Establishing A Working

Relationship

Jay Kr Ranjan, M.Phil. PhD

Assistant Professor
Department of Psychology, BHU Varanasi.
What is working relationship?
The working relationship is a unique
interpersonal experience in which the
patients feels a quality of warmth, trust,
acceptance and understanding such as never
encountered with any human being.
Varying needs of the patient
Need to be dependent
Because the emotionally ill person usually feels helpless,
and he wants a kind of agency to relieve the stress
Regressive dependency need are also found in all
patients
The therapist must know when to resist
dependency need and how to convince the patient
that their fulfillment (of dependency need) may
interfere with his capabilities to develop assertiveness,
strengths and independence.
Varying needs of the patient

The need for Unqualified Understanding,

Acceptance and Condonation
This may be especially urgent in the emotionally sick
individual who constantly anticipates rejection and
criticism
Therapist must be capable of empathizing with the
patient, of giving him warmth and approval, no
matter how much destructive and disturbed he may be
Same time therapist must avoid over-protecting the
patient
Varying needs of the patient
The need to relieve himself of painful feelings and
ideas
The desire to unburden himself of guilt, fear and
anxiety will often be overwhelming
Ventilation of suppressed feelings, attitudes and
past experiences usually provide immediate but
temporary relief
The therapist must be able to endure cathartic
outburst of painful emotions that are delivered by
the patient
Varying needs of the patient
The Need for the Factual Understanding
The patient always has a need for an understanding
of the unusual things are happening to him
The role of the therapist is to provide objective
information
The therapist must avoid contaminating the patient
with personal prejudices, and allow him to develop
his own sense of values
Varying needs of the patient
The need for a transference relationship
All patients seek media in which they can project
and act-out tendencies and feelings that relate to
actual or idealized parental personage
The therapist must be able to survive the intense
dependency needs, sexual demands, hostilities and
manifold misinterpretations that will be expressed by
the patient in the course of therapy
Building the Relationship
Communicating an understanding of the problem
Active listening and reflective listening
Reflecting unverbalized feelings and attitudes,
putting into words of unexpressed worries and
concern of the patient
Try to avoid expressions of confusion, such as acting
bewildered and forgetting important items of
information about the patient
Building the Relationship
Communicating Interest
Paying close attention to the patient’s personal life,
dislikes, hobbies,
Remembering and repeating to the patient’s
details that he mentioned about himself in last session
By which patient at least can understand the therapist
has genuine interest toward his problem
Building the Relationship
Communicating Tolerance and Acceptance
 Irrespective of how provocative the patient may
act, it is essential that the therapist control his
personal feelings and emotions
To respond with counter-hostility may prove fatal to
the establishing of a relationship
The therapist must avoid criticizing the patient for
his inability to verbalize or to think about himself
Therapist must avoid considering the patient’s
problem as his faults
Building the Relationship
Communicating Objectivity
Objectivity is insured by a tolerance, non-punitive
manner in the face of any attitude, demands or ideas
expressed by the patient
By displaying a sense of humor, and persistent
respect for the patient
Building the Relationship
Communicating Empathy
Verbalizing for the patient how upset he must feels
Elaborating on some of the obvious conscious conflicts
Recognizing the patient’s feelings and seeing things
from the his point of view
The therapist must able be extend support and
reassurance to the patient
Expressing warmth, not in words but by gestures,
facial expressions and other type of nonverbal
behaviour
Thank You…