The Therapeutic Relationship

The therapeutic relationship is one of my favorite topics to discuss. Why? Because of the impact that it has on the outcome of therapy. It is also referred to as the therapeutic alliance, working alliance, and the therapeutic bond. The therapeutic relationship is a special bond, or connection, that develops between the therapist and the client over a period of time. Without this bond, therapy is usually not effective. I say ‘special’ because it remains in the therapy room. You may begin to feel very close with your counselor, and sessions may be intimate emotionally and psychologically, but it is important to maintain a professional relationship, rather than a personal relationship. Numerous studies have highlighted the importance of the therapeutic relationship. In particular, a meta-analysis of 24 studies1, or research that combines the results of several different studies, showed that the therapeutic relationship, based on assessments completed by clients, was the best predictor of treatment outcomes. No matter what theoretical orientation the counselor ascribes to, it is all about the relationship!

Practice this exercise with me. Close your eyes and think about the first time you sat down with a therapist. If you have never been to counseling before, imagine what you think it will be like. Beginning therapy, or the thought of beginning therapy, can be scary. Will you trust this person? Will they really maintain my confidentiality? You’re sitting across from a complete stranger and they are asking you to tell them about things you may have never told anyone before. You may feel ready and excited or concerned, apprehensive, and scared to share your deepest thoughts and feelings with someone else. I totally get it. I have experienced some of these same feelings when beginning my own therapy journey. It is completely normal to have these feelings!

Like therapy, the therapeutic relationship is unique to each individual relationship. However, some common components that lead to the formation of the therapeutic relationship are empathy, unconditional positive regard, and congruence or genuineness. Empathy, on the part of the therapist, is the ability to recognize and understand the client’s thoughts, feelings, and experience. The therapist is then able to walk with the client through the journey of counseling, which validates the client’s experience. Unconditional positive regard also means non-judgmental acceptance of the client. The client is able to freely express their thoughts, feelings, and experience without feeling judged by the therapist or having to earn acceptance from the therapist. The therapist conveys a non-judgmental and accepting attitude by providing an environment that is caring and safe. From the moment the client enters the therapy room, the counselor’s responsibility is to remain unbiased and to accept the client. Lastly, congruence is being authentic and genuine with the client. Your therapist is just a person too, and this is typically conveyed to the client by simply being a human and relating to the client, without being the “expert” in the room. I do this with my clients by expressing that I truly believe that they are the expert of their own life. I am here to walk with you through life’s most difficult moments while also celebrating life's successes.

Written by: Rachel Ealy, M.Ed

Rachel is a counselor at Heights Family Counseling. She believes that counseling should be for everyone because everyone could use extra support, a place to define purpose and values, and tools to use to tackle life’s everyday problems, as well as someone to support your successes in life. Rachel specializes in working with children, adolescents, young adults, and couples. Learn more about Rachel's counseling approach by visiting