Is The Secret To Therapy The Therapeutic Relationship | Mental Health

Is The Secret To Therapy The Therapeutic Relationship?

The success or failure of therapy can be often come down to one thing, the therapeutic relationship. Although, you shouldn’t always expect therapy to meet all your ideal mental health recovery goals, as often that is unrealistic. Instead, therapy is there to help you improve your quality of life by helping you learn how to help yourself. Or at least that’s the idea of therapy that I subscribe to.

 

There are two types of counselling practitioners, the purest and the multimodal. A purest will stick rigidly to one theory or model of counselling, whereas a multimodal practitioner will take an eclectic approach, borrowing from different theories and models to best meet the client’s needs (Colledge, 2002). Both can be useful, depending on the context, and the theory or model.

 

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Unless you want support for something specific and you’ve looked into different forms of counselling and believe you’ve found one that will work best for you as an individual, then a multimodal therapist is probably going to be better. The success of either approach, however, may be down to the therapeutic relationship, especially for a multimodal approach.

 

The therapeutic relationship begins with how you start your sessions and even how you first meet each other. Starting each session by greeting the client and asking how they are, is important for several reasons. It’s friendly, helps build rapport, and it can help identify any immediate issues that need to be discussed. It can also be used to show the client they’re doing better than they’ve realised.

 

It gives you the opportunity to reflect back on previous examples about the client at the start of the session to correct their thinking errors, if appropriate.  It also allows you to do the same at the end of a session. You might be able to reflect on how the client said they weren’t doing to well at the beginning of the session and point out they’d made a lot of progress by point out stuff from that session, especially if they’ve discounted the progress they’ve made between sessions due to thinking errors.

 

For example, a client may feel they’ve not achieved anything since the last session when you ask how they are. But as the session progresses, the client might share achievements they’ve made, counselling homework they’ve completed, etc, which they’ve not appreciated, that you can then present to them at the end of the sessions to show they have in fact achieved quite a bit. You’d be surprised how common this comes up.

 

Is The Secret To Therapy The Therapeutic Relationship | Mental Health

 

More importantly, counselling is very much is a collaborative relationship (Frank and Davidson, 2014), and the effectiveness of that collaboration is down to the rapport and the quality of the therapeutic relationship. A good therapeutic relationship can recover from mistakes and making a faux pas.

 

The more comfortable the relationship is in the therapeutic setting, the more likely you are to feel comfortable with making yourself vulnerable so you can be properly supported with your needs. Think about it, would you share your inner demons with someone you can barely have a conversation with if you both felt awkward?

 

Evidence suggests that the type of treatment used in counselling doesn’t matter, the results are the same (Beutler, et al., 1991; and Baer, Kivlahan, and Donovan, 1999); a multiple model approach might be best (Ramanathan and Reischl, 1999). The personality traits of the client could be the main factor in which treatments will work best (Beutler, et al., 1991). If you’re solution-focused then something like CBT might work be best, but if you just want to talk about your problems, then Humanistic could fit the bill. Creating the right recovery environment to promote change in the addict is important; the regularity of substance use was reduced by 70% due to quality of care creating positive changes, Brown and Riley (2005).

 

If you feel that you lack rapport with your counsellor, then the first thing you should do is talk to your counsellor about it. They might be feeling the same thing you are, and talking about it could lead to the therapeutic relationship improving. But if that doesn’t work, don’t be scared to request working with another counsellor.

 

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Even though therapy should be a collaborative effort to improve your mental wellbeing, at the end of the day, your wellbeing is more important than staying in a therapeutic relationship that isn’t working for you. Your counsellor will understand, especially if you first gave yourselves the change to work on the therapeutic relationship.

 

As always, leave your feedback in the comments section below. Did you have more success with therapists you liked? Also, feel free to share your experiences of rapport and the therapeutic relationship in the comments section below as well. If you want to stay up-to-date with my blog, then sign up to my newsletter below. Alternatively, get push notifications of new posts by clicking the red bell icon in the bottom left corner.

