14. 协作工作

协作工作

在阅读了前面的章节后，我们期望您会同意，任何咨询过程的核心目标是让被帮助的人发生改变。人们通常在情绪困扰的状态下来看咨询师，期望通过咨询找到解决问题的方法并感觉更好，换句话说，他们期望改变。这种改变可能涉及他们的情感感受和/或思维的变化，使他们感觉更好，或者可能涉及他们行为的变化，使他们更有能力有效地应对日常生活中的问题。

影响积极咨询结果的因素是什么？

读者，您以前是否考虑过是什么使参与咨询过程的人能够改变？我们邀请您思考一下可能对改变过程有贡献的因素。

在第二章中，我们讨论了一些咨询师和咨询关系的可取属性。现在我们有一些问题要问：

咨询师的个人特质是否足以引起改变？
咨询关系的特质是否足以引起改变？
是否是使用特定的咨询技巧导致了改变？
是咨询师有效地促进了寻求帮助者的改变，还是寻求帮助者自己产生了改变？

如果您在一个培训小组中，您可能希望在继续阅读之前与您的小组讨论这些问题。显然，能够回答这些问题有助于我们更充分地理解咨询如何能够使一个人改变。

关于咨询有效性的研究

卡尔·罗杰斯是最早通过分析咨询对话和咨询关系的特点来研究咨询实践的人之一。他在20世纪50年代开始这项工作，关于咨询关系的本质和反思性倾听技巧的使用，他的贡献仍然非常重要。

自罗杰斯时代以来，大量研究已经开展了关于咨询过程的特点和咨询的有效性。在这个领域的文献中有许多贡献者，包括弗兰克和弗兰克（1991）、霍瓦斯（2001）和万普尔德和伊梅尔（2015）。大多数作者都认为，研究表明共同因素和治疗联盟对寻求咨询的人产生积极结果的影响。

共同因素

在前一章中，我们考虑了多种不同的咨询方法。因此，您可能会问，“哪种咨询方法最有效？” 一些作者认为，当由熟练的咨询师按照特定的咨询模式进行时，所有方法几乎同样有效，其有效性取决于一些对所有方法都通用的因素。此外，关于咨询有效性的研究一致发现，有多个对所有咨询方法都有积极影响的因素，这些因素对寻求咨询者的体验和咨询的有效性有正面影响（Wampold & Imel, 2015）。

不同作者以不同的方式描述了已被确定为有帮助的共同因素。这些因素包括：

咨询师的个人品质
求助者与咨询师之间的关系
求助者信任咨询师能够提供帮助
求助者的个人因素
希望和乐观的影响

咨询师和咨询关系的品质

咨询师的期望个人品质以及求助者与咨询师之间的关系在第2章中进行了讨论。然而，近年来被称为治疗联盟的另一种关系视角将在本章后面进行介绍。

被帮助者信任咨询师能够提供帮助

我们可能会问这样一个问题：“咨询师如何获得求助者的信任，使他们相信咨询师能够提供帮助？”在继续阅读之前，你可能希望先思考一下这个问题。

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咨询师和个人品质及咨询关系

虽然我们认为咨询师具备必要的个人品质并与求助者建立关系是有帮助的，正如第2章所述，但这还不够。为了使咨询关系充分发挥作用，咨询师需要熟练掌握咨询技能，并在咨询过程中给予充分的关注。当咨询师在这方面表现出色时，求助者可能会对与咨询师合作以实现其目标充满信心。咨询师在选择和运用个体微观技能时需要具备技巧。此外，咨询师需要理解和擅长促进整个咨询过程，不仅在每个单独的会话中，而且在整个一系列会话中。咨询过程将取决于咨询师偏好的特定咨询模型。这可能是前一章列出的某个模型，也可能是第15章和第16章中描述的整合咨询方法，该方法结合了多种模型的策略。

求助者的个人因素

早些时候我们提出了一个问题：“是咨询师在促进求助者的变化中起作用，还是求助者自己产生了变化？” 我们认为，大多数人内在都具有韧性和自我治愈的能力，这与罗杰斯的观点相符，即每个人都有能力找到自己的解决方案。那么，咨询师做了什么？咨询师充当促进者的角色，与求助者一起工作，促进、放大和扩展变化的可能性（Bohart & Tallman, 1996）。

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希望和乐观的影响

当禅师精神病学家霍华德·卡特勒（禅师与卡特勒，2000）交谈时，他们一致认为，对于一个人来说，要改变态度，首先必须意识到这是可能的，必须愿意这样做，然后......必须实施这些改变。如果我们接受这一点是正确的，那么作为咨询师，帮助那些寻求我们帮助的人拥有希望和预期，认为变化是可能的，显然是有用的。

希望和乐观是大多数人应对日常生活时不同程度使用的工具。像其他人一样，我们有时也会陷入消极思维，变得悲观。你也是如此吗？我们发现，消极的心态让我们感到不舒服，因此当我们意识到自己的消极时，我们会受到激励去改变态度，变得更加积极和充满希望。

