This text-based course is a transcript of the live seminar, “The Integrated Therapist: Engagement with Self and Other,” presented by Shirley Morganstein and Marilyn Certner Smith.
>> Shirley Morganstein: When we were invited to be a part of this seminar by Audrey Holland, aging and wellness seemed a topic that we had things to offer for, but perhaps differently from other presenters. Recently we have been focusing on what we as therapists can do to preserve our own wellness and to maintain healthy relationships with those we serve. As a profession, we are very focused on the needs of others, and sometimes we are so focused in that direction that we can miss our own. We need to grow. We need to develop to see our geriatric clients in a more human and humane light so that we can connect and relate. After all, these are the reasons we entered the field to begin with. Aging with a focus on wellness is for the therapist as well as the client. Marilyn and I will speak to the process of engagement and its relationship to normal aging. We will begin with Marilyn first defining some terms.
>> Marilyn Certner Smith: As we begin with definitions, we are actually going to sidestep the main definition, which is that of integrated therapist, but we will begin by discussing other key terminology.
The Integrated Therapist
An integrated therapist draws upon several models and philosophies to inform and advance the therapy practice. Specifically today we are going to be talking about relationship-based therapy and reflective practice. Relational-based therapy places the connection between the therapist and the client as the most important aspect of treatment to achieve a positive outcome, and if that is the case, then the content of therapy is secondary to the interpersonal considerations of the therapeutic process.
Relational-based treatment began back in the ‘40s with Carl Rogers. He developed a therapeutic approach that was called client-centered therapy (1951). It was considered nondirective. In this type of approach, the client directed the path for discovery in his own treatment as opposed to the therapist guiding the session with questions. Rogers identified some core requirements that must be present in order for a good therapist-client relationship. He talked about congruence, unconditional positive regard, and empathy. Let’s define some of these.
Congruence is relating to openness. In this relationship, the therapist’s attitude is of genuine involvement, including self-disclosure of feelings, a very authentic give and take. The next is unconditional positive regard. The therapist accepts the client’s perspective without judgment, approval, or disapproval. I did have a case of a young man who, at approximately age 42 and at about approximately a year post onset, was beginning dialogue about transition back to work. In this conversation, I had used the term disability and he stopped me in my tracks to say, “Wait, I am not disabled.” It was a moment that I listened and watched, and led me towards empathy in which the therapist seeks to understand the client’s point of view with a nonthreatening attitude. Relational-based treatment says that the therapeutic relationship is complex and original. No two people are alike, but the commonality is that positive alliances are essential to impact ultimate outcomes. Relational practice goes hand in hand with reflective practice, and throughout the presentation you will see how these two are intertwined.