Η θεραπευτική σχέση και οι μέθοδοι τροποποίησης συμπεριφοράς

Abstract

This study sought to reveal the coexistence of the treatment “alliance – outcome” relationship in a wide range of health care professions, using special measurement-tools to show their differentiation, but also the importance of therapeutic intervention. According to Rogers’ approach, the therapist experiences the way the client's private world feels as if, it were his own but, without ever losing the quality of himself; that is feeling the client's anger, fear or confusion as if it were his/her own, without committing to the reaction that would follow. Also, the therapist may express meanings in relation to the customer’s experience which the customer is not aware of. Beck's cognitive model explains the intervention in cognitive restructuring on emotional disorders, using cognitive biases to reorganize the erroneous thought processes in which cognitive functions are used inappropriately. Explaining in turn the processes that result from the misorganization of shapes, Beck points out that cognitive biases are consciously incorporated into automatic negative patterns that focus on oneself, the world and the future. An emphasis is given on the transfer dynamics for the value of maintaining the serious interest of the analyst and the sympathetic understanding of the patient, in such a way as to allow the healthy part himself to form a positive attachment to the analyst, as a result of the supportive attitude. Therefore, in a successful psychoanalysis, the client ranges between periods where the relationship is characterized by a mechanism of defense - displacement to move to a mutual alliance. Proving the nuances of the alliance-outcome relationship is complex, and further in-depth understanding will benefit from a closer examination of how the alliance develops over time. Therapeutic alliance is defined as the cooperative and emotional bond between therapist and patient. An expanded definition by Bordin divides the WAI Therapeutic Alliance into three subgroups: Goal, Task, and Bond. The objective refers to a mutual agreement on the specific results which is the objective of the intervention. The project includes an agreement on the current approach to achieving the goals. Finally, the bond reflects the development of a positive therapist-patient relationship characterized by a mutual trust. The clients’ ratings of therapeutic alliance typically started fairly high at the beginning of the services-declined, and then slowly rebounded. The analyses showed that the factor of early alliances affects the results, so that the patient's treatment expectations lead to the development of a therapeutic bond, which affects the results of treatment. Findings reveal that, a therapeutic bond with a strong communication is associated with the activation at the start of treatment, but not with a major change in symptom improvement scores. They suggest that strong communication and bond may be prerequisites for early activation of the healing relationship. On the other hand, the therapeutic alliance on the Task / Goal of therapy instills in patients a sense that they are able to manage their mental health conditions in the long run.