No act of kindness, however small, is ever wasted. Aesop
Four factors seem to capture the essence of effective counseling and therapy. Often referred to as the “common factors,” expectancy, therapeutic model, relationship, and client and extra-therapeutic factors suggest the likely outcome of therapy (see http://bit.ly/2xF156h for a more detailed review of this phenomenon).
What a practitioner expects accounts for 15% of the outcome of therapy, the therapeutic model employed accounts for another 15%, the relationship between the practitioner and client accounts for a full 30%, and client “extra-therapeutic” factors—personality traits like internal strength, environment, support system, etc.—40%. Although these are estimates based on a meta-analysis of empirical studies, they nonetheless suggest that the theoretical orientation of the practitioner contributes less to the outcome than does the simple interpersonal relationship that develops between the client and the practitioner. Put another way, next to those “extra-therapeutic effects” the client brings to treatment, the relationship is the most significant factor in determining the outcome of treatment.
Harold Kelly (1950[2]) found that when two random sets of students in an experiment received the same lecture from the same individual but following different introductions, one indicating the lecturer was a warm and knowledgeable individual in his field and the other that he was somewhat cold but knowledgeable, the students receiving the “warm” intro tended to rate the lecture better than did those receiving it from the “cold” lecturer.
“Warm” and “cold” are what social psychologists refer to as “central traits.” They are of great significance and possess the ability to shape one’s impressions of individuals even when other characteristics such as ability, performance, and reputation are presented. These perceived personal characteristics of “warmth” and “coldness” are so influential that they can affect how we interpret another’s other personal characteristics. In a now famous study conducted by Solomon Asch (1946), he found that when subjects were exposed to a description of someone as “warm and intelligent” or “cold and intelligent,” the actual meaning of the descriptor “intelligent” actually changed, resulting in a different impression of the individual being described.
What does this have to do with interviewing college students regarding their drinking behavior?
When interviewing students mandated to see me following a violation of the university’s alcohol policy, they would frequently show up acting as though they expected a “dad talk” – drinking is bad, you better never do this again, etcetera, etcetera. As we would enter my office, I would start the conversation by asking if they cared for a glass of spring water[3]. Often, they would say yes, perhaps only because they were surprised that I asked. As I went to get the water this left them a moment to look around my office, which was decorated in what I affectionately refer to as a “curio shop motif.” Among the many items in the office were in excess of 120 coffee mugs, hung on the walls, collected over the years and placed there simply because I had run out of shelf space.
When I would return with the water it was not uncommon that a student would say something about my office decor. If mentioning the coffee mugs—a favorite focal point for students—I would say, “Pick one.” The student would often look perplexed while saying, “Excuse me?” to which I would repeat my invitation, informing him or her that I would tell the story of how I got whichever mug was selected. Now, the most risqué story for any mug was rated PG, so these were boring stories. However, the point I make here is that the first 5-7-minutes of the mandated interview were spent treating the student as though she or he was a welcomed guest rather than a mandated client.
It was not uncommon that such students would return for sessions in addition to those mandated by the university, although often to discuss issues other than or in addition to the drinking that warranted the mandate in the first place. My point is, when the “person” who is our client is greeted by the “person” who is her or his counselor, it is at that juncture that the magic in counseling happens. It is the “person-to-person” interaction rather than “client-to-therapist” intervention that sets the stage for effective therapy.
True, I employed techniques heavily influenced by my affinity for CBT and conducted my intercessions[4] in a manner equally influenced by Motivational Interviewing, but the point remains, you sometimes have to give people what they want in order to get the opportunity to give them what they need…and what we all want, always, is to be respected and welcomed when interacting with another…in whatever venue.
What do you think?
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References
Asch, S.E. (1946). Forming impressions of personality. Journal of Abnormal and Social Psychology, 41, 258-290
Kelly, H.H. (1950). The warm-cold variable in first impressions of persons. Journal of Personality, 18(4), 431-439
Footnotes
[1] Borrowed from Kelly; see citation in the references above
[2] Before rolling your eyes at a 1950 citation, recall how often “old research” continues to inform practice today, consider Pasteur’s work with “germs” or Fleming’s with bacteria.
[3] After moving to the academic side of the street as a professor of behavioral health counseling, I did something similar with students who would stop by my office, only I offered them tea or spring water…something very soothing and “civilized” about proffering a cup of tea :)
[4] I prefer to conduct intercessions to interventions as the latter are too invasive and suggestive of an “us and them” dichotomy. For more on this, read my article in the INCASE Addiction Educator at http://incase.org/attachments/AE-Vol2.pdf See "Is a Rose by any Other Name Still a Rose?: A 21-Century Look at the Utility of Interventions in Addictions Treatment,” p. 4
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