Perspective of power in therapeutic relationships.
Therapists can have several reasons to reflect on the helping process from a perspective of power. In effect, they all use a theory of power, be it implicit or explicit. If this theory is meant to support therapeutic thoughts and actions, it has to meet several requirements. First, it must recognize the human qualities of therapists, clients, and other people involved. Second, it must account for the complexity and dynamics of therapeutic situations; it must, for example, high-light possible shifts in power differences. Third, it must be applicable to a variety of therapeutic circumstances and systems. This means that the familiar paradigm of control, predictability, simple causality, full rationality and linearity of action must be replaced by an evolutionary paradigm that assumes continuous flows of changes between actors and factors. Some of the emerging patterns get fixed, spontaneously or artificially and become visible as shorter--or longer-lasting--stable patterns on micro- and macro-levels. Power is focussed on by an anarchistic decision-making approach. The (combinations of) people involved are depicted as living, i.e., evolving and learning systems: all actors are supposed to have their own intentions, resources, strategies, interpretations, opportunities, and development. One has to look for power inequalities between the actors on operational, organizational, structural, and cultural decision-making levels. The result is a multi-actor, multidimensional decision-making model for the therapeutic relationship that opens up new possibilities for intervention.
van Mens-Verhulst
J
J
Department of Clinical and Health Psychology, Utrecht, The Netherlands.
D003657:Decision Making; D005260:Female; D006801:Humans; D008960:Models, Psychological; D011209:Power, Psychological; D011369:Professional-Patient Relations; D011613:Psychotherapy; D016387:Women's Health; D014933:Women's Rights