How important is the “client-clinician” relationship in therapy?

UnknownDr. Aaron Beck is the mastermind behind Cognitive-Behavioral Therapy (CBT) and has developed many scales clinicians use to help understand patient’s symptoms, such as the Beck Depression Inventory and Beck Anxiety Inventory. To show you how powerful CBT is, the county of Los Angeles recently switched their entire mental health system to use this kind of therapy and it has already improved treatment outcomes and reduced cost. It is intended to be a time-limited therapy with the idea being that you learn the tools necessary by the end of your treatment.

This is compared to maybe 100 years ago when psychologists learned psychoanalysis and were very influenced by Freud. However, psychology has changed and now instead of learning psychoanalysis, many programs teach using Dr. Aaron Beck’s philosophy of Cognitive-Behavioral Therapy. This is particularly significant because this type of therapy isn’t about exploring your deep rooted unconscious desires, but it’s about being present-focused with your problems and uncovering the thoughts behind your actions and being able to restructure the way you think about them to create the life you want to lead (note the emphasis on the life you want to lead). It’s about your goals, your needs, and your values in what you hope to get out of therapy.

In this video, Dr. Beck talks about the “therapeutic alliance,” which is essentially just the relationship or alliance between the client and the clinician. Many studies have shown that regardless of what type of treatment used, it is the therapeutic alliance that is predictive of treatment outcome. This can be a controversial topic depending on where people’s orientation lies in terms of how they think about a case – do they think about problems from a CBT framework? A psychodynamic framework? Either way, this is not meant to arouse a civil war within the psychology field, but instead trying to showcase the importance of the relationship that you can have with a therapist and finding one that works for you. CBT isn’t for everyone, neither is psychodynamic, neither is ACT.

At the end of the day, you have to find what works best for you and your personality and sometimes that will involve trial and error with finding a psychologist that you click with who is well-trained enough to be able to give you the tools that you need. Same goes for a psychologist and being able to remain flexible enough to adapt to a client’s needs. If you don’t feel heard, validated, or like you’re getting much out of your treatment, then maybe that’s a signpost to try someone else or to talk to your therapist or as a therapist to think about a new way of conceptualizing the case – possibly from a different orientation. I’ll leave with you Dr. Beck’s last line of the video:

The relationship [therapeutic alliance] gives you the motivation and the cognitive techniques gives you the tools.

Rubin Khoddam, Clinical Psychology PhD student at University of Southern California, founder of Psych Connection.

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Categories: Therapy, Videos

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4 replies


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