A Study of Mutual Influence in the Therapeutic Relationship

Abstract

Therapy is a mutual endeavour yet literature commonly portrays the process from the viewpoint of the therapist with minimal focus on client perspectives. The therapeutic relationship is considered central to healing, yet many questions remain about the interpersonal phenomenon that contributes to the healing process. Early research and literature has focused on the construct of the therapeutic alliance and the analytic concepts of transference and counter-transference. More recent research carries forward the focus on the alliance and relates it to treatment efficacy and outcome. To date there is a paucity of research focused on the mutual impact of therapists and clients within the context of a therapeutic relationship. This qualitative work explores the phenomenon of mutual influence in the therapeutic relationship by providing empirical accounts in the form of in depth interviews with therapists and their clients in a current therapeutic relationship. A phenomenological analysis revealed a number of interrelated themes with two overarching phenomena. Firstly relational boundaries contributed to the development of trust in all the relationships. This theme was explored in relation to previous therapy, choice of therapist, equality and agency, generosity of self and mutual trust. Secondly the personal aspects of the relationship between therapists and clients occupied the foreground of the therapeutic relationship over and above theory or model. The theme of a personal relationship was explored in relation to informed intuition, emotional relating and empathy, paradox, and the role of love in therapy. The findings point to the centrality of the bi-directional personal influence of both therapist and client on the quality of the therapeutic relationship. Therapist and client perspectives in context show the verity of the relationship between therapist and client as being more than, and different to, the construct of the therapeutic alliance. Findings are discussed in relation to the literature and recommendations are made for clinical practice and therapist's education. Future directions for research are identified.