THERAPEUTIC ALLIANCE ISSUES

PRARTHITA BISWAS-V058
OPTIONAL PAPER_REBT_01
Effective rational emotive behaviour therapy
(REBT) occurs when both you and your clients:
• know what your respective tasks are
• can implement these tasks in the service of
your clients’ goals
• can work together in an adult-to-adult
partnership
Ruptures in the task domain of the alliance
frequently occur when your clients:
• do not understand what their tasks are in REBT
• receive inadequate training from you in these tasks
• do not understand the relationship between carrying
out these tasks and reaching their therapeutic goals
• are being asked by you to practise tasks which have
insufficient potency to enable them to achieve their
goals
Vary your bond with different clients
• While we consider that it is important for you to vary your bond with
different clients, it is important that you do so authentically. Arnold
Lazarus (1989) coined the term ‘authentic chameleon’ to describe a
therapist who varies their interpersonal style with clients, but does so
authentically. If you are going to apply this concept in your practice of
REBT, rather than pay lip service to it, then it is crucial that you
consider honestly your range of authentic interpersonal behaviour.
We advise you to be genuine in your interactions with your clients
rather than inauthentically try to meet their preferences for therapist
behaviour. Refer a client to a colleague who will authentically offer
that client a preferred bond when you cannot do so.
Vary your influence base
We will now consider three styles of teaching that are relevant to the practice of REBT:
(1) authoritative; (2) laissez-faire; (3) hypothesizing.
• Authoritative REBT therapists demonstrate clearly that they know what they are doing
and this is, of course, related to the expert influence base.
• In laissez-faire teaching, the message the therapist communicates to the client is ‘You
do all the work and I will encourage you the best I can.’ The danger for laissez-faire
REBT therapists is that by being allowed to ramble their clients will not discover
rational principles by their own efforts. A laissez-faire style, however, is helpful for
those clients who are highly reactant to being influenced.
• The third style is one that we call hypothesizing. This style is similar to that advocated
by cognitive therapists in their principle of collaborative empiricism. Here the message
is ‘Let’s work together to discover the answer to your problem.’ The problem with this
style is that it can be somewhat hypocritical
Vary the extent of your directiveness over
the course of therapy
When your client is making progress on a particular problem , instead of
continually directing the client to the ABCDEs of REBT, you can ask
questions such as:
• ‘What are you thinking in order not to be anxious?’
• ‘How did you dispute that belief?’
• ‘How could you dispute it more effectively?’
• ‘How could you put that into practice?’
By asking such questions you will encourage your clients to internalize
the model of REBT problem solving in a way that allows them to utilize
their own resources
Work to facilitate your clients’ learning
• As a practitioner of REBT, you are educating your clients in healthy
rational principles. As such, help them to learn these principles as
effectively as you can.
• Pacing
• Checking clients’ understanding
• Encourage clients to take responsibility for their learning
• Cover material in manageable chunks
• Vary your use of bibliotherapy
Use the ‘challenging, but not
overwhelming’ principle
• Encourage your clients to undertake therapeutic
tasks which are challenging for them. Do not
pressure them into attempting tasks which are
‘overwhelming’ for them, and discourage them
from doing tasks which are insufficiently
challenging.
Establish the reflection process
• Key point
Establish the reflection process and refer issues to it at
suitable points throughout REBT. Encourage your clients to do
the same.
When you encourage your clients to reflect on the process of
REBT, the important point is that talking about therapy can
serve as a very useful learning experience for both of you.
Clients can learn that they can influence the course of therapy
and you can be helped to calibrate your interventions and
interpersonal style to facilitate client change.
Use a common language with your clients
• In REBT, rational means flexible, non-extreme, self-enhancing,
empirical and logical. To clients, however, the term may mean
unemotional, robot-like, a state to be avoided rather than to be
desired. If you have established an effective process of reflection with
your client , then you can discuss the different meanings of the word
‘rational’.
• The language you use with your clients serves as an activating event
which they will interpret and evaluate. Therefore, it is very important
to check out with clients their interpretations of the words you use. In
this context, it is particularly important to consider words which point
to the emotions.