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Lesley Kollikho

Building the Therapeutic Relationship



By now, most of us know (I hope), that the most important aspect of therapy, the thing most likely to induce change, and the catalyst to healing, is the therapeutic relationship.


How exactly do we achieve this? Read on for my eight top tips on how to build the foundation of a good therapeutic relationship with your clients. This list is by no means inclusive, and it's important to remember that relationships are complicated and will look different with each client. It's important to meet your client where they are, as building relationships are easier for some people than others.


1. This might sound simple, but be interested in your clients.

I'm not just talking about their trauma, or analysing their attachment pattern or their childhoods and all the other typical ‘therapy stuff’. Take an interest in them in the here and now. What music do they like? Where is their favourite place to go? What is their favourite meal? Are they a dog or a cat person? What is their favourite colour? What is their favourite genre of movie? Or are they not into movies and prefer books? If they were a Disney character, which one would they be?


Asking these sorts of questions, are not superficial chatter or small talk, they actually show your client that you want to connect with them as a whole person, not just a set of symptoms or a psychological condition. One of the ways in which the therapeutic relationship is unique, is that it is 50 minutes dedicated to that person.


2. Remember the small details.

If they spoke about a childhood pet that meant a lot to them, remember their name. If they told you about a work colleague, an uncle, or an author they are currently reading, remember the details. These things may seem small, but to someone they could be absolutely huge. In no other aspect of their life, may your client they get the same level attention and interest. It also shows your client that you are holding them in mind and you are interested. It can be such a moment of connection when you are able to link a somewhat innocuous detail to a present issue they may be going through.



3. Shared laughter.

Now, this might not always be appropriate, and I'm not advocating using humour as a defence all of the time, but therapy is a rather serious business. To be able to laugh with someone can be such important ways of connecting, relaxing and soothing. Therapy doesn't have to be doom and gloom, it's also about two people in a therapeutic relationship, thinking about life. Sometimes life is funny. Sometimes life is so tragic all you can do is laugh. Humour can be healing.


4. Keep to your boundaries.

This upholds the therapeutic frame and is important in establishing that the therapeutic relationship is different to the other relationships your clients may have in their life.

When thinking about boundaries I am including time and consistency, ideally, having the session on the same day, being mindful with the self-disclosure, being a therapist, rather than a friend. Keeping to your boundaries shows your client that you are consistent, trustworthy, and have their best interests at heart. It also suggests that you are reliable and professional. Boundaries help provide the necessary containment that is needed when a person is opening up and being vulnerable with another. The message is that If you are able to keep your to your boundaries, and provide structure, perhaps you are able to keep them safe, too.



5. Be patient.

Allow the client to go at their own pace. You cannot rush the building of a trusting relationship, this takes time. If you feel frustrated that the relationship isn’t developing ‘fast’ enough then its important to reflect on what your expectations are. Your client needs to learn to trust you, to feel safe with you, and many people who enter therapy are bringing traumas and hurt from past relationships. The relationship itself may be a threatening idea so tread carefully.


6. Explain the therapeutic process.

Someone who enters therapy is likely to be feeling vulnerable and perhaps unsure of the process. Explaining what therapy is, how you work, and providing some general psychoeducation about the process can help ease someone’s initial discomfort and expectations. Including the client as part of the process can help address the power imbalance, that's inherent in every psychotherapeutic relationship. It may also help the client to have a sense of agency over the work, rather than feel as if therapy is being done to them.


7. Self disclosure.

Self-disclosure can be important in building the therapeutic relationship. Often therapists are put on pedestals by their clients, and it can be helpful for them to know that we are human and fallible like everyone else. What you choose to disclose must be relevant to the client and their story, and you must also consider how comfortable you feel with a client knowing information about you. I have at some point disclosed to most of my clients that I have had therapy. I think this helps normalise the process, and shows them that having struggles with your mental health are part of the human condition.


8. Be genuine and authentic.

People can tell if you’re putting on an act, or trying to be a textbook therapist. If we ask our clients to bring themselves fully into the therapy, the same can be said of the therapist, too. This does not mean that the therapy is about you, but that you are presenting an authentic version of yourself for the client to see, and build a relationship with.


I hope you have found these tips useful, and bear in mind that there is no magic formula to building a relationship. Include the client in the process, listen, be present, show empathy and take your struggles to supervision.


Good luck!


Please do share any other tips you may have by commenting on send me a message.


Lesley












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