一个有用的问题是“我们如何利用咨询来激发希望？”弗兰克和弗兰克（1991）建议，一个充满希望的咨询师可以为寻求帮助的人带来希望和乐观的感觉。他们还建议，咨询师对求助者所面临问题的解释可以增强他们对未来希望的感觉。鉴于此，我们得出结论，希望在某种程度上是传染性的，如果咨询师对求助者的未来结果持乐观态度，那么求助者很可能会开始感到希望。

治疗联盟

如前所述，罗杰斯非常重视咨询关系的价值。他认为咨询关系本身就是治疗性的（Rogers, 1961）。自罗杰斯的研究以来，治疗联盟的概念被引入并进行了研究。研究表明，治疗联盟与咨询结果之间存在强烈的正相关关系（Hovarth, 2001）。

治疗联盟在咨询结果中的重要性最初是由Bordin（1975）提出的。他建议，首先需要在寻求帮助者和咨询师之间建立联系，包括信任、接受和信心的发展，此外，寻求帮助者和咨询师之间应就构成咨询过程的行为、干预和认知达成一致（Bambling & King, 2001）。因此，治疗联盟的概念表明，除了咨询师和咨询关系的特定属性外，协作的治疗关系对促进改变做出了重要贡献。

我们认为，为了建立良好的治疗联盟，咨询师在咨询开始时不需要以结构化或正式的方式与寻求帮助者协商，以达成关于咨询过程和目标的协议。然而，许多咨询师认为这一点很重要，因此你需要自己决定什么是适当的。

在我们看来，有效的治疗联盟扩展了寻求帮助者和咨询师之间的关系，使他们能够在整个咨询过程中协同工作。如果这一点成功实现，寻求帮助者前来咨询的原因将会被发现，咨询过程的目的和目标将在咨询师与其合作的过程中变得清晰。此外，通过合作，解决方案将会被找到。

建立治疗联盟确保寻求帮助者被视为有价值的人，如第二章所述，并且他们被认为有能力朝着发现解决方案的方向努力。然而，咨询师并不是旁观者，而是与他们在工作关系中合作。这使咨询师能够与他们建立尊重的伙伴关系，探索新的解决问题的方法和找到解决方案。在这种工作关系中，寻求帮助者带来了他们天生的技能、能力和资源，而咨询师通过提供他们的咨询专业知识和技能，以及作为平等者分享他们的想法，与他们合作。这种合作是在寻求帮助者充分了解和理解的情况下进行的，使他们意识到自己和咨询师的角色。

在展示对个人能力的尊重时进行协作

有趣的是，一些理论模型比其他模型更强调咨询师与求助者之间的协作。在以人为中心的咨询中，非常重视求助者从自身资源中寻找解决方案的能力。咨询师是一个促进者，促进一个过程，使个体能够利用自己的内在过程来解决问题并找到解决方案。其他方法，如叙事疗法和解决方案聚焦疗法，强调咨询师需要与个体作为平等伙伴共同寻找解决方案，同时尊重个体的能力。在这些方法中，咨询师积极使用问题来提出和探讨可能的替代解决方案。因此，在咨询模型之间存在重点差异。一些咨询师认为，我们主要需要促进一个依赖个体发现自身解决方案的能力的过程，而另一些咨询师则认为，尽管尊重个体的能力，但也需要关注参与协作过程以发现解决方案。显然，您需要自己决定什么最适合您。

如果要建立有用的咨询关系，咨询师必须尊重和重视求助者作为一个有能力的人。对于咨询师来说，尊重他们的能力并持有他们具备处理困扰问题、找到解决问题的方法、做出改变行为的决策并将所需改变付诸行动所需的内在资源的信念是非常重要的。有些人来咨询时相信他们没有内在资源和能力去做这些事情。他们的期望是咨询师将通过为他们找到解决方案来帮助他们。通常这样的人缺乏自我效能感和个人自信，这些是他们需要的，以便能够自立。如果咨询师坚持认为他们具备自立所需的内在力量和能力，那么咨询师将能够使他们接触自己的优势和资源，成为自立的人，做出适合自己的决策，从而提高自尊。在促进这一过程中，整合型咨询师作为协作伙伴，可能会引入新想法，这些想法可以与个体一起探讨。如果这样做时充满敏感性和尊重，个体将继续受到鼓励去探索自己的问题，做出自己的决策，并找到适合自己的解决方案。此外，咨询对话可以通过咨询师引入额外的想法而丰富。在这种情况下，个体可能会相信咨询师足够关心，愿意作为平等伙伴参与问题的探索和解决方案的寻找，从而增强关系；咨询师积极参与一个有目的的过程，与个体作为平等伙伴协作，贡献自己的技能和特质到咨询对话中。在这一协作过程中，咨询师展示了对个体能力和能力的尊重，因为他们探索困扰的问题并做出适合自己的个人决策。

