What is a collaborative approach in counselling

What Is Collaborative Therapy?

Collaborative therapy refers to a form of therapy in which both the psychologist and the client work together to make decisions about how best to proceed with treatment. It is based on several key principles of practice, including collaboration, accountability, integrity, and respect.

Collaborative therapists focus on empowering individuals to overcome their problems by setting goals collaboratively and identifying resources to achieve those goals.

Collaborative therapy was developed by psychotherapist Harlene Anderson after recognizing that therapy is sometimes hampered by a lack of collaboration between therapists and their clients, in particular for those who have difficulty trusting authority figures.

Types of Collaborative Therapy

Collaborative therapy refers to a philosophical stance toward therapy rather than a type of therapy. For this reason, there are no specific forms of collaborative therapy that can be identified. Instead, it is most frequently associated with the humanistic approach to psychotherapy, which includes therapies such as person-centered therapy and existential psychotherapy. Establishing a collaborative relationship with a therapist is an essential factor in any successful psychotherapy.

The two major formats of collaborative therapies are client-led and therapist-led.

• In client-led collaborative therapy, the client drives what topics and issues will be discussed and works with the therapist to help prioritize concerns and goals.
• In therapist-led collaborative therapy, the therapist is more actively involved in driving sessions by devising experiments for clients to test their beliefs, restructuring thoughts, or engaging in other forms of cognitive-behavioral therapy (CBT).

Techniques of Collaborative Therapy

Anderson notes that in collaborative therapy, “connecting, collaborating, and constructing with others become authentic and natural performances, not techniques.”

Although present in many approaches to psychotherapy, there are seven ideas that are emphasized and guide collaborative therapists on how to think about the therapeutic relationship. However, these are not rules or techniques, and each therapist can be creative and devise their own methods of therapy for each individual client:

1. Mutually inquiring conversational partnership: The therapist and client work together with respect, honesty, empathy, and genuineness to share information with each other in order for the client to fully understand their own issues.
2. Relational expertise: When therapists are able to listen carefully and understand the client’s experience, they can become more effective. The client is an expert in their own experiences, and the therapist must be an expert in listening to these.
3. Not-Knowing: The client is the only person who knows what it’s like to be in their situation. Not-knowing entails suspending judgments, not trying to quickly comprehend all aspects of a problem, and allowing the client to set the agenda for sessions.
4. Being Public: The therapist is open about their “invisible thoughts” so that the client is never left wondering what the therapist thinks about them. This can include thoughts that are professional (e.g., about diagnoses), personal (e.g., judgments), or theoretical (e.g., hypotheses). This is not the same as self-disclosure; rather, it is sharing thoughts about the client and the therapeutic process.
5. Living with uncertainty: Clinicians are not expected to have all of the answers, but instead must be comfortable living with uncertainty. This means that they can focus on what is happening in the moment during therapy, rather than feeling the need to constantly guide the process.
6. Mutually transforming: Therapy is an active process for both client and therapist, whereby each is constantly working to transform themselves and their relationship together.
7. Orienting toward everyday ordinary life: Therapy is thought of as a replication of outside life, rather than as a separate space. As such, the therapist can help the client find ways to move forward in daily life, rather than become reliant on therapy.

What Collaborative Therapy Can Help With

Collaborative therapy is not designed to help with any specific disorder. It is a method of transformation that can be applied to any problem the client is experiencing.

Instead of trying to find solutions for specific problems, it helps clients become aware of how they are thinking about their problems, which can then help them take control of their own feelings and behaviors.

Collaborative therapy may be particularly helpful for individuals who have not had success in therapy in the past due to a lack of trust for their therapist. The client’s ideas are always respected in this therapeutic approach, and the client is never judged or blamed for their feelings or behaviors.

Collaborative therapy is a client-centered approach that places the emphasis on collaboration, honesty, respect, and empowerment for both therapist and client. By working together as partners in the therapeutic relationship, clients are able to engage in meaningful conversation about what they want to change.

Benefits of Collaborative Therapy

Below is a list of specific benefits unique to collaborative therapy:

• Client experiences are respected: Although therapists should be experts in their field, the client has the most insight into their own life. Clients may therefore contribute valuable information to therapy sessions. They often know more about their problems than do psychologists, who might not have first-hand experience with certain conditions.
• The client has increased insight: As the client and therapist work collaboratively to solve problems, they may gain a better understanding of the issues involved. They can also work together to identify small changes that can lead to larger successes.
• Client engagement is increased: The client becomes a partner in therapy, rather than just being told what to do without understanding why they have to do it. This approach may lead clients to feel more motivated about the process.
• Client empowerment increases: By empowering the client in collaborative therapy, the focus is on helping them learn skills that they can continue to use in their life after sessions end.
• Client engagement in treatment increases: Clients who engage in “mutually transforming” therapy are ready to take an active role in understanding how they contribute to their own problems and what changes they would like to make. They may be more likely to follow through with difficult tasks, including homework assignments.

Effectiveness of Collaborative Therapy

Collaborative therapy is a philosophical stance toward therapy rather than a set of therapeutic techniques to be empirically evaluated. As such, given that the methodology can vary greatly, systematic analyses of the effectiveness of collaborative therapy have not been conducted. However, other types of therapy that draw on the collaborative approach, such as cognitive-behavioral therapy, do have extensive empirical support.

Things to Consider

Collaborative therapy may not be the right approach for every client. Indiviudals who prefer a structured format or a therapist who is more directive may not respond well to this approach.

In addition, it may be difficult to know whether your therapist is adhering to the principles of collaborative therapy given that there is no manualized instruction of this therapeutic approach.

