Importance of Therapeutic Relationship in Cognitive Therapy

Importance of Therapeutic league in Cognitive TherapyWithin cognitive therapy, the curative kind, along with the emotional aspects of therapy in general, has historically been of little splendor than for other cure modalities. In the last decade this has qualifyd and in the so-called third wind in cognitive therapy there is a much greater interest in the cure relationship (Hayes, Strosahl Wilson, 2004). This essay evaluates the relevance of the therapeutic relationship in cognitive therapy with reference to the resultant role research.The term therapeutic relationship covers a wide range of promoters within therapy, each of which comport been examined separately in the research. Hardy, Cahill and Barkham (2007) energise suggested that it is useful to break down this research into three field of operationss establishing the relationship, developing the relationship and, finally, maintaining the relationship. Starting with establishing a relationship, sacristan, Littaue r, Sexton and Tmmers (2005) examined the first two sessions with 34 different clients using anonymous ratings at 20 second intervals. They found that better therapeutic alliances were associated with earlier meaningful connection and emotional participation.Empathy is also theme to be a major component in establishing a relationship. The research on the contribution of empathy towards the therapeutic outcome has been subject to meta-analysis by Bohart, Elliott, Greenberg and Watson (2002). This found that between 7% and 10% of psychotherapeutics outcomes were explained by empathy therefore this relationship was particularly strong in cognitive therapies. Two further components central to establishing a relationship which have also garnered positive relationship with outcomes in the literature are engagement (e.g. Tryon, 2002) and mutual involvement (e.g. Tryon Winograd, 2002).The second research area is developing a relationship in order to progress clients mustiness have a s ense of commitment, trust and openness towards their therapist (Hardy, Cahill Barkham, 2007). This means the therapist must efficaciously manage the relationship, including negotiating factors like transference and counter-transference (Ligiero Gelso, 2002). This area, however, has not been extensively examined within cognitive therapy.The third research area is maintaining the relationship. Research has examined how therapists deal with the inevitable problems that arise in therapeutic relationships. Better outcomes are generally predicted by successfully dealing with challenges to the therapeutic relationship. Challenges studied have included negative feelings towards clients (Gelso Carter, 1985), disagreements (Safran, Muran, Samstag Stevens, 2001) and resistance (Binder Strupp, 1997). Stiles et al. (2004) looked at the boilers suit pattern of alliance development over the course of both cognitive and psychodynamic therapies. They found that those who had ruptures in the t herapeutic alliance, which were subsequently repaired, had the best treatment outcomes. This, along with similar previous research by Kivlighan and Shaughnessy (2000) strongly underlines the importance of relationship maintenance in treatment outcome.Much of the research on the therapeutic alliance crosswise treatment modalities has been reviewed in two meta-analyses (Horvath Symonds, 1991 Martin, Garske Davis, 2000). Both found positive support for its effect on outcome. In addition Norcross (2002) has estimated that 30% of psychotherapeutic outcomes are related to common factors mostly therapeutic alliance. This is compared to only a 15% influence of techniques a component of cognitive therapy that has traditionally been emphasised. This point, though, has proved controversial and DeRubeis, Brotman and Gibbons (2005) have criticised studies such as those cited above for merely providing correlational evidence. For example, almost without exception the studies analysed by Mart in et al. (2000) were correlational. DeRubeis et al. (2005) argue that a obedient outcome could well be producing a good alliance, rather than the reverse. Further Safran and Muran (2006) criticise the meta-analyses for only explaining 6% of the outcome variance. Despite these criticisms Craighead, Sheets and Bjornsson (2005) point out that a strong therapeutic alliance is still a vital component of positive change and research continues to underline its importance in cognitive therapy (e.g. Krupnick et al., 2006).In conclusion, the research on the therapeutic alliance in cognitive therapy has generally demonstrated its association with a positive outcome for clients. The importance of establishing and maintaining relationships have both been demonstrated in cognitive therapy. Some have even suggested the supremacy of common factors such as the therapeutic alliance over specific techniques of the cognitive modality. These claims are tempered, however, by methodological concerns wit h correlational data, which mean that the therapeutic alliance could be a dissolvent of a good outcome. 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