Levels in a psychotherapeutic relationship

Clarkson (2003) defines a five-relational framework of the psychotherapeutic relationship. That which seems to be consistent in all approaches in psychotherapy, Clarkson teased out into what seems like five overlapping layers of the psychotherapeutic contact.

These are:

1. The working alliance: This is the aspect of the client-psychotherapist relationship that enables the client and therapist to work together. It is not dependent on the desire of either party to be in this relationship (p. 35-66).

2. The transferential/countertransferential relationship: This describes the facet of the relationship, that is, the experience of wishes and fears transferred onto the relationship, which works to distort the alliance (ibid. p. 67-112).

3. The reparative/developmentally needed relationship: This is the facet of the relationship whereby the therapist provides corrective reparative or replenishing connection or action where previous relationships were deficient, abusive or overprotective (ibid. p. 113-151).

4. The person-to-person relationship: This relationship aspect is the dialogic here-and-now, subject-to-subject relationship, as opposed to an object-subject relationship (ibid. p. 152-186).

5. The transpersonal relationship: Clarkson describes this aspect of the relationship as the timeless facet of the psychotherapeutic relationship, “though difficult to describe, refers to the spiritual dimension or The many levels in a psychotherapeutic relationship”.

This presentation of the psychotherapeutic relationship into these five layers provides insight into the complexity of the psychotherapeutic alliance. Each of the five aspects is crucial to the relationship, and these together bring about the change- a process in therapy. Through the working alliance, the treatment gets initiated, while the codes and contracts act as the foundation for the cure.

References

Chew-Helbig, N. (2017). The Psychotherapeutic Alliance and Change: A discussion on the healing aspects in a psychotherapeutic relationship. Bachelor Thesis.

Clarkson, P. (2003). The Therapeutic Relationship. London: Whurr Publishers.