Hope in Psychotherapy

Hope in Psychotherapy

Michael J. Scheel, PhD, ABPP

Professor of Counseling Psychology, University of Nebraska-Lincoln

Hope goes both ways in psychotherapy…the client must have hope and the therapist must have hope for the client. Yes, sometimes therapists may have difficulty believing in their client’s capacity to change. Snyder’s Hope Theory (2002) teaches us that hope is a goal for the future, and high hope individuals exercise pathways thinking and use their agency (i.e., motivation) to attain their goals. Pathways means understanding the means by which the achievement of a client goal can be realized. 

The importance of hope in the quest for any human goal cannot be understated. Hope is a common factor across all forms of psychotherapy necessary to influence client change. Frank and Frank (1991) asserted clients come to psychotherapy demoralized (i.e., hopeless) and wanting to be healed (by the therapist). However, therapists do not have the power to heal. The therapist only can collaborate in a healing process with their client. Even though clients do not initially realize it, they have the power to heal (themselves). As Frank and Frank posited, therapists instill hope in the client through the establishment of (a) a healing setting, (b) a compelling rationale persuading clients to participate, and (c) opportunities for new learning in the form of culturally fitting interventions. In turn, clients respond through their engagement in an emotionally charged and confiding relationship with the therapist. This is not only a description of the contextual model of therapy and its essential elements, but also a recipe for how hope is established and client demoralization is replaced during the process of psychotherapy.

Therapists work to put in place a sense of  possibility – helping clients to envision a desired state in their future. Hope is fundamentally dynamic, fluctuating within the therapist’s experience (Bartholomew et al., 2019a, 2019b). Despite client efforts to convince the therapist that they are hopeless, therapists must use deliberate practice to be self-reflective in order to hold onto their hope for their client. Client influence on hope (both positive and negative) depends on the client’s engagement in therapy. Client engagement in therapy is the key factor that provides hope to the therapist that real positive change is possible. 

Thus, hope through engagement in the therapeutic process guarantees change. Therapists who prioritize a search for the one, correct intervention over the establishment of hope may be unsuccessful. 

We know hope is strongly related to the therapeutic alliance, client depression, client well-being, and client symptoms (Bartholomew et al., 2015). The establishment of hope in therapy facilitates the principle of equifinality; that many different interventions can all lead to the same end state, positive change. Hope is gained through the development of a healing context consisting of the therapeutic relationship and interpersonal processing between client and therapist. It is less important what interventions follow after a hopeful bond has been established between therapist and client.

Michael J. Scheel, PhD, ABPP, is professor of Counseling Psychology in the Department of Educational Psychology at the University of Nebraska-Lincoln. He is board certified in Counseling Psychology; an APA Fellow of the Society of Counseling Psychology (SCP); the past VP for Education and Training of SCP, and a past president of CCPTP. He was the 2014 recipient of the Shane Lopez Distinguished Contributions to Positive Psychology Award and the 2016 Outstanding Training Director Award through the Supervision section of SCP. His primary research interest is strength-oriented psychotherapy. He teaches courses covering the science of positive psychology and well-being. He mentors his graduate students to conduct therapy using a strengths perspective. He is the co-author with Collie W. Conoley of the 2018 book, Goal Focused Positive Psychotherapy: A Comprehensive Strength Oriented Therapy.

References:

Bartholomew, T. T., Scheel, M. J., & Cole, B. P. (2015). Development and validation of the Hope for Change through Counseling Scale. The Counseling Psychologist, 43(5), 671-702. https://doi:10.1177/0011000015589190    

Bartholomew, T. T., Gundel, B. E., Li, H., Joy, E. E., Kang, E., & Scheel, M. J. (2019). The meaning of therapists’ hope for their clients: A phenomenological study. Journal of Counseling Psychology, 66(4), 496-507. https://doi.org/10.1037/cou0000328 

Bartholomew, T. T., Gundel, B. E., Scheel, M. J., Kang, E., Joy, E. E., & Li, H. (2019). Development and initial validation of the Therapist Hope for Clients Scale. The Counseling Psychologist, 48(2), 191-222. https://doi:10.1177/001000019886428.  

Frank, J. D., & Frank, J. B. (1991). Persuasion and healing: A comparative study of psychotherapy (3rd ed.). Baltimore, MD: Johns Hopkins University Press.
Snyder, C. R. (2002). Hope Theory: Rainbows in the Mind. Psychological Inquiry, 13(4), 249-275. http://dx.doi.org.libproxy.unl.edu/10.1207/S15327965PLI1304_01