 

Lastly, if you’d like to support my blog then you can make a donation of any size below as well. Until next time, Unwanted Life readers.

 

 

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References

 

Baer, J., Kivlahan, D., and Donovan, D. (1999). Integrating Skills Training and Motivational Therapies Implications for the Treatment of Substance Dependence. Journal of Substance Abuse Treatment, 17(1–2), 15–23. Retrieved from https://www.journalofsubstanceabusetreatment.com/article/S0740-5472(98)00072-5/fulltext

Beutler, L. E., Engle, D., Mohr, D., Daldrup, R. J., Bergan, J., Meredith, K., & Merry, W. (1991). Predictors of Differential Response to Cognitive, Experiential, and Self-directed Psychotherapeutic Procedures. Journal of Consulting and Clinical Psychology59(2), 333-340. Retrieved from https://doi.org/10.1037/0022-006X.59.2.333

Brown, V. L., & Riley, M. A. (2005). Social Support, Drug Use, and Employment Among Low-Income Women. The American Journal of Drug and Alcohol Abuse31(2), 203-223. Retrieved from https://www.researchgate.net/publication/7828430_Social_Support_Drug_Use_and_Employment_Among_Low-Income_Women

Colledge, R. (2002). Mastering Counselling Theory. Basingstoke: Palgrave Macmillan.

Frank, R. I., & Davidson, J. (2014). The Transdiagnostic Road Map to Case Formulation and Treatment Planning: Practical Guidance for Clinical Decision Making. Oakland: New Harbinger Publications.

Ramanathan, C. S., & Reischl, T. M. (1999). Innovative approaches to predicting and preventing addiction relapse. Employee Assistance Quarterly15(2), 45-61. Retrieved from https://doi.org/10.1300/J022v15n02_04

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59 thoughts on “Is The Secret To Therapy The Therapeutic Relationship?

    • It’s so important the first meeting. I had a counselor who wanted to start a therapy without even really introducing herself. Didn’t want to get to know me at all. It was a disaster. On the other hand the best therapist would be able to hold a session that I felt was a conversation and leave with a profound realization. The therapist makes such a difference in style. It can take several tries before finding the right fit. Don’t give up.

  1. I love these insightful and informative posts. Addicted to your blog, because stuff like this is so hard to find. I appreciate your efforts in writing such posts

  2. Really interesting article. I’ve read that the therapist you have is often more important than the type of therapy you have, i.e. if the most relevant therapy to your diagnosis isn’t available, if you have a therapist where you have a good relationship that will still be beneficial. Which makes sense as you say you need a good relationship otherwise you won’t want to share your private thoughts and feelings with them!

    • My partner had a therapist they didn’t seem to be able to click with, and it was an issue throughout there session until they finally just stopped going. Some people just get on better with certain personality types

  3. Wow. We’re so in-sync! I’m just finalizing my next post and a lot of it discusses finding a mental health professional! Once again, I’m going to link your post with mine. ☺️

  4. This is an interesting view into the success or failure of therapy! I believe that establishing connection and feeling like you have someone to talk to who understands you and your little struggles is what keeps people coming back to a particular counsellor. We all want to feel understood and listened to. 🙂

  5. The relationship is vital, I had a therapist I just didn’t like the attitude of, I stopped going. Thankfully the other therapists I’ve seen I’ve got on with well enough.

  6. This is SO important. I have seen both therapists that I had a great relationship with and those that completely lacked. I can honestly say, meeting with a therapist where there was no connection left me feeling as though I was completely wasting my time. We weren’t accomplishing much because I wasn’t comfortable opening up and being vulnerable, which is necessary to really work through the topics that needed to be addressed.

