Importance of Therapeutic Relationship in Cognitive Therapy

Importance of Therapeutic Relationship in Cognitive Therapy Within cognitive therapy, the therapeutic relationship, along with the emotional aspects of therapy in general, has historically been of less importance than for other therapeutic modalities. In the last decade this has changed and in the so-called third wave in cognitive therapy there is a much greater interest in the therapeutic relationship (Hayes, Strosahl Wilson, 2004). This essay evaluates the relevance of the therapeutic relationship in cognitive therapy with reference to the outcome research. The term therapeutic relationship covers a wide range of factors within therapy, each of which have been examined separately in the research. Hardy, Cahill and Barkham (2007) have suggested that it is useful to break down this research into three areas: establishing the relationship, developing the relationship and, finally, maintaining the relationship. Starting with establishing a relationship, Sexton, Littauer, Sexton and Tà ¸mmerà ¥s (2005) examined the first two sessions with 34 different clients using anonymous ratings at 20 second intervals. They found that better therapeutic alliances were associated with earlier meaningful connection and emotional involvement. Empathy is also thought to be a major component in establishing a relationship. The research on the contribution of empathy towards the therapeutic outcome has been subject to meta-analysis by Bohart, Elliott, Greenberg and Watson (2002). This found that between 7% and 10% of psychotherapy outcomes were explained by empathy indeed this relationship was particularly strong in cognitive therapies. Two further components central to establishing a relationship which have also garnered positive relationship with outcomes in the literature are engagement (e.g. Tryon, 2002) and mutual involvement (e.g. Tryon Winograd, 2002). The second research area is developing a relationship; in order to progress clients must have a sense of commitment, trust and openness towards their therapist (Hardy, Cahill Barkham, 2007). This means the therapist must effectively manage the relationship, including negotiating factors like transference and counter-transference (Ligiero Gelso, 2002). This area, however, has not been extensively examined within cognitive therapy. The third research area is maintaining the relationship. Research has examined how therapists deal with the inevitable problems that arise in therapeutic relationships. Better outcomes are generally predicted by successfully dealing with challenges to the therapeutic relationship. Challenges studied have included negative feelings towards clients (Gelso Carter, 1985), disagreements (Safran, Muran, Samstag Stevens, 2001) and resistance (Binder Strupp, 1997). Stiles et al. (2004) looked at the overall pattern of alliance development over the course of both cognitive and psychodynamic therapies. They found that those who had ruptures in the therapeutic alliance, which were subsequently repaired, had the best treatment outcomes. This, along with similar previous research by Kivlighan and Shaughnessy (2000) strongly underlines the importance of relationship maintenance in treatment outcome. Much of the research on the therapeutic alliance across treatment modalities has been reviewed in two meta-analyses (Horvath Symonds, 1991; Martin, Garske Davis, 2000). Both found positive support for its effect on outcome. In addition Norcross (2002) has estimated that 30% of psychotherapeutic outcomes are related to common factors mostly therapeutic alliance. This is compared to only a 15% influence of techniques a component of cognitive therapy that has traditionally been emphasised. This point, though, has proved controversial and DeRubeis, Brotman and Gibbons (2005) have criticised studies such as those cited above for merely providing correlational evidence. For example, almost without exception the studies analysed by Martin et al. (2000) were correlational. DeRubeis et al. (2005) argue that a good outcome could well be producing a good alliance, rather than the reverse. Further Safran and Muran (2006) criticise the meta-analyses for only explaining 6% of the outcome varia nce. Despite these criticisms Craighead, Sheets and Bjornsson (2005) point out that a strong therapeutic alliance is still a vital component of positive change and research continues to underline its importance in cognitive therapy (e.g. Krupnick et al., 2006). In