Evidence-based relationships and responsiveness

Domain VI · Brief, integrative, trauma, hypnosis & coaching · John C. Norcross · 2011

What it is

This is not a single therapy. It is a research-based framework that sits on top of whatever treatment you already deliver. It has two parts. (a) Evidence-based relationship elements: therapist behaviours and qualities, such as the alliance, empathy and collecting client feedback, that predict…

Format

• The Task Force does not publish phases, a session count or a fixed format. It applies to individual, youth, couple/family and group therapy, and to any orientation (CBT, psychodynamic, humanistic, systemic). Its own practice recommendations form a loop that runs through the whole treatment:
• Demonstrably effective: alliance in adult individual therapy; alliance in child and adolescent therapy; alliance in couple and family therapy; cohesion in group therapy; empathy; collecting and delivering client feedback; goal consensus; collaboration; positive regard and affirmation.

Who practises it, and how they are trained or regulated

• Version followed: the Third APA Interdivisional (Divisions 12 and 29) Task Force on Evidence-Based Relationships and Responsiveness, chaired by John C. Norcross (Norcross & Lambert, 2018, 2019, Vol. 1, therapist contributions; Norcross & Wampold, 2019, Vol. 2, therapist responsiveness). Practice detail is taken from Norcross's Task Force slides, the Norcross & Wampold (2013) Compendium of Treatment Adaptations…

Evidence status, as the guide reports it

• Adapt the relationship and the treatment to patient characteristics where the evidence supports it.

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• How do you and the practitioner understand what is happening, in spiritual or cultural terms? Is that a source of comfort, worry, or both?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• Boundary blurring.
• Polite agreement without belief.
• Repeated boundary drift with one client.
• Subgrouping, scapegoating and silent members.
• The young person seeing you as "on the parents' side".

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.