Academic journal article The International Journal of Behavioral Consultation and Therapy

A Functional Analytic Perspective of Therapist Intimacy in and out of Session

Academic journal article The International Journal of Behavioral Consultation and Therapy

A Functional Analytic Perspective of Therapist Intimacy in and out of Session

Article excerpt

THE THERAPEUTIC RELATIONSHIP is integral to the process of psychotherapy. Norcross (2010) calls the therapeutic relationship the "cornerstone" of the factors that account for success in therapy. He pinpoints factors from the literature within the therapeutic relationship that have been studied, demonstrated to "work," and are associated with positive therapeutic outcomes. These factors are: empathy, alliance, cohesion, goal consensus and collaboration, positive regard, congruence/genuineness, feedback, repair of alliance ruptures, self-disclosure, management of countertransference, and quality of relational interpretations. Norcross (2010) highlights the importance of these factors within the therapeutic relationship, but his compilation of research lacks a concrete behavioral rationale for why the relationship contributes to change within individuals.

Another study suggests that the therapist role within the therapeutic alliance offers many qualities of an attachment figure (e.g., providing attention and emotional support) and can facilitate a corrective emotional experience for clients (Mallinckrodt, 2010). In fact, a secure attachment style with the therapist predicted greater progress in treatment when compared to other attachment styles between client and therapist. In a study conducted by Sauer, Anderson, Gormley, Richmond, & Preacco, (2010), secure attachment between the therapist and client, as measured by the Clients Attachment to Therapists scale (Mallinckrodt et al., 1995), was associated with significant reduction in distress over time, as measured by the Outcome Questionnaire--45.2 (Lambert et al., 1996). Avoidant-fearful and preoccupied attachments between the therapist and client were not associated with positive outcomes. As demonstrated by these studies, there is clearly some relationship between the therapeutic relationship and therapeutic outcome; however there is little investigation into the mechanism of change within the therapeutic relationship that is related to positive outcomes. Furthermore, some argue that there is more to the therapeutic relationship than present theory or research conveys and suggest that research focus on intimacy as a factor of influence within the therapeutic relationship (Kohlenberg, Yeater, & Kohlenberg, 1998).

More recent research attempts to focus on intimacy as a target of client treatment and in the formation of the therapeutic relationship (Bailey, 2002). However, a problem encountered with studying intimacy within multiple domains (e.g., romantic relationships, therapeutic relationship, friendships, etc.) is establishing an operational definition that is sufficient for measurement across all domains. We believe that many of the various definitions of intimacy within the literature are not effective definitions for a behavioral approach to research (see. Mosier, 2006; Reis & Shaver, 1988). This paper will define intimacy according to the behavior analytic perspective, operationally defined by Cordova and Scott (2001) as events "in which behavior vulnerable to interpersonal punishment is reinforced by the response of another person" (p. 75). For example, suppose a client tells the therapist of his or her victimization in a past sexual assault, exposing him or her to possible interpersonal punishment (e.g., therapist avoiding conversation, providing aversive statements to client, or invalidating client's experience). The therapist then responds in a way that may cause the client to feel validated (reinforcement from perhaps acknowledging the client's painful experience, offering a safe place to disclose, and/or demonstrating a willingness to listen and be present with the client). This response may then increase the likelihood of further disclosure.

Cordova & Scott (2006) also propose that intimacy cannot exist without punishment or risk of punishment and note the importance of monitoring an intimacy ratio, which compares reinforcement to punishment during the change process. …

Search by... Author
Show... All Results Primary Sources Peer-reviewed

Oops!

An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.