Re:venting as a way to strengthen therapeutic alliance

You've defined vent as "emotional release", but I'm still unclear as to what's implied by the word allow in this context. I think it's safe to assume that you're imagining a situation in which the therapist lets the client "get it all out" and doesn't interrupt her. But it's what happens after the emotional release that seems most important to answering your question.

Reaction 1: Simple Empathy
The therapist expresses empathy with a phrase like, "I can see why that must be very difficult for you."

Reaction 2: Rogerian 'Reflection'
The therapist repeats what the client has said using a combination of the therapist's words and some of the client's own words.

Reaction 3: Cognitive Intervention
The therapist attempts to help the client see the relationship between her thoughts (and, later in therapy, her beliefs, attitudes, or schema) and the emotion she just expressed.

Insofar as they convey empathy and understanding, Reactions 1 & 2 could very well strengthen the therapeutic alliance, particularly very early in therapy before socialization to the cognitive model has begun in earnest. If, however, the client has a good understanding of the cognitive model, then Reaction 3 (or some combination of reactions that includes Reaction 3) would be the strongest option.

After all, if you're 'doing' Cognitive Therapy, you've probably spent a lot of time emphasizing the relationship between cognition and affect up to this point -- treating this 'vent' with only Reactions 1 or 2 might indicate to the client that you consider this emotional release different from others (i.e. not subject to cognitive analysis) and therefore not central to the client's problem. This could create the impression that you're ignoring the 'vent' or not taking it seriously, despite showing empathy. (Which would, no doubt, damage the therapeutic alliance.)

Replies:

Re:venting as a way to strengthen therapeutic alliance , by Jim Pretzer, 01/17/04 Re:venting as a way to strengthen therapeutic alliance , by JustBen, 01/19/04 Re:venting as a way to strengthen therapeutic alliance , by Jim Pretzer, 01/20/04

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