Why a Therapeutic Alliance Is Important in Therapy

Table of ContentsView AllTable of ContentsWhat are Four Key Elements of the Therapeutic Alliance?What Are 5 Types of Therapeutic Alliances?What Are the Five Components of the Therapeutic Relationship?Impact of a Therapeutic AllianceMeasuring the Therapeutic AllianceHow Therapists Can Strengthen the Therapeutic Alliance

Table of ContentsView All

View All

Table of Contents

What are Four Key Elements of the Therapeutic Alliance?

What Are 5 Types of Therapeutic Alliances?

What Are the Five Components of the Therapeutic Relationship?

Impact of a Therapeutic Alliance

Measuring the Therapeutic Alliance

How Therapists Can Strengthen the Therapeutic Alliance

Close

A therapeutic alliance is defined as the collaborative, trusting relationship between a therapist and a client. It is sometimes referred to as the “working alliance." The therapeutic alliance provides an essential foundation for successful therapy; without it, therapeutic progress would be difficult, if not impossible.

The therapeutic alliance is based on trust and mutual respect: both the therapist and client need to work together in order to achieve positive changes. This involves open communication and understanding so that the goals of therapy can be effectively discussed and achieved. Mutual collaboration is necessary for effective problem-solving and for delving into the client’s past in order to understand their current reactions, emotions, and behaviors.

The therapeutic alliance between a therapist and client is essential for successful treatment outcomes. It establishes trust, encourages collaboration, and reinforces realistic expectations that enable clients to achieve their therapy goals. By focusing on these four key elements of a therapeutic alliance, therapists can create an atmosphere where meaningful change can occur:

The therapeutic alliance is based on trust and mutual respect: both the therapist and client need to work together in order to achieve positive changes.

The therapeutic alliance between a therapist and client impacts the effectiveness of treatment. Different types of therapeutic alliances can be used to achieve different goals, such as improving communication skills or increasing motivation for change.

Types of Therapeutic Alliances

Below are five types of therapeutic alliances commonly used in therapy:

The following five components are essential for creating a strong therapeutic bond that encourages meaningful change:

What Is a Treatment Plan in Therapy?

The quality of the therapeutic alliance between a therapist and client has far-reaching implications for the success of therapy.

A strong alliance helps foster open communication, encourages collaboration, and reinforces realistic expectations that enable clients to achieve their goals.

It also creates an environment where meaningful change can occur as clients explore their thoughts and feelings in a safe, non-judgmental space. Ultimately, the therapeutic alliance is an essential part of successful therapy.

The strength of the therapeutic alliance helps determine how well clients respond to treatment and how likely they are to make positive changes that last beyond therapy.

It can be difficult to measure the quality of the therapeutic relationship, as quantifying “successful” relationships can be subjective, but there are numerous tools available to assess the strength of the therapeutic bond, such as The Working Alliance Inventory.

The Working Alliance InventoryThe Working Alliance Inventory is a survey that asks clients and therapists questions about their experience with each other in order to assess levels of satisfaction, mutual understanding, trust, and communication within the therapeutic relationship.

The Working Alliance Inventory

The Working Alliance Inventory is a survey that asks clients and therapists questions about their experience with each other in order to assess levels of satisfaction, mutual understanding, trust, and communication within the therapeutic relationship.

Overall, a strong therapeutic alliance between a therapist and client is essential for achieving positive mental health outcomes. By creating an environment of respect, empathy, authenticity, safety, and positive expectations between both parties, individuals are more likely to move through theirhealing processpositively and effectively.

Additionally, therapists should strive to maintain an environment of respect at all times while acknowledging the client’s autonomy in making decisions about their care.

Finally, therapists should focus on creating a safe space for clients to openly discuss difficult topics without fear of judgment or criticism. By taking these steps, therapists can build a strong therapeutic alliance with their clients that promotes meaningful change and healthy outcomes.

