Therapeutic Alliance
Do You Have a Good Therapeutic Relationship?
The relationship between client and therapist is key for successful treatment.
Posted April 30, 2025 Reviewed by Davia Sills
Key points
- Trust and safety are the foundation of a strong therapeutic relationship.
- Therapists must be consistent, respectful, and maintain clear professional boundaries.
- Therapy is collaborative; clients and therapists work as equals toward shared goals.
- Feedback, even (especially!) negative, is encouraged and helps strengthen the therapeutic process.
The therapeutic relationship between a therapist and client develops over time and is built on trust. The client must trust the therapist enough to be honest about what they are thinking and feeling, and they must trust that the therapist can help them overcome challenges, solve problems, and improve their overall well-being. A good therapeutic relationship is a cornerstone for successful treatment. But many people—both those new to therapy and those who have been in therapy before—may not know that there are specific behaviors that a therapist should engage in to ensure that the relationship with a client is strong—and that it remains strong throughout treatment.
In general, a client who has a good therapeutic relationship views the therapist as genuine, supportive, caring, respectful, competent, and safe. Some clients who have difficulty trusting other people may initially have difficulty trusting their therapist, too. But their trust in the therapist should grow over time, and the therapist should adapt treatment as needed to help the client feel safe and supported. Clients should feel as if they can “be themselves,” without fear of judgment.
The therapist should be consistent in terms of how they present themselves. They are punctual and follow through with what they say they will do. They keep treatment confidential (unless the client poses an imminent threat to themselves or others or requests that the therapist communicate with a third party) and set clear boundaries. For example, they are careful not to develop a “friends” relationship with clients, although they are certainly friendly.
Most therapists are happy to reveal superficial information about themselves when asked. But they don’t necessarily answer all of a client’s questions, as a friend might. If the therapist thinks a discussion has become too personal, they should redirect in a gentle way: “I’m sorry. I think we should probably get back to working on your goals for this session.” Likewise, they are gentle but straightforward, letting clients know that they need to end sessions on time and are available between sessions if there is a crisis, but not generally otherwise.
The therapist shows unconditional regard and acceptance of the client. They use empathy, validating clients’ emotions, unless clients do not want direct expressions of empathy. In addition, they do not necessarily validate all of the client’s thoughts, because they know that when individuals are distressed, they don’t always perceive situations accurately. Instead, if they suspect the client has misperceived a situation or problem, they seek permission to help the client figure out whether their viewpoint on any given situation or issue is both accurate and helpful. They evaluate the client’s thoughts with them and teach them the skill of doing that themselves.
Understanding what effective therapists do
Therapists work hard to motivate and support clients and help them reach their goals. They listen carefully to the client and ask questions so they can understand what the client is feeling emotionally and what the client’s experiences mean to them. Throughout the therapy session, they reflect back what the clients have said and ask if they’ve accurately understood them. The therapist is transparent, sharing their treatment plan and the rationale for it, and asking for feedback. The therapist is also transparent about the techniques they use in sessions, offering a description and a rationale, and then asking the client if that sounds OK to them.
While therapists may offer guidance or suggestions, they respect the client’s autonomy. At times, they may ask if the client wants their advice, but more often, they ask clients what they view as their options to solve a certain problem or make a certain decision. Telling clients what to do deprives them of the opportunity to improve their problem-solving and decision-making skills. Therapists empower clients to make their own choices and take responsibility for their actions.
Therapy is not one-size-fits-all. The therapist should elicit and help clients live in alignment with their personal values and aspirations. They also vary treatment for each individual, sometimes in small ways, sometimes in large ways, considering each client’s characteristics, such as their age, gender, education level, family history, trauma experiences, race, culture, and so on.
While the client is active in the therapy session, so is the therapist. A major goal of therapy is to teach clients to become their own therapists. So, they not only use certain techniques with clients, but they also teach clients to use the techniques themselves. And they work at a pace that is comfortable for the client. The therapeutic relationship is equal, not hierarchical, with therapist and client working together as a team.
Therapists should directly ask clients to provide feedback during and at the end of sessions, providing the rationale for why that is necessary. When a client provides negative feedback to the therapist, the therapist should say something along the lines of “It’s good you told me that.” And it is good. If there’s a problem in the relationship or in treatment, the therapist needs to know so they can address it appropriately.
If, for example, the client tells the therapist, “You misunderstood what I was trying to tell you,” the therapist should praise the client for letting them know and then apologize and ask for clarification. While it’s easy for many clients to be honest with their therapist, it can be painfully difficult for others, especially for individuals who have experienced abusive relationships. Therapists usually need to encourage these clients to give honest feedback. When they do, it can be an important learning experience for clients who, at some cost to themselves, avoid providing negative feedback when it is warranted to other people with whom they interact.
Finally, clients do not have a duty to emotionally protect their therapist if they want to terminate the relationship before the therapist would like them to. It may be an opportunity for emotional growth for the client to have a final session with the therapist in which they explain why they are terminating, but that isn’t essential—nor is writing an email or letter to the therapist. But it may make the client feel better to do so.
If it seems like there are many things a therapist needs to do to ensure that they have a good therapeutic relationship with their clients—there are. The therapeutic relationship is a foundational element of effective treatment, characterized by mutual trust, collaboration, and a shared commitment to the client’s growth. While essential, it’s also important to recognize that the therapeutic relationship is just one of many critical components that contribute to improved client well-being and lasting psychological change.