在本章开头，我们列出了与“哪些因素促进积极的咨询结果？”相关的一些问题。我们希望您会同意，我们已经为这个问题提供了一些答案，同时让您自己决定在咨询实践中您认为什么是最好的。

学习总结

研究表明，一些对所有咨询方法都通用的因素促进了有效的咨询结果。寻求帮助的人需要信任咨询师能够提供帮助。咨询师是一个促进者，帮助个体利用自己的自然资源来实现改变。治疗联盟涉及使用协作的工作关系。通过协作，咨询师能够通过与个体作为平等伙伴互动，并将不同的技能和特质带入咨询对话中来展示尊重。

参考文献和进一步阅读：

拉姆布林格(Bambling, M.)和金(King, R.)2001年，《临床实践中的治疗联盟》，《澳大利亚心理治疗》，第8卷第1期，11月。

伯托利诺(Bertolino, B.)和奥哈伦(O’Hanlon, B.)2002年，《合作型、基于能力的咨询与治疗》，艾伦与贝肯出版公司，波士顿。

博哈特(Bohart, A.C.)和塔尔曼(Tallman, K.)，《积极的客户：治疗即自助》，《人本主义心理学杂志》，36: 7-30。

博尔丁(Bordin, E.S.)1975年，《工作联盟：心理治疗的一般理论基础》，在华盛顿特区社会心理治疗研究协会会议上发表。

禅师(Zindel, Z.)与卡特勒(Cutler, H.C.)2000年，《幸福的艺术：实践手册》(音频磁带)，西蒙与舒斯特出版公司，纽约。

1)赖登(Ryden, W.)2009年，《作为整合框架的治疗联盟》，载于W.赖登与A.里夫斯编著，《行动中的咨询关键问题》(第2版)，SAGE出版公司，伦敦，第1-18页。

弗兰克(Frank, J.D.)与弗兰克(Frank, J.B.)1991年，《说服与治疗：心理治疗的比较研究》(第3版)，约翰斯霍普金斯大学出版社，巴尔的摩。

霍瓦特(Horvath, A.O.)2001年，《治疗联盟：概念、研究与培训》，《澳大利亚心理学家》，36:170-6。

罗杰斯(Rogers, C.R.)1961年，《成为自己》，康斯特布尔出版公司，伦敦。瓦姆波尔德(Wampold, B.E.)和伊梅尔(Imel, Z.E.)2015年出版了《伟大的心理治疗辩论：心理治疗为何有效》一书，由Routledge出版社在纽约出版。

本章知识点阐述

进一步阐述知识点

协作工作

核心目标：任何咨询过程的核心目标是让被帮助的人发生改变。这种改变可能涉及情感感受、思维或行为的变化，使他们感觉更好，或更有能力应对日常生活中的问题。
期望：人们通常在情绪困扰的状态下来看咨询师，期望通过咨询找到解决问题的方法并感觉更好。

影响积极咨询结果的因素

咨询师的个人品质：咨询师的个人品质，如真诚、同理心和专业能力，对咨询过程的成功至关重要。
咨询关系：咨询师与求助者之间的良好关系是改变的重要基础。信任和尊重是建立这种关系的关键。
求助者的信任：求助者必须信任咨询师能够提供帮助，这是改变的前提条件。
求助者的个人因素：求助者的动机、态度和行为也会影响咨询的效果。
希望和乐观：希望和乐观的态度可以增强求助者的内在动力，促进积极的改变。

关于咨询有效性的研究

早期研究：卡尔·罗杰斯是最早通过分析咨询对话和咨询关系的特点来研究咨询实践的人之一。他的贡献至今仍非常重要。
后续研究：自罗杰斯时代以来，大量研究已经开展了关于咨询过程的特点和咨询的有效性。研究表明，共同因素和治疗联盟对寻求咨询的人产生积极结果的影响。

共同因素

咨询师的个人品质：咨询师的个人品质，如真诚、同理心和专业能力，对咨询过程的成功至关重要。
咨询关系：咨询师与求助者之间的良好关系是改变的重要基础。信任和尊重是建立这种关系的关键。
求助者的信任：求助者必须信任咨询师能够提供帮助，这是改变的前提条件。
求助者的个人因素：求助者的动机、态度和行为也会影响咨询的效果。
希望和乐观：希望和乐观的态度可以增强求助者的内在动力，促进积极的改变。

通过这些内容，本书旨在帮助读者理解咨询过程的核心目标，以及影响咨询效果的各种因素。这些知识不仅提高了咨询师的专业能力，还增强了他们在实际工作中的应用效果。

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进一步阐述知识点

咨询师的期望个人品质

专业素养：咨询师应具备扎实的专业知识和技能，能够有效地帮助求助者解决问题。
真诚与同理心：咨询师应表现出真诚的态度，能够理解并同情求助者的感受。
尊重与接纳：咨询师应尊重求助者的个性和选择，接纳他们的情感和行为。
保密性：咨询师应严格遵守保密原则，保护求助者的隐私。

