What is a power differential analysis

Julie,* a third-year psychology graduate student, was taken aback when a junior faculty member teaching one of her classes started objecting to her asking "too many" questions in class.

The faculty member told Julie that posing so many questions was disrespectful and threatened to speak to her advisor about it.

In response, Julie started withholding comments and asking questions more deferentially. When the faculty member continued to criticize her style, Julie consulted her advisor, who encouraged her to discuss the issue in person with the faculty member. Their meeting did not go well. Julie left without any further clarification and a blunt message to stop speaking in class.

The interaction reduced her to tears, and she started dreading the seminar every week. The intense negativity made it difficult for her to concentrate on other coursework, especially as she faced the daunting reality that the faculty member had the power to influence her ability to pass her comprehensive exam and graduate.

Julie's story highlights the dilemma of the power differential between graduate students and their superiors. Like others in similar positions, she had to make a decision: Should she continue to tolerate the situation or take action?

In graduate school, differences between students and faculty pop up constantly, whether it's on authorship or theoretical perspectives or even whether a student is ready for an internship. But it is often difficult for students to raise concerns with those who have the power to evaluate their progress, determine when a dissertation is complete and write letters of recommendation for practica, internships and jobs, says Richard Heimberg, PhD, a psychology professor at Temple University in Philadelphia.

Despite this tension, a well-planned, thoughtful conversation about a trying situation has the potential to significantly improve students' experiences in graduate school — and also teach them invaluable professional skills, says Nadine Kaslow, PhD, a professor at Emory University School of Medicine in Atlanta.

"Life is full of having difficult conversations, and it is good to get experience with them early in your career," says Kaslow, also a former president of APA. "Students should be treated fairly and with respect, and their views are really important."

And, she says, by speaking up, "they have a better chance of getting what they want and deserve."

Find support

In Julie's case, she decided to seek help outside of her department by contacting the university's director of student safety. This person suggested that she file a complaint with the school's department of equity, diversity and community relations. Once Julie did, the chair of the psychology department called for a meeting with Julie, her advisor and the junior faculty member. During the meeting, Julie asked that the faculty member recuse herself from certain positions of power, such as sitting on Julie's comprehensive exam board. The faculty member agreed.

"Through this experience, I learned that it's important to be brave about having these conversations because the situation was significantly affecting my graduate school experience," says Julie, who graduated on schedule in 2014. "I also learned that there are university resources available outside the department, and I felt very supported."

Have a plan

Graduate students may also encounter complicated situations in which the relationship with a mentor crosses into a dual relationship, such as a student who agrees to become an advisor's babysitter, Heimberg says. Now, the mentor and student are also relating as employer and employee. Initially, the agreement may be mutually beneficial if the student needs money and the advisor needs child care, but the added dimension of the relationship has potential to create problems, he says. Heimberg has seen cases when the babysitting requests start to interfere with a student's time for schoolwork and personal life, but he or she feels uncomfortable declining due to the power differential.

One strategy that increases the odds of having a successful, honest conversation is taking time to think about a positive solution, Kaslow says. Rather than focusing on the things that are not working, she encourages students to suggest an alternative arrangement. For example, a student who wishes to end a time-consuming babysitting situation could offer to orient a new babysitter to the job, Heimberg says.

"And practice these conversations before you have them," she says. "Role play it with a friend, and start by taking the other person's part."

That can give you the other person's perspective "and watching someone else play you may give you some excellent ideas about effective ways to proceed," she says.

Propose a memorandum of understanding

Another potential source of anxiety for students is their unmet expectations for mentors. This can be a particularly sensitive topic to broach, says Sue C. Jacobs, PhD, a counseling psychology professor at Oklahoma State University in Stillwater.

"What if your supervisor is psychoanalytic and you are cognitive, or you feel that the supervision is more beginning level and you are intermediate?" she says. "I've seen many cases in which students are afraid to talk to advisors when they feel that the advisor lacks competence in an area."

In some cases, it may be as simple as different beliefs on how frequently the advisor and student should meet. Mary Guerrant, a doctoral candidate at North Carolina State University, was in her first year of graduate school when she realized she needed to talk to her advisor about meeting more frequently.

