Therapeutic immediacy (TI) is a term used to encompass any discussion between a client and therapist during a session. The therapeutic alliance formed between the two parties as a result of the discussion is fundamental to the success of treatment. “Recently, in order to capture the more interactive and dyadic nature of the therapeutic relationship, this definition has been broadened to also include any client-initiated disclosures of feelings about the therapist or their relationship, and the revised term of therapeutic immediacy has been suggested,” said Jason Mayotte-Blum of the Derner Institute of Advanced Psychological Studies at Adelphi University, and lead author of a recent study on the effect of TI. “Typical examples of therapeutic immediacy include exploring parallels between external relationships and the therapy relationship; client or therapist expression of in-session emotional reactions; inquiring about the client’s reactions to therapy; the therapist commenting on his or her experience of the client; supporting, affirming, and validating the client’s feelings in the therapy relationship; and expressing gratitude. Use of therapeutic immediacy in the therapeutic relationship can then act as a template for interpersonal functioning in the client’s outside relationships.”
Mayotte-Blum analyzed data from two case studies for his recent study. In both instances, the clients and therapists were not told that TI was the focus of the study. Mayotte-Blum and his colleagues examined data from 16 sessions over a four-year period and found that TI was used quite often by both the therapist and the client. Mayotte-Blum said, “Session excerpts of therapeutic immediacy identified prominent areas of treatment focus such as (a) the building of trust, mutual respect, and recognition of deep feelings with a male figure; (b) the generation of new relational templates and skills related to in-session discussion of the therapeutic relationship; and (c) Ann’s [client] increasing ability to tolerate intense affect such as sadness and anger.” He added, “Although it is unclear to what extent the use of immediacy was responsible for these therapeutic gains, we can surmise from these direct client reports that the use of immediacy was at least experienced as a positive and facilitative intervention during their treatment.”
Mayotte-Blum, J., Slavin-Mulford, J., Lehmann, M., Pesale, F., Becker-Matero, N., & Hilsenroth, M. (2011, November 7). Therapeutic Immediacy Across Long-Term Psychodynamic Psychotherapy: An Evidence-Based Case Study. Journal of Counseling Psychology. Advance online publication. doi: 10.1037/a0026087
© Copyright 2011 by By John Smith, therapist in Bellingham, Washington. All Rights Reserved. Permission to publish granted to GoodTherapy.org.
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