求助者与咨询师之间的关系

建立信任：信任是咨询关系的基础，咨询师需要通过言行一致、真诚互动等方式建立信任。
沟通与理解：有效的沟通和深刻的理解是建立良好咨询关系的关键。
支持与鼓励：咨询师应提供支持和鼓励，帮助求助者增强自信和解决问题的能力。

治疗联盟

定义：治疗联盟是指咨询师和求助者之间的一种合作关系，强调双方的合作和共同目标。
重要性：治疗联盟对咨询效果具有重要影响，良好的治疗联盟可以增强求助者的参与度和满意度。
建立方法：通过建立信任、有效沟通、共同制定目标等方法来建立和维护治疗联盟。

被帮助者信任咨询师能够提供帮助

专业形象：咨询师应展示专业的形象，包括知识、技能和态度，使求助者相信咨询师有能力帮助他们。
倾听与理解：通过倾听和理解求助者的问题和感受，建立深厚的信任关系。
积极反馈：给予积极的反馈和肯定，增强求助者的信心和动力。
透明与真诚：保持透明和真诚的沟通，让求助者感受到咨询师的真诚和可靠。

希望这些信息能帮助你更好地理解和应用咨询中的信任建立技巧，确保咨询过程的有效性和自然性。 ]

进一步阐述知识点

咨询师的个人品质

必要性：咨询师具备必要的个人品质，如真诚、同理心、尊重和接纳，是建立良好咨询关系的基础。
局限性：仅具备个人品质是不够的，咨询师还需要具备专业技能和对咨询过程的深刻理解。

咨询技能的熟练掌握

微观技能：咨询师需要熟练掌握个体微观技能，如倾听、反馈、提问等，这些技能在具体会话中发挥关键作用。
宏观技能：咨询师需要理解和擅长促进整个咨询过程，包括每个单独会话和整个系列会话的管理。

促进咨询过程

会话管理：咨询师需要在每个单独的会话中管理好时间、内容和情感，确保会话的顺利进行。
系列会话管理：咨询师需要在一系列会话中保持连续性和连贯性，确保咨询目标的实现。

咨询模型的选择

单一模型：咨询师可以选择前一章中列出的某个特定咨询模型，如认知行为疗法、人本主义疗法等。
整合模型：咨询师也可以采用整合咨询方法，结合多种模型的策略，以适应不同求助者的需求。

建立信任和合作

专业形象：咨询师展示专业的形象，包括知识、技能和态度，使求助者相信咨询师有能力帮助他们。
有效沟通：通过有效的沟通和深刻的理解，建立深厚的信任关系。
积极反馈：给予积极的反馈和肯定，增强求助者的信心和动力。
透明与真诚：保持透明和真诚的沟通，让求助者感受到咨询师的真诚和可靠。

希望这些信息能帮助你更好地理解和应用咨询中的技能和过程管理，确保咨询过程的有效性和自然性。

进一步阐述知识点

求助者的内在能力

内在韧性：大多数人都具有内在的韧性和自我治愈的能力，这意味着他们在面对困难和挑战时，有能力自我恢复和成长。
自我解决能力：罗杰斯认为，每个人都有能力找到自己的解决方案，这强调了个体的自主性和自我效能感。

咨询师的角色

促进者：咨询师的主要角色是促进者，而不是解决问题的专家。咨询师通过与求助者合作，帮助他们发现和利用自身的资源和能力。
促进变化：咨询师通过以下方式促进变化：
- 倾听和理解：通过倾听和理解求助者的问题和感受，建立信任关系。
- 提供支持：通过提供情感支持和积极反馈，增强求助者的信心和动力。
- 引导和启发：通过提问和反思，帮助求助者发现新的视角和解决方案。
- 扩展可能性：通过鼓励和激励，帮助求助者看到更多的可能性和机会。

咨询过程中的合作

共同工作：咨询师与求助者共同工作，形成一种合作的关系，而不是单方面的指导。
双向互动：咨询过程是一个双向互动的过程，咨询师和求助者之间的沟通和互动是推动变化的关键。

研究支持

实证研究：Bohart 和 Tallman（1996）的研究表明，咨询师通过促进、放大和扩展变化的可能性，有效地支持了求助者的成长和变化。

希望这些信息能帮助你更好地理解和应用咨询中的个人因素和咨询师的角色，确保咨询过程的有效性和自然性。 ]

进一步阐述知识点

希望和乐观的重要性

应对日常生活：希望和乐观是大多数人应对日常生活时使用的工具，帮助他们在面对挑战时保持积极心态。
消极心态的影响：消极心态会让人感到不舒服，影响情绪和行为，因此及时调整态度非常重要。

