MUTUAL RELATIONSHIP BUILDING
A working relationship can be established only if we engage individuals on an equal plane and incorporate their views into problem identification. In recent years, we have shifted to viewing the client as a partner in the helping process. We should be careful not to consider the professional as the expert on the issues presented, because people understand what is happening in a distinctive way. Kivlighan, Marmarosh, and Hilsenroth (2014) found that there was agreement among researchers that the therapeutic alliance should contain collaboration and reciprocity. Peeble-Wilkins (2003) refers to understanding clients with mutuality and within their own context as being at the core of effective collaboration.
Establishing and maintaining a working relationship, or therapeutic alliance, is essential for a positive collaboration between client and therapist. Bordin (1979, p. 253) defined three features of this alliance: “an agreement on goals, an assignment of a task or series of tasks, and the development of bonds.” Beck, Friedlander, and Escudero (2006, p. 360) found that clients have to feel safe within the therapeutic process and have “good emotional connections with the therapist” to have a strong alliance with the therapist. Dybicz (2012) describes the need for a social worker to have expertise and authority to assist clients with their needs. He notes the importance of the ability to form a genuine connection in the helping process.
Hilsenroth, Peters, and Ackerman (2004) determined that establishing a therapeutic alliance begins during the assessment process. They found that this influences the entire treatment process thereafter. Therefore, from the very beginning of any client interaction, the establishment of a genuine and collaborative relationship with a client cannot be overlooked. This often begins with showing respect, interest, and warmth during the intake procedure and should be maintained and ongoing. Tailoring treatment for each individual is essential in forming an alliance. It is important to accept another person's identity as he or she defines it and go forward from there. Once this is established, there can be a collaboration to work toward mutually defined goals. Developing relationships, establishing therapeutic alliances, and showing empathy are topics that are covered in most training for the helping professions.
Training professionals to be culturally competent begins with helping them to understand and have an awareness of their own cultural identity and views about difference. This will help them to develop the ability to learn and build on the varying cultural and community norms they will encounter as individuals and for their clients while students. It is the ability to understand the within-group differences that makes each student unique, and students should be encouraged to celebrate the between-group variations that make our country a tapestry. This understanding informs and expands teaching practices in the culturally competent educator's classroom. This is a key for educators of clinical and helping professionals in making them effective in their careers in human services. While some information can be taught and encouraged in the educational process, students' personalities must be taken into account in the learning process.
Hersoug and colleagues (2009) found that clients are sensitive to therapists' attitudes. They found that a therapist who is seen as distant, indifferent, or disconnected will have a negative impact on the ability to form a positive working relationship. Their study indicated that attitude is not necessarily influenced by professional training; the therapist's comfort with closeness may be a more important factor. Another barrier to developing a mutual relationship is when the helping professional is using the time with the client to gather information without using exploratory questions that allow for a more thorough verbal exchange. This may happen when there is a focus on gaining the information that you need for an intervention based on preconceived notions or assumptions of prior knowledge. Facilitating another person's expression of his or her situation will lead to an understanding between the parties and the gathering of knowledge that may not have been anticipated. This will also help the relationship to develop based on mutuality and trust.
In addition, personal styles and characteristics of helping professionals have been found to affect their ability to work with diverse cultures. Weatherford and Spokane (2013) reported on studies that found a positive association between extraversion, openness to experience, empathy, and feminism to acceptance of diverse cultural groups. Homophobia, dogmatism, and neuroticism were reported to negatively impact attitudes toward cross-cultural groups. They also found various studies indicating that having a worldview associated with a feeling of superiority of one's cultural group, conventional ideas, and aggressiveness toward nonconforming groups may be a predictor of cultural prejudice. This is important since it may not be possible, based on their evidence, to educate or train all helping professionals to work effectively with diverse cultural groups.
The social group a person belongs to or identifies with often has an inherent status that gives the person an advantage. Advantaged groups can allow individual members to have greater access to opportunities and power, as well as feelings of dominance and privilege. Having an understanding of white privilege may enable a more positive intervention with racially diverse clients. White privilege, according to Peggy MacIntosh (1988), is an invisible knapsack filled with the proper codes, passports, and tools for a successful life. Historically, members of this group enjoy unearned social and political advantages for access to resources, whereas nonmembers may be viewed as disadvantaged, subordinate, targeted, or oppressed, which denies or limits their access to opportunities. Perceptions of those in the disadvantaged group may define and limit goals of its members. These feelings may also influence the person providing the help. Conscious and unconscious thoughts may interfere with one's ability to embrace training in the treatment of diverse clients (Bhui & Ascoli, 2012).
By monitoring their own emotional responses to a client in the helping process, professionals are more likely to be able to develop mutuality in the relationship and collaborate on solutions. Such awareness allows the social context for the client and worker to be validated as a framework to engage in a humanistic way. Clinician self-awareness will help to reduce operating as a professional information gatherer and move to operating with mutual recognition and empathic caring. Personal growth or behavioral change can occur when there is a reciprocal understanding and articulation of the process as a working model. When information is received, it is interpreted through our own beliefs and narratives, and this dictates our behavior or response. Ultimately, this will control our reaction and our experience to any treatment, either positively or negatively. Change will be possible if the internal validation allows for new frameworks and ideas to be accepted.
Knowing yourself is important for the well-being of both the client and the clinician. Tarver-Behring (1994) studied white women's identity formation. She found that as they became cognizant that they were not all the same, had within- group diversity, and were often devalued compared to men, they started to appreciate issues affecting women of color and reduce their feelings of ethnocen- tricity. This awareness helped them appreciate many of the complexities that go into forming identity. People who are not aware of the privilege within their own group may be resistant to accepting the need to work on cultural competence. Not only is consciousness raised, but defensiveness in response to denying inequality and oppression is reduced so that there can be positive self-development and increased cultural sensitivity.
Goh (2012) studied the integration of mindfulness and reflection exercises into undergraduate social work curricula. She found that the students had to learn active listening skills in order to form a bond with their clients. Active listening was inhibited by students' thinking ahead or multitasking while engaging with the client. Students may think ahead in an interaction so they can formulate an action plan for the client, or they may be uncomfortable with silence and begin to prepare to give advice. Raising awareness for students that this would be counterproductive for the relationship helped students become more aware of their own listening styles and make positive changes. Active listening, or empathic listening, is “being with and understanding clients and their world” according to Carl Rogers (cited in Goh, p. 588). Distorted listening can result when students use stereotypes or evaluate statements while engaging in a dialog. This may result in clients' being put into categories where they may not actually belong.