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What Is a Therapeutic Relationship?

By T. Carrier
Updated Mar 03, 2024
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A therapeutic relationship goes by many other names, including therapeutic alliance and helping alliance. Although the term is most often used in mental health therapy and clinical psychology, it can reference any healthcare setting. In short, the positive working relationship and bond forged between healthcare personnel and patients constitutes a therapeutic relationship. A positive relationship will likely help treatment.

The first crucial portion of a therapeutic relationship is the working alliance. Both a healthcare worker and a patient work together to create a mutually agreeable treatment plan in which goals and tasks are set. When both parties place their faith and energy into the common obtainment of these goals, a working alliance is formed. Professional tests such as the Scale to Assess Relationships and the Working Alliance Inventory can measure the strength of a working alliance.

A therapist usually possesses several traits and skills in order to foster a positive therapeutic relationship. Foremost, a therapist demonstrates security and trustworthiness by offering a patient empathy and neutrality. The patient should feel safe in revealing anything to the therapist, no matter how shameful or fearful. Therapists can demonstrate their trustworthiness by being prompt to appointments and maintaining attentive interest throughout interactions with the patient.

Many times, the patient may need an outlet for expressing hidden thoughts or emotions. The therapist helps the patient unleash all worries, frustrations, or needs. This process is known as transference, and is another important component of the therapeutic relationship.

Eventually, the patient should begin to identify with the therapist so that when the therapist asks questions, the patient will ask those same questions of themselves. By relating to a therapist who has the patient’s best interests at heart, the patient will eventually come to understand his or her own needs. Thus, the patient will become more introspective and more subject to self-evaluation and self-correction. This marks the real and successful therapeutic relationship: a transition from dependence to independence.

A positive therapeutic relationship is vital for treatment outcomes, according to research. Feelings of trust and security generated by such a relationship increase the likelihood that a patient will continue to carry out treatment protocols. In turn, the treatment has a greater chance for success.

Good therapeutic relationships have enhanced many types of treatments, particularly addictions. Often, the most successful relationships depend on a certain compatibility between the individuals. Natural rapport leads to easier trust and better collaboration. A therapeutic relationship should, however, remain professional, positive, and should not cross personal boundaries.

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Discussion Comments
By candyquilt — On Oct 15, 2014

@literally45-- Sometimes, a therapist just isn't a good fit. It happens. I urge you to see another. There is bound to be a therapist that you will form a good therapeutic relationship with.

By ZipLine — On Oct 15, 2014

@literally45-- Yes, it doesn't sound like a good therapeutic relationship was formed in that situation.

I actually understand that a therapist's job is rather difficult. They meet people with a so many different types of traumas, issues and disorders. It can be challenging for them as well. But a therapist should still have the necessary skills to manage and understand their patients, even if the patient is not all too keen to trust them right away.

Without trust between the therapist and the patient, the sessions will not be productive.

By literally45 — On Oct 14, 2014

I had a counselor (who was a psychologist) that I used to see once a week in college. But the sessions were difficult for me. I'd end up feeling worse after them because talking about my problems made me more anxious. As a result, I stopped going for several weeks to feel better. Then, I made another appointment. The counselor basically told me in a nice way not to return.

I don't know what a therapeutic relationship between therapist and patient should be like. But I'm sure that what I experienced was certainly not it. I expected the counselor to be more understanding that the sessions were difficult for me and that I wanted a break. It was almost as if he was angry with me for not going.

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