I'm not convinced that unconditional positive regard has anything to do with how blunt or gentle a clinician is. I think perhaps these are separate issues that are easy to conflate. That's why the conversation in the OP sort of confused me.

Couldn't one say, "Well, if The Reefer works so well for you, why do you keep coming back for treatment?" without being a **** about it? Or, even if one is a **** about it, does that dickishness really need to touch the core of who the client/patient is?

I think one can be frustrated with a behavior while still believing that the client is, at his or her core, a good and valuable person. To me, that's what unconditional positive regard is. That, whatever a person does, you maintain a core belief that they are worthy, valuable, etc.

Maybe that seems disingenuous to some--it's certainly different than the more natural, spontaneous thing that is affection or genuinely liking someone. Liking may or may not co-exist with unconditional positive regard, or it may wax and wane.

I like some of my students better than others, for reasons that have more to do with me than them. I make the decision to hold all students in positive regard, and I'm mostly successful. How blunt/gentle I am with them has to do with what I think they'll respond best to, not how much I like them or whether I hold them in positive regard.

Mostly. Sometimes I get snappish. No one's perfect.

I always figured it was more or less the same way with T's. But I could be wrong.