and in Stage 3 (action), they learn skills to help clients in the active process of making meaningful change.
Corey and Corey (2021), Gladding (2018), and Egan (2013) provided other models of the developmental nature of the stages of helping relationships. Although the terms used to describe these stages may differ, there seems to be a consistency across these models: The stages move from initiation of the relationship through a clinically based working stage to a termination stage. The following developmental stages show our conceptualization of this relationship-building process and are based on the consistency found in our research and our clinical experience:
Stage 1: Relationship development. This stage includes the initial meeting of the client and counselor or therapist, rapport building, information gathering, goal determination, and informing the client about the conditions under which counseling will take place (e.g., confidentiality, taping, counselor/ therapist and client roles).
Stage 2: Extended exploration. This stage builds on the foundation established in the first stage. Through selected techniques, theoretical approaches, and strategies, the counselor or therapist explores in depth the emotional and cognitive dynamics of the client, problem parameters, previously tried solutions, and decision-making capabilities of the client. There is also a reevaluation of the goals determined in Stage 1.
Stage 3: Problem resolution. This stage, which depends on information gained during the previous two stages, is characterized by increased activity for all parties involved. The counselor’s or therapist’s activities include facilitating, demonstrating, instructing, and providing a safe environment for the development of change. The client’s activities focus on reevaluation, emotional and cognitive dynamics, trying out new behaviors (both inside and outside of the sessions), and discarding those behaviors that do not meet goals.
Stage 4: Termination and follow-up. This stage is the closing stage of the helping relationship and is mutually determined by all persons involved. Methods and procedures for follow-up are determined prior to the last meeting (see Sidebar 1.2).
Sidebar 1.2 Client Transparency
In the first stage of a helping relationship, the client may not be entirely forthcoming about what they really want to address. Often this is because the client needs time to feel safe and comfortable with the counselor or therapist. However, some clients will move very quickly to the core of the issue or concern. Neither possibility should be a surprise to the counselor or therapist.
It is important to keep in mind that people do not automatically move through these identified stages in a lockstep manner. The relationship may end at any one of these stages based on decisions made by the client, the counselor or therapist, or both. Lack of counselor preparation and education may also disrupt this cycle. For example, in one study, lesbian and gay clients who terminated counseling prematurely reported problems related to microaggression, shaming, lack of normalizing, lack of knowledge, and imposing heteronormative values (Van Meter, 2019). As far as stages are concerned, it is not possible to identify the amount of time that should be devoted to any particular stage. Sapiro (2020) discussed how marginalized adolescent clients are reluctant to trust and disclose in counseling settings. Joo et al. (2019) recommended that Korean clients may need more time on Hill’s (2014) exploration stage and less on the insight stage. Moreover, cultural variations may call for stages and stage-related helping skills to be moderated.
Viewing the helping relationship as an ongoing process that is composed of developmental stages provides counselors and therapists with a structural framework within which they can function effectively. Inside this framework fit the core conditions and strategies that serve the goals of movement through the relationship process and enhancement and encouragement of client change. We discuss these core conditions and strategies in the following two sections.
HELPING RELATIONSHIPS: CORE CONDITIONS
The concept of basic or core conditions related to the helping relationship has its basis in the early work of Rogers (1957) and the continued works of authors such as Carkhuff and Barenson (1967), Combs (1986), Egan (2013), Hill et al. (2014, 2020), and Truax and Carkhuff (1967). Their works pursued a question, “What are the core conditions and basic skills that exist in the best of therapeutic relationships?” From a biological perspective, what has been discovered in the last few decades is that the identified core conditions, such as empathy, have neurobiological correlates (Coutinho et al., 2014). For example, “mirror” neuron mechanisms, or neurobiological social learning “copy processes,” help individuals produce and perceive facial emotional expressions vital to empathy (Krautheim et al., 2019). Basically, humans are prosocially gifted, and counselors are taking advantage of and enhancing, if not mastering, this. Core conditions are the result of more than neurobiology as they are mediated by lived experiences, personality traits, culture, or some combination of these. It should be obvious that the concept of core or basic conditions relates directly to various personal characteristics, capacities, or behaviors that the counselor or therapist brings to and incorporates into the helping relationship (see Sidebar 1.3).
Sidebar 1.3 Supervision Responsibility and the Counselor Educator
The idea that graduate students must already be able to provide clients with core conditions in a helping relationship for supervision, instruction, and mentoring to enhance or expand this ability raises some interesting questions about the role of the counselor educator in the process of working with a graduate student enrolled in a counselor education program. Is the role of the counselor educator to help raise awareness on the part of a beginning counselor with respect to inherent traits and ways of relating to others that automatically contribute to the provision of therapeutic core conditions that can be enhanced and strengthened, or is it possible for the counselor educator to help a student develop such traits if they are not already present? What is the responsibility of the counselor educator if a student who wants to be a licensed professional counselor cannot seem to provide the core conditions needed to establish a safe working alliance with clients?
The ability to provide clients with core conditions in the context of a helping relationship must already be present to some degree in the personhood of graduate students for supervision, instruction, and mentoring to enhance or expand the ability to cocreate core conditions. Building from this base, counselors must study, train, and be committed despite long hours and inevitable discomfort of personal growth that allows them to create conditions mutually with clients that will affirm, support, and empower. The concept of basic or core conditions suggests that, when present, they enhance the effectiveness of the helping relationship at various stages. The terminology for these conditions varies from author to author but generally includes the following: empathic understanding, respect and positive regard, genuineness and congruence, concreteness, warmth, and immediacy (see Sidebar 1.4).
The remainder of this section deals with the core conditions and relates these directly to personal characteristics or behaviors of counselors or therapists that should enhance their ability to effectively use these conditions in the process of helping. Although definitions, emphases, and applications of these conditions differ across theoretical systems, there seems to be agreement about their effectiveness in facilitating change in the overall helping relationships (Brammer et al., 1993; Brems, 2000; Clark, 2010; Freedberg, 2007; Gatongi, 2008; Gladding, 2018; Prochaska & Norcross, 2013).
Empathic Understanding
Empathic understanding is the ability to feel with clients as opposed to feeling for clients. It is the ability to understand feelings, thoughts,
