrick, Janzen, Chamodraka, & Park, 2006;Mohr & Woodhouse, 2001), very little of this research has investigated the statistical relationship between the client's perspective on counsellor behaviours and the strength of the alliance, instead focusing on the identification of alliance factors and processes. Consequently, there is a deficiency in our knowledge about whether or not the counsellor behaviours that clients think relate to the development of the alliance actually do relate to the development of the alliance.…”

Section: Introductionmentioning

confidence: 98%

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Counsellor behaviours that predict therapeutic alliance: From the client's perspective

Duff

Bedi

2010

Counselling Psychology Quarterly

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The therapeutic alliance has been shown to be a robust predictor of counselling outcome. However, the specific counsellor behaviours that relate to the alliance have not been clearly and consistently identified, and prior attempts to identify these variables have not been typically based on client-derived conceptualizations of the alliance. A total of 79 adult counselling clients participated in a study examining the relationship between 15 client-identified counsellor behaviours and the strength of the therapeutic alliance. Correlational analyses revealed that 11 of the 15 behaviours moderately to strongly correlated with the strength of the alliance, and hierarchical regression analyses found that three particular counsellor behaviours (making encouraging statements, making positive comments about the client, and greeting the client with a smile) accounted for 62% of the variance in alliance scores. The findings suggest that seemingly small, strengths-fostering counsellor micro-behaviours can play a key role in strengthening therapeutic alliances. Given the role that alliance plays in positive counselling outcomes, it is suggested that these behaviours be tactfully implemented early on in the counselling process.

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Section: Discussionmentioning

confidence: 84%

Section: Correlational Analysesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 98%

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Counsellor behaviours that predict therapeutic alliance: From the client's perspective

Duff

Bedi

2010

Counselling Psychology Quarterly

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“…That is, they needed to be willing to disclose sensitive information but also to be open to suggestions about how to deal with their difficulties. One study (Fitzpatrick, Janzen, Chamodraka, & Park, 2006) labelled this process 'productive and receptive openness' and explained how it was circular in nature: as each party started to trust and open up to each other, the relationship developed further, increasing the level of selfdisclosure and so forth. This process was exemplified by a client who described that his therapist: …asked me questions, which I might have felt they haven't got anything to do with what I'm talking about, but I'm willing to say, 'Okay, I'll go there ' [receptive], and I went there… and after talking about it I realised, 'Yeah, there was a good reason for us to talk about that thing' [productive] (Fitzpatrick et al, 2006, p. 491).…”

Section: -13mentioning

confidence: 99%

The Experience of Forming a Therapeutic Relationship from the Client’s Perspective: A Metasynthesis

Noyce

Simpson

2016

Psychotherapy Research

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Objective: This review aimed to synthesise qualitative research exploring clients' perspectives of forming a therapeutic relationship with their therapist or counsellor. Method:Noblit and Hare's meta-ethnographic approach was used to guide the synthesis of 13 studies meeting inclusion criteria. The quality of each study was rated using the CASP quality rating checklist. Results: Findings demonstrated that clients create a hierarchy of desired therapist characteristics to assess how well the therapy can meet their needs (theme 1: assessing clienttherapist match). The formation of the therapeutic relationship is facilitated by an openness from both the therapist and client (theme 2: facilitating openness) and helps to develop a connection through which the client can be fundamentally understood (theme 3: connecting on a deeper level). Displays of disrespectful or disempowering behaviour generate barriers in the formation of a therapeutic relationship (theme 4: empowerment through respect). Conclusions:The meta-ethnographic approach extended the findings from each individual study to highlight some significant discoveries, including that clients across different settings created a hierarchy of therapist characteristics which were of varying importance to them depending on their perceived needs. Additionally, clients reported that they preferred their therapists to disclose information in order to facilitate the therapeutic relationship.

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“…Explicitly focusing on positive emotions in therapy, have been found to be effective (Luborsky et al 1983). In addition, Fitzpatrick and Stalikas (2008) and Fitzpatrick et al (2006) reported that engendering positive emotions, particularly in the early part of therapy, opens clients up to the therapeutic process.…”

Section: Recommendations For Research and Clinical Practicementioning

confidence: 95%

Positive Motivational Interviewing: Activating Clients’ Strengths and Intrinsic Motivation to Change

Csillik

2014

J Contemp Psychother

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Motivational interviewing (MI) is a widely disseminated, scientifically-tested method of psychotherapy, which combines a supportive, collaborative and empathic counselling style with a consciously directive method as a means to positively resolve tension created by unresolved ambivalence about change. This article outlines MI as a positive approach to psychotherapy and considers some of its core concepts: the client-centered attitudes and its links with positive psychology interventions (PPIs). The objective of this article is to present MI in the light of positive psychology (PP) in order to build bridges between the two and to gain a better understanding of the processes involved in positive behavior change with both MI and PPIs. The review of the literature shows the strong links that exist between PP and MI: they have much to offer each other. MI is a strength-focused approach that builds on client's resources and skills and is an important example of how client-centered approaches to psychotherapy operate their effects. MI has a theoretical and practical flexibility and is a well proven approach for increasing intrinsic motivation to change. PPIs could be used combined with MI, in order to increase adherence to psychotherapy, as the PPIs, often delivered in self-help format, request effort and motivation. Integrating MI with the PPIs could also produce synergistic effects and lead thus to better outcomes. We propose several examples of how MI can be integrated with other forms of PPIs. Finally, implications for clinical practice and further research are discussed.Positive psychology (PP) is the scientific study of positive experiences and positive individual traits and the institutions that facilitate their development (Duckworth et al. 2005, p. 630). It aims to broaden the focus of psychology beyond suffering and psychopathology in order to increase well-being by building strengths and not just by correcting people's weaknesses. Its main assumption is that meaning and purpose do not come about automatically, simply when suffering is removed. Introduced as an initiative of Martin Seligman in 1998, then president of the American Psychological Association, PP is the scientific study of strengths, well-being and optimal functioning (Seligman and Csikszentmihalyi 2000). Arguing that a negative bias prevailed in psychology research, where the main focus has been for a long time on negative emotions and treating mental health problems and disorders, they proposed a new approach to psychology with an explicit focus on positive traits, good character and well-being. Research findings from PP are intended to supplement and not to replace what is known about human suffering, weakness and disorder. The intent is to have a more complete and balanced scientific understanding of the human experience .Historically, most interventions in psychotherapy proposed a deficit-oriented medical model in which psychotherapists assessed and treated psychopathology. Few interventions have explicitly attended to the positives resource...

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Client critical incidents in the process of early alliance development: A positive emotion–exploration spiral

Cited by 42 publications

References 26 publications

Counsellor behaviours that predict therapeutic alliance: From the client's perspective

Counsellor behaviours that predict therapeutic alliance: From the client's perspective

The Experience of Forming a Therapeutic Relationship from the Client’s Perspective: A Metasynthesis

Positive Motivational Interviewing: Activating Clients’ Strengths and Intrinsic Motivation to Change

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