Therapeutic alliance in vocational rehabilitation counseling: assessing client factors and functioning

2021 ◽  
pp. 1-10
Author(s):  
Ayse Torres ◽  
Patricia Diaz ◽  
Robert Freund ◽  
Tracy N. Baker ◽  
Andrew Z. Baker ◽  
...  
Keyword(s):  
Therapeutic Alliance ◽  
Vocational Rehabilitation ◽  
Therapeutic Relationship ◽  
Rehabilitation Counseling ◽  
Client Outcomes ◽  
Client Factors ◽  
Rehabilitation Agency ◽  
The Impact ◽  
The Relationship ◽  
Overall Functioning

BACKGROUND: The therapeutic relationship is often acknowledged as one of the most significant factors in clinical process that influences client outcomes. OBJECTIVE: While considerable research has been conducted on the therapeutic relationship in psychotherapy, there is a paucity of research on the impact of the therapeutic relationship in vocational rehabilitation counseling settings. METHODS: This study explored the relationship between areas of client functioning (individual, interpersonal, social, and overall) and the therapeutic alliance among clients who receive services from the State vocational rehabilitation agency. RESULTS: In this study, younger clients (ages between 16 to 29) reported stronger therapeutic alliance. CONCLUSION: The findings of this study suggest that clients’ perceived individual, interpersonal and overall functioning have a significant positive relationship with the task and bond components of therapeutic relationship.

scholarly journals Videoconferencing Psychotherapy: a literature review of the perspective of relationships for patients and psychologists (Preprint)

2020 ◽  
Author(s):  
Francesco Cataldo ◽  
Shanton Chang ◽  
Antonette Mendoza ◽  
George Buchanan
Keyword(s):  
Literature Review ◽  
Therapeutic Alliance ◽  
Therapeutic Relationship ◽  
Active Role ◽  
High Demand ◽  
Face To Face ◽  
Patient Relationships ◽  
The Impact ◽  
The Relationship

BACKGROUND During the COVID-19 pandemic, people are being encouraged to maintain social distance. Technology is helping people to reschedule meetings from “face-to-face” interactions to remote videoconferencing. Psychologists are in high demand, due to an increase in stress as a result of COVID. Many seek to both keep treating their current patients, and welcome new ones, given the current high demand for their services. Videoconferencing provides an opportunity to do this. However, shifting treatment from face-to-face to the videoconferencing is not simple as both the psychologist and the patient miss the in-person information and cues, such as body language provides. OBJECTIVE A new theoretical framework is proposed to guide the design of future studies on the impact of the computer as a mediator of psychologist-patient relationships, and the influence of videoconferencing on the whole relationship process. METHODS A literature review has been conducted, screening studies focusing on communication, and the key concepts of therapeutic relationship and therapeutic alliance. RESULTS Studies report that patients are generally satisfied with videoconference therapy in terms of the relationship with their therapists and the establishment of the “therapeutic alliance”. However, psychologists report difficulties in establishing same quality of therapeutic relationship and therapeutic alliance. The analysed studies lead us to interpret data under a different perspective. A new model of relationship is proposed, along with further hypotheses. CONCLUSIONS It is important to consider the computer as having an active role in psychologists and patients’ relationships. CLINICALTRIAL

Fidelity with Flexibility

2016 ◽  
Author(s):  
Lisa Sanetti ◽  
Melissa A. Collier-Meek ◽  
Lindsay Fallon
Keyword(s):  
Treatment Success ◽  
Treatment Fidelity ◽  
Evidence Based ◽  
Client Outcomes ◽  
Cultural Fit ◽  
Therapeutic Outcomes ◽  
Client Factors ◽  
Evidence Based Treatments ◽  
Evidence Supported Treatments ◽  
The Relationship

