The Rigid Therapeutic Relationship

While overly flexible boundaries between the therapist and the client seems to be undesired, a therapeutic relationship should not be rigid as well. Guidelines are developed to create boundaries between the therapist and the client (Lazarus, 1994). However, when the guidelines are followed too strictly by the therapist, it creates rigid boundaries between the therapist and client. It can result in poor and rigid therapeutic relationship, which lacks authenticity and sensitivity (Davidson, 2005). The rigid therapeutic relationship leads to an inaccurate assessment and poor working alliance (Eaton et al., 1993, as cited by Ackerman & Hilsenroth, 2001; Iwakabe, Rogan, & Stalikas, 2000). Working alliance involves the planning of tasks and the goals

Isolation of patient, lack of agreement on goals, lack of willingness to understand client, and avoidance of client will occur when the therapeutic relationship is rigid (Pilette et al., 1995). This can lead to clients decreasing willingness for trust and rapport and having feelings of low self-worth, which result in insufficient help for the client (Davidson, 2005). Shattell, Starr, and Thomas (2007) found that mental healthcare service users want their mental healthcare providers to be understanding, honest, genuine and knowledgeable. Similarly, Gilburt, Rose, and Slade (2008) found that that effective communication, sensitivity and the absence of coercion are importance factors for good therapeutic relationship. Moreover, client’s perception of therapist’s flexibility is also important to ensure client’s satisfaction of the therapy (Reis et al., 2008). These findings reflect the characteristics of flexible therapeutic relationship to create good working alliance and suggest that rigid therapeutic relationship is not desired by clients. To further support this, Plexico, Manning, and DiLollo (2010) researched on effective and ineffective therapeutic relationship between therapists and clients with speech stuttering. The participants were asked to describe the experience with their therapists who effectively changed their stuttering and the experience with those who were unable to change their stuttering. Effective therapists were described as more competent because the therapists could show their understanding of the clients and willing to listen to the clients. On the other hand, ineffective therapists were described as the lack of competence due to the lack of understanding and willingness to listen. Additionally, a meta-analysis of 49 studies by Karver et al. (2006) found that therapeutic relationship has an important role in treatment process and outcome for child and adolescent.