What Makes a Good Therapeutic Alliance?

Jessica Pontis, LCSW

Making the choice to connect with a therapist can be challenging, after all, people don’t usually seek out therapy if they’re feeling great. Finding a good therapeutic fit is essential to having a good experience.  It’s important to be thoughtful in what you’re looking for in a therapist and trust the process. Recognize that maybe the first person you connect with isn’t going to be the best fit for you, but don’t let that discourage you from exploring therapeutic relationships with other providers.  

Once you find a provider that meshes well with your needs, you may notice the benefits of that working relationship right away. 

This may look like feeling very comfortable with someone after the first session and feeling like you can trust them to hold your feelings as sacred and work with you in a non-judgmental way. As you continue to work with this person these feelings of comfort and safety grow, thus firmly establishing what we in the field call the therapeutic alliance. According to Dorothy Stubbe, the therapeutic alliance is the relationship between a client and the therapist that is linked to the overall success of the psychotherapeutic treatment process. They go on to describe the three common themes that work together to create a strong therapeutic alliance, and thus, stronger positive outcomes (2018).

Collaboration  

The first significant theme is the collaborative nature of the relationship, which is how well the clinician and client work together towards emotional and functional goals (Stubbe, 2018). Having a strong collaborative relationship would look like an equal balance of power between the clinician and the client, where the client feels like they are respected. As a client, you should feel that your input is heard and utilized in a meaningful way and that it feels like each of you can challenge one another safely.  

Bonding

The second common theme that can impact the therapeutic alliance is the bond between the client and the therapist. Do you like your therapist on a personal level? Are they someone you see as being human, or as someone who feels unapproachable? If you sense that there is a friendly relationship between you and your therapist, then this would indicate a strong bond. However, it’s also important to recognize that these relationships should still be treated in a professional way, especially on the side of the therapist. While getting along on a personal level is important, your therapist is unable to be your friend outside of the working relationship.  

Agreement

The last important common theme in strong therapeutic alliances involves the client’s and therapist’s ability to agree on shared goals and tasks (Stubbe, 2018). When you first meet with a therapist, whether that’s for an initial consultation prior to scheduling the first session or during the first session, it’s important to establish an understanding of what you would like to discuss or work on during therapy. This may be wanting to learn new coping skills, develop better work/life balance, process trauma, or whatever else you feel is bringing you to connect with therapy. If both clinician and client can outline these goals early in the relationship that can lead to better long-term outcomes. It’s also important to check in on progress towards these goals from time to time and add or change any existing goals as the treatment process allows.  

A large part of what can make therapy a successful and safe experience relies on the therapeutic alliance. If you’re interested in discussing this concept further, or would like to connect with someone to walk with you on this journey, reach out to one of the licensed therapists with Symmetry Counseling. We invite you to explore our counseling services online, and then contact our intake specialists to get paired with one of our Chicago therapists.