By John D. Ellis, M.A. AMFT
A key component to finding success through the mechanism of therapy is establishing a strong therapeutic alliance or relationship. This article will give insight into how both therapist and patient accomplish the relationship task.
Irvin D. Yalom, internationally renowned psychiatrist and psychotherapist, writes in “The Gift of Therapy: An Open Letter to a New Generation of Therapists and Their Patients,” that a full disclosure of the mechanism of therapy is required. I have practiced disclosing the mechanism of therapy since my practicums and internships at Syracuse University. This assists in establishing a working therapeutic alliance. It also alleviates additional anxiety that the therapeutic process invokes. Below is an illustration from that book about what to expect if you were to engage in therapeutic services. Written by Yalom, it also exemplifies how a therapist would disclose aspects of the mechanism of therapy:
“It is clear that one of the areas we need to address is your relationship with others … Sometimes your descriptions may be unintentionally biased, and I’ve found that I can be more helpful to you by focusing on the one relationship where I have the most accurate information — the relationship between you and me. It is for this reason I shall often ask you to examine what is happening between the two of us.”
Therapists should invite the examination of both self-disclosure and the therapeutic relationship, as it holds intrinsic value in the therapeutic process. The therapeutic relationship is a central component and agent of change. When appropriate, as a marriage and family therapist, I would go a step further and invite you to include a relationship into your therapy.
Why do I share this with the public? It is important to be a good consumer when engaging in therapeutic services. The relationship with your therapist is more important than their expertise in a particular theory, intervention or practice. The patient needs to invite this into therapy by asking for transparency related to the therapist’s personal mechanism of therapy. Another step is to self-disclose the intricacies of what it is to be you and reside in your respective relationships and environments. The content and process this creates between therapist and patient will collude to the existence or absence of a healthy therapeutic alliance. In adhering to the description above a healthy therapeutic alliance can form and begin to perpetuate desired change. Both therapist and patient play a vital role in the development of therapeutic alliances.