Counseling and Psychotherapy. Группа авторов
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data demonstrated that counseling supervisees attended to the quality of the supervision relationship and appreciated supervisors who were clear and balanced and who relationally connected with supervisees.
Limitations
Unlike manualized treatments, RCT is a counseling theory and worldview about clients’ and counselors’ relational worlds, power in social contexts, and nuanced interpersonal connections. Although the BRCTM showed great promise for guidelines and counseling processes that followed RCT principles, there is a need for more outcome and comparative studies to evaluate the effectiveness of RCT-based interventions. Nevertheless, research undoubtedly shows that the counseling relationship, creative adaptations of evidence-based practices, and counselor relational abilities are the most robust predictors of client change (Wampold, 2015). With this in mind, RCT provides a road map for effective relationships that honor and respect clients from diverse backgrounds.
THE CASE OF CLARITA: AN RCT APPROACH
From an RCT perspective, we can see how Clarita has historically thrived in her relationships and at work. She has been a leader within her family and a role model for others in her hometown. Her parents trusted her with the care of her siblings when she was an adolescent, and she felt successful in her life. Attending college and branching out into a new cultural context away from Puerto Rico was exciting for her, and she married a man outside her social context, which was disappointing to those around her. And yet Clarita forged forward, moving back to Puerto Rico and cocreating a life with her husband and children. Unfortunately, she experienced abuse in her marriage and ultimately divorced. She carries full responsibility for caring for her two children and feels lacking in energy or support. She does have friends, which is important, although she often distances from them and feels depressed. Afraid of entering into new romantic relationships, her nocturnal dreams are debilitating, and she is exhausted. She feels responsible for ruining her life and the lives of others. Clarita is clearly experiencing what RCT would describe as condemned isolation.
Goal 1: Fostering Authenticity and Vulnerability
Clarita is a member of at least two marginalized groups—being a woman and being Puerto Rican. One could also include being divorced as a third marginalized group, particularly within the context of her family and early religious affiliation. Using an RCT framework, a counselor would begin work with Clarita by bringing the counselor’s authenticity and supporting Clarita’s apparent vulnerability.
Goal 2: Recognizing and Conceptualizing Relational and Controlling Images Through Mutual Empathy
It would be important for the counselor to consider Clarita’s cultural contexts and the ways these affect her now. When she married, Clarita’s Puerto Rican roots merged with her husband’s southern culture. In counseling, Clarita could explore the intersection of these two cultures and any associated controlling images she carried. From the case description, it seems that Clarita feels she is not good enough in many areas. Being aware of any controlling images and recognizing the ways these operate in her life could give voice to Clarita’s struggles with self-worth and sense of alienation.
The counselor would recognize the impact of Clarita’s disconnections and controlling and relational images, and the counselor would open up to experiencing Clarita’s pain. As they work together, they would explore the relationships in Clarita’s life and the sense of powerlessness that Clarita currently feels. The counselor would open themself to Clarita’s story and communicate that impact to her. This foundational expression of mutual empathy begins the process of Clarita’s grief work and the reworking of her relational and controlling images. It would also support the necessary work of increasing self-empathy and self-compassion.
Goal 3: Conceptualizing Connections, Disconnections, and Strategies for Survival
According to RCT, people are all born with an innate desire to form and sustain connections, and yet disconnections are a natural part of life. Whether disconnections are acute, chronic, or traumatic, despite people’s desire for connection, they may behave in ways that keep them out of the relationships they so badly want. Clarita is experiencing depression, chronic disconnection, and acute loneliness. She feels unworthy and hopeless. Her love for her children sustains her, and she feels tremendous guilt over her inability to care for them adequately.
The counselor would need to respect Clarita’s strategies for disconnection as they arise. She would need to remain humble in knowing that Clarita needs the time and has the wisdom to move at a pace that makes sense to her. During those times when Clarita is unable to sustain connection with the counselor, the counselor would honor that strategy, recognizing it as one born for survival.
Goal 4: Creating Mutuality and Connection in Counseling to Foster the Five Good Things
Clarita is disconnected from her family and their love and support. She is disconnected from her familiar home, and she feels lonely and overwhelmed. Counseling would involve authentically being with Clarita in her pain and cocreating a space where she could experience the five good things. This would involve creating a counseling climate in which Clarita can feel energy from the connection with the counselor, clarity in their work together, and an increased sense of self-worth because she feels seen and valued. Over time, the hope would be that Clarita would feel a desire to increase connections with others and to be moved to act (Jordan, 2018).
Working from an RCT perspective would not preclude asking questions about suicide and developing a collaborative safety plan. Using relational ethics as a framework, the counselor and Clarita would determine what is in her best interest and collaboratively make decisions about suicide prevention as needed. If Clarita were to be in danger, the counselor would take the time needed to help Clarita find safety and would stay connected to her throughout the process.
Summary
Through this case study, one can see how the crises and traumas in Clarita’s life are relationally situated. The hope for healing is also relationally situated. Clarita experienced the central relational paradox when she withdrew from relationships yet longed for them. Movement for Clarita may come by resolving the paradox through mutual empathy, supported vulnerability, and the emergence of a growth-fostering therapeutic relationship. An RCT-focused counselor works from a place of sociocultural humility and awareness of the power differential inherent in the therapeutic relationship. The science of relational neurobiology informs Clarita’s counselor that a mutually empathic relationship will enliven the neural pathways of healing, which will open up possibilities for more complex relational connections (Banks, 2015).
REFERENCES
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2 American Counseling Association. (2014). ACA code of ethics. https://www.counseling.org/resources/aca-code-of-ethics.pdf
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