As therapy methods progress, so does the positioning of the therapist. But for many therapists, the role of hierarchy still holds firm. Does it make sense in today’s shorter-term, proactive climate of treatment?
Its time to take another look at that stance in light of my clinical model that bridges coaching and therapy.
The Case for Hierarchy
The therapist-client (or therapist-patient) relationship is traditionally a hierarchical one, for several good reasons. The issues that bring people to a therapist are often entrenched and complex, and clients may present with complicated diagnoses and layers of issues that cloud important details. Therapy clients are often in treatment to address serious mental health problems. They come to us hurt, vulnerable, traumatized, addicted, or in crisis; as a result, sometimes the therapist needs to make a hard call to protect the life or well-being of the client, or to set a course of immediate action.
The hierarchy also encourages the emergence of transference, one of the traditional methods some therapists use to help clients access unconscious material. Therapists take their work seriously, and most engage in years of additional training, far beyond their academic education, bolstered by close supervision to enhance clinical quality assurance.
Leveling the Playing Field
But contrast the purpose of therapy to that of coaching.
For a coach, it’s less about what the coach knows (via academic education, previous expertise, or career experience) and more about the coach’s skill and training in the competencies of coaching, to elicit what the client knows. coaching clients are by definition, moderately to well-functioning. They sign up for coaching, say life coaching, because they want to make changes quickly.
Action is the hallmark of all coaching. The coach is essentially a facilitator. In a pure coaching relationship, the coach considers that clients hold the seeds of their solutions and the answer to their own problems. The coach is a partner in change.
Collaboration: The Great Leveler
The collaborative position used in coaching is a powerful tool of behavioral change. It reduces the friction of hierarchy and projection, and as such can promote faster behavioral change.
You may have experienced this kind of collaboration with a personal coach who runs alongside you as you jog around a track. Or perhaps you had a tutor who sat next to you as you tired to solve a math problem, rubbing shoulders and sharing his calculations when you got stuck, to help you find the key to unlock the formula. Having a partner helps a person to take action.
Can this collaborative position be used in therapy? I suggest a qualified yes.
Heighten Collaboration in Therapy
Therapists will never be partnering with clients in the same way that coaches do. We have our ethics, licensure, purpose and practices that hold us to therapy standards. We need to protect and impose more structure and boundaries on our professional relationships than coaches tend to require. But we can hold those boundaries and shift a bit toward collaboration and partnership, in service of promoting behavioral change.
We can reduce the friction of projection and transference.
To further the coaching approach elements of therapeutic partnership, the therapist must herself relate in a proactive way that signals authenticity. To do this, you need to be a presence in the room, not a neutral, blank slate. You need to be “real”—to talk normally, rather than with stilted or carefully worded interpretations.
I urge therapists using my method to avoid therapeutic jargon. Be expressive. Allow some normal reactions to show on your face, as you would in outside relationships.
Let yourself be seen as both an expert and a person. Communicate curiosity. Show real interest. Have a sense of humor. Shift to the following ways of relating to clients, so that as a clinician you can be:
- Natural (versus neutral)
- Proactive (versus nondirective)
- Supportive (versus diagnostic)
- Curious (versus quiet)
- Responsive (versus deflecting)
- Questioning (versus interpreting)
Hope this article helps you to find new ways to build rapport and relate with collaboration.
To read more, see Chapter 4: “Creating Therapist-Client Collaboration” in my book: Therapy with a Coaching Edge: Partnership, Action and Possibility in Every Session.”