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The Client/ Clinician Relationship & Practice Evaluation

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Danielle Hershkowitz

on 5 November 2013

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Transcript of The Client/ Clinician Relationship & Practice Evaluation

The therapeutic alliance or relationship might be the most important part of beginning therapy.

Many studies indicate that the therapeutic relationship is the best predictor of treatment outcome.

Any successful therapy is grounded in a continuous strong, genuine therapeutic relationship
Introduction Cont'
Without mastering the art and science of building a therapeutic relationship with your client, their may be a lack of trust from the client inhibiting the ability to work together efficiently

Therefore, the helping relationship should be the number one priority in the treatment process.
What is Empathy?

- Empathy is the ability to understand and share the feelings of another

Empathy is trying to get into others’ shoes to feel what they feel. You don’t necessarily ignore your own emotions but your goal is to try to be in their unique experience

The Client/ Clinician Relationship & Practice Evaluation
By: Danielle Hershkowitz, Dani Marr, Nicole Wadler, Rebecca Burkett & Jessica Rotonda
Empathy Cont'
Pros of using Empathy in Therapy:

1. It can greatly reduce the amount of conflict in an individual’s life

2. It improves relationships.

3. It can reduce feelings of racism, sexism, and all other types of intolerance

4. It makes people more open-minded about life in general
Barriers To Empathy
1.When the client feels pressure from an involuntary
referral, the empathic social worker understands and
is aware of that pressure and how it feels.
HOWEVER, At the same
time, the social worker must remain outside of the
client’ s world and avoid being overwhelmed by his or
her fears, anger, joys, and hurts, even as the social
worker deeply senses the meaning and significance of
these feelings for the client.

2. When social workers support their clients’ feelings, the clients may feel no need to examine their behavior
or circumstances and may not engage in the process of
self-exploration that is so vital to growth and change.

Unconditional Positive Regard
What is it?
The clinician conveys warmth, support, and high regard to the client (nonjudgmental)
Acceptance of the client's experience
Why is it important?
Clinicians should always remember that their clients are human beings and not what their diagnosis label says they are.
The clients progress can be assisted by the clinicians use of unconditional positive regard.
It could also be very useful when the clinician is of a different racial/ethnic background than the client.
Communicating you care to clients can assist them when they are in a crisis or feeling stressed; "my therapist cares for me and can help me."



Each client differs in their need of the clinician's expression of positive regard.

Clinicians should be aware and monitor their use of positive regard in order to fit the needs of the client's.

Clinician's may also remind their client's that they should express their level of need for the clinician's positive regard (ex: support, encouragement, etc)

The client/clinician relationship impacts why clients improve or don't improve, just as much as a specific intervention/treatment.

On-going evaluation of this therapeutic relationship can help to avoid early termination and in evaluating the effectiveness of intervention choice.

Opportunity to improve the client/clinician relationship and model positive behavior.
Shared Agreement on Goals
Clinician's should work with the client's on developing goals .
Clinician verses Patient Agendas (both have them)
Imposing goals on client's
Resistance and Separation throughout sessions
Mandated verses Options: Internalized Goals
Shared goals at NDHS





Humor is defined as the quality of being amusing or comic, esp. as expressed in literature or speech, or a mood or state of mind.

In therapy, humor can teach clients not to take themselves too seriously and can be a therapeutic experience for clients.

Humor can allow the client to feel more in control of their situation
Humor indicates a good therapeutic alliance
Humor and the Clinician/Client Relationship:
Humor builds relationships

Humor changes feelings and thoughts

Humor changes behavior

Humor changes biochemistry
Barriers Of Using Humor In Therapy
If the therapeutic alliance is not strong, humor can be destructive.

The humor must be in the client's interest, or else they can feel rejected.

The therapist risks alienating the client.

The therapist also risks being viewed as less competent, and not taking the client's problems seriously.
Humor Slides:
Elliot, M. (2013) Finding the Fun in Daily Occupation: An Investigation of Humor. Occupational Therapy in Mental Health, 29(3), 201-214.
Siporin, M. (1984) Have you heard the one about social work humor? Social Casework,65(8), 459-464.
Sultanof, S. (1992) The impact of humor in the counseling relationship. Laugh it Up, Publication of the American Association for Therapeutic Humor, (7), 1.
Horvath, A.O. and Symonds, B.D. (1991) Relation between working alliance and
outcome in psychotherapy: a meta-analysis, Journal of Counseling Psychology, 38 (2), 139-149.
Singer, R. A. (n.d.). The therapeutic relationship is the most important ingredient in
successful therapy. In Self Growth. Retrieved November 2, 2013.

Farber, B. A. (2010). Chapter 8: Positive Regard and Affirmation. In J. C. Norcross (Ed.), Evidence Based Therapy Relationships (pp. 17-18).
Norcross, J.C. & Lambert, M.J. (2010). Chapter 1: Evidence Based Therapy Relationships. In J. C. Norcross (Ed.), Evidence Based Relationships (pp. 1-3).

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