Don’t Underestimate the Power of the Therapeutic Alliance

“How do I find a therapist?” “What makes him/her good?” “What should I research about them?” “What’s the most important thing to know about finding a therapist?” “How will I know if this therapist can help me or not?” As a mental health therapist, I am often asked questions like these from friends, family, colleagues, or even initial clients when considering or starting therapy. Most people believe that there are certain criteria or a checklist to have when finding a therapist. Yes, there are criteria you want to consider when finding a therapist, such as insurance coverage, location, availability, degree, theoretical orientation, or experience, but those are not the most important aspect when finding a therapist. Just as I tell anyone who asks me, the most important part of finding a therapist is the engagement between the therapist and the client, also referred to as the therapeutic alliance.

The therapeutic alliance is the one key element in therapy that can determine whether or not therapy will be successful or beneficial. During therapy, one needs to be open and honest about their situation, difficulties, emotions, relationships, behaviors, thoughts, and feel comfortable discussing often times very difficult topics. Most people seek out therapy to help them better understand themselves, change a negative aspect of their lives, improve their mental health, relationships, or well-being, or to improve their lives in any number of ways. Being in therapy can be difficult, vulnerable, and emotionally challenging. It is important to find someone who you feel comfortable with, trust, feel is there for you and understands you, and who you can develop a good rapport with.

So how can you tell if you have a good therapeutic alliance? As with most things in life, it is good to go with your gut instinct upon meeting the therapist or after the initial session. You know yourself best and what will work for you. If you are still unsure, there are a few questions you can ask yourself to try to figure out if it will be a good fit and relationship. Ask yourself: Did you feel like your therapist “got you?” Was he/she easy to talk to and seemed to be listening to you? Do you get the sense that they want to work with and help you? Do you feel a sense of relief after talking to your therapist? Do you want to go back?

Your therapist may not have all the answers or fully understand everything about you or your issue(s), but they should show interest, empathy, an understanding of the basic situation or problem, and be able to communicate that to you. You do not want to sit with someone for an hour session who does not seem interested or available to you. Your therapist should show interest by asking relevant questions, actively listening, being attentive, and making eye contact. Therapists should also not be emotionless. Therapy sessions can become very emotional and having a therapist who is stone, not displaying emotion, will not help to create a safe environment for open communication. The therapeutic alliance can take some time to develop and can involve meeting with multiple therapists until you find a good fit, but you should have an overall sense of comfortable with your therapist and that they are there for and to work with you.
Finding a therapist who is covered by your insurance, has the appropriate degree and licensure, has available times that fit your schedule, a convenient location, has experience, and may come recommended are all valuable in your search. But overall the outcome and benefit of therapy will be significantly impacted by the therapeutic alliance. In the end, make sure to ask yourself: “Do I feel comfortable with my therapist?” “Do I feel better after my session?” “Do I want to go back?”