咨询师的角色

激发希望：咨询师的一个重要任务是帮助求助者树立希望和预期，认为变化是可能的。
传递希望：咨询师的乐观态度可以传染给求助者，增强他们的希望感。弗兰克和弗兰克（1991）指出，咨询师的希望和乐观可以传递给求助者。

咨询过程中的具体方法

倾听和理解：通过倾听和理解求助者的问题和感受，建立信任关系，为激发希望奠定基础。
积极解释：咨询师对求助者问题的解释应积极正面，帮助他们看到问题的另一面，增强对未来的希望。
设定目标：与求助者共同设定具体可行的目标，帮助他们看到改变的可能性。
提供支持：通过提供情感支持和积极反馈，增强求助者的信心和动力。
引导和启发：通过提问和反思，帮助求助者发现新的视角和解决方案，激发他们的内在动力。

研究支持

实证研究：弗兰克和弗兰克（1991）的研究表明，咨询师的希望和乐观态度对求助者的积极影响是显著的，能够增强他们的希望感和改变的动力。

希望这些信息能帮助你更好地理解和应用咨询中的希望和乐观概念，确保咨询过程的有效性和自然性。 ]

进一步阐述知识点

治疗联盟

定义：治疗联盟是指咨询师和寻求帮助者之间的合作关系，这种关系建立在信任、接受和信心的基础上。
重要性：治疗联盟在咨询结果中的重要性最初由Bordin（1975）提出。研究表明，治疗联盟与咨询结果之间存在强烈的正相关关系（Hovarth, 2001）。

治疗联盟的构成要素

建立联系：首先需要在寻求帮助者和咨询师之间建立联系，包括信任、接受和信心的发展。
达成一致：寻求帮助者和咨询师之间应就构成咨询过程的行为、干预和认知达成一致。
协作关系：有效的治疗联盟扩展了寻求帮助者和咨询师之间的关系，使他们能够在整个咨询过程中协同工作。

咨询师的角色

不是旁观者：咨询师不仅仅是旁观者，而是与寻求帮助者在工作关系中合作。
提供专业知识：咨询师通过提供他们的咨询专业知识和技能，以及作为平等者分享他们的想法，与寻求帮助者合作。

寻求帮助者的角色

带来资源：寻求帮助者带来了他们天生的技能、能力和资源。
参与合作：寻求帮助者积极参与合作，与咨询师一起探索新的解决问题的方法和找到解决方案。

建立治疗联盟的方法

信任和接受：建立信任和接受是建立治疗联盟的基础。
明确目标：咨询师和寻求帮助者应就咨询过程和目标达成一致。
透明沟通：确保寻求帮助者充分了解和理解咨询过程，使他们意识到自己和咨询师的角色。

通过这些内容，本书旨在帮助读者理解治疗联盟在咨询过程中的重要性，以及如何建立和维护有效的治疗联盟。这些知识不仅提高了咨询师的专业能力，还增强了他们在实际工作中的应用效果。

进一步阐述知识点

在展示对个人能力的尊重时进行协作

理论模型的差异：
- 以人为中心的咨询：非常重视求助者从自身资源中寻找解决方案的能力。咨询师是一个促进者，促进一个过程，使个体能够利用自己的内在过程来解决问题并找到解决方案。
- 叙事疗法和解决方案聚焦疗法：强调咨询师需要与个体作为平等伙伴共同寻找解决方案，同时尊重个体的能力。咨询师积极使用问题来提出和探讨可能的替代解决方案。
咨询师的角色：
- 促进者：在以人为中心的咨询中，咨询师主要是一个促进者，帮助个体利用自己的内在资源。
- 平等伙伴：在叙事疗法和解决方案聚焦疗法中，咨询师作为平等伙伴，与个体共同寻找解决方案。
尊重个体的能力：
- 内在资源：咨询师需要尊重个体的能力，相信他们具备处理困扰问题、找到解决问题的方法、做出改变行为的决策并将所需改变付诸行动所需的内在资源。
- 自我效能感：有些人来咨询时缺乏自我效能感和个人自信，咨询师需要帮助他们重建这些能力。
建立有用的咨询关系：
- 尊重和价值：咨询师必须尊重和重视求助者作为一个有能力的人。
- 敏感性和尊重：在提出新想法和探讨解决方案时，咨询师需要充满敏感性和尊重，以鼓励个体探索自己的问题，做出自己的决策，并找到适合自己的解决方案。
咨询对话的丰富性：
- 引入新想法：咨询师可以引入新想法，这些想法可以与个体一起探讨，从而使咨询对话更加丰富。
- 增强关系：个体可能会相信咨询师足够关心，愿意作为平等伙伴参与问题的探索和解决方案的寻找，从而增强咨询关系。
个体的自主性：
- 个人决策：在这一协作过程中，咨询师展示了对个体能力和能力的尊重，帮助他们探索困扰的问题并做出适合自己的个人决策。
- 自尊提升：通过这一过程，个体的自尊和自信心会得到提升。

