How Issues of Difference and Equality Impact Upon Therapeutic Relationship

Diff/Equal/Therapeutic Relationship Issues of difference and equality can have a major impact upon a therapeutic relationship. The relationship between therapist and client should be strictly professional. It is not uncommon for clients to project certain ideas and perceptions onto the counselor. It is the counselor's role, in such cases, to shift the focus back to the client and the issues s/he needs to address.

Because the job of the therapist is to help individuals, some people may feel the relationship is one between a superior and a subordinate. The counselor may have more education than the client, or in some cases less. The counselor's education was designed to provide the foundation from which therapy can be offered. This professional preparation does not make the counselor superior to clients in the absolute, but it does mean the counselor is trained to share insights and develop treatment plans.

Some clients may transfer inappropriate feelings to the counselor. They may see the counselor as a parent figure or a romantic figure. They may perceive the counselor as being of a higher class than themselves. There is evidence that culture plays varied and multiple roles often characterized by cultural dissonance between client and therapist (Flaskerud, 2007, p. 1081). Therapists are often stereoptyped as Western, middle class, English-speaking and white.

Where there is cultural dissonance, there are differences in value systems, meaning and expression of symptoms, perceptions of behavior, diagnosis, access to care, acceptability of care, treatment, and the meaning and effect of pharmacotherapy (Flaskerud, p. 1081). For example, a counselor might speak about going on holiday. The client might imagine an exotic vacation, whereas in reality the counselor might be preparing to spend a week at a relative's home, or sleeping in a tent on a camp ground.

In this case the client is projecting the idea that the counselor is middle class and can afford many luxuries. The reality may be that the counselor hails from a working class background and does not, in fact, have any more money that anyone on the roster of clients. It is important that the issue of class and cultural difference be resolved in order for the therapy to be effective. It is not uncommon for clients to imagine a romantic relationship with their therapists.

The therapist, because it is his/her job, is a patient listener. S/he is supportive of the client, really hears what is being said, and is non-judgmental. The client can perhaps relax in the therapist's office in a way that cannot be done anywhere else. It may be a place where there is complete lack of pressure and the client can pour out thoughts and feelings without fear of recrimination. It is easy for a client to fantasize that the therapist would be an ideal spouse or girlfriend (boyfriend).

The client does not see the therapist in real-life situations but only in the structured environment of a counseling section, where the therapist is calm, in control, and seemingly in possession of all the right things to say. The counselor's professional empathy can be mistaken for romantic feelings. There is a need for the counselor to help the client create new meaning around the therapeutic relationship by discerning how the actual details of what is being experienced differ from previous relationships the client has had in her life (Norton, 2011, p. 97).

The therapist's job is to establish a relationship with a client so there can be empathy and trust, yet the relationship must have clear boundaries. It is up to the therapist to set the boundaries; often, the client cannot. Empathy is one of the most important components in a therapeutic relationship. It can.