What is the therapeutic relationship?
The therapeutic relationship, sometimes called the therapeutic alliance or working alliance, is the relationship between therapist and client. It includes the client’s confidence in their therapist and the strength of the relationship between them. The therapeutic relationship is sometimes broken down into how aligned the therapist and client are in terms of their goals, the therapeutic tasks and the strength of their bond (Bordin, 1994). Research suggests that there is an association between a positive therapeutic relationship and good outcomes for the client (Howgego et al., 2003).
Why is the therapeutic relationship important?
There are many different therapeutic models which are effective for different people, which will be discussed further in our next blog on finding the right approach for the right person. However, the fact that many different models can be effective for similar mental health problems suggests the effectiveness of the model is underpinned by a common thread: the strength of the therapeutic relationship.
Mental health problems can be rooted in relationship or social struggles and a strong therapeutic relationship can provide clients with a sensitive and responsive secure base. Clients enter therapy because they have experienced hurt in some way. The therapeutic relationship can form a new template for how clients view other people. For example, their therapist may be the first person they can trust, the first woman they respect or the first man they do not fear. Equally, the end of therapy brings about the end of a positive relationship which can demonstrate to clients that the ending of relationships does not have to be painful.
Before entering therapy clients may have felt unable to share their story with anyone else. They may experience shame. The therapeutic relationship is an opportunity for the client to have someone listen and absorb their feelings, before summarising them and reflecting them back. This process of organising feelings can only be achieved with a strong therapeutic relationship.
How to ensure a strong therapeutic relationship
At Morency we understand the importance of building a strong therapeutic relationship with our clients. If you engage in a therapeutic process at Morency you will find that your therapist remains open to and invites reflection on the relationship between themselves and you. As clients, there are also things you can do to help build a strong therapeutic relationship with your therapist:
- Give the relationship time. Like any relationship, a client-therapist relationship builds over time
- Spend time thinking about what you would like from therapy and try to be open about your goals
- Use early conversations with your therapist, your goals and our next blog to guide you into choosing the right therapy for you. With the appropriate therapeutic model, a strong alliance is easier to build as some models expect a different type of relationship between therapist and client
- Don’t rule therapy out due to a bad or ineffective previous experience. A different therapeutic model or a different therapist may be able to help you reach your goals
Bordin, E. (1994). Theory and research on the therapeutic working alliance: New directions. In A. Horvath & L. Greenberg (Eds.), The working alliance: Theory, research and practice (pp. 13-37). New York: Wiley.
Howgego, I. M., Yellowlees, P., Owen, C., Meldrum, L. & Dark, F. (2003). The therapeutic alliance: the key to effective patient outcome? A descriptive review of the evidence in community mental health case management. Australian and New Zealand Journal of Psychiatry, 37(2), 169-183. DOI: 10.1046/j.1440-1614.2003.01131.x