Touchstones of Connection: A Concept Mapping Study of Counselor Factors That Contribute to Relational Depth
The purpose of this study was to use concept mapping to explore counselor factors that create moments of relational depth with clients. Results support the use of Rogers's (1957, 1980, 1989) core conditions of empathy, genuineness, and unconditional positive regard and more specific counseling skills and approaches. Keywords: relational depth, counseling relationship, concept mapping The therapeutic relationship has factored significantly into effective therapeutic outcome (Lambert Barley, 2001; Norcross Wampold, 2011; Orlinsky, Ronnestad, Willutzki, 2004) After exploring over 1,000 studies, Orlinsky et al. (2004) concluded that the bond between the counselor and client consistently contributed to therapeutic outcome. Horvath, Del Re, Fluckiger, and Symonds (2011) conducted a large scale meta analysis of more than 14,000 treatments and found the therapeutic alliance to be a predictor of treatment outcome. Thus, it seems clear that the therapeutic relationship is an important component of effective therapy. One unique aspect of the overall therapeutic relationship is the experience of relational depth, or deeper moments of profound connection between counselor and client. More specifically, relational depth has been defined as "a state of profound contact and engagement between two people, in which each person is fully real with the Other, and able to understand and value the Other's experiences at a high level" (Mearns Cooper, 2005, p. xii) After controlling for pretherapy effects, moments of relational depth have been shown to contribute to therapeutic outcome over and above the therapeutic alliance (Price, 2012; Wiggins, 2013) Furthermore, in qualitative studies of relational depth, clients have stated that these experiences have positively affected relationships with self and others, contributed to progress in counseling, facilitated healing (Knox, 2008) promoted greater insight and a sense of the counselor's presence (McMillan McLeod, 2006) and provided clients with courage to face their issues (Knox, 2008; McMillan McLeod, 2006) It is believed that clients initiate these deeper moments of engagement when they are ready and willing to open to such a vulnerable experience (Knox Cooper, 2011; McMillan McLeod, 2006) This initiation is thought to be predicated on some perceived invitation from their counselor (Knox, 2008, 2013; Knox Cooper, 2010, 2011) However, we do not yet know how counselors invite and facilitate these deepened experiences of connection. On the basis of the relational depth literature, researchers could infer certain counselor factors that may contribute to these relational depth invitations. First, our understanding of the theoretical background of the construct informs knowledge in this area. Relational depth is grounded in the tenets of Rogers's (1957, 1980, 1989) person centered therapy, which emphasizes the core conditions of empathy, genuineness, and unconditional positive regard. Thus, relational depth is inherently humanistic. It is interesting, though, that relational depth is believed to exemplify an "upward extension of the working alliance" (Wiggins, Elliott, Cooper, 2012, p. 140) emerging from the powerful synergistic effects of the core conditions (Knox, Wiggins, Murphy, Cooper, 2013; Mearns Cooper, 2005) Based simply on this theoretical background, it can be inferred that any attempts to cultivate greater empathy, genuineness, and unconditional positive regard and communicate these to the client could serve as a relational depth invitation. However, such a conclusion still lacks specificity and direction with regard to counselor development and thus provides little direction for training. To better understand the developmental trajectory of cultivating the capacity to invite these deepened moments of connection, we turned to Rowan and Jacobs's (2002) three positions of the therapist's use of self.