"I came to graduate school straight out of undergraduate school, so there was a power differential in addition to an age and experience gap," she says. "But the more I avoided these conversations, the more I became hyper aware of that power differential, and the number of things I wanted to talk about started to accumulate."

She finally had the conversation, and was pleased with the result. Since then, she's learned to speak up earlier about a concern, and acknowledge in the beginning of the conversation that it is a difficult — but important — subject to discuss.

Guerrant is also a proponent of using a memoradum of understanding at the outset of a mentoring relationship. APA's Lesbian, Gay, Bisexual and Transgender Graduate Student Mentoring Program adapted an MOU used by the Australian Clinical Psychology Association, and sent the document to all mentors and mentees in September.

"Participants who opt to use the MOU write down things like planned frequency of contact, three mentoring goals and preferred contact details," Guerrant says. "I think it helps people think more critically about these issues, and it gives them a way to hold each other accountable."

Pick your battles

While it is generally wise to address areas of conflict proactively rather than letting them fester, Leslie Jenkins, PhD, cautions students to be thoughtful about selecting topics for difficult conversations.

"It's really important to reflect on what the deal-breakers are for you when you start graduate school," says Jenkins, a psychologist with Home of the Innocents in Louisville, Kentucky. "I've learned to pick and choose my battles because it's not feasible to bring up everything I disagree with."

Jenkins was a third-year graduate student at Indiana University when she started to feel overwhelmed by the workload at a practicum site. She decided to speak to her supervisor because she was struggling to manage the long commute, consecutive hours without breaks and after-hours workload — and she felt she was compromising her ability to provide quality care.

The supervisor was unsympathetic, and Jenkins sought advice from the school's program director, who wrote a letter to the supervisor. Nothing changed, but Jenkins was hesitant about the repercussions of leaving a practicum site. Ultimately, she overcame her fear of being stigmatized and left the site. Before accepting a new role, she inquired about expectations for the job, and the conversation set a tone for open communication throughout her time there. Her decision was reinforced when she moved to the new site and had a positive experience.

Since then, she's continued to hone her skills in having difficult discussions as she has worked as a postdoc and an employee. Jenkins has learned to seek input first from former supervisors and colleagues, especially when emotions about the issue are intense. "I've gotten better at having these conversations over time," Jenkins says.

And looking back, she has no regrets about the difficult discussions she's had. While it may be uncomfortable to speak honestly with an advisor or supervisor, Jenkins says the long-term mental health benefits to herself and her clients far outweigh this temporary distress.

In this article, we will talk about the importance of power differential in psychotherapy.

We will also talk about the therapeutic relationships, ethics in psychotherapy, and we’ll give you a few tips for becoming a good therapist. 

What is the power differential?

The power differential is, in simple terms, the power of influence which experts in a certain field have.

Doctors, counsellors, psychologists, psychotherapists, social workers, teachers, nurses, lawyers, judges, tour guides – these are just a few examples of professions that have a power differential role.

Practically, when you go to the doctor, you trust in all his knowledge to make a diagnosis.

Your freedom is in the hands of a lawyer, understanding a subject in the skills of a teacher, your relaxation in the hands of a masseur, and so on.

The power differential is essential in therapy sessions too, its role being huge in treating mental health issues.

Power differential in the client-therapist relationship

The relationship between the psychotherapist and the client is of equality, of mutual respect, and will be neutral, non-directive.

The professional psychotherapist does not give advice, directions or indications to the client, but only helps him to see the objective reality more clearly and to identify his blockages or dysfunctional, self-sabotaging or limiting beliefs. 

Thus, by using the power differential attribute, the client will be guided and encouraged to observe things more closely and to be able to make the right decisions for the situation in which he is.

The right chemistry between the client and the psychotherapist is essential and goes so far as to break the therapeutic relationship when there are such incompatibilities.

The therapeutic relationship is gradually built over several sessions, from four upwards, and cemented along the way. 

The psychotherapist understands the client, uses empathy, puts himself in his shoes, in his situation, and somehow evaluates the situation from the inside.

So in a few sessions, he gets to know his client better than he knows himself!

Especially relevant is the ability to resonate with the client and to succeed in involving him in his own self-healing process.

If there are mutual trust and openness, the optimal solutions appear and the results are often amazing!