How to Get Started

Are you interested in getting started with collaborative therapy? Below are the steps to getting started:

1. Find a collaborative therapist: Collaborative therapists do not necessarily advertise themselves as such. A good way to find someone who offers this approach is by asking about their specific therapeutic orientation. Also, check to see if they accept insurance and consider how you may be able to pay for your sessions.
2. Attend your first appointment: This appointment is the time to talk about your own goals and expectations for therapy. If you are attending therapy online, expect that your first appointment will consist of a video session. You can prepare for this appointment by thinking about what you want to discuss with your therapist and the goals you want to achieve.

Collaborative therapy, a treatment approach developed by Harlene Anderson, focuses on the development of a collaborative and egalitarian relationship between a person in therapy and their therapist to facilitate dialogues that lead to positive change. This method is significantly influenced by postmodernism, and it is used to treat individuals, families, groups, and even organizations. 

People, couples, or groups seeking therapy to reach mutual understanding, improve communication, or resolve conflict may find collaborative therapy useful for exploring different perspectives.

History of Collaborative Therapy

Collaborative therapy was developed by Harlene Anderson over the course of her work as a therapist and through informal research with those she worked with in therapy. Interested in understanding why therapy worked for some people and not others, Anderson sought to discover what facilitated the transformation process of therapy and the types of conversations therapists could have with people in therapy to help them feel hopeful. Anderson conducted part of her informal research by engaging in discussions with conversational partners, including colleagues, people in therapy, and students. Through these dialogues, she developed the postmodern collaborative approach that collaborative therapy is grounded in.

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Theory and Principles of Collaborative Therapy

The foundation of collaborative therapy is postmodernism, a philosophical approach advocating both a skeptical attitude toward knowledge and the belief that knowledge is a socially constructed concept, not a universal truth. There are two key concepts of postmodernism fundamental to collaborative therapy. The first is the idea that knowledge is fluid, created as language evolves, and thus the process of growth and learning happens through dialogue with others. The second postmodern concept influencing collaborative therapy is the idea that multiple realities exist, so there is no single correct way to see a situation. In collaborative therapy, the perspective of the person in therapy is considered equal to the therapist’s.

Anderson considers collaborative therapy more of a philosophy rather than a theory or model. The two key principles of this approach are developing a collaborative relationship between therapist and the individual in therapy and engaging in dialogues that encourage growth and change. Anderson believes collaborative therapy facilitates transformation for both the person in therapy and their therapist. As meaningful conversations occur and various perspectives are explored, both parties may acquire new knowledge and understanding. 

What Is a Collaborative Therapy Session Like?

During the collaborative therapy session, the therapist and person in therapy develop a partnership in which they talk with each other, not to each other. Individuals can tell their story while a therapist actively listens and seeks to understand their perspective. To facilitate dialogue, the therapist might ask questions, comment, and make sure they accurately understand what the person in therapy is saying. By forming a cooperative relationship, they work together to create a new understanding of the individual’s experience, allowing for transformation. 

A crucial part of collaborative therapy is the therapist’s recognition that a person in therapy is the expert on their own experience. The therapist does not act as an authority figure or as if they have greater knowledge or understanding. They may offer their own suggestions or perspective, but they avoid imposing their own ideas on the individual in therapy. 

Specific techniques a collaborative therapist may use include inviting the individual to tell their story in their own way and at their own pace and demonstrating genuine interest in their experience. The therapist may attentively listen and respond, pay attention to verbal and nonverbal communication, ask the person in therapy whether their own interpretation of the experience is accurate, and pause, using silence to create space for reflection. 

How Can Collaborative Therapy Help?

Because collaborative therapy is considered a therapeutic stance and not a model, there is no specific issue or diagnosis it is designed to treat. Rather, it is an approach that may help people make positive transformations and address many types of issues and concerns. The therapist can focus on nearly any need or agenda presented by the person in therapy. The collaborative approach between individual and therapist may be particularly helpful to those experiencing issues with power differentials in relationships or those who have difficulty trusting others, especially figures of authority.

Collaborative therapy can be used with individuals or groups, whether those groups are couples, families, or other types of social systems. The collaborative relationships and dialogues fundamental to collaborative therapy can occur in groups of many sizes.

Training and Certification

While there is no specified certification for collaborative therapy, Anderson does offer consultation and training. She sees training in collaborative therapy as an ongoing process in which the therapist is continually learning. Learning to conduct collaborative therapy is often less about learning specific techniques and more about learning a specific philosophical stance, or way of interacting, with those seeking therapy. 

Concerns and Limitations

No single therapeutic approach is appropriate for everybody. While some individuals may respond well to collaborative therapy, others may prefer a more structured or directive approach in which the therapist uses more specific tools or techniques. Additionally, because collaborative therapy is conceptualized as a philosophical stance rather than a specific treatment model, the way it is practiced can vary widely. Collaborative therapy does not offer a manualized training or certification process, making it difficult to ensure the therapists using it adhere to its principles.  

References:

1. Anderson, H. (n.d.). Consultations and training. Retrieved from http://www.harleneanderson.org/index.html
2. Anderson, H. (2001). Postmodern collaborative and person-centered therapies: What would Carl Rogers say? Journal of Family Therapy, 4(23), 339-360. doi: 10.1111/1467-6427.00189
3. Anderson, H. (2007, October 5). The therapist and the postmodern therapy system: A way of being with others. Retrieved from http://www.europeanfamilytherapy.eu/wp-content/uploads/2012/10/anderson.pdf