University Psychology 13: Exploring the Therapeutic Triad

This psychology essay delves into the therapeutic triad, a crucial concept in mental health care. It explores the significance of awareness of verbal and non-verbal communication, unconditional positive regard, and empathy in counselling sessions. The author, a mental health practitioner, reflects on their experiences, highlighting the importance of understanding patient emotions, maintaining ethical boundaries, and fostering trust. The essay emphasizes the role of cultural competence and integrative psychotherapy in delivering effective, patient-centered care. Through a detailed analysis of communication dynamics, including examples, the author underscores the need for counsellors to develop skills in active listening, emotional regulation, and building rapport to facilitate positive therapeutic outcomes. The essay also highlights the importance of self-awareness and reflection throughout the counselling process to ensure effective and ethical practice. The essay provides a comprehensive overview of the elements of the therapeutic triad and its application in real-world scenarios, providing valuable insights for students and practitioners in the field of psychology.

RUNNING HEAD: PSYCHOLOGY
PSYCHOLOGY
Name of Student
Name of University
Author note

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Stress and anxiety as well various other forms of behavioural, emotional and complex
personality plus cognitive derangements leads to decrease in the quality of life as well in
diminishing the well- being of the individual and the well-being of the other individuals
(Bright et al., 2019). It is very important that these persons are dealt with care and affection
as well as they are at first treated with respect and dignity that they expect in their daily day
to day lives. Institutionalization and dinstitutionalization both has its own benefits and in a
long term plus short term care scenario – the community as well as the mental health institute
settings play a vital role in the delivery of proper mental health services (Ahonen 2018). It is
very important to be considered that the counselling processes as well as the psychiatric
medications that is the non-pharmacological and the pharmacological management
respectively play a very important role in the delivery of the appropriate mental health care
delivery process in a clinical setting (Palmer 2017). The various types of clinicians and the
allied health staffs involved in the mental health care processes delivery needs to comply with
proper evidence based practices both to ensure a patient centered care delivery and a safe care
delivery that is equalled with beneficence and non-maleficence. It is very important that
individuals who are working very closely with the mental health patients such as the doctors,
the mental health nurses, the psychologists and the counsellors as well as the supportive staffs
must be trained properly with the proper prerequisite education and with the proper type of
staff development sessions in order to develop the skill sets and the required counselling as
well as mental patient attending quality parameters, so that the care delivered is meaningful
and profound in a holistic manner. Cultural competence is a very important contemporary
concept in modern mental health care setting and all the doctors, the mental health nurses, the
psychologists and the counsellors has to be trained properly in the correct manner in order to
help them comply with the competency practices. The competency of a certain mental health
care professional is dependent on how he is being to manage his emotions and feeling

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without getting diffused with feelings and emotions of the patient that he or she is attending
and it is very critical indeed that the right form of empathy is used as an important tool to
make sure the treatment is delivered sensibly and professionally. As a mental health
professional, I have practices throughout the years with complete integrity as I have been
learning from my practice experiences and always striving to learn how to adhere myself
better with the practice guidelines that are dependent on the mental health principles of care
such as empathy, emotional regulation, keeping the boundaries intact, maintaining the ethics
in a right manner, confidentiality, maintaining silence, restraining from being or getting
judgemental and keeping up the unconditional good regard, maintain the power flow and
power display in a therapeutic relationship, keeping the correct level of awareness about
verbal and non-verbal communication, active listening skills, having respectful bonding with
the patient and building confidence in the patient through the application of correct forms of
motivation, being aware to facets of non-verbal and verbal aspects of communication with the
subject and it is very important along with all these above mentioned principles of mental
health care – that I always has believed to be a center part of the counselling process is
reflection (Schiltz & Zimoch 2017). Reflecting throughout the course of the counselling
process and understanding the innermost feelings, emotions and understand the most valuable
part of the patient’s thought content and that being able to separate it from my own feelings
and emotions is critical – is very important and vital as well. Integrative psychotherapy
which I have used as a mental health care practitioner, many a times to understand, assess and
treat my patients in the right manner and in the most apt professional evidence based practice
way – has proved to be very helpful to both patient and to my skill development as my
professional practice or rather a huge part of my mental health care professional practice is
comprised of various types of talk therapies which are different types of counselling required
in a variety of mental health cases. Mirroring, paraphrasing and summarising is critical to the

