Characteristics Of Helping Relationship 4te3f

CHARACTERISTICS OF HELPING RELATIONSHIP 1. Can I be a unified personality-one that can be what I deeply am? This means that whatever feeling or attitude I am experiencing would be matched by awareness of that attitude. Carl Rogers, states in his book, the term “Congruent” is one he used to describe the way he would like to be. (Congruency is to be freely and deeply yourself within the relationship, your actual experience accurately represented by your own self-awareness and what you actually are in this moment of time). Rogers believed that being authentic-not playing a role or being phony was an essential part of the equation. He thought that the therapist needed a very high degree of self-knowledge in order to maintain a consistent degree of personal transparency. Trust is based upon consistency rather than compatibility. The senior cannot reveal him or herself nor share important information unless he/she can rely upon you. He must believe that you will react with the same behavioral characteristics each time he or she meets with you. He/she needs to know that you will keep content from the interview confidential, as mutually agreed upon. You may have to delay obtaining certain information until a sense of trust is established. This is because the elderly patient may feel very threatened by an interview or examination. In addition, you must feel that you can predict the person’s behavior because you have an understanding of the person (Rogers 1976). 2. Can I be expressive enough as a person – that what I am can be communicated unambiguously? “If in a given relationship is that it is safe to be transparently real. If in a given relationship I am reasonably congruent, if no feeling relevant to the relationship are hidden either to me or the other person, then it can be almost sure that the relationship will be a helpful one.” –Carl Rogers Genuineness refers to the extent to which the nurse is able to be honest in the relationship in a ‘real’ way. Nurses need to have an awareness of their own thoughts and feelings when they are with the patient, and to engage in the relationship as a real person with these thoughts and feelings. This does not necessarily telling the patient how

you feel, but it does not mean noticing how you feel and accepting it. This can be confusing for nurses because of boundaries and roles, but it is not about developing a personal relationship o acting a part. For example, if you are aware of having a feeling of dislike towards a patient, you would not expect to act this out towards the patient, but it may be that there is something about how they relate to people which engenders this reaction. It may be useful for the patient to know about this at some point, but it would probably not be helpful just to tell them outright. Neither would it be helpful to encourage them to feel that you were very fond of them. Genuineness requires the nurse to ‘wear’ their role rather like a uniform, which maintains the formal nature of the relationship. Genuineness means that nurses remain themselves, aware of their own reactions and feelings, while also being a nurse. Genuineness calls for the nurse to be tactful but honest in their relations with the patient as this is the foundation of a trusting relationship. If one can form a helping relationship with himself, and if he/she is aware of his own feelings then, the likelihood that you can form a helping relationship with others. Just like in a saying that, you cannot love and appreciate somebody else, if in the first place you didn’t know how to love and appreciate yourself. Understanding others starts from understanding your own self. 3. Can I let myself experience positive attitude toward this person – attitudes of warmth, liking interest and respect? Rogers was describing an unconditional warmth, a momentary setting aside of judgment to promote an atmosphere of trust and openness. Positive regard implies respect. It is the ability to view another person as being worthy of caring about and as someone who has strengths and achievement potential. Respect is usually communicated indirectly by actions rather than directly by words. One attitude through which a nurse might convey respect is willingness to work with the client. That is, the nurse takes the client and the relationship seriously. The experience is viewed not “a job”, “part of course”, or “time spent talking”, but as an opportunity to work with the client to

help him or her develop personal resources and actualize more of his or her potential in living. Nurses are more effective when they guard against using their own value systems to judge client’s thoughts, feelings, or behaviors. For example, if a client is taking drugs or is involved in sexually risky behavior, you might recognize that there behaviors are hindering the client from living a more satisfying life, posing a potential health threat, or preventing the client from developing satisfying relationships. However, labeling these activities as bad or good is not useful. Rather, focus on exploring the behavior of the client and work toward identifying the thoughts and feelings that influence this behavior. Judgmental behavior on the part of the nurse will most likely interfere with further exploration. 4. Am I strong enough to retain my own separateness, so I will not be downcast by his/her depression, engulfed by his/her dependency nor destroyed by his anger? “When I can freely feel this strength of being a separate person, then I find that I can let myself go much more deeply in understanding and accepting him because I am not fearful of losing myself.” Relating this when you have a relationship with someone, is one should that during the process of having relationship one should not forget that you are separate individuals, and that you should not depend and entrust your life with him/her. In this way, you can have a harmonious relationship because you wouldn’t have any doubts during the relationship. 5. Am I secure enough to permit him to be what he is and not feel he should mold himself after me? The nurse’s role in the therapeutic relationship is theoretically rather well defined. The client’s needs are separated from the nurse’s needs, and the client’s role is different from that of the nurse. Therefore, the boundaries of the relationship seem to be well stated. In reality, boundaries are at risk of blurring, and a shift the nurseclient relationship may lead to nontherapeutic dynamics. Pilette and associates (1995) described the following two common circumstances that can produce blurring of boundaries:  When the relationship slips into a social context

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When the nurse’s needs are met at the expense of the client’s needs