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What to Expect During Your First Therapy Session

11 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Price B.Developing patient rapport, trust and therapeutic relationships.Nurs Stand. 2017;31(50):52-63. doi:10.7748/ns.2017.e10909Epton T, Currie S, Armitage CJ.Unique effects of setting goals on behavior change: Systematic review and meta-analysis.J Consult Clin Psychol. 2017;85(12):1182-1198. doi:10.1037/ccp0000260Wang K, Chung H, Stuart-Maver SL, et al.The relationship between clients' expectation of therapist support and challenge and treatment outcome: A response surface analysis.Psychotherapy (Chic). 2022;59(3):481-486. doi:10.1037/pst0000440Delsignore A, Carraro G, Mathier F, Znoj H, Schnyder U.Perceived responsibility for change as an outcome predictor in cognitive-behavioural group therapy.Br J Clin Psychol. 2008;47(Pt 3):281-293. doi:10.1348/014466508X279486Ng CT, James S.“Directive approach” for chinese clients receiving psychotherapy: is that really a priority?Front Psychol. 2013 Feb 13;4:49. doi: 10.3389/fpsyg.2013.00049. PMID: 23408043; PMCID: PMC3571202.Cuijpers P, Driessen E, Hollon SD, van Oppen P, Barth J, Andersson G.The efficacy of non-directive supportive therapy for adult depression: a meta-analysis.Clin Psychol Rev. 2012;32(4):280-291. doi:10.1016/j.cpr.2012.01.003Anderson T, Ogles BM, Patterson CL, Lambert MJ, Vermeersch DA.Therapist effects: facilitative interpersonal skills as a predictor of therapist success.J Clin Psychol. 2009;65(7):755-768. doi:10.1002/jclp.20583Grover S, Avasthi A, Jagiwala M.Clinical Practice Guidelines for Practice of Supportive Psychotherapy. Indian J Psychiatry. 2020 Jan;62(Suppl 2):S173-S182. doi: 10.4103/psychiatry.IndianJPsychiatry_768_19. Epub 2020 Jan 17. PMID: 32055060; PMCID: PMC7001359.Wilson WH, Diamond RJ, Factor RM.A psychotherapeutic approach to task-oriented groups of severely ill patients. Yale J Biol Med. 1985 Jul-Aug;58(4):363-72. PMID: 4049917; PMCID: PMC2589925.Stubbe DE.The Therapeutic Alliance: The Fundamental Element of Psychotherapy. Focus (Am Psychiatr Publ). 2018 Oct;16(4):402-403. doi: 10.1176/appi.focus.20180022. Epub 2018 Oct 18. PMID: 31975934; PMCID: PMC6493237.Munder T, Wilmers F, Leonhart R, Linster HW, Barth J.Working Alliance Inventory-Short Revised (WAI-SR): psychometric properties in outpatients and inpatients.Clin Psychol Psychother. 2010;17(3):231-239. doi:10.1002/cpp.658