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areas of my mental health practice and it is critical that as a mental health practitioner – the
same along with the above mentioned skills and practice principles are practiced in a very
pertinent manner in order to deliver a patient centered care and this is what I have done or
rather I have always tried to do it, over the years to elevate the quality of my professional
practice as well as improve the quality of my delivered services to the mental health patients.
In this study, the therapeutic triad in form of awareness to verbal and non-verbal
communication, unconditional positive regard and empathy has been explored.
Awareness to verbal and non-verbal communication
As a mental health practitioner, reflecting on my past experiences – the first and the
foremost thing is to understand and comply with very fine aspects of verbal and the non-
verbal aspects of the communication. The fine underpinnings and the most important aspects
of the talk therapy counselling processes are dependent on the various minute facets of non-
verbal and verbal communication. I have understood and realized very early in my career that
understanding the true nature and the psyche of the person is very important and that only
through the understanding of the psyche and nature of the personality of a certain subject, his
mental health issues whether it pertains to emotional, personality, behavioral, social,
delusion, cultural, identity, sociocultural, psychosocial, traumatic and neurodegenerative
changes related biological decay of the cognitive networks are concerned – can be solved in
the most right and in the ethically correct ways of professional mental health service delivery.
Talk therapy, I have learned from my experience, is one of the most important and most
powerful method of therapeutic psychology but it is always to be integrated with right skills
and the right sets of expertise application procedures to make the patient counselling session
a successful one. Although the counselling sessions range from weeks to months at times –
depending on the complicacy of the presented mental health problem (Lee et al. 2016). In
each of my cases where I have counselled the patients through some form of counselling

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technique – whether it is cognitive behavioural technique or a psychoanalysis or a
psychodynamic therapy but in all the counselling process, although they were diverse and
covered different ranges of treatment procedures using and utilizing different psychological
rhythms as well as mental health processes – one thing I found to be constant and it is very
important that these areas are maintained and regulated properly to deliver a right and correct
procedure of mental health care. Awareness to the patient, to one’s own self and to the
surrounding are the three most vital basis of counselling procedure and this is very important
that the verbal and non-verbal communication is maintained properly throughout the course
of the counselling process in order to understand, recognize, assess and address the emotions,
feelings and problems of the patient in a very pertinent manner. I myself is a very
intrapersonal individual and as counsellor, I have focussed on verbal components of the
counselling process better than the non-verbal aspects and this was a huge barrier that I faced
in the initial days of my practice. The most important aspect is that I focussed on, was the
content and the nature of the speech but I had problems identifying the tone of the speech as
well as recognizing the expressions of the patient and connect the same with the voice of the
patient. With time and experience and seeing more number of cases – I grew the non-verbal
skills relating to tone, body language, nature and identification of facial expressions of the
patient which helped in professional growth as a practitioner gradually. I grew my skills
pertaining to body posture, body contact, head movements and I applied with the verbal
aspects of the counselling communication such as content. Fluency and attributes of the
speech along with opening and closing of the communication is important as a counsellor, I
focussed on all these aspect to understand and apply my therapeutic skills to case. A
counselling session has two aspects or rather two very important parts – firstly the part is
assessment where the problems of the person is explored and the various implicit
understanding of the personal behaviour and state of mental well-being is identified as well