通过这些内容，本书旨在帮助读者理解在展示对个人能力的尊重时进行协作的重要性，以及如何在咨询实践中实现这一点。这些知识不仅提高了咨询师的专业能力，还增强了他们在实际工作中的应用效果。

进一步阐述知识点

通用因素促进有效咨询结果

信任：
- 信任的重要性：寻求帮助的人需要信任咨询师能够提供帮助。这种信任是建立有效咨询关系的基础。
- 建立信任：咨询师需要通过展示专业能力、真诚和同理心来建立信任。
咨询师的角色：
- 促进者：咨询师的主要角色是促进者，帮助个体利用自己的自然资源来实现改变。
- 支持和引导：咨询师通过支持和引导，帮助个体发现和利用自己的内在资源。
治疗联盟：
- 定义：治疗联盟是指咨询师和个体之间的协作关系。
- 建立联盟：治疗联盟的建立需要双方的信任、接受和合作。咨询师需要与个体建立一种平等的伙伴关系。
协作的重要性：
- 平等伙伴：通过协作，咨询师能够与个体作为平等伙伴互动，展示对个体的尊重。
- 技能和特质：咨询师将不同的技能和特质带入咨询对话中，丰富了咨询过程，帮助个体更好地探索问题和找到解决方案。
展示尊重：
- 尊重个体：咨询师通过与个体作为平等伙伴互动，展示对个体的尊重。
- 个体自主性：通过尊重个体的自主性，咨询师帮助个体增强自信心和自尊，从而更有效地解决问题。

通过这些内容，本书旨在帮助读者理解促进有效咨询结果的通用因素，以及如何在咨询实践中建立和维护治疗联盟。这些知识不仅提高了咨询师的专业能力，还增强了他们在实际工作中的应用效果。

Working collaboratively After reading the earlier chapters we expect that yon will probably agree that a central outcome of any counselling process is for change to occur in the person being helped. People typically come to see a counsellor in a distressed emotional state with the expectation that as a result of counselling they will find solutions to their problems and will feel better, in other words, they have an expectation of change. This change may involve changes to their emotional feelings and/or thoughts so that they feel better, or may involve changes in their behaviour so that they are more able to deal effectively with issues that confront them in daily life. WHAT FACTORS PROMOTE POSITIVE COUNSELLING OUTCOMES? Have you, the reader, previously thought about what it is that enables a person who is engaged in a counselling process to change? We invite you to think for a minute about what might contribute to the change process. In Chapter 2 we discussed some of the desirable attributes of a counsellor and of the counselling relationship. Now we have some questions to ask: • Are counsellor attributes sufficient to produce change? • Are attributes of the counselling relationship sufficient to produce change? • Is it the use of particular counselling skills that produces change? • Is it the counsellor who is effective in promoting change in the person seeking help, or is it the person themselves who generates the change? If you are in a training group you might want to discuss these questions in your group before continuing to read on. It is clearly useful to be able to answer these questions so that we can understand more fully how counselling can enable a person to change.

RESEARCH INTO THE EFFECTIVENESS OF COUNSELLING Carl Rogers was one of the first people to initiate research into counselling practice by analysing the characteristics of counselling conversations and the counselling relationship. He began doing this in the 1950s and his contribution with regard to he nature of the counselling relationship and the use of reflective listening skills continues to be of major importance. Since Rogers’ time, a considerable amount of research has been conducted with regard to the characteristics of the counselling process and the effectiveness of counselling, There have been many contributors to the literature in this area, including Frank and Frank (1991), Horvath (2001) and Wampold and Imel (2015). Most authors agree that research studies have identified the influence of common factors and the therapeutic alliance in producing positive outcomes for those who seek counselling.

COMMON FACTORS In the previous chapter we considered a number of different approaches to counselling. As a consequence, you may be asking, 'Which counselling approach is the most effective?' Some authors contend that when practised by competent counsellors who adhere to a particular model of counselling, all the approaches are almost equally effective, and their effectiveness depends on a number of factors which are common to all approaches. Further, a consistent finding through research into the effectiveness of counselling is that there are a number of factors common to all counselling approaches that have a positive influence on the experience of the person seeking counselling and on the effectiveness of counselling (Wampold & lmel, 2015). The common factors that have been identified as helpful are described in different ways by different authors. Included among these factors are: • the counsellor s personal qualities • the relationship between the person seeking help and the counsellor • the person trusting that the counsellor is able to be of help • personal factors of the person seeking help • the influence of hope and optimism.

QUALITIES OF THE COUNSELLOR AND THE COUNSELLING RELATIONSHIP Desirable personal qualities of the counsellor and the relationship between the person being helped and the counsellor were discussed in Chapter 2. However, an additional perspective on the relationship, in recent years referred to as the therapeutic alliance, will be described later in this chapter. THE PERSON TRUSTING THAT THE COUNSELLOR IS ABLE TO BE OF HELP We might ask the question ‘How can a counsellor obtain a person’s trust in such a way that they will believe that the counsellor can be of help?’ You may wish to think about this question for a while before reading on.

