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Decades of clinical research reveal that “therapeutic alliance”—the strength of the client-therapist bond and collaborative working relationship—is a critical mechanism for positive behavior change:
- For low-motivated clients in treatment for alcohol use disorder, a stronger therapeutic alliance improved their motivation for recovery, in 2006 findings in the Journal of Substance Abuse Treatment.
- A strong therapeutic alliance substantially affected clinical outcomes, proving a significant predictor of treatment engagement, retention and success, in earlier research.
- And, as early as 1964, Sigmund Freud was proposing that before meaningful change could occur, a sufficient rapport must first be established between client and therapist.
In summary, a strong therapeutic alliance can mean the difference between an entrenched bad habit and the positive motivation, choices and behaviors that sustain lasting sobriety.
Finding a Strong Therapeutic Alliance – What to Look for
For clients in early recovery, this breakthrough insight naturally precedes the following question: “If a strong therapeutic alliance is key to my recovery, how do I get it?” Here are some things that you can look for in gauging the strength of a therapeutic alliance:
- The therapist is warm, supportive and empathetic.
- You believe the therapist is helping you define and reach your goals in therapy.
- You trust the therapist.
- The therapist has your best interests in mind.
- You feel genuinely listened to, and that the therapist values and respects you.
- The therapist can detect obstacles that are impeding positive change in your life.
- Both you and your therapist believe in the therapeutic process.
- Your therapist comes recommended.
- You are making a significant investment in sessions (either financially, emotionally or with time).
The Importance of Time and a First Meeting
It’s unrealistic to assume that the strength of a therapeutic alliance can be determined in just one meeting with a prospective therapist. Usually it takes time—(at least a few sessions)—to gauge whether a therapeutic relationship is made of the stuff that can facilitate positive behavior change.
That said, don’t underestimate the eye-opening value of a first meeting either. A good therapist will begin to establish rapport with you as early as your first session. During any first session, then, be on the lookout for the following, based on recommendations from Dr. Deborah L. Cabaniss, a professor of psychiatry at Columbia University:
- Does the therapist convey that they are interested in you and in what’s troubling you?
- Do they let you know that they have a sense of how difficult, sad or painful the problem is for you?
- Do they understand at least the nature of your problem and the issues involved, and do they communicate that understanding?
- Do you feel comfortable talking with them? Are you able to talk freely?
- Do you feel relieved after talking with them?
Has working with a therapist helped your recovery? If so, what about that therapeutic relationship was most helpful? Share your experience with the rest of us!