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and I have noticed that this is in this phase, the patient is more guarded and he or she restrains
from responding verbally and is very anxious and in many, they are afraid that they are
seeking help as they have no control over the situation plus no control over their own lives as
well. This is very vital that as counsellor, I felt the need of understanding the thought nature
of the person or what is going on in his or her mind just by assessing her or his tense facial
expression, the taut posture and restricted movements and through the passage of my career, I
have learned a lot about comforting the person with dignity and care but in a professional
way for example by touching the hands of the patient (at maximum), maintain a firm tone
thus acknowledging the feelings and emotional state of the person in order to let the subject
feel confident that his or her feelings are actually being listened to and that they are getting
addressed as well. The very important factor in the awareness skill of a counsellor, according
to me, is that the counsellor must use and apply the right blend of proximity, eye contact,
body posture and tone in order to help the patient understand that he or she is in the right
place and that he or she can actually express their feelings (no matter they are very
confidential, violent, traumatic, fearful, incongruous with reality, delusional, hallucinatory)
without any worries pertaining to social or cultural or any other form of stigmatization. That
is why, I believe, once again, it is very important that the trust of the subject is earned and
that the cultural competence of the counsellor is at full use which communicating with the
subject and addressing the problems of the patients in a professional manner. From my
experiences, I have learned that both verbal and non-verbal aspects of the communication is
regulated and explored by the counsellor in an imperative manner in order to promote well-
being of the subject and the state of mental recovery of the attending mental health subject.
Verbatim example
Counsellor How are you doing today

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Stephen?
Client [Moves a bit. Stiff posture]
‘fine’
Counsellor ‘Mr. Stephen, we will be
starting from where we left
last time. I hope you are
keeping a journal and
righting your feelings
regularly’.
Client ‘Yes, I am doing just like
you said and I feel a
difference. I am being able
to control the bad thoughts.’
Counsellor ‘You look better, let me tell
you. I am sure you are doing
well.’ [leans forward]
Client ‘Yes, thank you’
[posture relaxes]
Counsellor ‘Let us continue then’

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Unconditional positive regard
This is very important that the esteem, respect, dignity needs of the person or rather
the subject attending the counselling process is addressed in a pertinent manner and as a
mental health care practitioner, I have always focussed on the same vital aspect of
Unconditional positive regard to aid the subject have a positive, therapeutic counselling
experience. I learned very early in my career from the type of cases I have seen by then, that
even if the procedures and all the clinical skills are applied in a very tactical and sequential
manner but still the same fails to have a very remarkable impact on the mental health and
well-being of the patient, until and unless the same is equalled and supplemented with a good
respectful and dignified approach towards the rapport building process with the patient or
subject who has come to counselling in a pertinent manner. The most important aspects of the
talk therapy or psychotherapy process whether it is cognitive behavioral therapy, dialectal
behavioral therapy, schema therapy, client centered therapy, Adlerian therapy or any other
form of counselling – it is to be considered that the counsellor must take up a non-
judgemental approach towards the character or nature of the person he or she is counselling
and this form of unconditional positive regard is not only essential for any type of existential
therapies but for all types of psychotherapies whether it is client centered, directive or
eclectic counselling. Having a positive empathy and positive regard for what the delusional,
schizophrenic or personality or a paranoia patient is going through is critical and I as a
counsellor has always maintained a positive relationship with the subjects, varying to
different degrees but a unconditional good regard all the same, thus addressing the dignity
needs and the esteem needs of the subjects in a very purposeful manner. I, as a mental health
practitioner has identified various forms of confidence and motivation boosting techniques
being directly dependent on the level of positive optimism and connectedness that the subject
(suffering from a particular mental illness or a mental condition that has yet not translated

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into a mental health disease) feels with the counsellor and this not only grows the confidence
and trust of the person but also adds to the intrinsic motivation of the subject. The self-
efficacy of the person towards his own mental health recovery process is also improved on a
great manner.
Verbatim example
Counsellor ‘How are doing today Mr.
Patrick?’
Client ‘Well, thank you but I think
some of the stuffs you told is
not working. I did not find
any positive outcome.’
Counsellor ‘That’s okay sir. Thank you
for sharing your feedback
and now we can alter certain
things to see if they work for
you.’
Client ‘But I am not sure…’
Counsellor ‘Mr. Patrick, I can see you
have both sensitivity and
awareness to what is going
on around you and with you
and this is a good sign.’