Studies show that the therapeutic relationship contributes 30% to the effectiveness of therapy and is based on unconditional acceptance, empathy and congruence.

It is important to look at it not as a goal achieved at a certain point in the therapy, and as a constant long-term process that is gradually worked on in each session.

The therapist takes steps to build a strong relationship through a sincere, warm, empathetic, interested and involved attitude.

The role of the therapist is to listen, to explain and to encourage the process of implementing different techniques.

The client’s role is to express their concerns, to learn from therapy and to apply what they have learned. 

Thus, the therapist does not tell the client what to do, but uses the strengths and attributes of each client to guide him in making changes – this is what power differential is about.

The educational substrate used has the benefit of maintaining positive long-term results.

When you understand how and why changes are for the better, you know what you need to do to keep up the progress.

The psychotherapist can be a graduate of a faculty with a profile other than psychology! 

Such as medicine, social work, special pedagogy, or even theology! Important is the competence to communicate, relate, and guide the client to concrete results and to find suitable solutions.

Or developing the client’s ability to build their own solutions. Personalized, individual solutions that only suit him.

The psychotherapist is rarely very concerned with the precise diagnosis of the client (here we are already talking about the client, not the patient).

In psychotherapy, the therapeutic relationship, the way of communication, the support offered to the client and his guidance towards regaining functionality are important.

Regardless of the known or hidden labels, conditions or malfunctions that the client carries out consciously or subconsciously.

The patient develops in the environment in which dysfunctional relationships act, he enters therapy with a state of anxiety towards interpersonal relationships.

It will not be completely different if he manifests the same state of anxiety towards the therapist so that he will end up in the paradoxical situation in which he manifests both confidence and anxiety towards the therapist. 

The patient seeks the help of the therapist because he trusts or hopes that he can help him solve or overcome his problems.

At the same time, it brings with it a state of tension and mistrust in any relationship with other people.

 There is a conflict that can be overcome if the therapeutic relationship is formed and developed properly, mainly in the sense described by humanist-experiential theories: unconditional acceptance, empathy, congruence, spontaneity, etc.

Power differential and ethics in psychotherapy

First of all, the therapist must not exercise his personal power in this process of change, of the healing that psychotherapy implies.

He does not have to act like a boss, who knows what needs to be done and who needs it, who has all the solutions and tells the client what to do and what is best for him. 

Psychotherapy involves a partnership relationship, where the two, who participate in the process, are equal.

The therapist tries to help the client find out what is the best solution for him, to discover himself and in no way tells him what to do.

The therapist is also a human being and, therefore, the solutions that seem suitable for the therapist may not be suitable for the client, they may not represent the client, they may not be suitable for him. 

I quote an important passage from the deontological code of ethics of the psychotherapist profession: 

“Psychotherapists are engaged in increasing knowledge of human behaviour, of the understanding that people have of themselves and to others, as well as the use of this knowledge to increase the well-being and quality of life. 

They make every effort to protect the well-being of people who use their services, as well as those in contact with those who use their services (when this does not conflict with the needs of their customers).”

Here we will make a clarification related to the well-being of the client. Often what the client thinks is best for him is actually a symptom.

And this is where the therapist’s intuition and good training come in to put the most telling mirror in front of the patient, in order to see how he is and not how he thinks he is. 

Also, another clear aspect of the code of ethics is that therapists do not exploit the trust of their clients.

They make every effort to avoid dual relationships that could affect their professional judgment or increase the risk of exploitation. 

Another important point in the deontological code of the psychotherapist profession refers to confidentiality.

Psychotherapists have a fundamental obligation to respect the confidentiality of information obtained from their clients. 

They shall disclose such information to other persons only with the consent of the person concerned, except in those unusual circumstances where failure to do so would likely result in a clear danger to the person concerned or to the safety of somebody else.

