Relevant therapeutic skills in psychotherapy
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п»ї<title>Relevant therapeutic skills in psychotherapy</title>
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Therapeutic skills are an essential and indispensable tool when working in therapy. Psychologists or psychotherapists, therefore, have to learn such skills and implement them in sessions, just as they do with endorsed psychological techniques.
The concept of therapeutic alliance, originating in the psychodynamic model, was introduced by Bordin several decades ago. It can be conceptualized as an essential ingredient of change in any therapeutic model. That is, it is an ingredient that must be present throughout the treatment if we want it to really work.
The components of this therapeutic alliance are three: the bond between client and therapist, determined by the emotional tone and collaboration; the agreement on the objectives to be achieved and the agreement on the tasks to achieve these objectives.
Other authors, such as Rogers, from humanistic therapy, state that the ingredients that must be present in all therapies are: authenticity or congruence of the therapist, unconditional acceptance of the client and empathy. In fact, Rogers believed that these components were necessary and sufficient for change to take place. In addition to the essential alliance, other types of skills that favor the creation of the alliance are also necessary.
One of the most important therapeutic skills is the psychologist's ability to establish a good alliance or rapport with the patient.
Important therapeutic skills in a therapistTo study the variables to be taken into account in the use of therapeutic skills, the study by Sloane and collaborators (1975) on the importance given by patients to these variables, which they consider to be the reason for success, is a compulsory reference. They were grouped into five:
The therapist's personality.
The therapist's listening skills.
The therapist's way of gradually encouraging the patient to practice what was bothering him.
The therapist's ability to speak in a way that was understood.
The help the therapist offered him in understanding himself.
Other authors, such as Ackerman and Hilseroth (2003) review the literature on this topic and find that the therapist's characteristics that favor the alliance are:
Flexibility: he/she accepts and adapts his/her way of communicating to the situation and the patient in front of him/her.
Experience: shows clinical expertise
Honesty: the patient perceives him/her as sincere.
Respect: shows respect for the patient's values and the way of expressing and communicating in general.
Loyalty: trustworthy
Self-confidence: the patient perceives that he/she knows what he/she is doing.
Interest in the patient and his problem
Attention: he/she is attentive to what is happening in the session. That is, the patient's verbal and non-verbal manifestations.
Closeness: the patient perceives him/her as close
Warmth: affectionate, affectionate
Open-mindedness: understanding of other points of view.
Currently, it can be concluded that there is abundant information on the importance of the therapist's characteristics on treatment outcomes.
Studies indicate that treatment efficacy and session reduction is significantly higher when these strategies are used than when they are not.
Approximately half of the patients who come for treatment drop out in the first session. Therefore, the first sessions are crucial in deciding whether to continue or not.
Some studies reveal that the first interview in which patient and therapist meet for the first time is decisive for most patients. Thus, therapists who "hook" patients into treatment show greater verbal facility and diagnostic skills than therapists with low hooking.
If we isolate factors unrelated to the treatment, such as the patients' economic possibilities or travel time to attend the session, the authors agree that there are two main reasons for dropouts. These are, on the one hand, the personal characteristics of the therapist and his or her lack of interest in the proposed intervention approach. On the other hand, the patient believes that he/she has improved sufficiently to decide not to continue.
It has been seen that the opportune moment to establish a good alliance with the patient is between the third and fifth therapy session. However, the possibility of abandonment arises before such a bond can be established. In this sense, the therapist's personality can do a lot to prevent the patient from dropping out.
Regarding early dropout, studies suggest that it is the therapist's verbal skills that influence the ultimate success of treatment, to the point that the number of dropouts is significantly lower in therapists who have these skills.
Therefore, in light of the studies, it is important for therapists to learn useful skills in therapy. It is not enough to have good or extensive knowledge, but it is also necessary to know when to put it into practice, how to present it and to what type of patient. Training helps in this task of precision.
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