While we believe that it is helpful for a counsellor to have the necessary7 personal qualities and to be able to create a relationship with the person seeking help, as described in Chapter 2, we do not consider this to be sufficient. For the counselling relationship to be fully effective the counsellor needs to be proficient in the use of counselling skills and in attending to the counselling process. When the counsellor does these things competently, the person is likely to feel confident in working with the counsellor in order to achieve their desired goals. The counsellor needs to be skilful when selecting and making use of individual micro-skills. Also, the counsellor needs to have an understanding of and expertise in facilitating the overall counselling process, not only as it occurs in each individual session but also as it extends over a series of counselling sessions. The counselling process will depend on the particular counselling model preferred by the counsellor. This might be one of the models listed in the previous chapter or might be an integrative counselling approach, as described in Chapters 15 and 16, which brings together strategies from a variety of models. PERSONAL FACTORS OF THE PERSON SEEKING HELP Earlier we asked the question ds it the counsellor who is effective in promoting change in the person seeking help, or is it the person themselves who generates the change?" It seems to us that most human beings have within them the resilience and ability to heal themselves, and this fits with Rogers’ belief that each person has the ability to find their own solutions. So what is it that the counsellor does? The counsellor acts as a facilitator working together with the person to promote, amplify and extend the possibility of change (Bohart & 1 allman, 1996). THE INFLUENCE OF HOPE AND OPTIMISM When His Holiness the Dalai Lama was in conversation with psychiatrist Howard Cutler (Dalai Lama & Cutler, 2000), they agreed that for a person to change in attitude the person must first realise that this is possible, must wish to do so and .... t............................... ........ must then implement the changes. If we accept that this is correct, then it is clearlv useful for us as counsellors to enable those who seek our help to have the hope and expectation that change is possible.

Hope and optimism are processes used in varying degrees by most people to cope with daily life. Like anyone, we ourselves will sometimes sink into thinking negatively and become pessimistic. Are you the same? We have discovered that being in a negative frame of mind is uncomfortable for us, so when we recognise our negativity we are motivated to change our attitude so that we are more positive and hopeful. A useful question is 4How can we use counselling to engender hope?’ Frank and Frank (1991) suggest that a counsellor who is hopeful can contribute to a sense of hope and optimism in the person seeking help. They also suggest that the explanation the counsellor gives about why the person is experiencing the presenting problem can lead to their sense of hope for the future. In view of this, we have come to the conclusion that being hopeful is in some way contagious, and that if the counsellor is hopeful about outcomes for the person seeking help, then that person is likely to start to feel hopeful themselves.

THE THERAPEUTIC ALLIANCE As discussed previously, Rogers placed great emphasis on the value of the counselling relationship. He believed that the counselling relationship was therapeutic in itself (Rogers, 1961). Since Rogers’ work, the concept of the therapeutic alliance has been introduced and investigated. Research has shown a strong positive relationship between the therapeutic alliance and counselling outcomes (Hovarth, 2001). The idea that the therapeutic alliance is of importance in counselling outcomes was originally proposed by B ordin (1975). He suggested that initially it is important to establish a bond between the person seeking help and the counsellor, including the development of trust, acceptance and confidence, and additionally that there should be agreement between the person and the counsellor with regard to the counselling behaviours, interventions and cognitions that form the counselling process (Bambling & King, 2001). Therefore, the concept of the therapeutic alliance suggests that, in addition to particular attributes of the counsellor and of the counselling relationship, a collaborative therapeutic relationship makes an important contribution to the promotion of change. We ourselves do not think that to achieve a good therapeutic alliance the counsellor needs, when counselling commences, to consult in a structured or formal way with the person seeking help in order to negotiate agreement with regard to the counselling process and goals. However, many counsellors do believe that this is important, so you will need to decide for yourself what you think is appropriate. In our view, an effective therapeutic alliance extends the relationship between the person seeking help and the counsellor to enable them to work together collaboratively throughout the whole process of counselling. If this is done successfully, the reason that the person has come for counselling will be discovered, and the purpose and goals of the counselling process will become clear as the counsellor collaborates with them. Further, through collaboration, solutions will be found. Creating a therapeutic alliance ensures that the person seeking help is valued as a person, as explained in Chapter 2, and that they are respected as being capable of working towards the discovery of solutions. However, rather than being a bystander, the counsellor collaborates with them in a working relationship. 1 his enables the counsellor to enter into a respectful partnership with them in exploring new wavs of addressing problems and finding solutions. In this working relationship the person seeking help brings their innate skills, competencies, resources and natural ability to self- heal into the relationship, while the counsellor collaborates by offering their counselling expertise and skills, and sharing their ideas as an equal, rather than as an expert. This collaboration is effected with the person’s full knowledge and understanding so that they are aware of their own and the counsellor’s roles.

