Strategies for Building Therapeutic Alliance (Dr. Brew)

Question 1

1. Being present

Answer 1

skills: reflections (content/feeling), pacing, and non-verbal behaviors

–> clear your mind by deep breaths, eliminating as many distractions as possible (if you find yourself veering off inside, ground yourself to get back to client)
–> e.g., “You’re kind of mystified about where this comes from.”

Question 2

2. Use of open body language.

Answer 2

skills: personal space, body posture, mirroring, reflect gestures, and reflect facial expressions

–> e.g., laughing when a client laughs
–> e.g., pointing out the client’s hand gesture – “Ah, that’s a powerful gesture you did there. I could just feel the distance you must have been feeling.”
–> e.g., “Your face really lit up as you thought about the connection that you shared with her.”

Question 3

3. Demonstrating empathy.

Answer 3

skills: use of tentative statements/inflections, summaries, use of silence, “both/and” statements

–> e.g., “Part of you feels proud and another feels disappointed.”
–> e.g., “It sounds like you either do your best or you are a disappointment.”

Question 4

4. Trusting client’s self-actualizing tendencies.

Answer 4

skills: recognizing patterns and faciltiating insight

–> language: “Do you have any thoughts about where that came from?” or “I’m wondering, where do you think that first started?”
–> e.g., points out different observations about how Carla is putting a lot of self-imposed pressure on her shoulders to be perfect, even though this was not expected by her family
–> e.g., Counselor points out eagerness to start a family and jump into relationships –> traces it back to father abandoning him and fear of being abandoned in relationships

Question 5

5. You’re not along (walking alongside and normalizing experiences).

Answer 5

skills: conveying empathy, “name it to tame it” (noticing and labeling emotions as they are happening)

–> e.g., “You’re really touched when you say that.” regarding Carla talking about taking care of her sister

Question 6

6. Goal alignment.

Answer 6

skills: clarify problem (summarizing, checking in), suggestion, and conveying hopefulness

–> e.g., “I’m hearing that you are overwhelmed with your responsibilities and would like to figure out how to put less pressure on yourself. And perhaps recognizing your accomplishments and figuring out how to let that be your motivator. How does that sound to you?”