Q.Describe the nature and scope of psychotherapy. Highlight the importance of therapeutic relationship in psychotherapy.

Psychotherapy is a voluntary, contractual relationship between a client seeking help and a trained therapist, aimed at solving psychological problems, changing maladaptive behaviour, reducing distress and helping the client adjust better. Its scope covers goals like reinforcing the client's resolve, easing emotional pressure, changing thinking patterns and improving relationships. It is scientific (systematic application of principles), requires trained practitioners, focuses on the client, and works through interaction between the two people. The therapeutic relationship (alliance) is central: a confidential, trusting bond in which the therapist is accepting, empathic, genuine and warm, showing unconditional positive regard. This alliance is the very vehicle of change.

Nature of psychotherapy

Psychotherapy is a voluntary relationship between the one seeking treatment (the client) and the one who treats (the therapist). Its purpose is to help the client solve the psychological problems being faced. The relationship is deliberately built to be conducive to trust, so that the client can discuss problems freely. Broadly, psychotherapies aim to change maladaptive behaviours, decrease the sense of personal distress, and help the client adapt better to her/his environment. Inadequate marital, occupational and social adjustment may also call for major changes in a person's personal environment.

All psychotherapeutic approaches share certain characteristics:

• There is systematic application of principles underlying the different theories of therapy.
• Only persons who have received practical training under expert supervision can practise psychotherapy — not everybody, since an untrained person may unintentionally cause more harm than good.
• The situation involves a therapist and a client who seeks and receives help for emotional problems; the client is the focus of attention.
• The interaction of these two persons results in the formation of the therapeutic relationship — a confidential, interpersonal and dynamic relationship that is central to any therapy and is the vehicle for change.

Scope — the goals of psychotherapy

Psychotherapies aim at a few or all of these goals: reinforcing the client's resolve for betterment; lessening emotional pressure; unfolding the potential for positive growth; modifying habits; changing thinking patterns; increasing self-awareness; improving interpersonal relations and communication; facilitating decision-making; becoming aware of one's choices in life; and relating to one's social environment in a more creative and self-aware manner.

The therapeutic relationship (alliance) and its importance

The special relationship between the client and therapist is called the therapeutic relationship or alliance. It is neither a passing acquaintance nor a permanent bond. It has two major components:

• Contractual nature — two willing individuals enter a partnership aimed at helping the client overcome problems.
• Limited duration — it lasts until the client can deal with problems and take control of her/his own life.

Why the relationship matters:

• It is a trusting and confiding relationship; the high level of trust lets the client unburden and confide personal problems.
• The therapist is accepting, empathic, genuine and warm, and does not judge the client — continuing to show the same positive feelings even if the client confides 'wrong' things. This is unconditional positive regard.
• Empathy — understanding the plight of another and feeling like the other person, seeing things from her/his perspective ("putting oneself in the other's shoes") — is different from mere sympathy or cold intellectual understanding. Empathy enriches the relationship and transforms it into a healing relationship.
• The alliance requires strict confidentiality; the therapist must not exploit the client's trust and must keep the relationship professional.