BEING COLLABORATIVE WHILE SHOWING RESPECT FOR THE PERSON’S COMPETENCE It is interesting to note that some theoretical models place a stronger emphasis on collaboration between a counsellor and the person seeking help than other models. In Person-Centred Counselling there is a strong emphasis on the ability of the person seeking help to find solutions from their own resources. 1 he counsellor is a facilitator who facilitates a process that enables the person to use their own inner processes in order to resolve issues and find solutions. Other approaches, such as Narrative Therapy and Solution-Focused Therapy, emphasise the need for the counsellor to work together with the person as equal partners in finding solutions, while still respecting the person’s competence. In these latter approaches, the counsellor is active in using questions to propose and explore possible alternative solutions with the person. 1 here are therefore differences in emphasis between the models of counselling. Some counsellors believe that primarily we need to facilitate a process that relies on the person’s ability to discover their own solutions, while others believe that while respecting the person’s abilities it is also beneficial to focus on engaging in a collaborative process to discover solutions. Clearly, you will want to decide for yourself what fits best for you. If a useful counselling relationship is to occur, the counsellor must respect and value the person seeking help as a capable person. It is extremely important for a counsellor to respect their competence and to hold the belief that they, have the inner resources needed to deal with troubling issues, find solutions to problems, make decisions to change behaviour and put desired changes into action. Some people come to counselling believing that they do not have the inner resources and capability to do such things. Their expectation is that the counsellor will help them by finding solutions for them. Often such people appear to lack a sense of personal powrer and self-confidence, which they require to enable them to be self-reliant. If the counsellor maintains the belief that they do have the required inner strength and competence required for self-reliance, then the counsellor will be in a position to enable them to get in touch with their own strengths and resources, to become self- reliant, to make decisions that suit them, and consequently to gain in self-esteem. In facilitating this process the integrative counsellor may, as a collaborative partner, introduce new ideas which can be explored with the person. If this is done with sensitivity and respect, the person can continue to be encouraged to explore their issues, to make their own decisions, and to find solutions which are a good fit for them. Also, the counselling conversation can be enriched by the introduction of additional ideas by the counsellor. In this situation, the person is likely to believe that the counsellor cares enough to be involved as an equal partner in the exploration of problems and the search for solutions, thereby enhancing the relationship; the counsellor is actively^ helpful and involved in a process that is purposeful while working collaboratively with the person as an equal partner by contributing their own skills and attributes to the counselling conversation. During this collaborative process, the counsellor shows respect for the person’s competence and ability as they explore troubling issues and make personal decisions which suit them. At the beginning of the chapter we listed a number of questions related to the question ‘What factors promote positive counselling outcomes?1 We hope you will agree that we have provided some answers to this question, while leaving you to make your own decisions about what you think is best with regard to counselling practice.

Learning summary Research has shown that some factors that are common to all counselling approaches promote effective counselling outcomes. The person seeking help needs to trust that the counsellor is able to be of help. The counsellor is a facilitator and enables the person to use their own natural resources in order to change. The therapeutic alliance involves the use of a collaborative working relationship. Being collaborative enables the counsellor to show respect by engaging with the person as an equal partner and by bringing different skills and attributes to the counselling conversation. References and further reading Bambling, M. & King, R. 2001, ‘Therapeutic alliance in clinical practice’, Psychotherapy Australia, 8(1), November. Bertolino, B. & O’Hanlon, B. 2002, Collaborative, Competency Based Counselling and Therapy, Allyn & Bacon, Boston. Bohart, A.C. & Tallman, K. 1996, ‘The active client: therapy as self-help’. Journal of Humanistic Psychology, 36: 7-30. Bordin, E.S. 1975, ‘The working alliance: basis for a general theory of psycho-therapy’, paper presented at the meeting of the Society for Psychotherapy Research, Washington, DC, August. Dalai Lama & Cutler, H.C. 2000, The Art of Happiness: Handbook for Lining (audio tapes), Simon & Schuster, New York. 1)ryden, W. 2009, ‘The therapcutic a 11 iancc as an integrating framework', in W. Dryden & A. Reevcs, Key Issues for Counselling in Action, 2nd edn, SAGE, London, pp. 1 — 18. Frank, J.D. & Frank, J.B. 1991, Persuasion and Healing: A Comparative Study of Psychotherapy, 3rd edn, Johns Flopkins University Press, Baltimore. Horvath, A.O. 2001, ‘The therapeutic alliance: concepts, research and training’, Australian Psychologist, 36: 170-6. Rogers, C.R. 1961, On Becoming a Person, Constable, London. Wampold, B.E. & Imel, Z.E. 2015, The Great Psychotherapy Debate: The Evidence for IVhat Makes Psychotherapy 14TR, Routledge, New York.