summary:: The relationship is the key intervention. Common Factors (e.g., alliance, empathy, coherent and agreed-upon plan, etc.) provide a framework for enhancing practitioner efficacy.

Defining the Radical Rogerian

The ongoing inspiration of Carl Rogers

Carl Rogers argued that the core conditions of counseling are Empathy (ability to see the worldview of the other), Congruence (ability to be genuine), and Unconditional Positive Regard (ability to withhold judgement and provide warmth).

Through dialogue with classmates and clinical applications of my own personal meditative practices, I have found that Rogers' core conditions are more complete an approach to counseling than clinicians often assume.

The humans in the room are the Common Factors to therapeutic success

Especially at the beginning of our careers, we clinicians often feel lost without this intervention or that activity; we crave some structured thing to get us through our sessions. An agenda, an itinerary, helps us to cope with the difficulty of sitting in ambiguity and uncertainty with our clients. Through activity we feel helpful, a driving desire for many of us to enter the field in the first place.

Looking at the literature also reveals our professional bias toward finding our "theoretical orientations," planting our flag as adhering to CBT, or as a psychoanalyst. Indeed, a peculiar feature of modern research into therapy is the obsession with intervention and theory as they impact therapeutic outcomes. Yet time and time again we see that the most predictive variables of growth and success are the Common Factors. These factors include:

• extratherapeutic variables (what's going on in the client's life outside the session),
• motivational factors (a client's motivation to change), and among many others,
• the therapeutic alliance.

This last factor―the therapeutic alliance―points to the relationship between therapist and client, especially when rated from the perspective of the client.

The literature supporting the Common Factors as most predictive of therapeutic growth, coupled with the core conditions of healing relationships defined by Rogers, have led me to the following conviction when working with clients:

I firmly believe that all psychotherapeutic interventions should be punted if they interfere, degrade, or otherwise deteriorate my relationship with a client.

The relationship is the primary "intervention"

I don't dispute the utility of interventions. My concern is that we clinicians are saturated in a professional culture that over-emphasizes niche knowledges of theory and intervention to the detriment of our counseling skills. We over-emphasize the micro-interventions while neglecting the macro- or meta-intervention of the relationship itself. Another way to put it: The very act of walking into a counseling office and entering into relationship is the primary intervention.

Yes, our knowledge of mental health and illness, of personality growth and psychological development, of family systems and relationships, of wellbeing and pathology, of change and stagnation, of diversity and multiplicity of worldview―our training requires a tremendous amount of learning in these and many more areas. And theories offer unique packages that attempt to encapsulate these concerns within certain temporal (i.e., present vs past vs future focused), relational (e.g., expert or fellow traveler, directive or nondirective), and conceptual/philosophical/teleological (e.g., have you suppressed your urge to copulate with your parents, or are you seeking ways to self-actualize?) parameters.[1]

Yet as we leave behind our masters-level courses, how easy is it to neglect and forget the concrete tools of counseling? These are our skills of relating to another person. The use of body, gesture, and posture. Tone and cadence and pacing of questions, the use of reflections, and the comfort in silence. So much more here. But, the ultimate goal of building rapport (always building rapport) rests upon our ability to modulate our microskills to fit the client in the room.

These skills, in turn, say nothing about our need and desire to bracket our self―including our "theoretical orientation"―in our attempt to truly understand the client's world as they see it. This is a journey that undoubtedly must take the clinician inward, to know their self enough to detect when their "stuff" is entering the session. This is where the existential and philosophical and
the existential and philosophical and spiritual components of the therapist's personal life enters, and will be an ongoing subject throughout this blog.

The Radical Rogerian promotes the quality and depth of the therapeutic relationship as the single most important "intervention." Any micro-intervention which dismisses or damages the relationship in pursuit of some other teleological aim (e.g., truth, insight, interpretation) is itself dismissed. In other words, their is a fundamental trust that the helping relationship provides the necessary ingredients for positive therapeutic growth.

In the (oft-quoted) words of Carl Rogers:

This quote holds a further implication of the therapeutic relationship. Namely, that the relationship between clinician and client provides a framework for how one ought to relate to oneself. Such an understanding is embodied in approaches like Radical Acceptance, which holds that tremendous healing and growth occur once we are able to completely accept what is arising right in this moment.

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