Research has linked the use of evidence-supported treatments to effective, efficient therapeutic outcomes. Questions related to the best way to disseminate and implement evidence-supported treatments in the field has led to discussions about transportability of treatments from controlled to applied settings. Specifically, scholars have focused on issues related to treatment fidelity, acceptability, and adoption versus adaptation of evidence-based treatments in practice. Treatment fidelity, a multidimensional construct, pertains to how extensively a treatment is delivered to a client, and it may be affected by several variables. Although the relationship is complex, treatment fidelity is considered an important moderator of client outcomes. Furthermore, the acceptability of a treatment appears to be of importance. Simply, if a treatment is perceived to be acceptable, it is more likely to be implemented with high levels of fidelity, increasing the chances that successful therapeutic outcomes will result. Nevertheless data indicate that some clinicians are wary of using evidence-supported treatments; their chief concern is feasibility of implementation, which could affect treatment fidelity and acceptability. Thus, there is a debate about whether evidence-supported treatments should be adopted strictly as developed or whether they might be adapted to improve implementation and acceptability. In adaptation of a treatment, relevant clinician variables (e.g., training received, availability of resources) and client factors (e.g., cultural fit) might be considered to promote therapeutic outcomes. This chapter describes how the key to treatment success may be to strike a balance between fidelity and adaptation of evidence-based treatments and fidelity with flexibility.

The Impact of Interpersonal Style on Ruptures and Repairs in the Therapeutic Alliance Between Offenders and Therapists in Sex Offender Treatment

Sexual Abuse ◽  
2015 ◽  
Vol 29 (7) ◽  
pp. 709-728 ◽  
Author(s):  
Rachael Watson ◽  
Stuart Thomas ◽  
Michael Daffern
Keyword(s):  
Sex Offenders ◽  
Therapeutic Alliance ◽  
Therapeutic Relationship ◽  
Sexual Offenders ◽  
Group Treatment ◽  
Sex Offender ◽  
Psychological Treatment ◽  
Offender Treatment ◽  
Interpersonal Style ◽  
The Impact

The therapeutic relationship is a critical component of psychological treatment. Strain can occur in the relationship, particularly when working with offenders, and more specifically, those offenders with interpersonal difficulties; strain can lead to a rupture, which may affect treatment participation and performance. This study examined ruptures in the therapeutic relationship in sexual offenders participating in offense-focused group treatment. Fifty-four sex offenders rated the therapeutic alliance at the commencement and completion of treatment; at the completion of treatment, they also reported on the occurrence of ruptures and whether they believed these ruptures were repaired. Ruptures were separated by type, according to severity—Each relationship was therefore characterized as experiencing no rupture, a minor rupture, or a major rupture. Offender characteristics including interpersonal style (IPS) and psychopathy were assessed at the commencement of treatment; their relationship with ruptures was examined. Results revealed that more than half of the offenders (approximately 55%) experienced a rupture in the therapeutic alliance, with one in four of these ruptures remaining unresolved. Offenders who did not report a rupture rated the therapeutic alliance significantly higher at the end of treatment compared with those offenders who reported a rupture that was not repaired. Offenders who reported a major rupture in the therapeutic relationship were higher in interpersonal hostility and hostile-dominance. No interpersonal or offense-specific factors affected the likelihood of a rupture repair.

Predictors of Competitive Employment of Adults With Deaf-Blindness Following Vocational Rehabilitation

2019 ◽  
Vol 50 (2) ◽  
pp. 148-159
Author(s):  
Ian Shadrick ◽  
Carol Etlen
Keyword(s):  
Vocational Rehabilitation ◽  
Job Search ◽  
Employment Outcomes ◽  
Fiscal Year ◽  
Competitive Employment ◽  
Client Outcomes ◽  
Related Services ◽  
Rehabilitation Services Administration ◽  
Placement Services ◽  
The Relationship

The purpose of this study was to examine employment outcomes for adult vocational rehabilitation clients with deaf-blindness. Specifically, this study examined the relationship between case service provisions, and competitive employment outcomes for individuals with deaf-blindness. The sample was obtained from Rehabilitation Services Administration Case Service Report (RSA-911) data and included 135 cases of individuals with deaf-blindness identified as their primary or secondary disability and whose cases were closed during the fiscal year 2016. The independent variables consisted of vocational rehabilitation case service-related variables. The dependent variable was attainment of competitive employment. Results indicated that three vocational rehabilitation case service variables were associated with client outcomes for those with deaf-blindness seeking and obtaining competitive employment. Implications for improving employment outcomes for clients with deaf-blindness include supporting postsecondary educational attainment opportunities, providing job placement services, and providing job search-related services. Implications for services provided by vocational rehabilitation agencies are discussed.

