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Chapter 2 - CHAPTER 2 Contexts of Effective Treatment...

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CHAPTER 2 Contexts of Effective Treatment Characteristics of Successful Clients Role of the Client Client Diversity The Therapeutic Alliance Essential Conditions of Effective Therapeutic Relationships Important Clinician Skills, Training, and Experience Personal and Professional Characteristics of the Effective Clinician The Impact of Setting on the Treatment Process Ethical Guidelines and Standards Skill Development and Exercises Role Induction Exercises in Role Induction Building a Positive Therapeutic Alliance Exercises in Building a Positive Therapeutic Alliance Exercises in Self-Assessment Summary As you learned in chapter 1 , skillful application of appropriate treatment approaches and intervention strategies is a requisite of effective treatment. However, many other factors also have a strong relationship to treatment outcome. This chapter focuses on many of those factors, including the following: •Characteristics of successful clients •The therapeutic alliance •Essential conditions of effective therapeutic relationships •The training, skills, and experience of effective clinicians •Personal and professional characteristics of the clinician •Treatment setting •Ethical guidelines and standards The final section of this chapter focuses on self-assessment and the important clinical skills of role induction and developing a positive therapeutic alliance. CHARACTERISTICS OF SUCCESSFUL CLIENTS Both the personal qualities and the backgrounds of clients help determine the success of their treatment. Clinicians can maximize the positive influence of these factors in three ways: •First, they need to be aware of those client characteristics that are likely to correlate with therapeutic outcome. •Second, they need an in-depth understanding of each client, paying attention to that person’s history; family composition and interactions; culture, religion and spirituality; relationships; socioeconomic status; physical health; abilities; and other relevant attributes. This understanding helps clinicians view the world through their clients’ eyes and determine interventions that are likely to be well received and effective. •Finally, clinicians can instill or develop in clients those qualities that are typically associated with a positive therapeutic outcome—in a sense, socializing the person to treatment (Walborn, 1996 ). This process, called role induction, will be discussed later in this chapter.
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The client’s personality understandably plays a significant role in determining treatment outcome (Asay & Lambert, 1999 ). The following client characteristics bear a particularly strong relationship to outcome: Maturity People whose lives are reasonably well-organized and who are responsible and knowledgeable about the world seem better able to engage in productive treatment than people who lack these characteristics (Asay & Lambert, 1999 ). Clients who are mature also are more likely to make a commitment to treatment and to follow through on agreed upon steps to help themselves.
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