Therapeutic Alliances in Organizations

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When we consider best practices in managing staff in organizations, we tend to anchor our argument to human resource practices such as: the role of the leader, authority, hierarchy, chain of command, performance measures, and training.  Tertiary at best, is the importance of healthy and productive relationships in an organization, even though we know that poor communication and weak relationships can sink the proverbial ship.

I believe that fostering healthy relationships in organizations should be of paramount concern for leaders.  Poor relationships lead to conflict and conflict leads to all manner of pernicious outcomes.  Absenteeism, presenteeism, turnover, losses in reputation and finances are a few of the damaging outcomes that impact organizations as a result of unchecked conflict and toxic environments that flow from conflict.  Conflict can distort communication and create organizational relationships that are unhealthy and unproductive.  Erbe (n.d.) notes that poor organizational governance leads to “distrust, unhealthy competition, alienation, and complaints” (sec 2266).

There is a vast collection of literature that offers solutions to the destructive by-products of organizational conflict; however, any solutions that ignore the elemental influence of communication and relationship will not offer a sound or enduring solution.

Conflict in organizations is common, Costantino and Merchant (1996) argue that “In an organizational context conflict is an expression of dissatisfaction with an interaction, process product, or service” (p. 4).  Conflict is often thought of as an unwelcome organizational fact of life and even necessary to unearth an underlying problem.  The tension created by conflict can sometimes cause individuals to confront a difficult truth and bring it to resolution rather than avoiding the problem outwardly and allowing it to inwardly fester.  Johnson (2005) labels a difference in priorities as a “Polarity” which is an “…ongoing and chronic issues that are unavoidable and unsolvable” (p. 3).  Each party has the one correct answer that is seen as independent of the other.  So, conflict can generate a necessary change or can fester into a pattern of systemic divisiveness, creating poor quality relationships that do not benefit the employee, organization or any stakeholder.

One possible way to address workplace conflict is by applying the concept of a “Therapeutic Alliance” (Rogers, 1978, 1980; Martin, 2011; Norcross, 2002) in the organizational milieu.  The concept of a therapeutic alliance is commonly used in therapeutic psychological counselling and has been adopted by some professionals in other helping professions such as medicine and social services.  The therapeutic alliance helps reduce the reluctance of the client to engage in services or intervention and creates a coalition between the helper and the individual being helped. 

To illustrate this, visualize emotional pain as physical pain, such as an open wound.  Now visualize that the wound has not healed and is improperly dressed.  It may be that treating the wound involves the excruciating process of removing the current dressing, irrigating the wound, and painfully removing debris from the wound.  The patient may be reluctant to let anyone near that wound.  However, if a doctor is serene and considered in her approach, she explains what to expect, empathetically reassures the patient that she will remain present during the entire process and only then does she treat the wound, as painful as it is, an alliance of sorts has formed, allowing for a pathway for healing.  Therapeutic counselling is similar but often with more shame and stigma inherent in acknowledging a painful truth exacerbating an individual’s reluctance to engage in the therapeutic process.  Studies demonstrate that a purposeful collaborative relationship between a therapist and client leads to better therapeutic outcomes.

Particularly influential in our current understanding of the therapeutic alliance is the work of Carl Rogers and his concept of “Person-Centered Therapy” (Rogers, 1978, 1980; Martin, 2011).  Three pillars the “Rogerian” or “Humanistic” approach include “congruence” which refers to the practice of genuinely relating to the client without emphasizing professional status, “unconditional positive regard” by demonstrating appreciation for the individual without judgment and listening attentively to the individual without interruption or direction.  A final pillar is the need for the therapist to project “empathy” and understanding to the client (Rogers, 1978).

The theoretical underpinnings of a therapeutic alliance are consistent with NCRP practices and can be applied to good effect in organizational design.  Carl Rogers (1980) concept of unconditional positive regard proposes that a therapist should communicate and project regard for the patient.  It is accepted that, as part of the human condition, we are more likely to like people that appear to like us.  When people treat us with regard, we are more inviting of positive and negative feedback. 

I believe that insufficient attention is paid to promoting and maintaining healthy relationships in organizational design.  In “Organizational Conflict Resolution” Erbe (n.d.) notes that the worst organizational processes demonstrate an absence of listening and understanding and lack of reflective practice.  The tenets of a therapeutic alliance are intuitively transferable to the workplace by honoring and venerating the employee, by paying attention to health of relationships within an organization and projecting that these relationships are a priority.  Pay attention to the health of your relationships and those healthy relationships will pay dividends.

 

ENDNOTES

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