  7. Thanks for this vital info about therapy sessions. Definitely the first encounter and the first few minutes will set the pace of the sessions. Rapport and the ability to be trusted must be established and hopefully work on the objective of the therapy. Also its good that you highlight that it’s OK to request for a change of therapist if you don’t see any improvement or if you don’t feel comfortable.

    • A lot of people are worried about trying to change therapists, but if you don’t feel it’s working the therapist most likely is feeling something similar too

  8. This is really well written! Simple to read but obviously researched.
    For me, rapport would be the biggest hurdle to successful therapy. I have a very difficult time being vulnerable and there isn’t trust, respect, and some friendliness (boundaries may limit the friendliness a little) then it won’t work for me.

  9. This is such a key feature of great therapy. I don’t think you need to ‘like’ your therapist and a friend or something, but it is very important that you feel like your therapist understands you up to a certain amount and that you feel safe with them. Otherwise, you’ll never really get to the core of things. A professional therapist will understand this and won’t get mad if it’s ‘just not there’.

    • Indeed. Each person has their own individual differences that’ll results in them clicking better with certain types of therapists, so they shouldn’t take it personally if that doesn’t happen

  10. Great article. It makes sense that the success of your therapy depends largely on your rapport with the therapist. If you don’t trust her, then forget about vulnerability and healing. And often, it’s not that you totally dislike him. It may be something that he says that bothers you or a quirk he has. Therapy is complicated. Thanks for sharing!

    • Hopefully if it’s just something the therapist might have said, the brining it up and discussing it will lead to fixing the relationship, which might save time with starting again with a new therapist

  11. Thank you for sharing this post. I don’t think many people really take in that factor of a therapeutic relationship. I think its very important to have that relationship. This is someone that you’re going to talk about your most deepest problems with. My 1st round with therapy I really didn’t think about that. Thankful she was a great therapist. But after that I started to see the importance of it. This was very informative especially for those just starting out.

  12. You really have a wonderful and comforting way with your words. You truly take the reader by the hand and I think that it’s great. I really appreciate everything that you have to offer to so many people.

  13. Amazing and informative posts that many will find help. For me it really boils down to the rapport that is established between client and therapist. If there is no rapport, then there is no connection which will lead to minimal or no positive outcome

  14. This is a really relevant article especially in current times when a lot of awareness regarding benefits of therapy are being spread around. But ultimately if one doesn’t get comfortable and at ease with their counsellor, then they are totally wasting time.

    • It’s certainly true that progress is easier with a counsellor you feel more comfortable with, but that doesn’t mean you can still get positive results from one you don’t feel comfortable with. Sometimes you may need to feel uncomfortable to bring about important changes. So I guess, like most things, context is key

  15. A really informative and well-written article. I followed the link to your post on thinking errors too, which I genuinely found fascinating due to your very specific examples. I think a lot of people in my life would benefit from reading that post. Overall, keep up the great work. Your site looks awesome too!

  16. I really enjoyed this. The therapeutic relationship is such an important factor to consider, and it seems like there is lots of data that shows its effects. Near the beginning you mentioned the importance of building rapport at the start of the sessions. I work in clinical trials and when we train people to administer assessments we always stress building rapport with the patients as it really affects their potential success during the meeting

    • One of the reason placebo treatments can be so effective is because of the rapport that develops and the extra attention they get from sessions, for stuff like acupuncture

  17. This is a really cool post. More often then not this is a subject that is not spoken about when the basis of therapy is to connect with others and yourself, so how could whether or not you feel comfortable with your therapist affect the outcome of therapy itself. At a very young age I disliked one therapist as I always felt they focused on the wrong thing and were in fact creating a new problem in itself. However, because of how young I was then, I had to realise with age that it didn’t mean all therapists were pointless. I never thought about speaking about my differences with her back then but it probably would’ve helped a lot.

  18. Do I seem weird if I say I haven’t been to a therapy sessions before haha. I think i’m going to consider sine it help with future, thank you for sharing it!

  19. It’s so good to see how therapy works and is carried out from the other side. Another great post 👌

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