Exercising Leadership Within the Therapeutic Alliance: An Autonomy-Grounded Perspective

Abstract

Leadership within therapeutic practice encompasses the capacity to formulate and accomplish strategies that are mindful of one’s ethical duty toward fostering clients’ autonomy. Here, clinical practitioners’ role as “leader” involves not only sustaining the momentum of the therapeutic alliance, but also contributing toward the purpose of this alliance. The very telos of therapy is to create an environment that facilitates clients’ ability to move toward autonomy: to lead clients, paradoxically, beyond a need to engage in the clinical relationship. Here, fostering client autonomy lies at the heart of therapeutic leadership because the experience of autonomy—which is developed interpersonally—expresses itself in a state of internal clarity and cohesiveness through which clients are more capable of exercising control over the trajectory of their life beyond the cessation of the therapeutic relationship. Three characteristics of the therapeutic leader are important in this regard: discernment, determination, and humility. Each of these are most fully exercised when the practitioner possesses a commitment to ensuring an ethic of collaboration and egalitarianism, underpinned by therapeutic “presence.”