2. I expect that my
therapist to be Of course my
compassionate listener professional role as a
who will address their therapist implies
concerns in a reserving personal
reasonable and non judgment and focusing on
biased manner. patients needs.

4. WOW, you are
extremely irritating to
me.

5. Do your friends or
family ever seem to
be exasperated or
short-tempered with Lets talk about some
you? possible triggers for that.

6. A contemporary collaboration include
an active exchange of information and
shared decision making.

7.  The therapist is reasonable for
structuring both individual session and
the therapy as a whole, this objective can
only be achieved with active input and
feedback from the patient.
This important process of negotiation between patient and
therapist (Safran & Muran, 2000) is more than superficial
consensus; it is both a necessary condition and an intrinsic
part of a change process.

8. With other patients, more specific
effort is needed because there are
particular problems in therapeutic
collaboration.

9. Two types of problematic collaboration
1. Passive Noncollaboration- may stem from low
expectations for success.
2. Active Avoidance- suggests negative, personalized
meaning such as distrust of therapy or externalized
blame.

10. To avoid problems in collaboration
How do you feel about your Frustrated. I want
progress so far in
overcoming your anxiety and to be a lot further
doing things are difficult for along.
you to do?

11. Nothing really, but I think I
need someone to force me
What do you think has gotten to do what is difficult. I'm not
in your way, or held you back? very good at disciplining
myself, and I need a
demanding taskmaster to
make me do what I don’t
want to do.

12. Id like to hear about your homework, which
if I remember correctly, was to schedule an
hour for doing something just for yourself Well, I thought about
that you might enjoy. We discussed some the assignment a lot,
ideas, as I recall. Were I able to try out any but didn’t actually do
of the things we considered, or did you try anything
something completely different?

13. That sounds like some
important cognitive work. Okay, but I don’t
Can we talk further about
that?
know what there
is to talk about. I
didn’t do anything

14. That’s okay; what is important is to
Yeah, there was. I really sort of
understand your thought process.
wanted to do something just
Can you tell me about your internal
for me. The idea sounded
conversation about this idea? Was
good, like something I never
there sort of a back-and-forth
do. I even called and
deliberation?
scheduled an appointment at a
nail salon to get a pedicure and
was looking forward to a nice
treat.

15. There is a coffee shop next to the salon, and I was
going to get one of those delicious caramel
frappachinos and just relax and enjoy being pampered
for a little bit. But then I realized that I would be taking
time away from my family and spending money on
myself, and I just didn’t feel right about it. I guess I felt
that taking time for me was going to turn me into one of
those selfish, uncaring, “high maintenance” types and I
just couldn’t do it. If I took that time for myself, I felt like I
would be letting my family down. So I spent the
afternoon ironing clothes instead.

16. I noticed you winced just
then, and seemed a bit
agitated. Was there something Actually, I was feeling
that crossed your mind just irritated.
then?

17. Well, I don’t like
Was the irritation related answering question. I
to the topic we are feel uncomfortable
discussing, or possibly trying to put my
something in my
feelings into words. I
manner?
wish you already know
what is bothering me

18. I really appreciate your effort to be thorough in telling me how
you are doing.
I want to ensure that we stay productively focused, but it’s a little
hard to do that and take everything in. I’d like to check out a
possibility with you that might help us be more efficient.
Do you think that it is necessary for me to know everything that
has happened to fully understand and help you? Is that maybe
one reason why you work so hard to tell me everything?

19. Well, yes. I don’t really
know what is important. So
I need to get all the
information to you so that So your assumption is that I
you can figure out how to need to know everything so that
solve my problems. I can figure out the solution to
your problems.

20. Yes. Is that strategy working very well
so far?

21. Not really. I’m working
really hard and I haven’t
really gotten to hear How about if we consider
what you think I should some different ideas about
do yet. how to make our work
more productive?

22. Five Indications of a Good
Working Relationship
1. There is a desire to have contact.
2. Information is shared.
3. Positive affect is expressed.
4. Sense of teamwork.
5. Negative sentiment is productive.