The 4 Necessary Components and 5 Stages of Successful Psychotherapy
Posted On April 30, 2020
First recognized by Carl Rogers, there are components to psychotherapy that are experienced in the therapeutic relationship. The three basic ones become apparent when one researches the literature.
This article will focus on the three vital components of psychotherapy, including unconditional positive regard, genuineness, empathy, and confidentiality, plus the various stages of psychotherapy as well to round out our time together.
Unconditional Positive Regard
This seemingly long-phrase means that the Therapist accepts their client for who and where they are in the present. The Therapist shows that they believe in their client and does not see them as a diagnosis, but rather as a person. One can see how this attitude will help the client to feel trust quicker and to allow them to open up to their Therapist because they do not fear rejection. Unconditional positive regard also demonstrates to the client that the Therapist does not feel superior to the person they are helping.
No one likes to sit and speak about private matters with someone who is exhibiting a facade. As humans, people are more interested in being themselves with someone who is also being “real” with them. A therapist must, therefore, know themselves well and show who they indeed are to their client. This does not mean there are no boundaries. Some things are private and should not be shared, such as inappropriate details about the Therapist’s intimate relationships. It is important to remember that each Therapist has their own set of values as to what is confidential information. Plus, there are ethical rules that they must follow. With a genuine therapist, the client can feel freer to be themselves as well.
A well-trained therapist will put themselves into the shoes of their client. This allows them to understand, on a deep level, the emotions and thought processes that are brought to their office. The Therapist will also show appropriate emotions, such as weeping with their client. This allows their client to see genuine emotions about the feelings they may have on a subject. This is a clear signal that the Therapist is genuinely listening and paying attention to the client’s needs. This is a powerful tool and a necessary component if the client is to experience healing.
With the above components being practiced by the Therapist, a client can begin the arduous work of self-discovery needed to overcome whatever obstacles are holding them back from living a hope-filled and complete life.
Confidentiality is the cornerstone of psychotherapy and one of the most essential terms of which clients sometimes have little understanding. It is necessary to know your rights and how confidentiality works to protect yourself and to reassure yourself that your privacy will be maintained by your Therapist. It is only with confidentiality that a client can feel free to tell their Therapist the secrets that bind them from being able to move on with their lives. Without this privacy, healing would not be possible.
An important rule many clients do not understand is the Health Insurance Portability and Accountability Act of 1996 (HIPPA). This rule protects most “individually identifiable health information” held or transmitted by a covered provider or their business associates. This information may be in any form, electronic, paper, or oral.
This act was passed into law in the United States by congress to protect the privacy of health information. With this critical law, a client’s information, whether it be something written down, posted to a website or verbal, cannot be given or transmitted without the express permission of the client. Even in the case of insurance companies billing for services, the only information that is necessary, such as a diagnosis code, may be shared. In other words, anything said or done in the confidence of a Therapists presence is protected by law. This gives the client a lot of assurance and opens the door for meaningful and healing dialogue.
There are myths about confidentiality that are perpetuated by television programs and movies that simply are not true. One of the most prevalent is that everyone who offers psychotherapy services is bound by rules protecting confidentiality. This is incorrect. Some service providers, such as life coaches, are not regulated enough. Therefore they are not bound by the regulations that have been set up to protect the client’s privacy. Another myth is that a licensed professional can never tell anyone information shared during a therapeutic session.
This, too, is incorrect. Under certain circumstances, a Therapist may indeed share information they have learned in their office from a client, but only if the life of that client or someone else is endangered. They may also have to share information as a mandated reporter if a child, the elderly, or a disabled person is suspected of being abused. If they are subpoenaed by a court of law, they may have to testify about what they have learned during sessions with a client, but it takes unusual circumstances for them to do so
As can be seen, the client’s rights are strictly regulated. If a person believes their rights have been violated, they have the privilege and the right to report such abuses to the licensing service of their Therapist. They may also have grounds for a lawsuit.
The Stages of Psychotherapy
It is important to remember that, although the stages described below usually occur in order, they are not written in stone. Quite frankly, these stages may repeat over-and-over again, or there may be more stages in between.
This work will describe five stages. They are orientation, introduction, commitment, working, and resolution.
Orientation. This stage is where the beginning of trust is established. The client identifies why they have gone to a therapist, and a rapport between the client and Therapist is begun. Orientation begins when the client makes that first appointment, not really knowing what to expect from their new Therapist.
Introduction. As the title suggests, this is the stage where the client and Therapist genuinely begin to get to know one another. It is essential for the client to feel free to ask questions of the Therapist and for the Therapist to establish clearly defined boundaries as to what they will and will not disclose. It is also in this stage that goals are discussed. The well-trained Therapist will not push their own goals onto the person seeking their help but rather will follow the lead of the client.
Commitment. Here the client commits themselves to the healing process of healing, and the Therapist engages themselves to aid their client in every way they can. Both parties must make this commitment so that the client can make progress. This commitment only be for a brief time or may take several years. It depends on the needs of the client and the speed at which they can tolerate proceeding.
Working. In this stage, trust has been established, and the demanding work begins. The client begins to share the deep needs they have, and they feel that their Therapist is on their side. This stage may include telling the Therapist some dark secrets that the client has never shared with anyone before and therefore is the most challenging part of therapy. The Therapist aids their client by not giving advice, but rather by offering differing points of view on how a situation might be handled. The Therapist’s goal is to help their client understand and change the ways they may be incorrectly seeing the world.
Resolution. In this final stage of therapy, the client has decided that they have met the desired goal (reasons they entered treatment), and it is time to leave. Although this is a positive outcome, because of the intimate nature of the therapeutic relationship, the experience of fear of abandonment on the part of the client is natural. Careful preparation can alleviate the strong emotion of abandonment. This involves talking about the impending loss of the Therapist in the client’s life. Also, recounting of the positive changes that have occurred during the time the client and Therapist have had together.
Seeking out and attending therapy for issues such as those faced by survivors is tough. It takes an enormous amount of guts to meet what happened in the past and to then continue into the future.
I hope this piece helped both those who are beginning therapy and those who have been on their healing journey for a long time by acknowledging therapy’s vital components and stages. Knowing what to expect takes much of the mystery out of the process and aids in understanding how therapy can help you.
No matter what, keep your chin up, even when times seem ugly. Take it from someone who has been there, there will be an end to the suffering and pain. Just hang on and never give up.
“It always seems impossible until it’s done.” ~ Nelson Mandela