Psychotherapy- Working Alliance

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Introduction……………………………………………………………………………Pg 1 The Working Alliance Concept………………………………………………………Pg 1-2 Assessing the Establishment of the Working Alliance……………………………....Pg 2 A solid foundation - The Core Conditions of Rogers……………………………………………………...Pg 2-3 Practicalities of initial meetings & establishing collaboration regarding bonds, goals and tasks………...Pg 3 Is the therapeutic relationship positive? - Attending to the transference configuration………………….Pg 3-4 What is the attachment style?........................................................................................................................Pg 4 What is the client’s experience of the relationship?......................................................................................Pg 4 My understanding of Ruptures & Examples of dealing with them…………………Pg 5-6 Rupture resolution…………………………………………………………………………………………..Pg 6 Conclusion………………………………………………………………………………Pg 7 References……..………………………………………………………………………..Pg 8-9

INTRODUCTION
When I initially ponder the basic concept of the ‘working alliance’ and review the pertinent literature reflecting the varied research and theoretical allegiances, I am aware of elements of concurrence within myself yet also quite a degree of confusion and puzzlement. On the one hand, there is a sense of an instinctive affirmative understanding of the ‘working alliance’ as a phenomenological, felt, reality; of a bond or alliance in the relationship between therapist and client. However, counter to this, or more correctly, in parallel with this, is the puzzlement as to what exactly is this ‘so called’ ‘working alliance’? How can it be construed and constructed? Can it truly be differentiated from the ‘real’ or the ‘transferential’ as Greenson (1967) suggests. My questioning arises from multiple perspectives – reflections on my experience as a client within long-term psychoanalytic therapy and shorter-term humanistic therapy, reflections on my work as an addiction counsellor and a review of some of the diverse and, at times, contradictory research and theoretical writings on the subject. With this in mind I feel it is important to, firstly, pay close attention to what the ‘working alliance’ concept or construct means; or at least what it means for me as a trainee in counselling psychology. Having explicated this present understanding, discussion of the criteria involved in assessing sound working alliance establishment and dealing with the ruptures therein, should more coherently ensue.

THE WORKING ALLIANCE CONCEPT
Since Elizabeth Zetzel coined the term ’therapeutic alliance’ in 1956 there has been a broad spectrum of conceptualisations that have attempted to portray the assorted understandings as to what is the make-up of such a construction. Safran & Muran (2006) in writing on how best to conceptualise it state that traditionally an assumption was made that “a distinction can be made between the distorted or transferential aspects of the therapeutic relationship and the more rational or mature dimension of the collaboration between therapist and patient, even though there has been some acknowledgement that this distinction is a heuristic one and that transference and alliance always overlap in reality (eg. Greenson, 1967)”. They further draw attention to writers such as Brenner (1979) stating that “critics argue that all aspects of the therapeutic relationship are transferential, insofar as the perception of the present is always shaped by one’s past”. However one views the various roles of transference, writers such as Horvath (1993) and Gaston (1990) posit that there is a growing consensus to delineate the alliance as a distinct aspect of the current relationship. Bordin’s (1979) conceptualisation somewhat side-steps the above dichotomy by broadening the construct to include mutually understood ‘goals’, the ‘tasks’ required to achieve these goals, as well as the interpersonal ‘bonds’ between...
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