Whether you’re currently in therapy or are curious about starting the process, it’s natural to have a lot of questions about what the experience might be like. There are so many clinicians out there who all utilize a different approach to therapy, who focus on different parts of your life more frequently, and apply different ‘interventions’ or ‘techniques’ to guide you towards growth and healing. Out of all of those components, the most important thing that exists in the therapy world that can help with progress and change is the relationship between you and your therapist!
Based on findings from the American Psychological Association’s task force on Evidenced Based Relationships and Responsiveness, and on self-reports from millions of individuals in therapy, it has been concluded that clients who have therapists that approach them with genuine curiosity about their lives, hold compassion and gentleness, while also challenging them on adjusting maladaptive behaviors, are the individuals who notice the most profound improvements (DeAngelis, 2019). These findings also showed that therapists who constantly checked in on the therapeutic relationship with their clients and adjusting according to what their clients need had the best outcomes.
Interventions, techniques, and skills discussed and taught in therapy are important and have a place, but if you don’t feel safe enough to be vulnerable in your sessions or if you don’t feel like you have built a strong foundation of rapport and trust with your therapist, it might be hard to notice any beneficial changes or progress. This is because therapists must be attuned to you as an individual - your unique experiences, emotions, reactions, thoughts, attachment style, etc - in order for you to feel seen and heard. Once you begin therapy, you’re entering into a new relationship with another person, and this relationship is not unlike other long lasting relationships that you have in your life - you must feel supported and understood to maintain it. This is the therapist’s job to do, and it is also crucial for the therapist to assess how you are perceiving them and your relationship in the therapeutic space in order to meet you where you are and understand your needs. It might be helpful for a therapist to ask you questions like, “How are you experiencing me today?”, “I noticed that you turned away from me after I said that. What happened there?”, or “This is your time and your space - let me know if I am moving too fast or slow, and I’ll adjust to what feels natural for you”, or “Your crossed arms tell me you might be feeling closed off today, or like you might not want to share things with me. Does that feel accurate to you, or am I off base?”. All of these statements bring the relationship into the here and now, and require both you and your therapist to reflect on your interactions and your connection. Since the therapy room is a microcosm of your real life, these conversations can be a helpful guide to approach other people in your life as well.
So, how can I tell whether I have a good relationship with my therapist?
You are included in decision making like treatment planning, session content, and termination
Therapy is a collaborative process→ you get a say on what is discussed, what you don’t want to share on any given day, and when to cease treatment. It should not feel forced.
Your therapist checks in on you during session, and invites feedback
This might mean they ask you about your comfortability in the room itself, how you’re feeling about the pace of things, and whether you are feeling understood or not by the therapist in the here and now. By directly asking you how you’re feeling about the therapy itself, it gives you a voice and an opportunity to express your needs!
If there is rupture, there is repair
It’s possible your therapist might say something that you disagree with, makes you upset, or that you just simply don’t like. They are human, after all! While this can cause a rupture in the relationship, it’s important that your therapist tends to it by acknowledging it and - if necessary, apologizing - all while being curious about what you might need to be different in order to feel secure. This shows repair.
You feel genuinely cared about, but also challenged
Having our feelings normalized and validated helps us feel seen, understood, and supported and being treated with genuineness and compassion is foundational to all growth and healing. However, a therapist should also be able to gently challenge you to make changes in your life or challenge you to see things from a different perspective if you’re feeling stuck.
There are many different types of therapists out there, and the above qualities are not the only indicators that you have a positive and supportive relationship with your therapist. However, don’t be afraid to speak up and ask for what you need in session - your therapist will welcome an opportunity to know your concerns better and be what you need!
Citations
DeAngelis, Tori. “Better Relationships with Patients Lead to Better Outcomes.” Monitor on Psychology, American Psychological Association, 1 Nov. 2019, www.apa.org/monitor/2019/11/ce-corner-relationships.
Fagan, Abigail. “The Importance of the Relationship in Therapy.” Psychology Today, Sussex Publishers, 22 Dec. 2016, www.psychologytoday.com/us/blog/compassion-matters/201612/the-importance-of-the-relationship-in-therapy?msockid=24c039a561f668cc34082d5d60b9694e.