11 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Price B.Developing patient rapport, trust and therapeutic relationships.Nurs Stand. 2017;31(50):52-63. doi:10.7748/ns.2017.e10909Epton T, Currie S, Armitage CJ.Unique effects of setting goals on behavior change: Systematic review and meta-analysis.J Consult Clin Psychol. 2017;85(12):1182-1198. doi:10.1037/ccp0000260Wang K, Chung H, Stuart-Maver SL, et al.The relationship between clients' expectation of therapist support and challenge and treatment outcome: A response surface analysis.Psychotherapy (Chic). 2022;59(3):481-486. doi:10.1037/pst0000440Delsignore A, Carraro G, Mathier F, Znoj H, Schnyder U.Perceived responsibility for change as an outcome predictor in cognitive-behavioural group therapy.Br J Clin Psychol. 2008;47(Pt 3):281-293. doi:10.1348/014466508X279486Ng CT, James S.“Directive approach” for chinese clients receiving psychotherapy: is that really a priority?Front Psychol. 2013 Feb 13;4:49. doi: 10.3389/fpsyg.2013.00049. PMID: 23408043; PMCID: PMC3571202.Cuijpers P, Driessen E, Hollon SD, van Oppen P, Barth J, Andersson G.The efficacy of non-directive supportive therapy for adult depression: a meta-analysis.Clin Psychol Rev. 2012;32(4):280-291. doi:10.1016/j.cpr.2012.01.003Anderson T, Ogles BM, Patterson CL, Lambert MJ, Vermeersch DA.Therapist effects: facilitative interpersonal skills as a predictor of therapist success.J Clin Psychol. 2009;65(7):755-768. doi:10.1002/jclp.20583Grover S, Avasthi A, Jagiwala M.Clinical Practice Guidelines for Practice of Supportive Psychotherapy. Indian J Psychiatry. 2020 Jan;62(Suppl 2):S173-S182. doi: 10.4103/psychiatry.IndianJPsychiatry_768_19. Epub 2020 Jan 17. PMID: 32055060; PMCID: PMC7001359.Wilson WH, Diamond RJ, Factor RM.A psychotherapeutic approach to task-oriented groups of severely ill patients. Yale J Biol Med. 1985 Jul-Aug;58(4):363-72. PMID: 4049917; PMCID: PMC2589925.Stubbe DE.The Therapeutic Alliance: The Fundamental Element of Psychotherapy. Focus (Am Psychiatr Publ). 2018 Oct;16(4):402-403. doi: 10.1176/appi.focus.20180022. Epub 2018 Oct 18. PMID: 31975934; PMCID: PMC6493237.Munder T, Wilmers F, Leonhart R, Linster HW, Barth J.Working Alliance Inventory-Short Revised (WAI-SR): psychometric properties in outpatients and inpatients.Clin Psychol Psychother. 2010;17(3):231-239. doi:10.1002/cpp.658

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Price B.Developing patient rapport, trust and therapeutic relationships.Nurs Stand. 2017;31(50):52-63. doi:10.7748/ns.2017.e10909Epton T, Currie S, Armitage CJ.Unique effects of setting goals on behavior change: Systematic review and meta-analysis.J Consult Clin Psychol. 2017;85(12):1182-1198. doi:10.1037/ccp0000260Wang K, Chung H, Stuart-Maver SL, et al.The relationship between clients' expectation of therapist support and challenge and treatment outcome: A response surface analysis.Psychotherapy (Chic). 2022;59(3):481-486. doi:10.1037/pst0000440Delsignore A, Carraro G, Mathier F, Znoj H, Schnyder U.Perceived responsibility for change as an outcome predictor in cognitive-behavioural group therapy.Br J Clin Psychol. 2008;47(Pt 3):281-293. doi:10.1348/014466508X279486Ng CT, James S.“Directive approach” for chinese clients receiving psychotherapy: is that really a priority?Front Psychol. 2013 Feb 13;4:49. doi: 10.3389/fpsyg.2013.00049. PMID: 23408043; PMCID: PMC3571202.Cuijpers P, Driessen E, Hollon SD, van Oppen P, Barth J, Andersson G.The efficacy of non-directive supportive therapy for adult depression: a meta-analysis.Clin Psychol Rev. 2012;32(4):280-291. doi:10.1016/j.cpr.2012.01.003Anderson T, Ogles BM, Patterson CL, Lambert MJ, Vermeersch DA.Therapist effects: facilitative interpersonal skills as a predictor of therapist success.J Clin Psychol. 2009;65(7):755-768. doi:10.1002/jclp.20583Grover S, Avasthi A, Jagiwala M.Clinical Practice Guidelines for Practice of Supportive Psychotherapy. Indian J Psychiatry. 2020 Jan;62(Suppl 2):S173-S182. doi: 10.4103/psychiatry.IndianJPsychiatry_768_19. Epub 2020 Jan 17. PMID: 32055060; PMCID: PMC7001359.Wilson WH, Diamond RJ, Factor RM.A psychotherapeutic approach to task-oriented groups of severely ill patients. Yale J Biol Med. 1985 Jul-Aug;58(4):363-72. PMID: 4049917; PMCID: PMC2589925.Stubbe DE.The Therapeutic Alliance: The Fundamental Element of Psychotherapy. Focus (Am Psychiatr Publ). 2018 Oct;16(4):402-403. doi: 10.1176/appi.focus.20180022. Epub 2018 Oct 18. PMID: 31975934; PMCID: PMC6493237.Munder T, Wilmers F, Leonhart R, Linster HW, Barth J.Working Alliance Inventory-Short Revised (WAI-SR): psychometric properties in outpatients and inpatients.Clin Psychol Psychother. 2010;17(3):231-239. doi:10.1002/cpp.658

