Compare and contrast the models of therapeutic relationship

The need for an effective restorative relationship in successful psychotherapy is without question and can be tracked back again to the most important aspects of a 'romantic relationship' in modern culture. Indeed, one of the great determinants of sociable well-being and joy stems from the capability to form close interactions with others, illustrated by the idea of 'support sites' as a healing framework. The patient-physician romance is an integral part of this therapeutic support network, perhaps even a compensatory system for the identified decline in religious and moral romantic relationships entered into in the modern age. Upon exploration of the connection between medical doctor/therapist and patient it would appear that a number of different methodological approaches are practiced, varying in line with the intended aim of the therapeutic relationship and the intrinsic vicissitudes evident in the 'presenting complaint'. Two popular and utilised views of the restorative relationship are the transference/countertransference model and the reparative model, both of which adopt different methods in order to analyse and explore the essential issues of the restorative requirement. This paper will provide an overview of the healing romantic relationship in modern practice, particularly through evaluation and contrast of these models, providing examples of effective therapeutic request. The similarities and dissimilarities between your models will be discussed and properly summarised.

The Restorative Relationship

When taking into consideration the essential components to a successful therapeutic partnership, deconstruction of the motivations of the therapist is required in order to specify the dynamics which might emerge, as undoubtedly the individual has a role in the collaboration, '. . . to utilize the analyst not and then solve them, but as a receptacle for his pent-up emotions'. Among the key areas of the role of the therapist should be that they enter into the relationship on a voluntary basis and strive to effect an operating romance, by whatever means or model they feel most appropriate. Indeed, it's been suggested that the particular choice in model will not influence the outcome of therapy significantly, but rather the relationship created is a far more important determinant of success. Regardless of this a variety of techniques are utilised to various levels by psychotherapists, adapted to suit particular problems. Clarkson (1990) provides an overview of these models, determining five major examples: the working alliance; the transference/ countertransference romance; the reparative/ developmentally needed romantic relationship; the I-You romance; and, the transpersonal romance. In this newspaper the transference/countertransference and the reparative will be reviewed at length.

Overview of Models

The transference/countertransference model is dependant on the concept of transference, which is an important idea in psychodynamic theory, as relevant today as it was a hundred years previously. Essentially, transference is when thoughts present from childhood re-emerge and be a means of interpreting current situations. These emotions are often representative of encounters with parental statistics from childhood. Inside the therapeutic website, projection of these wishes and/or concerns onto the therapeutic relationship may take two different varieties: proactive and reactive. Proactive transference identifies the past experience which the patient brings to the relationship, while reactive transference is the result of the patient to ideas presented by the therapist. This causes the definition of countertransference, which is essentially the elements of the relationship created by the therapist (and can be proactive or reactive). Both elements must be tackled for the relationship to work.

A commonly cited example of transference is the imposition of the parental amount onto the therapist. Something may have prompted this sensation, such as behaviors or appearance of the therapist, leading to emotional and mental need transference for this situation. This concept was initially determined by Freud, but had not been greatly elaborated upon: he considered that it may be a hurdle to psychotherapeutic success first. However, countertransference enables the therapist to raised understand the partnership and enables higher control over their own feelings. Naturally, the therapist is a human being with past experiences and psychological perspectives and therefore brings a certain amount of those exposures to the partnership. Establishing the way the patient may be attempting to elicit reactions from the therapist, is one of the key top features of countertransference understanding.

The goal of this intervention is to determine the underlying known reasons for the transference also to abut those inappropriate replies with a reaction that is suitable to the proposed therapeutic dynamic i. e. the actual situation. It is important to note that although it can be an important process, and underlies a sizable degree of psychoanalytical theory, it is not an essential part of 'treating' the individual. It should certainly not be forcibly launched into a romantic relationship. Rather transference should be invited within the analytical process and then gradually disassembled through interpretation.

The second model is the reparative romance, which adopts a contrasting approach to the quality of patient issues and concerns. The foundation of this strategy is that the therapist intentionally aims to correct or repair a parental relationship or action when there is certainly evidence for misuse, deficiencies or over-protection in the initial parenting. Those elements that have been absent for the reason that initial parental relationship are given by the psychotherapist so that they can compensate for the previous actions. Another term because of this model is the developmentally needed romance, which can be an accurate explanation in a whole lot of circumstances, as there is a perceived need in today's that was without childhood. Typically, it could be detected that the adult (patient) regresses i. e. reverts to a form of thinking more suited to earlier stages of their development, when such a need comes up, determining the role of the therapist as the mediator of the regression through reparation.

