What is a Healthy Therapeutic Alliance and How to Cultivate it?

Clients come to therapy with various unresolved emotions, experiences and secret thoughts. The expectation of them sharing all this with a stranger; the therapist might cause anxiety and overwhelm. Based on research and clinical observation, it has been concluded that initial sessions can be way more uncomfortable than future ones. It gets better once this alliance is established and cultivated.

In this blog I discuss how to work on this alliance, cultivate it and assess its health. As therapists manage to work on building this alliance with their clients, they still intend to support them in their pursuit of goals, hold them accountable and provide them with the solid confident anchoring they are looking for.

Successful therapy depends on a client’s readiness, honesty sharing their experiences and behavior and trust in their therapist. Yet many clients have spent a lifetime avoiding or concealing thoughts, feelings, and behaviour due to suppressed shame, lack of awareness, and perceived incompetence. They might have never had a secure attachment with another human being who they can trust and rely on. It is essential to highlight the importance of giving the client the time and space they need. It takes time for a therapist to earn a client’s trust, and build a level of connection, collaboration and attunement. Therapists should not expect that all clients will immediately open up and resonate with them.

I find it helpful to be present and mindful with no judgment or perceived plan.  A new client requires to build a positive working alliance with their therapist; however, it is also important to acknowledge that we need to attune to their unspoken goals, fears and anxieties.

As therapists, we have our clients’ best interest as our main focus. The ethical obligation that our profession is founded on is to be present with no judgment, personal agenda or hidden expectations. The pursuit of change in the client might in some cases be faced by a level of unconscious resistance. That said, this resistance might happen for a variety of reasons unrelated to the therapist; fear, shame, worry, and/or inaccessible resources. With this in mind, we need to acknowledge that therapy is not only the relationship or even the technique. It is way more. It entails the trust and resonance between the client and the therapist that depicts both walking on this path of wellness.
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Finally, we need to remind ourselves that therapists are human beings with their own emotional baggage, just like their clients. It's easy to feel overwhelmed, rejected or judged by a client who does not talk or participate. It is our responsibility to take care of ourselves between and during sessions, talk to another therapist or a supervisor, seek more training and/or therapy. This can help us identify these thoughts and emotions and work on resolving them in order to protect our clients from unconscious biases. Our responsibility and ethical obligations entail that we seek ongoing training, self care and refer clients when we identify that we are not a good fit.