Tips for becoming a good therapist

• Remove the obstacles to personal development – The task of a psychotherapist is to remove obstacles that block the path of his patients. The rest comes naturally, through the patient’s own strengths.
• Avoid diagnoses – Although a diagnosis is undoubtedly crucial for determining the treatment of severe cases with the biological substrate, in the daily therapy of patients suffering from less serious diseases, it is counterproductive. The diagnosis only limits the vision and diminishes the psychotherapist’s ability to report to his patient.
• The psychotherapist and the patient are “companions on the same path” – Although there are many expressions for the therapeutic relationship, Yalom prefers to think of his patients as companions. This expression eliminates the differences between “them” (the suffering) and “us” (the healers).
• Involve the client – Nothing is more important in psychotherapy than caring for and maintaining a relationship with the patient. You must constantly pay attention to him and evaluate the stage of the therapeutic relationship.
• Be Encouraging – Looking back many years, patients do not remember the therapist’s insight or his interpretations, but his words of encouragement. Acceptance and encouragement from a person who knows the patient so well is a huge help for him.

• Empathy: look from the patient’s window – Therapy has the best chance if the psychotherapist enters the patient’s world. Patients and the therapist live different experiences during the session.
  It is very difficult to know exactly how the other person is feeling; most of the time we project our own feelings on the other. Analyzing the patient’s past can be important not so much for building causal chains, but for being able to be empathetic.

• Teach patients to be empathetic – The psychotherapist must help the patient to develop empathy for others.

• Acknowledge your mistakes – If you make a mistake, admit it. At some point the patient will feel that you are not sincere and the therapeutic act will fail.
• Create a new therapy for each patient – It is necessary for the therapy to proceed spontaneously, always following other paths. There is no therapeutic protocol in psychotherapy. The therapy must be personalized, the therapist must find the best working method and the process of elaborating the therapy is the essence of the therapist’s work.
• Participate in personal therapy programs – Personal psychotherapy is the most important part of training programs in psychotherapy, as the most valuable tool of the psychotherapist is his own self. The therapist must show patients the way by personal example. 
• Therapists must know their own dark side and be able to empathize with all human desires and impulses. Young therapists need to analyze their own neuroses, learn to accept feedback, discover their weaknesses. Having a psychologically demanding activity, the psychotherapist must develop his strength of understanding and inner strength to face the risks of his profession.

• The concept “here and now”, use it, use it, use it – Here and now, it’s a gold mine for psychotherapy, it’s the psychotherapist’s best friend.

Why was the concept “here and now” used? – There are two main arguments: the importance of personal relationships and the idea of ​​therapy as a social microcosm.

• Be transparent – It is necessary for the therapist to carefully prepare new patients, giving them all the necessary information about psychotherapy.

Disclosure of the therapist’s personal life. Do it carefully.

• Be aware of deceptive healing – It is about the radical and sudden improvement of the patient’s condition, based on magic, which emanates from the illusory image of the therapist’s power.
• Talk about death – Death visits us during every therapy. Most therapists avoid direct discussion of death, but true therapists cannot afford to ignore the great thinkers who have come to the conclusion that learning to live well means learning to die well.

Death makes our lives richer – Many patients who have faced death have gone through an important positive personal change: they have become wiser, they have changed their priorities, they have begun to enjoy the simple things in their lives.

• Talk about the meaning of life – People are creatures in search of meaning. One of the most difficult tasks is to invent a sense of existence strong enough to justify life. Yalom is of the opinion that you must immerse yourself in the river of life and leave the question to the will of the torrent.
• Help patients take responsibility – A good therapist helps patients understand how they contribute to their own unhappiness. Taking responsibility is an essential step in the therapeutic process. Once the patient recognizes the role he has in creating a difficult situation in his life, he realizes that he, and he alone, has the power to change the situation.

• Never (almost never) make decisions for the patient.

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Conclusions

In this article, we talked about the importance of power differential in psychotherapy.

We also talked about the therapeutic relationships, ethics in psychotherapy, and we gave you a few tips for becoming a good therapist.

The power differential is, in simple terms, the power of influence which experts in a certain field have. Doctors, counsellors, psychologists, psychotherapists, social workers, teachers, nurses, lawyers, judges, tour guides – these are just a few examples of professions that have a power differential role.

The relationship between the psychotherapist and the client is of equality, of mutual respect, and will be neutral, non-directive.

The professional psychotherapist does not give advice, directions or indications to the client, but only helps him to see the objective reality more clearly and to identify his blockages or dysfunctional, self-sabotaging or limiting beliefs.

If you have any questions, comments or recommendations, please let us know!