Meet Heidi Levitt, expert on therapeutic relationships

  Clinical psychologist Heidi Levitt discusses what’s helpful in relationships

JR:  What would say are 2 or 3 core features that need to be present in all helping relationships

HL: Empathy, Congruence/Genuineness, Mutual understanding of (and agreement with) what is ‘helping’ in that relationship

JR: You observed that the therapist acted as a surrogate for others’ approval until the client had developed a strong enough sense of self-approval. What are some of the ways that therapists help their client’s develop self-approval? Do you think mentors can help mentees in similar ways?

HL: Yes.  I think that many others can provide support for the development of others, including therapists, parents, teachers, and mentors.  I think that having another who offers a stable sense of approval can allow clients or mentees to take tolerate the anxiety inherent in exploring and then accepting aspects of themselves which might be threatening to their own self-concept or their beliefs about being acceptable to others.  A structured relationship, such as a mentor can offer, has advantages as it can offer mentees a context of self-acceptance in which self-awareness and exploration can be supported but which is enough outside of their regular interpersonal circle to make these risks more manageable.  Allowing mentees to becoming aware of their feelings and needs in an accepting context can help them gradually internalize acceptance and can show them that they can be loveable or likeable even though they are not perfect or are different than what they might like.  A therapist might structure a more focused attention on internal processes, but the beauty of being a mentor is that you can show this acceptance in real interactions within many contexts of the mentees life.

JR:  Likewise, I found it really interesting when a therapist would actively break rules in the structure of the therapy session it had the potential to demonstrate the therapist’s investment and thus strengthen the relationship. This is something we’re finding with adolescents–who sometimes interpret teachers’ and others transgressions as an indication of being special. In what ways did the therapist break the rules. When did they go too far?

HL: Good therapists broke rules when the rules did not hurt anyone else and did so as exceptions to a generally structured relationship.  Therapists also were careful that they were not being manipulated to break rules as a matter of course and with clients who have trouble with boundaries they would be even more careful.  Breaking the rules when something important was happening for the client though signaled that the therapist was attuned to the clients’ vulnerability, was supporting a process of growth.   For instance, they did not run over time every session or when another client would be waiting, but if a client was at a pivotal point or was in crisis the therapist might support that client by staying longer and  helping the client through to an insight or a more stable place.  Clients often reported that when these were rare exceptions and were responsive to their experience, they felt that the therapist really cared about then — and this caring was one of the most poignant experiences in therapy.

JR:  Your core conclusion is that “clients need just enough structure to facilitate reflexivity while needing to feel special enough to risk revealing and to be known.” Can you explain what you mean by this? what the implications for mentors working with youth?

HL: If I were going to translate this message to the mentoring relationship, I’d say that mentees need enough structure to help them feel safe sharing their lives with a mentor.  Regular meetings, dependability, a relationship that is enduring all can help but some children may need more structure than others.  For instance, some might benefit from consistent activities, some might like new activities that are planned ahead, and some may enjoy spontaneity.  In addition, although security can help mentees feel safe sharing, they are less likely to share things that are important unless they feel that their mentors care about them — that they are special to them.  Just as they need the right amount of structure, they also might need an individualized amount and type of caring.  For some mentees attention that is too focused or full of praise can be threatening while others might enjoy that.  It can be important to notice what allows your mentee to be comfortable with you.  If mentees can share their opinions, thoughts, and feelings in a safe relationship where they feel accepted, this process is likely to further their self awareness and let themselves recognize their own faults and vulnerabilities.  They might share some of these awarenesses with their mentors (e.g., in jokes, in confessions, in demonstrations) whose support and acceptance can foster, in turn, their own self acceptance.  Support doesn’t mean that mentors accept all behaviors of mentees, and might in fact require boundary setting, but that mentors also continue to convey their acceptance of mentee as people and their commitment to their relationship.

JR:  You were among the first researchers to really study the moment-by-moment aspects of therapy that clients find useful. Why do you think so few researchers have delved into this vitally important area.

HL: I stand on the shoulders of others who have researched types of clients’ experiences before me (notably, Robert Elliott and David Rennie), but my work has contributed the formulation of process-level principles for directing therapy in sessions.  I think that this is a minority focus in psychotherapy because as a field psychology tends to understand psychotherapy within a medical model and we tend to think that we as clinicians deliver doses of interventions to cure clients.  Although research repeatedly suggests that psychotherapy process and relationship factors appear to be the aspects of therapy that contribute the most variance to client outcome, we are acculturated to conduct research as though psychotherapy is composed of orientation and intervention behaviors that are replicable in similar ways across clients.  We forget that clients are people who want to be special to us and that we are people too and our ability to be connected and accepting may be far more powerful than any specific intervention.

JR: You are a college professor who advises many college students-do you ever draw on your research in your work as an advisor or mentor?

HL: Going back to the first question – as a college advisor I spend time to figure out what kind of help the student wants.  Sometimes students don’t know what types of help are available so I talk with them about what types of help I can offer or help them to find.  As a graduate student mentor, I think it is important to have a mutual understanding of the type of help being given in this type of mentoring and I talk about this with students explicitly when they are interviewing and during their time in the program. I like being genuine as much as possible and will tell my students when I am excited about their work as well as when I am worried about something they are doing or if I disagree with a decision.  I convey to my students my commitment to their development in an explicit way especially when we have disagreements or when I need to explain the limits of what I can or am willing to do.  I like to be empathic but my focus is more on students’ experiences and needs related to their professional development rather than on other aspects of their lives, in keeping with my role as an academic mentor rather than as a therapist or as a mentor in other areas of life.   Most of all, I continually ask students what they are needing.  Even though I may not be able to meet their needs always, it helps to talk openly.  I sometimes learn from them about needs that I did not know about or learn from them how best to mentor them through different obstacles.  I try to show them that I think about them, value them, and care about their development across all aspects of their professional lives and that I am open to and invested in helping them solve problems that arise on this front.