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This refers to the ability to develop and maintain effective working alliances with clients, including individuals, carers and services.
This concept is closely related to the idea of 'engagement', defined in the competence frameworks for CBT, psychodynamic and systemic therapies as:
'While maintaining professional boundaries, an ability to show appropriate levels of warmth, concern, confidence and genuineness, matched to client need'.
Clinical
psychologists should recognise that the working or therapeutic alliance is part
of an intervention. It is commonly thought of as having three factors:
1. The relationship or bond between therapist and client
2. Consensus between therapist and client regarding the techniques/methods
employed in the therapy.
3. Consensus between therapist and client regarding the goals of therapy
Relevant competences for achieving this are:
| An ability to engender trust |
| An ability to develop rapport, being warm friendly affirming and open. |
| An ability to be flexible, adapting personal style so that it meshes with that of the client |
| An ability to recognise the importance of discussion and expression of a client's emotional reactions |
| An ability to adjust the level of in-session activity and structuring of the session to the client's needs |
| An ability to convey an appropriate level of confidence and competence |
| An ability to listen to the client's concerns in a manner which is nonjudgmental, supportive and sensitive, and which conveys a comfortable attitude when the client describes their experience |
| An ability to ensure that the client is clear about the rationale for the intervention being offered |
| An ability to gauge whether the client understands the rationale for the intervention, has questions about it, or is sceptical about it, and to respond to these concerns openly and non-defensively in order to resolve any ambiguities |
| An ability to help the client express any concerns or doubts they have about the therapy and/or the therapist, especially where this relates to mistrust or scepticism |
| An ability to help the client articulate their goals for the therapy, and to gauge the degree of congruence in the aims of the client and therapist |
| An ability to avoid negative interpersonal behaviours known to reduce the possibility of forming a positive alliance, being rigid, critical, distant, aloof, distracted or making inappropriate self disclosure/use of silence |
| An ability to maintain the alliance recognising when strains in the alliance threaten the progress of therapy |