| Abstract: | While the psychotherapeutic relationship has been assumed to be relatively free from external influence, we suggest that the therapeutic alliance develops within a larger environment, much of which is beyond the control of client and therapist. The reticence of practitioners and researchers to recognize and explore ecological issues is likely related to therapeutic tasks that are necessary for insight-oriented treatments (e.g., developing a therapeutic setting that protects clients from the intrusion of outside influences). Two sources of ecological disruption are discussed, managed care and psychotherapy research, and an illustrative case example of ecological disruption within a psychotherapy research setting is presented. We suggest that addressing ecological disruptions in the context of the therapeutic relationship may facilitate the establishment and maintenance of a positive therapeutic alliance. By doing so, the therapist can integrate the demands of the external world into the therapeutic relationship, thereby increasing the meaningfulness of interpersonal interventions and easing discussions about therapeutic alliance ruptures. (PsycINFO Database Record (c) 2010 APA, all rights reserved) |
