In It Together: The Importance of the Therapeutic Alliance

 

Today’s rapidly developing range of psychotherapeutic modalities offers sophisticated, targeted interventions to address the needs of people suffering from all forms of mental health disorders. With increased research, understanding, and awareness of psychiatric illnesses, experts are creating more and more effective methods of alleviating emotional and behavioral suffering. People who sought mental therapy years ago only to find themselves unable to achieve relief for their symptoms are how returning to treatment to find a plethora of new, evidence-based therapies offering the promise of more advanced, effective avenues for healing. Those who are new to treatment can often access the most up-to-date therapies immediately. For many, this is groundbreaking. However, even in these exciting times of emerging treatments, one constant remains: the therapeutic alliance.

Therapeutic Alliance as a Keystone in Mental Therapy

The therapeutic alliance, or relationship you have with your therapist, is one of the most important components of successful treatment outcomes, regardless of the specific form of therapy. As Jeffrey Kottler, researcher and professor of counseling at California State University, Fullerton, says:[1. http://ct.counseling.org/2014/08/connecting-with-clients/]

I can recall few instances, either from research studies or my own practice, in which clients reported that it was some singular technique or intervention that was most helpful to them. Instead, they so often say that they felt heard and understood and valued by their counselor. They talk a lot about the power of the relationship.

A body of research extending as far back as the 1980s firmly establishes this alliance as a “keystone in psychotherapy;” a metareview of 85 studies published by the American Psychiatric Association in 1985 found that “the strength of the alliance between patient and therapist was a better predictor of therapeutic success than the specific kind of therapy, the qualities of the therapist, or the kind of patient.”[2. http://www.nytimes.com/1985/07/23/science/dissatisfied-patients-urged-to-consider-therapist-switch.html?pagewanted=1] Since then, researchers have confirmed this significance again and again. A positive therapeutic alliance has been found to reduce suicide attempts amongst people with Borderline Personality Disorder in Dialectical Behavioral Therapy. A positive “early working alliance” is associated with a reduction in symptoms in chronically depressed patients. People with bipolar disorder who report a positive therapeutic alliance with their care providers are significantly more likely to adhere to treatment, including pharmacotherapy.[5. http://www.ncbi.nlm.nih.gov/pubmed/25751116] Even people experiencing psychosis are more likely to benefit from treatment in the presence of a strong, trusting therapist-client relationship.[6. http://webspace.qmul.ac.uk/spriebe/publications/pub%20by%20year/2010/2010%20-%20Does%20the%20therapeutic%20relationship%20predict%20outcomes…systematic%20review%20-%20Richardson%20-%20PSYCHOTHERandPSYCHOSO.pdf]

The Qualities of Therapeutic Alliance

So what makes a good therapeutic alliance? Some erroneously assume that if you like your therapist, that means you have a positive therapeutic alliance. However, establishing a true, positive therapeutic alliance goes beyond just liking your therapist. There are three components of establishing a positive working relationship in mental therapy:

Relationship Quality: You and your therapist share a connection. You feel understood, validated, and supported by your therapist and believe at she or he is working with your best interests in mind. This does not mean that you are necessarily similar or have shared life experiences, but it does mean that your therapist practices with empathy and instills a sense of trust that allows you to explore your emotions and history safely.

Shared Perspective and Goals: You and your therapist have a mutual understanding of the purpose of therapy. As Dr. Gregg Henriques writes, you have a “shared conceptualization … of your story, your character and your problems, and, based on that understanding, the treatment goals that stem from them.”[7. https://www.psychologytoday.com/blog/theory-knowledge/201410/the-key-ingredients-good-psychological-therapy]

Agreement On the Means for Change: You and your therapist agree on the methods and modalities you will use to spur change.

Finding the Right Therapist

For many, mental therapy is a difficult and painful prospect; exploring distressing emotions and experiences may make you feel intensely vulnerable, scared, or even ashamed. Creating a trusting relationship with your therapist can be particularly hard for people who have experienced trauma or neglect, were denied meaningful, trusting bonding in early childhood, or have had negative experiences in psychiatric treatment in the past. However, by connecting with the right therapist who strives to work with empathy and compassion, you can begin to open up and create a positive therapeutic relationship in which to start healing.

To optimize your chances of successful treatment, look for the following qualities in a therapist:

  • Well-developed interpersonal skills: You therapist should make you feel welcomed, supported, and accepted and be able to communicate with you in a way that is meaningful for you.
  • Instilling a sense of trust: Do you feel safe sharing with this person? If you know you have pre-existing factors that make trust difficult for you, this can be hard to gauge. By making your therapist aware of your needs, he or she can work to create a safe environment for you.
  • Having a plan: Your therapist should develop a personalized plan to help you reach your goals and implement the best therapeutic modalities to ensure successful treatment.
  • Tracking progress: Your therapist should give you feedback regarding the progression of therapy and maintain an ongoing dialogue regarding what is working, what isn’t, and how to modulate treatment to ensure you stay on track.

A residential treatment program can provide an ideal, immersive setting to quickly develop collaborative, healing relationships with highly trained therapists. At Bridges to Recovery, we offer four individual psychotherapy sessions per week, in addition to a wide variety of daily group therapies selected specifically for your needs to help you find relief from symptoms rapidly. Our clinicians not only have the expertise necessary to deliver sophisticated, modern therapeutic interventions, they also understand the critical role the therapeutic alliance plays in treatment, regardless of modality, and work to create safe, positive, and productive relationships with clients. By delivering the highest standard of care with respect, empathy, and warmth, the psychiatrists and therapists at Bridges can help you move forward and find lasting relief from psychiatric distress.

 

Bridges to Recovery offers preeminent care in a beautiful residential setting for people suffering from mental health disorders. Contact us to find out more about how we can help you or your loved one today.