Discuss_the_Theme_of_Therapist_Competence_in_Counselling

Competence In this mini-essay I will examine the concept of therapist competence in the context of perfectionism, a theme which runs throughout Kottler’s work. As a newcomer to the field of counselling, and reminiscing on the sheer bulk of technical knowledge that was required to become Chartered in a previous field, interest has definitely been peaked in this area in a quest to discover just how much experience a freshman counsellor might need to amass to be able to mirror Kottler’s “superpower” status. Let’s perhaps begin with the question: are therapists miracle workers' Brogan, Prochaska & Prochaska (1999) report that premature termination after just one session stands somewhere between 20% and 57%, and some 30-60% of clients drop out before the counsellor thinks they should (p. 105). These are rather shocking statistics and present a “formidable assault on a psychotherapist’s fantasy of perfection” (Wittenberg & Norcross, 2001, p. 1544). Is it ethical however, to swim outside of one’s known territory when it comes to competence, if perhaps it feels possible to make some kind of progress with a new client' Whilst the work of Norcross & Guy (2007) beseeches therapists to stay firmly within their limits and to “relentlessly define who you are and what you do” (p. 103), Kottler (2010) frankly admits that this situation does arise, and, in his chapter on the pretence of perfectionism, discloses agreeing to take on referrals whilst “scanning the bookshelves or the internet for a quick education” (p. 236). As newcomers to the field, if we were to refer every client that we felt was out of our depth, we would certainly enjoy a very light case load! Later in his book Kottler (2010) advocates increasing exposure to uncertain situations, as this is one of the best ways that we can “visit new places with our work” (p. 310), a view upheld by the research of Jennings, Sovereign, Bottorff, Mysell & Vye (2005) who set-out to establish the ethical values of master therapists. They concluded that exceptional therapists strongly upheld the principles of “professional growth” and “openness to complexity” which certainly captures the spirit of investigating unchartered territory. If we then continue to toil hard academically and put our emphasis on training and experience, will that allow us to eventually climb to the upper-echelons of the therapy world' The rather sensational work of Herman (1993) would suggest almost the complete opposite. Pulling together a host of studies in the area of competence, Herman (1993) concluded that theory and training have almost no predictive influence on a successful therapy outcome, and that less tangible elements of counselling sessions, especially the strength of the therapeutic alliance had the power to help, quoting a study which pits the skills of trained counsellors against relative laypersons in the counselling arena and found that the paraprofessionals “equalled or surpassed the clinical outcomes of professionals” (Durlak, 1979, as cited in Herman 1993). How do we then know if we have a strong enough therapeutic alliance with a client to enable us to drill into the crux of their problems without driving them away, or at worst causing harm' Certainly good monitoring and supervision will play a part as a novice, however Horvath (1995) developed a curious little thought-provoking tool known as the Working Alliance Inventory which asks both therapist and clients a set of questions, the answers to which Horvath (1995) believes can offer a strong indicator of the risk of a client dropping out as well as highlighting any areas of disconnect in the relationship. Having explored a plethora of reading around the minefield of competence, perhaps nobody wraps it up more aptly than Kottler (2010) when he states that “people respond to us not only because of our professional competence but also because of our uniquely personal aura” (p. 234). References Brogan, M. M., Prochaska, J. O., & Prochaska, J. M. (1999). Predicting termination and continuation status in psychotherapy using the transtheoretical model: Psychotherapy: Theory, Research, Practice, Training, 36(2), 105-113. Herman, K. (1993). Reassessing predictors of Therapist competence. Journal of Counseling and Development, 72, 29-32. Horvath, A. O. (1995). The therapeutic relationship: from transference to alliance. In Session: Psychotherapy in Practice, 1(1), 7-18. Jennings, L., Sovereign, A., Bottorff, N., Mussell, M., & Vye, C. (2005). Nine ethical values of master therapists. Journal of mental health counseling, 27(1), 32-47 Kottler, J. (2010) On being a therapist (4th ed.). San Francisco: Jossey-Bass Norcross, J. & Guy, J. (2007). Leaving it at the office: A guide to psychotherapist self-care. New York, USA: The Guilford Press Wittenberg, J. & Norcross, J. (2001). Practitioner Perfectionism: Relationship to Ambiguity Tolerance and Work Satisfaction. Journal of clinical psychology, 57(12), 1543–1550