• Understanding the Therapeutic Relationship

    Written by: Katie Lawliss

    We have relationships with many people over the course of our lives. However, there is a uniqueness to the relationship we have with our therapists. We sit with another person (virtually or in person) and tell them all about ourselves, our lives, and are vulnerable while doing so. You might know some things about your therapist’s personal life or maybe you know nothing at all, which makes this relationship especially unique. 

    This relationship is often referred to as the therapeutic relationship or therapeutic alliance. The relationship between a client and their therapist is what can make or break a therapy experience. In order for therapy to be as effective as we want it to be, it is important to trust and like your therapist. “Anyone who dispassionately looks at effect sizes can now say that the therapeutic relationship is as powerful, if not more powerful, than the particular treatment method a therapist is using,” says University of Scranton professor John C. Norcross, PhD, ABPP. There have been numerous studies and meta analyses that demonstrate this fact. 

    So what is really going on in this relationship? There are a few parts of this relationship that are important to understand. 

    1. Your therapist genuinely cares about you. As therapists we often hear clients worry that we do not really care about them and that we care because we are getting paid. It is understandable why clients feel that way, because the fact is we are getting paid. Therapy is a bit strange in that it is a deeply personal experience with another person while also being a business transaction. However, therapists really do care about their clients. We are paid because this is how we support ourselves and make a living. However, we would not choose this occupation if we did not genuinely care about others. You are building a relationship with your therapist and they are building a relationship with you. As a therapist, I deeply care for my clients and want the best for them. That genuine feeling of care is a main component of the therapeutic relationship. 

    2. A healthy therapeutic relationship involves boundaries. Boundaries in this relationship are to protect the client in many ways. It may seem strange that your therapist knows everything about you, but you know little to nothing about them. There is a reason for that. Therapy is typically the one space people have that is solely focused on themselves. There are very few times in someone’s life that they do something truly only for themselves and the time is only about them. Boundaries are important to help maintain therapy as that type of space and protect that time for you, the client. 

    If your therapist discussed their issues as well, like a friend or family member would, that space becomes clouded with another person’s needs. That being said, your therapist may share some personal information, we call this “self disclosure”, when it is relevant and may be helpful to the therapeutic relationship. Therapists are mindful about what they share and how it may impact the relationship. Boundaries also include not having a dual relationship, which means having multiple roles within the relationship. For example, I cannot be both your therapist and your child’s volleyball coach. If I do not play your child in the final game, you may have an emotional response to that which would impact our relationship in therapy and take away from the work we are doing in therapy. There are many ways a dual relationship can negatively impact therapy and the client. 

    3. Therapists are human and make mistakes. Mistakes range from harmless to harmful. A mistake could be something as simple as misremembering your aunt’s name to saying something harmful without the intent to do so (this does not include obviously harmful things). The important thing is to remember that when your therapist makes a mistake, it does not mean they do not care about you and are not taking the time seriously. The important thing after the mistake is that your therapist can recognize the mistake and talk it through with you if needed or do their own self work to address the issue outside of the therapy space. 

    That being said, there are some mistakes a therapist can make that really negatively impact the client. Communication is key in these moments because the therapist may not realize it is harmful. Communication allows for the therapist to work on self reflection and doing better once they know. However, if you feel like your therapist is not well educated in pieces of your identity such as race, sexual orientation, gender, or something else and it is harming you as the client through microaggressions, you have the autonomy to either discuss this with them or find a therapist who is a better fit. If you find yourself feeling harmed in the relationship often due to a lack of knowledge and/or willingness to work on their own biases, then it is important to find a therapist who is a better fit for you. 

    4. Communication is key. The therapeutic relationship is based on communication. If you are finding therapy not useful, it is important to bring this up to your therapist because they can switch things up or revisit your goals to help them better understand. If you are feeling judged by your therapist or are nervous to be honest with them about something then let them know that. Perhaps you are upset about something that happened in a previous session. While it can be hard to communicate this, it can help your therapeutic relationship get even stronger and allow you to meet your goals. Communication is essential to any healthy relationship and that includes your relationship with your therapist. These conversations help deepen the relationship and make therapy even more effective. 

    5. The therapeutic relationship is a healing experience. Having a positive relationship with your therapist can help you understand what healthy relationships look like, what it feels like to be cared for, and help you realize that you deserve to be listened to and cared about. 

    I myself have been both a therapist in these relationships and also a client in these relationships. They are quite different from each angle but hold the same truths. I hope you have a positive healthy relationship with your therapist. If you are not in therapy yet or hope to have a better connection with a therapist you can contact us at QOP to set up an initial appointment with one of our therapists.