Friday 6th

Panel discussion

Chair: Lou Lasprugato

Panelists: Robyn Walser, Manuela O’Connell, Jim Lucas, Michael May

English

The therapeutic relationship has been of interest to the field of psychology since the late 1800s with Freud’s psychoanalytic approach to therapy. In the mid-1900s, Rogers identified three critical qualities of an effective therapeutic relationship: empathy, authenticity, and unconditional positive regard. Each of which has continued to be thought of as part of a good alliance. Bordin later (1979) reformulated what has become known as the therapeutic (or working) alliance to include goal collaboration, task agreement, and the affective bond. Since then, research into the therapeutic relationship has proliferated, finding moderate but robust relationships between alliance assessment and client outcome measures (Flückiger et al., 2018). Yet, uncertainty and dissent persist over which factors are most salient (Finsrud et al., 2022), even though it is generally considered, by many therapists and researchers alike, to be the primary mechanism of change in psychotherapy.

 A quite modest body of research evaluating acceptance and commitment therapy (ACT) suggests that the transference of psychological flexibility skills may account for any significance of the alliance within the therapeutic relationship (Walser et al., 2013; Gifford et al., 2011). That is, as clinicians model, evoke, and reinforce psychological flexibility processes, the benefits of the working alliance can be realized. The relationship is the vehicle of change, and work done to conceptualize and quantify the alliance should not consider process and outcome as separate entities. This panel will call upon ACT experts to discuss their perspectives on this crucial phenomenon, including the role that on-the-fly functional analysis may play in determining what processes to target within the relationship itself. The audience will then be invited to provide clinical scenarios for panelists to demonstrate process-based shaping within the therapeutic relationship.

Learning Objectives:

• Compare and contrast qualities of the therapeutic alliance from different perspectives

• Explain how psychological flexibility processes naturally support the therapeutic/working alliance

• Explain the role that functional analysis plays in determining what processes to target within the therapeutic relationship.