Rehabilitation Counseling with Dual Diagnosis Clients

1987 ◽  
Vol 18 (1) ◽  
pp. 35-37 ◽  
Author(s):  
Guy Walker
Keyword(s):  
Mental Health ◽  
Vocational Rehabilitation ◽  
Dual Diagnosis ◽  
Independent Living ◽  
Rehabilitation Counseling ◽  
Mentally Retarded ◽  
Health Needs ◽  
Mental Health Needs ◽  
The Impact

This article describes a philosophy and methodology for meeting the mental health needs of mentally retarded adults. It illustrates the impact such counseling can have in realizing the potential of such persons for independent living and vocational rehabilitation.

Client Perceptions of the Rehabilitation Counseling Relationship: Humanistic Approaches and Related Outcomes

1997 ◽  
Vol 28 (2) ◽  
pp. 10-14 ◽  
Author(s):  
Gregory G. Garske ◽  
Marcel Soriano
Keyword(s):  
Therapeutic Relationship ◽  
Help Seeking ◽  
Rehabilitation Counseling ◽  
Counseling Students ◽  
Rehabilitation Counselors ◽  
Counseling Relationship ◽  
Client Outcome ◽  
Persons With Disabilities ◽  
Seeking Behavior ◽  
The Relationship

For persons with disabilities, help-seeking behavior requires courage, trust, and confidence in others. It is critical for rehabilitation counselors to be cognizant of how they may be perceived by the client. This article focuses on the relationship attitudes, and behaviors which enable the formation of an effective therapeutic relationship. A review is made of the humanistic approaches and conditions relevant to the therapeutic relationship and rehabilitation client outcome. This article is to serve as a primer for rehabilitation counseling students and a review for veteran practitioners.

Relational Genetic Counseling

2019 ◽  
pp. 125-142
Author(s):  
Barbara B. Biesecker ◽  
Kathryn F. Peters ◽  
Robert Resta
Keyword(s):  
Genetic Counseling ◽  
Therapeutic Alliance ◽  
Therapeutic Relationship ◽  
Genetic Information ◽  
Counseling Skills ◽  
Informed Decisions ◽  
Psychotherapeutic Approach ◽  
The Relationship

This chapter emphasizes the importance of the relational components of a psychotherapeutic approach to genetic counseling. It outlines the steps to developing a therapeutic alliance with a client that are implied but not stated in the Reciprocal Engagement Model. Reinforced are the need for safety and trust for the client, conveying respect, and being genuine in the relationship. Contracting is described as an exchange between the counselor and client to establish the session goals. Relational counseling skills are used to establish a relationship that fully addresses the implications of genetic information. These skills include asking open-ended questions, followed by closed-ended questions; clarifying understanding; paraphrasing; reflecting feelings; and summarizing the client’s perceptions and needs. They constitute the process used to establish a therapeutic relationship that is essential to addressing the threat of genetic information and clients’ related fears and hopes. What results from this process is an empathic connection with clients where informed decisions are made, coping is enhanced, and/or adaptation is facilitated.

scholarly journals The effect of early therapeutic alliance on treatment dropout in cognitive processing therapy and client factors as moderators of this relationship

2021 ◽  
Author(s):  
Iris Sijercic
Keyword(s):  
Therapeutic Alliance ◽  
Cognitive Processing ◽  
Ptsd Symptom ◽  
Dropping Out ◽  
Cognitive Processing Therapy ◽  
Treatment Dropout ◽  
Client Factors ◽  
Ptsd Symptom Severity ◽  
The Relationship ◽  
Implementation Trial

Although efficacious treatments, including Cognitive Processing Therapy (CPT), are available for treating Posttraumatic Stress Disorder (PTSD), a substantial number of clients do not receive a full course of CPT due to clients dropping out prematurely. Examining factors associated with treatment dropout may increase our understanding on how to tailor interventions to prevent treatment dropout. This study examined the relationship between early therapeutic alliance and treatment dropout, and client age and pretreatment PTSD symptom severity as predictors of dropout and moderators of the alliance-dropout association. Clients were part of a larger randomized implementation trial, and either began CPT and dropped out (n = 38) or completed 12 sessions of CPT (n = 74). Results indicated early therapeutic alliance did not significantly predict treatment dropout, and age and PTSD severity were not significant predictors or moderators of the alliance-dropout association. Clinical implications of the findings are discussed.

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