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Client ‘okay, proceed kindly’
Counsellor ‘Thank you for the
permission, we can now
proceed with the altered
treatment’.
Empathy
Empathy is a very vital aspect of the counselling process and over the years, I have
identified the need of developing empathy with all of my subject at a certain plane. Empathy,
unlike to sympathy, leads to more attachment with the main issue of the subject and the
greater insight can be developed through reflective practice. The various techniques that are
applied in the counselling processes and over the years, I have noted that the reflective
techniques that are incorporated in the therapeutic and assessment taking approaches works
best and effectively when paired with actual empathic understanding of the subject –
produces better and more effective results. Empathy to me, is a tool that is effective when the
emotions of the counsellor does not gets mixed into the emotions of the patient and using and
applying empathy as a tool it is critical to understand that the feelings of the person would be
understood in a better manner and in a more significant way. When empathy is used, the non-
judgement approach of a counsellor becomes more effective and without any bias, the
treatment or the therapeutic process can be applied or delivered to the concerned person.
Empathy is core of the therapeutic triad and this has helped me a great way to solve any
problems of many patients.
Verbatim example

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Counsellor ‘After the last session and
with the following
mindfulness exercises, how
are you now?’
Client ‘ the session was fine but the
week was pretty rough, my
son has been into drugs and
other things, I guess and it is
troubling me a lot.’
Counsellor ‘I see. That’s really bad. We
cannot see our loved ones
drift away isn’t it.’
Client ‘You are right and that is
what is keeping me
agitated.’
Counsellor ‘But you know any stress
and agitation is not good for
you? We can surely talk to
your son if he is in that kind
of problem.’
Client ‘Really, can you help him
come out of addiction?”
Counsellor ‘Yes we can try but you

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should get on with the
cognitive behavioral therapy
sessions. It is really
important for you. Isn’t it ?’
Client ‘yes’.

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Conclusion
It can be concluded saying that the various types of allied health staffs plus primary
mental health care clinicians who are involved in the mental health care processes delivery
needs to adhere with the proper evidence-based practice protocols pertaining to mental health
recovery. I have learned from my experiences that in order to ensure proper service delivery -
the therapeutic triad pertaining to the major three aspects of care such as empathy, awareness
to verbal and non-verbal communication as well as the unconditional good regard – is
important and has to be incorporated into daily day to day mental health clinical and
community care service.

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References
Ahonen, H. (2018). Using music and medicine research to inform music psychotherapy
practice. Music and Medicine, 10(1), 26-32. Retrieved from
http://www.europeancounselling.eu/wp-content/uploads/2017/04/EJC-TRAP-1-5.pdf
Bright, K. S., Mughal, M. K., Wajid, A., Lane-Smith, M., Murray, L., Roy, N., ... &
Kingston, D. (2019). Internet-based interpersonal psychotherapy for stress, anxiety, and
depression in prenatal women: study protocol for a pilot randomized controlled
trial. Trials, 20(1), 1-11.retrieved from
https://trialsjournal.biomedcentral.com/articles/10.1186/s13063-019-3897-z
Coetzer, R. (2018). Anxiety and mood disorders following traumatic brain injury: Clinical
assessment and psychotherapy. Routledge.
https://www.taylorfrancis.com/books/9780429471841
Lee, D. J., Schnitzlein, C. W., Wolf, J. P., Vythilingam, M., Rasmusson, A. M., & Hoge, C.
W. (2016). Psychotherapy versus pharmacotherapy for posttraumatic stress disorder:
Systemic review and meta‐analyses to determine first‐line treatments. Depression and
anxiety, 33(9), 792-806. doi.org/10.1002/da.22511
Palmer, S. (2017). Multimodal Relaxation Method applied to counselling, psychotherapy and
coaching. European Journal of Counselling Theory, Research and Practice, 1(5), 1-5.
Schiltz, L., & Zimoch, A. (2017). Using arts psychotherapy in psycho-oncology as a means
of coping with stress and anxiety. Archives of Psychiatry & Psychotherapy, 19(1), 47-55.
DOI: 10.12740/APP/68295.

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