A variety of popular psychoanalysts have implemented this process in response to parents who have been mistreated or under-loved as children. Sechehaye and Ferenczi both lengthened the parameters of this relationship to the point that they would take the patient on outings, or let them live aware of them for extended periods of time. Certainly, a vibrant approach is adopted by many psychotherapists who utilise this model, though perhaps not to the same extremes.

Comparison of models

Having explored the intricacies of the two models, there are a few noticeable differences which are immediately identifiable. Firstly, the approach to the individual is quite different: where as in the transference/ countertransference model there's a basic consensus that the therapist should remain impartial in their replies, quite contrary holds true in the reparative model. A good example of this is illustrated by Clarkson, who uses the therapist response to the patient-posed question 'How are you?', usually the first notable interaction in a therapeutic session, as a way of contrasting these models. For example, the therapist would either respond silently or by querying the primary reasons for wishing to know why the individual can be involved with the therapists well being in the transference model. Within the reparative model, the therapist will bottom part their response on the perceived developmental need of the individual: if indeed they were encouraged never to demonstrate their good care towards their parent as a kid, the therapist might reply and give thanks to them for his or her fascination with their well-being.

The response to this simple question is a microcosm for succeeding relationships in the program, or sessions, with the general idea that in the reparative process an intentionally organized set of responses are offered to fulfill the developmental need, while in the transference method an opposing view emerges which does not conform to the child-parent relationship which may be desired by the patient. Therefore it can be said that the role of the therapist is in contrast: one method considers the therapist as a parental shape (or substitute in extreme instances), and the other views the therapist performing as an 'adult' rather than 'mother or father'. Or put another way, that the therapist will not enjoy the child-parent conversation desired by the individual. Indeed, this might seem to represent an elevated level of dynamism with respect to the therapist in the reparative model.

The approach followed by the therapist is very different in these models, which perhaps implies that there is a difference in planned therapeutic outcome or 'end-point'. Obviously, as mentioned before, there is data to suggest that it is the therapeutic relationship itself which establishes the effectiveness of intervention, rather than the model used, however it is clear that the 'means to the end' are very different in these examples. Firstly, in the transference model there can be an emphasis on the analytical vitality of the process, somewhat than any idea of identified 'stop'. If performed correctly, exposure of the transferences and their underlying causes lead to research and remedy. However, when one considers the methods utilised in the reparative model it could seem that the goal of treatment is to elicit change immediately. Therefore, it can be said, that the reparative model, alternatively than behaving as an analytical tool per se, functions as a pivot for change by addressing the inadequacies/deficiencies in the patient's past. Interestingly, this boosts another distinction, where it is suggested that the transference romantic relationship is 'past-focused' and the developmentally needed marriage 'future-focused'. Plainly, this can be an over-simplification, but essentially when a patient goes through reparation there is an focus on future change which compensates for previous occurrences.

Despite these dissimilarities, there are distinct features within both models. For instance, the nature of transference is a core component of the reparative model as there is a re-living of the past in today's. Within the reparative model the repetition of days gone by is altered in such a way so that traumatic incidents aren't constantly revisited, somewhat by modifying an aspect of days gone by (i. e. the therapist adopting a parental role) the knowledge serves as a system for treatment. However, it could be argued that the reparative way represents nothing but an idealised version of the transference marriage, hence too little recognition of the model in a few important psychotherapy works. Therefore the degree of similarity can change the reparative strategy into an expansion of transference. Modern day thought still retains a distinction between the models however, based on the marked dissimilarities as discussed previously.


In conclusion, the therapeutic romance is a vital area of the therapeutic process. A number of different approaches can be found to the therapist, which help contrasting connections with the individual, unique to their issues. In transference/countertransference your client imposes aspects of their child years onto the healing marriage, forcing the therapist to adjust their responses in order to challenge this behaviour. Once the behaviour has been determined then further examination will enable image resolution. This contrasts to the reparative marriage model, in which the therapist seeks to improve parental inadequacies or overprotectiveness by altering their responses appropriately. The client will project certain behaviours and thoughts onto the restorative romance and the therapist must guide this regression, to be able to assist in future behavioural change. In spite of these variances, it is clear that whichever model is utilised, provided it is done effectively, the outcomes should not are different greatly. The increased responsibility and effort on behalf of the therapist in the reparative model, may however limit its use in practice.

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