Embracing Authenticity in the Therapeutic Alliance

by Nompilo Loice Shava-Zibanayi, BSW

     I recently started my fieldwork placement. Naturally, I was nervous. This was my first time getting on-the-job training in a clinical capacity. I wasn’t sure who to be. I obsessed about whether I was walking into the patient’s room the correct way, or if I was greeting the client using the right words. “Am I smiling enough? Should I even be smiling?” I wondered. I wanted everything to be perfect, and I obsessed about what perfect looks like as a social worker. “The stakes are too high,” I thought. Yes, the stakes are always high, because we deal with vulnerable clients who deserve the highest standards of service. So, I guess my heart was in the right place. I was just going about it the wrong way.

     Having just completed the course, Theories for Evidence-Based Clinical Social Work Practice, I remembered that the therapeutic alliance was constantly emphasized as one of the main determinants for success in treatment. Many scholars concur that the therapeutic alliance is a key agent in the treatment process (Ardito & Rabellino, 2011). Here I was, stepping into this daunting clinical role, wondering if “I was enough” for the therapeutic alliance. It’s one thing to read about the therapeutic alliance and another to actually engage confidently with a client.

     In this regard, the importance of fieldwork placement cannot be overstated. Fieldwork training is one of the things I appreciate and applaud about the social work profession. Some things only make sense when you experience them firsthand. Being in a clinical agency setting helped to demystify any misconceptions I had about the therapeutic alliance.

     As I shadowed the excellent clinical social workers and mental health social workers, a clearer image began to emerge. There isn’t just one personality type that makes the best therapists. What I observed were different individuals, with their unique personalities, showing up for their clients. I didn’t need to change my personality into a stereotypical personality that I was making up in my head. I needed to have the confidence to show up as myself. The common thread I observed was the unconditional positive regard that the therapists showed to their clients.

     Now that I have stopped worrying about whether I’m good enough to engage with patients in a clinical capacity, I have the freedom to work on the things that truly matter in the therapeutic alliance, like establishing rapport, using questions appropriately, active listening, and showing empathy. As social workers, we use ourselves to help bring change to our clients, and that requires authenticity. As I continue with my fieldwork placement, I realize that there is a lot still left to learn and master, but I am confident that showing up as my authentic self is the best way to grow as a social worker in training.

References

Ardito, R. B., & Rabellino, D. (2011). Therapeutic alliance and outcome of psychotherapy: Historical excursus, measurements, and prospects for research. Frontiers in Psychology, 2, 270. https://doi.org/10.3389/fpsyg.2011.00270

Nompilo Loice Shava-Zibanayi, BSW, is a master of social work student at the University of Central Florida. She is currently carrying out her fieldwork placement at Halifax Health Medical Center in the department of adult behavioral health services.