Exercising Leadership Within the Therapeutic Alliance: An Autonomy-Grounded Perspective

Abstract

Leadership within therapeutic practice encompasses the capacity to formulate and accomplish strategies that are mindful of one’s ethical duty toward fostering clients’ autonomy. Here, clinical practitioners’ role as “leader” involves not only sustaining the momentum of the therapeutic alliance, but also contributing toward the purpose of this alliance. The very telos of therapy is to create an environment that facilitates clients’ ability to move toward autonomy: to lead clients, paradoxically, beyond a need to engage in the clinical relationship. Here, fostering client autonomy lies at the heart of therapeutic leadership because the experience of autonomy—which is developed interpersonally—expresses itself in a state of internal clarity and cohesiveness through which clients are more capable of exercising control over the trajectory of their life beyond the cessation of the therapeutic relationship. Three characteristics of the therapeutic leader are important in this regard: discernment, determination, and humility. Each of these are most fully exercised when the practitioner possesses a commitment to ensuring an ethic of collaboration and egalitarianism, underpinned by therapeutic “presence.”

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“…Jafnraeði, virðing og þekking er mikilvaeg í sambandinu. Fagfólk þarf að sýna naergaetni, hlusta og vera móttaekilegt fyrir þörfum skjólstaeðingsins (Kinsella, 2023). Hluti af því sem þátttakendur töluðu um sem fordóma virðist vera samskiptavandamál, misskilningur og þekkingarleysi.…”

Það er eðlilegt að tala um offitu en það er ekki sama hvernig það er gert. Reynsla einstaklinga með offitu af heilbrigðiskerfinu

“…Jafnraeði, virðing og þekking er mikilvaeg í sambandinu. Fagfólk þarf að sýna naergaetni, hlusta og vera móttaekilegt fyrir þörfum skjólstaeðingsins (Kinsella, 2023).…”

The ethical imperative to honor autistic clients’ autonomy in mental health treatment

“…Kinsella ( 17 ) provides a humanistic perspective and argues that it is a clinician’s ethical duty to foster clients’ autonomy. He states that an ethically-grounded practice requires believing that clinicians can nurture clients’ autonomy by being adaptive and supportive of each client’s strengths and needs.…”

“…While we may think of autonomy as pertaining to an individual, Kinsella ( 17 ) rethinks it as a reciprocal and relational process. He emphasizes the importance of a clinician replacing paternalism with a more egalitarian “relatedness.” Chapman and Botha ( 18 ) emphasize that neurodivergence-informed therapy relies upon a relational model of mental health.…”