Price B.Developing patient rapport, trust and therapeutic relationships.Nurs Stand. 2017;31(50):52-63. doi:10.7748/ns.2017.e10909

Epton T, Currie S, Armitage CJ.Unique effects of setting goals on behavior change: Systematic review and meta-analysis.J Consult Clin Psychol. 2017;85(12):1182-1198. doi:10.1037/ccp0000260

Wang K, Chung H, Stuart-Maver SL, et al.The relationship between clients' expectation of therapist support and challenge and treatment outcome: A response surface analysis.Psychotherapy (Chic). 2022;59(3):481-486. doi:10.1037/pst0000440

Delsignore A, Carraro G, Mathier F, Znoj H, Schnyder U.Perceived responsibility for change as an outcome predictor in cognitive-behavioural group therapy.Br J Clin Psychol. 2008;47(Pt 3):281-293. doi:10.1348/014466508X279486

Ng CT, James S.“Directive approach” for chinese clients receiving psychotherapy: is that really a priority?Front Psychol. 2013 Feb 13;4:49. doi: 10.3389/fpsyg.2013.00049. PMID: 23408043; PMCID: PMC3571202.

Cuijpers P, Driessen E, Hollon SD, van Oppen P, Barth J, Andersson G.The efficacy of non-directive supportive therapy for adult depression: a meta-analysis.Clin Psychol Rev. 2012;32(4):280-291. doi:10.1016/j.cpr.2012.01.003

Anderson T, Ogles BM, Patterson CL, Lambert MJ, Vermeersch DA.Therapist effects: facilitative interpersonal skills as a predictor of therapist success.J Clin Psychol. 2009;65(7):755-768. doi:10.1002/jclp.20583

Grover S, Avasthi A, Jagiwala M.Clinical Practice Guidelines for Practice of Supportive Psychotherapy. Indian J Psychiatry. 2020 Jan;62(Suppl 2):S173-S182. doi: 10.4103/psychiatry.IndianJPsychiatry_768_19. Epub 2020 Jan 17. PMID: 32055060; PMCID: PMC7001359.

Wilson WH, Diamond RJ, Factor RM.A psychotherapeutic approach to task-oriented groups of severely ill patients. Yale J Biol Med. 1985 Jul-Aug;58(4):363-72. PMID: 4049917; PMCID: PMC2589925.

Stubbe DE.The Therapeutic Alliance: The Fundamental Element of Psychotherapy. Focus (Am Psychiatr Publ). 2018 Oct;16(4):402-403. doi: 10.1176/appi.focus.20180022. Epub 2018 Oct 18. PMID: 31975934; PMCID: PMC6493237.

Munder T, Wilmers F, Leonhart R, Linster HW, Barth J.Working Alliance Inventory-Short Revised (WAI-SR): psychometric properties in outpatients and inpatients.Clin Psychol Psychother. 2010;17(3):231-239. doi:10.1002/cpp.658

Hannah Owens, LMSW

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