conclusion, the research on the therapeutic alliance in cognitive therapy has generally demonstrated its association with a positive outcome for clients. The importance of establishing and maintaining relationships have both been demonstrated in cognitive therapy. Some have even suggested the supremacy of common factors such as the therapeutic alliance over specific techniques of the cognitive modality. These claims are tempered, however, by methodological concerns with correlational data, which mean that the therapeutic alliance could be a result of a good outcome. Despite this, given that current research continues to point to the benefits associated with the therapeutic alliance, it seems likely this factor will continue to emerge as a vital component of cognitive therapy. References Binder, J. L., Strupp, H. H. (1997). Negative process: a recurrently discovered and underestimated facet of therapeutic process and outcome in the individual psychotherapy of adults. Clinical Psychology: Science and Practice, 4(2), 121-139. Bohart, A. C. , Elliott, R., Greenberg, L., Watson, J. C. (2002). Empathy. In J. R. Norcross et al. (Eds.), Psychotherapy Relationships That Work (pp. 89-108). New York: Oxford University Press. Craighead, W. E., Sheets, E. S., Bjornsson, A. S. (2005). Specificity and nonspecificity in psychotherapy. Clinical Psychology: Science and Practice, 12(2), 189-193. DeRubeis, R. J., Brotman, M. A., Gibbons, C. J. (2005). A conceptual and methodological analysis of the nonspecifics argument. Clinical Psychology: Science and Practice, 12(2), 174-183. Gelso, C. J., Carter, J. A. (1985). The relationship in counseling and psychotherapy: components, consequences, and theoretical antecedents. The Counseling Psychologist, 13(2), 155. Hardy, G., Cahill, J., Barkham, M. (2007). Active ingredients of the therapeutic relationship that promote client change: a research perspective. In: P. Gilbert R. L. Leahy (Eds.). The Therapeutic Relationship in the Cognitive Behavioral Psychotherapies (pp. 24-42). Oxford: Routledge. Hayes, S. C., Strosahl, K. D., Wilson, K. D. (2004). Acceptance and commitment therapy: an experiential approach to behaviour change. New York: Guildford Press. Horvath, A. O., Symonds, B. D. (1991). Relation between working alliance and outcome in psychotherapy: A meta-analysis. Journal of Counseling Psychology, 38, 139–149. Kivlighan, D., Shaughnessy, P. (2000). Patterns of working alliance development: A typology of clients working alliance ratings. Journal of Counseling Psychology, 47(3), 362-371. Krupnick, J. L., Sotsky, S. M., Elkin, I., Simmens, S., Moyer, J., Watkins, J., et al. (2006). The role of the therapeutic alliance in psychotherapy and pharmacotherapy outcome: findings in the national institute of mental health treatment of depression collaborative research program. Focus, 4(2), 269-277. Ligiero, D. P., Gelso, C. J. (2002). Countertransference, attachment, and the working alliance: The therapists contributions. Psychotherapy: Theory, Research, Practice, and Training, 39(1), 3-11. Martin, D. J., Garske, J. P., Davis, M. K. (2000). Relation of the therapeutic alliance with outcome and other variables: A meta-analytic review. Journal of Consulting and Clinical Psychology, 68, 438–450. Norcross, J. C. (2002). Psychotherapy relationships that work: therapist contributions and responsiveness to patients. Oxford: Oxford University Press. Safran, J. D., Muran, J. C. (2006). Has the concept of the therapeutic alliance outlived its usefulness. Psychotherapy: Theory, Research, Practice, Training, 43(3), 286-291. Safran, J. D., Muran, J. C., Samstag, L. W., Stevens, C. (2001). Repairing alliance ruptures. Psychotherapy, 38(4), 406-412. Sexton, H., Littauer, H., Sexton, A., Tà ¸mmerà ¥s, E. (2005). Building an alliance: Early therapy process and the client–therapist connection. Psychotherapy Research, 15(1), 103-116. Stiles, W. B., Glick, M. J., Osatuke, K., Hardy, G. E., Shapiro, D. A., Agnew-Davies, R., et al. (2004). Patterns of alliance development and the rupture-repair hypothesis: are productive relationships U-shaped or V-shaped? Journal of Counseling Psychology, 51(1), 81-92. Tryon, G. S. (2002). Engagement in counselling. In: G. S. Tryon (Ed.). Counseling based on process research: Applying what we know (pp. 1-26). Boston: Allyn Bacon. Tryon, G. S., Winograd, G. (2002). Goal consensus and collaboration. In: J. R. Norcross (Ed.). Psychotherapy Relationships That Work (pp. 109-125). New York: Oxford University Press.

