The Fuente Interpersonal Relationship Assessment, or “FIRA” for short, was developed by Thomas de la Fuente to provide a tool that could serve as a springboard to characterize therapy relationships. As we have seen in our review of existing methods, practically all of them tend to emphasize the question whether a specific relationship is conducive to therapeutic outcome—or not so much. Based on this premise, they then make a quantitative statement about how helpful the relationship might be to the patient. While this approach is useful, it has its limitations, as many qualitative nuances are either missed or not at the center of attention. Here, the FIRA takes a different route. It uses archetypal situations that may manifest in the consulting room, and it inquires about both the patient’s and therapist’s emotional state in these situations. To be even more precise, the FIRA investigates the patient’s and therapist’s sense of the atmosphere between them and offers a selection of 24 archetypal patterns that may be employed to describe the nature of the mood in the room.
In doing so, the FIRA enables clinicians to do three things: First, it supports the therapist in analyzing and structuring their own experience of the therapy relationship. Finding the right words to describe one’s impressions is not necessarily commonplace in contemporary psychotherapy, depending on a clinician’s training and working methods. Psychoanalytically oriented health professionals will refer to transference and countertransference reactions but even this group will rarely emphasize the atmosphere between themselves and the patient—the qualitative aspects of the relationship per se. Second, the FIRA can help the clinician to gauge the extent to which the patient shares their experience of the therapeutic rapport. The expectation is not that both parties will produce the same FIRA results if the treatment is progressing well. Rather, accounting for the differences indicated in the FIRA can help the clinician to better understand the patient.
The FIRA can also be an excellent starting point for the exploration of the themes represented by its 12 questions: if a patient recollects a certain situation rather differently from the therapist, a closer look at the discrepancies may not only deepen mutual understanding but also reveal underlying emotional dynamics that have not been dealt with on a conscious level. Third, the patient—or the therapist, for that matter—may have found specific situations in the clinical setting uncomfortable or even unsettling: they may have reminded them of traumatic events, hurtful relational patterns, or difficult feelings such as guilt, regret, and shame. The FIRA can bring these challenges to light in cases where they have previously been missed. It can also support the therapist in isolating any areas in which the patient’s past relational experiences have kept them from more fully embracing the therapy relationship as a springboard for personal transformation and growth. Thus, the FIRA goes beyond merely assessing the therapy relationship for what it is at a given point in time; it aims to support the therapeutic process by facilitating the effort of bringing the emotional interactions between therapist and patient to greater consciousness on both sides.
Downloads
Here, you can download the FIRA questionnaire for free. Please note that all materials are protected by copyright and may only be modified with the author’s prior written consent. Future versions of the FIRA may not be freely available with the copyright owned by different parties.