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  • Writer's pictureKevin Kenealy

Why It's Critical to Therapy Success to Have a Good Working Relationship With Your Therapist

According to research, the therapeutic connection is one of the most significant determinants of effective therapy.

Most patients question before commencing psychotherapy, "Will this counseling truly assist me with my problems?" Numerous studies show that various factors influence the outcome of therapy, including the severity of the problem(s) being addressed, the patient's confidence in the efficacy of the counseling, and the therapist's level of competence.

However, research over the last 50 years has found that one thing is more important than any other: the strength of the therapist-patient relationship.

In 1913, Sigmund Freud proposed that a fundamental component of successful treatment is the relationship between the therapist and the patient. Since then, research has shown that the strength of this relationship, which is called the "therapeutic alliance," is the most critical factor in how well the treatment works.

Surprisingly, regardless of the type of treatment evaluated, the quality of the therapeutic connection appears to be crucial to treatment effectiveness.

Numerous studies on individual, couple and family therapy have been undertaken, utilizing various evaluation methodologies to determine the relationship's quality (i.e., patient or therapist reports or observational ratings). In these studies, which looked at a wide range of people, including children and adults, in-patients, and out-patients, they found that the therapeutic relationship is significant to the success of the treatment. This is because the relationship between the two people is substantial.

In earlier research, a bit more than half of the favorable benefits of therapy are attributed to the quality of the alliance (in earlier research). Patients and therapists frequently (but not always) agree on the quality of the relationship. However, the best predictor of therapy effectiveness is the patient's opinion of the quality of the relationship. Patients' assessments of their relationship with their therapist, even very early in therapy—after the first or second session—accurately predict their subsequent recovery. People who say they don't like their therapists are more likely to stop going to therapy early.


Given the importance of the therapist-patient connection to treatment effectiveness, professionals have attempted to define a "healthy relationship." A successful therapeutic relationship consists of three fundamental characteristics:

● An emotional link of trust, concern, and respect

● Agreement on the therapy's goals

● Participation in the treatment's "work" or tasks

Qualities of a successful therapeutic partnership include the following:

● Mutual trust, regard, and concern

● Consensus on the therapy's objectives and duties

● Joint decision-making Participation in "the labor" of therapy

● The capacity to discuss "here-and-now" elements of one's connection with another

● The ability to communicate negative emotional responses to one another. The capacity to resolve any conflicts or challenges that may develop in the relationship.

A shared sense of responsibility for the therapy appears to be necessary. For example, do the therapist and patient have mutual faith that the other is making a concerted effort to ensure the treatment's success? Do they collaborate on treatment-related choices, such as how the therapy is done and which intervention methods are used?

Every intimate relationship has its share of issues, challenges, and misunderstandings, and the therapist-patient connection is no exception. However, the therapist and patient working through these obstacles is another critical component of the relationship's success. Can the therapist and patient discuss any unpleasant sentiments, hurt, or anger that may have occurred due to the difficulties? And are they capable of resolving any issues that may arise throughout their collaboration?

The Importance of Expanding the Term "Therapeutic Relationship"

Historically, the therapeutic relationship has been studied exclusively through the lens of the patient's interaction with the therapist. However, research has demonstrated the critical necessity of broadening this definition to incorporate the effect of significant other people in the patient's life throughout time. For example, in individual therapy, support for the treatment from the patient's essential people (family members, spouse, or close friends) was related to a favorable outcome. In pair therapy, the couple agreed on treatment objectives, goals, and bonds was a good sign of how well the treatment worked.

How do therapists improve their therapeutic relationships?

According to research, the capacity to develop positive interactions with patients depends not only on a therapist's training or experience level. Many starting therapists are just as adept at establishing effective therapeutic connections as their more seasoned colleagues. However, research indicates that experienced therapists are more adept at developing relationships with patients who have had difficulty in previous relationships. On the other hand, professional therapists are better at spotting and solving problems in the therapeutic relationship than novices.

Therapists contribute significantly to the creation of a positive therapeutic connection. The therapist must express empathy and understanding towards the patient. Additionally, the therapist's openness, flexibility, and readiness to modify the treatment to the patient's requirements are critical components. Skilled therapists aggressively request patients' feedback regarding therapy goals and procedures to foster cooperation.

What Assists Patients in Forming a Successful Therapeutic Relationship?

According to research, patients who possess strong interpersonal and communication skills are more likely to develop a positive therapeutic connection. For example, honest patients and upfront about their needs are more likely to have good relationships with their therapists.

How can I improve my relationship with my therapist?

If you are having trouble with your therapist, it is critical to speak with them directly. If you have any questions or concerns regarding any aspect of the therapy, don't hesitate to contact your therapist. Open and honest communication is a very beneficial technique for resolving conflicts. Indeed, research shows that having this kind of "relationship conversation" is an excellent way to improve the connection and make treatment more likely to work.

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