Facilitation: Therapeutic Alliance

Developing an effective therapeutic relationship between the practitioner and the client, often referred to as therapeutic alliance, is a critical component to effective facilitation and successful treatment. Adventure therapy (AT) has the potential to enhance the development of a positive therapeutic relationship. These interventions support not only the alliance with the practitioner, but also development of alliance among other participants in the treatment process (Newes, 2000; Gass, 1993; Gerstein, 1992; Itin, 1994; Ringer, 1994).

There are multiple beliefs among practitioners as to why this is the case. Some ideas include:

  • Shared experience in the treatment process. This highlights the collaboration between practitioner and client in developing treatment objectives and solutions(Alvarez & Stauffer, 2001;Gilbert, Gilsdorf & Ringer, 2004; Newes, 2000; Lung, Stauffer & Alvarez, 2008)
  • Potential for dynamic modeling on the part of the practitioner in areas such as responding to challenges, giving and receiving feedback, coping with failure, and having fun (Lung, Stauffer & Alvarez, 2008;Newes, 2000; Luckner & Nadler, 1992; Nadler, 1993).
  • Focus on the here and now engagement of the treatment process. Intervention can occur at the point of performance, providing immediate feedback and support related to emergent treatment issues (Gass, 1993, 1999; Itin, 1998; Priest & Gass, 1999).
  • Opportunity to connect behavior to clients' inner process, emotional response, behavioral response, current coping strategies, and cognitive response. This reflects a particular theoretical perspective that says it is valuable to link behavior and inner process (Gass, 1999; Itin, 1998; Newes, 2000; Trace, 2004).
  • Opportunity for clients to experience behavioral success and to attribute this to the therapeutic relationship.
  • Opportunities for clients to exert their power by making choices and experiencing natural consequences. This changes the role of the practitioner, as practitioners are removed from a place of doling out consequences (Gass, 1999; Newes, 2000; Priest & Gass, 1999).

Establishing Therapeutic Alliance

Practitioners can use several approaches to build therapeutic alliance with clients. Standard relationship building skills are employed throughout the process, but utilizing aspects of AT to enhance this development is useful. The following suggestions are provided:

  • Engage in activities with the client, when appropriate (Lung, Stauffer & Alvarez, 2008).
  • Build rapport through listening, responding appropriately, assuming a non-judgmental approach, and meeting clients where they are in terms of the treatment process (Alvarez & Stauffer, 2001; Lung, Stauffer & Alvarez, 2008; Schoel & Maizell, 2002).
  • Respect client choice and use client choices intentionally to support client's progress in treatment (Cole, Erdman & Rothblum, 1994; Davis-Berman & Berman, 1994; Mitten, 1994).
  • Attempt to connect with client from the moment they arrive. Give client an appropriate welcome and thanks for attendance.
  • Allow client to manage their own level of self-disclosure. Encourage reflection and introspection but don't demand it. As the relationship develops, it is appropriate to challenge and encourage more in this area if the practitioner is trained (Gilbert, Gilsdorf & Ringer, 2004; Rollnick & Miller, 1995).
  • Make observations that demonstrate our understanding of something about the client (Mitten, 1995).
  • Choose activities that foster reliance and trust in the practitioner.
  • Model and encourage healthy strategies during the conflict (Lung, Stauffer & Alvarez, 2008;Newes, 2000; Luckner & Nadler, 1992; Nadler, 1993).
  • Allow practitioner to be human and express genuine emotion intentionally and appropriately. For example, if a practitioner makes a mistake and demonstrates accountability, a client is likely to respect that practitioner more and perhaps be willing to do so as well (Gilbert, Gilsdorf & Ringer, 2004; Newes, 2000).
  • Maintain appropriate level of self-disclosure. Respect client boundaries (Davis-Berman & Berman, 1994; Newes, 2000).