PERSONAL CONNECTION IS THE GATEWAY TO SUCCESSFUL THERAPY

In PSYC 475, Survey of Clinical Psychology, we learned about the idea of common factors in counseling. These include a good therapeutic relationship, hope, and attention. The idea is that a therapist who uses these three factors in their counseling will generally be successful, regardless of therapeutic orientation or specific techniques. The therapeutic relationship is the most important factor in determining success of therapy, because it builds a connection and builds trust. Hope is portraying the idea that things can improve, and that the situation is not doomed. Attention is simply showing respect and being engaged listening to the client. By using at least these three basic principles, one has a great chance at being a successful therapist for their clients.

One of the experiences that has really allowed me to use and apply the skills I have learned in my psychology classes is being a registered behavior technician (RBT) at the Unumb Center for Neurodevelopment, a center that provides services to children with autism spectrum disorder. Through my training for becoming an RBT, I learned so much about how to connect with the children we would be serving. One of the ways we learned to connect with the kids was by using PRIDE skills. These include Praise: telling them exactly what good behaviors their exhibiting, Reflect: repeating what they say or express, Imitate: doing what they are doing, like playing with the same toys, Describe: saying what they’re doing, and Enjoy: showing that you enjoy what you are doing while spending time with them. I also learned how to collect data and implement the different behavioral principles and techniques we use to bring about change in their lives. I learned how applied behavioral analysis (ABA) is the best intervention for individuals with autism because of the emphasis on improving socially significant behaviors. These can vary based on the individual client, but socially significant behaviors that ABA targets often include communication, social, leisure, safety, hygiene and job skills. The behaviors targeted are also measurable and observable, which makes it possible to collect and analyze actual data in order to alter it. ABA also focuses on analyzing the relationship between the individual’s environment and their behaviors in order to learn what environmental stimuli maintain the behaviors, and uses repetitive positive reinforcement to alter these behaviors. These scientific and evidence-based facets are what has made ABA the most effective intervention for individuals with autism.

We learned a lot of technical skills and concepts, like how to take data and run different ABA programs, but one of the first and most important things we learned was pairing. Pairing is the word used in the ABA community for bonding and connecting with your client. We were taught how important it is to first pair with your client by building rapport and trust in order to become a positive reinforcer, or someone they are fond of. They instilled in us how important it is to begin every session with pairing in order to keep up the positive relationship you have with the client. While pairing, I often use the PRIDE skills I described above, and refrain from placing demands, like questions, as much as possible.

When I went in for my first day with a client straight out of training, I was extremely nervous and overwhelmed. I had never met him before, and I did not know much about his normal schedule, so I was not feeling confident about how I would run his session. I was frantically shuffling through his treatment plan and previous data when I realized that the majority of what I needed to do, especially on our first day together, is pair. As soon as he came into the clinic and up to his room, I focused on pairing and simply enjoying our time together. He started out shy, since he had never met me before but within about 20 minutes we were laughing and playing, and he was engaging with me much more than I had expected for our first day together! There were some bumps in the road like times where my attempts to pair did not land, and I felt like we weren’t connecting as much as I’d hoped. When this would happen, I reminded myself that these sessions will never go perfectly smooth, but to keep persevering and doing my job the way I know how. I continued to use my PRIDE skills, and if that continued to not work, I simply gave him some space and stopped talking. Throughout this experience I learned that even if I follow my training exactly, there will still be challenges that I can’t foresee. We paired for most of the day, and even though there were some challenges, I felt like we paired really well. The next time I worked with him, he remembered me, and we were able to continue to grow our relationship.

I am so thankful for not only my job training, but my education through PSYC 475, because I was able to build off of both of these learning experiences and apply it to my therapy session. Not only was I thinking about pairing and the PRIDE skills we learned in training, but I was also thinking about the common factors. I focused on building my relationship with the client and gaining his trust. I also thought about hope and was sure to encourage him when something went wrong to give him hope that he can improve. I also focused on attention, as I focused on paying attention to what he was doing and saying and engaging when he talked with me or included me in what he was doing. This paid off, as we paired really successfully, and I am very excited to see how our teacher-client relationship continues to grow, and how it will lead the way to truly effective therapy for him. These common factors will also inform my professional career as I continue as an RBT, and for my future goals of being a mental health counselor. While learning the skills and techniques for a job as a therapist is very important, it is most important to build relationships in order to allow for future success and well-being of the client.