Creating and Maintaining a Therapeutic Alliance 1. Which of the following promotes empathic attunement? Therapist maintains eye contact. Therapist asks couple about a recent argument Therapist explains couple’s problem in light of their interaction pattern Therapist trains couple in a communication model. 2. Bob turns away from Marie, crossing his arms and legs in a tight fashion, saying, “You just don’t understand.” Which of the following would most powerfully promote empathic attunement? So she doesn’t understand you? Bob, I think you are withdrawing from her because you are scared. So you don’t think she understands you, and you think it is pointless to try. Yes, it’s difficult, you feel like you are not getting through, like even your body is closing off. 3. List two comments you might make that could show a client you are connecting with his experience as the client closes off his body posture and turns away from his partner saying, “You just shut me out.” 4. A client’s eyes well with tears as she describes the frustration she has in trying to reach out to her partner. What could a therapist do to promote empathic attunement? Note the discrepancy between her tears and her spoken frustration Notice the tears and ask about her experience. Identify with her pain and frustration through self-disclosure. Focus on a time when she felt less frustrated. 5. The therapist infers that a husband is afraid of the intimacy that his wife is seeking, noting that he seems curious but proves hesitant when his wife pursues him. The husband withdraws in silence and pulls back from being involved in the session. How might the therapist respond in monitoring this change in the therapeutic relationship? What would you say? “If you were to put words to your silence what would they say?” .“I wonder if that fits for you, I am not sure if my comment about your fears is really what you experience. What’s it like when you hear me talk about this fear of intimacy?” “Many husbands that I work with have similar fears.” “I wonder if it is safer for you to hold onto your thoughts and feelings than to share them.” 6. . If the therapist offended the client, the therapist could respond to the client to minimize the rupture by saying: “So it seems like I jumped to a conclusion. Fear and vulnerability are strong words that really don’t fit what you are going through. Do you think you can help me better understand what it is like for you?” “It seems like it is difficult for you to see this intimacy issue in your relationship.” “Could you tell me when intimacy was less of a problem for you than it is now?” “What is it like for you when I raise these questions about closeness and intimacy?” Time's up