The nursing actions that may be manifested when boundaries are blurred include the following (Pilette et al., 1995): 1. Overhelping—doing for clients what they are able to do themselves or going beyond the wishes or needs of clients 2. Controlling—asserting authority and assuming control of clients “for their own good” 3. Narcissism—having to find weakness, helplessness, and/or disease in clients to feel helpful, at the expense of recognizing and ing clients’ healthier, stronger, and more competent features 6. Can I let myself enter fully into the world of his feelings and personal meaning and see these as he does? It is important to understand you client for you to better asses him/her, and to gain his/her trust, but it should be empathic understanding, where you sense the other’s private world as if it where your own, without ever losing the ‘as if’ quality. Rogers thought it was essential for the person to feel deeply understood. To do that meant going “inside” the other person’s frame of reference to get a real sense of what the person’s experiences felt like. And then able to communicate that knowing and understanding back to the other person deeply and accurately. Empathy means the attempt to understand the other person in a deep way. To try and set aside one’s own judgments and preconception and to understand how the other person experience things, gain understanding of their thoughts and feeling and what these means to them. It may be difficult to understand how the patient feels about things, but it is important to try and let the patient know that you are trying. 7. Can I be accepted of each facet of this other person which he presents to me? Acceptance is the positive resect a nurse has for their patient. It means that nurses accept that people simply are who they are and have the right to be respected for it. It also assumes that people are

not willfully bad or unpleasant, but are doing their best to manage in their particular circumstances. This idea can be challenging for mental health nurses who may, for example, be working in a forensic setting with patients who have committed crimes that the nurse finds abhorrent. The point is not that the nurse is wrong or should not have that feeling or should forget about the crime but, rather, that the nurse’s personal judgment is not helpful to the patient. Telling a smoker that we dislike and disapprove of smoking does not help him stop, but accepting that he does smoke and exploring with him his motivation and feelings about it may help him feel differently about it. Similarly, telling a patient who has committed a serious sexual assault that he shouldn’t have done it is unlikely to be helpful, whereas exploring with him how and why it came about may be. 8. Can I help him with such sensitivity that it is perceived as nonthreatening to me? The work we are beginning to do in studying the physiological concomitants of psychotherapy confirms the research by Dittes in indicating how easily individual are threatened at a physiological level. The psychogalvanic reflex - the measure of skin conductance – takes a sharp dip when the therapist responds with some word which is just a little stronger that the client’s feelings. And to a phrase such as, “My you do look upset,” the needle swings almost off the paper. My desire to avoid even such minor threats is not due to a hypersensitivity about my client. It is simply due to the conviction based on experience that if I can free him as completely as possible from external threat, then he can begin to experience and to deal with the internal feelings and conflicts which he finds threatening within himself. 9. Can I keep the relationship free of external evaluation? In almost every phase of our lives - at home, at school, at work – we find ourselves under the rewards and punishment of external judgments. “That’s good”; “that’s naughty.” “That’s worth as A”; “That’s a failure.” “That’s good counseling”; “That’s poor counseling.” Such judgments are part of our lives from infancy to old age. I believe they have a certain social usefulness to institutions and organizations

such as schools and professions. Like everyone else find myself all too often making such evaluations. But, in my experience, they do not make for personal growth and hence I do not believe that they are a part of a helping relationship. Curiously, enough a positive evaluation is as threatening in the long run as a negative one, since to inform someone that he is good implies that you also have the right to tell him he is bad. So I have come to feel that the more this will permit the other person to reach the point where he recognizes that the locus of evaluation, the center of responsibility lies within himself. The meaning and value of his experience is in the last analysis something which is up to him and no amount of external judgment can alter this. So I should like to work toward a relationship in which I am not, even in my own feelings evaluate him. This I believe can set him free to be selfresponsible person. 10. Can I meet this individual as a person who is in the progress of becoming not bound by his past or by my past? If, in my encounter with him, I am dealing with him as an immature child, an ignorant student, a neurotic personality, or a psychopath, each of these concepts of mine limits what he can be in the relationship. Martin Buber, the existentialist philosopher of the University of Jerusalem, has a phrase, “conformity means accepting the whole potentiality of the other. I can recognize in him, know in him the person he has been created to become. Confirm him in myself, and then in him, in relation to this potentiality that can now be developed, can evolve.” If I accept the other person as something fixed, already diagnosed and classified, already shaped by his past, then I am doing my part to confirm this limited hypothesis. If I accept him as a process of becoming, then I am doing what I can to confirm or make real his potentiality. I have then to use Buber’s term – confirmed him as a living person, capable of creative inner development.

References: Book

1. O'Carroll, M., & Park, A. (2007). Essential mental health nursing skills. Edinburgh: Mosby. 2. C. R., Kirschenbaum, H., & Henderson, V. L. (1989). The Carl Rogers reader. Boston: Houghton Mifflin. 3. Rogers, C. R. (1995). On becoming a person: A therapist's view of psychotherapy. Boston: Houghton Mifflin Internet 1. www.ohsu.edu/xd/outreach/occyshn/trainingeducational//developingTherapeuticRelationships_Ch10.pdf