College Admissions Essay: I Will be a Writer! :: College Admissions Essays

I Will be a Writer! Two books helped me define myself as a writer, or rather, helped me decide what kind of writer I would be. The first was the Brothers Karamazov by Dostoyevsky. I read it when I was a freshman in high school. By then, I had already begun to wrestle with questions of good and evil which I encountered in the novel and would later work with again and again in my poems. Perhaps because I had been raised Catholic, it made the novel more resonant for me, for I firmly believed in the existence of evil, as firmly as I believed in the existence of goodness and its power to transform, although at the end of the book, I had begun to realize that goodness alone is not always enough and that indeed, sometimes we are not transformed by suffering, but are destroyed by it. The second book was Body Rags, poems by Galway Kinnell who made a profound impression on me. For weeks after reading Galway, I carried Body Rags around as if it were holy script, as if it were a sacred guide to the writing life. I remember feeling as if I had some amulet against the unpoetic mundane world I inhabited in my everyday life. I thought if a book could make such a difference, perhaps one day, if I persevered and was lucky enough to write one, I too could be an inspiration to someone and that feeling encouraged me to keep writing. The other book I read around the same time, was The Temple of the Golden Pavilion by Yukio Mishima - I was reading a lot of Japanese fiction at the time.

Quality management Essay

Dialogue 2: Identify two (2) thought leaders relative to quality management. Research each to determine their core ideas and contributions. Synthesize your thoughts about each into a one paragraph (per leader) that contains important and meaningful statements about each thought leader, their contributions, and the relevance of the contribution today regarding the work of project managers. Joseph M. Juran Dr. Juran devoted 70 years to his books, thoughts, and life work revolutionizing the philosophy of total quality management. His developed quality management ideas work around the quality trilogy of Quality Planning, Quality Improvement, and Quality Control. Through the Juran Institute, Dr. Juran has maintained the capability to continually broaden the experiential learning of economist, scientist, and engineers around his work. Dr. Juran’s teachings and guidance focus efforts on the customer and their needs, optimizes the product for those individuals, optimizes the processes involved, and ensures that the process will actually produce the product. Dr. Juran understood that the human component (the customer, the manager, the scientist, the engineer) was an integral piece of the quality process. His lessons contributed to the rise of the Japanese economy after his hands on workings with the Union of Japanese Scientist and Engineers. The push of information today has allowed th ese theories to flourish. Customer satisfaction is an ever pressing position for large and small businesses. Today’s managers would be hard pressed to understand the human factor, if individuals like Dr. Juran did not lay the ground work to focus efforts on the human factors. Genichi Taguchi Taguchi was a Japanese Textile Engineer that understood the processes and influences of small and large businesses. He realized there were variables within management’s control and others that we not. His major contributions/theories were the following: The Loss Function- an equation to quantify the decline of a customer’s perceived value of a product, as the quality declines; Orthogonal Arrays and Linear Graphs- tools to identify and isolate the items concerned when dealing with effective costs and time; Robustness- the identified course of developing products and processes that perform uniformly regardless of the uncontrollable forces.

The Impact Of Stem Extra Curricular Activities On Student...

This literature review focuses on three different areas related to this program evaluation: 1. the achievement gap of underprivileged minorities in STEM academic subject areas and careers, 2. the impact of STEM extra-curricular activities on student involvement, interest and ultimately achievement in the subject areas, and 3. the important role makerspaces fill in addressing the need for positive, out-of-school experiences for underprivileged youth. In addition, the review will also cover what successful research methodologies have been employed to study similar topics in the past. Present state of underprivileged minorities in education and the economy STEM occupations are predominantly populated by White males. Whites and Asians are overrepresented in STEM fields, making up 71% and 14.5 % of the STEM workforce respectively while Hispanics are at 7% and Blacks at 6% (Landivar, 2013). This lack of representation puts underrepresented minorities at an economic disadvantage as STEM fields are expected to increase by 17% by 2020 as compared to non-STEM jobs that are expected to increase by 9.8% (Langdon, McKittrick, Beede, Kahn, Doms, 2011). STEM jobs have remarkably better job security. In 2010, the unemployment rate nationwide bordered around 10 percent while STEM workers had a rate of 5.3 percent (Cover, 2011). Likewise, the average wage for all STEM occupations was $77,880 in May of 2009 while the US average for non-STEM jobs was $43,460 (Cover, 2011). It should beShow MoreRelatedSports And Physical Activity Play1699 Words   |  7 Pagesliving â€Å"rough† without secure housing, as well as through their exposure to , and involvement in, crime, drugs, alcohol, and sexual abuse. The program helps get homeless youth off the street and into a more productive lifestyle. 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