On paper, it is easy to assume that participation is all a client needs to ensure therapy success. However, the relationship built between counselor and client is often just as important a factor.
After all, clients’ conversations with their counselors and therapists are likely highly personal! It stands to reason those counselors should focus on building strong relationships on trust at the very least.
However, the counselor-client relationship runs a little deeper than just trust. In fact, the strength of understanding between the two charges can be vital in positively affecting the therapy’s final outcome.
This guide will examine why building a positive counselor-client relationship is essential to therapy outcomes and how to build a therapeutic relationship that supports both parties effectively.
What is a therapeutic relationship?
If you are entering into counseling as a professional (or are the one actively counseling), you will likely come across the term “therapeutic relationship” or “therapeutic alliance” during your studies. These terms describe the connections between clients and counselors.
The therapeutic relationship is the groundwork on which counselors and clients build healthy discourse. Essentially, this relationship forges on mutual respect, honesty, and, of course, trust.
For a client to share helpful information with a counselor, there needs to be a clear line of trust established early on in discussions. What is more, a counselor must encourage their clients to be honest and open about what they are feeling and experiencing. Thus, it is a two-way street.
The stronger the therapeutic relationship, the more likely clients will leave counseling feeling refreshed, mentally fit, and confident about the challenges they face.
Why is this therapeutic relationship so important?
The basic therapeutic relationship’s strength directly impacts how quickly a client develops self-coping mechanisms, the confidence to succeed, and the ability to manage their problems. The key to this is that the stronger the link between therapist and client is, the more likely they will “open up” and discuss what is at the root of their problems.
Let’s explore a few of the positive outcomes of strong therapeutic relationships.
Good relationships foster confidence
One of the most significant barriers counseling clients will face when speaking with counselors is the ability to talk freely about their problems. For example, they may feel embarrassed or unworthy or wish to retain complete control and thus continue to struggle with internalized guilt or other harmful emotions.
The more positive, open, and respectful a relationship between client and counselor is, the more likely said client will be ready to share deeper information about themselves. Sharing of information is critical not only for counselors to understand a client’s problems better (and thus find solutions) but also vital for clients who may find the process cathartic.
A counselor who actively listens to their clients without prejudice and gives them the platform to speak openly without reproach is more likely than most to encourage positive growth.
If a client does not feel confident about sharing personal details or what may be at the root of their problems, there is unlikely to be any positive progress for some time.
Good relationships offer reassurance
While confidence to speak up is beneficial for the counselor (so they can start to look for ways to help their clients, a good therapeutic relationship offers more than just catharsis for the client.
In many cases, people in counseling will look for reassurance. They will need a voice they can trust and respect, who will give them assured feedback on how they are handling things. Naturally, a good counselor will never tell a client they are performing badly. However, if it appears they are not coping as well as they might, reassurance may arise in the form of constructive feedback.
Clients are more often than not looking for safe spaces where they can gain insight into their lives. Even those not in counseling will know that listening to one’s own thoughts and feelings constantly produces an “echo chamber” effect. It is healthy to get an outside perspective.
Reassurance can go a long way in helping to heal people attending counseling sessions. While a counselor should never lie to a client purely to help them feel better, they need to hear constructive feedback they can put into action.
This is only possible when a counselor has laid the groundwork for a client to feel confident, willing to share information, and receptive to advice.
Good relationships produce results
Ultimately, no positive results are achievable without a good working therapeutic relationship. Both parties need to be genuine and open in all they discuss. The more genuine and open discussion is, the deeper work can go.
An open and positive relationship between counselor and client will open doors for the latter to discuss all they feel – without the restrictive fear of judgment.
A poor working relationship will mean little information is shared between the two parties, so the counselor – vitally – has very little to work with, effectively relying on guesswork, assumptions, and using templated resources.
A healthy relationship between client and counselor ensures that treatment and advice continue to tailor to the former’s specific needs. Millions of self-help books and guides offer template advice and guidance – someone in counseling does not need this – they need a platform to speak and receive advice that is bespoke to their needs.
What are the core conditions?
To build a healthy therapeutic relationship and ensure that clients can experience beneficial results, much of the work initially lies on the therapist or counselor. That means they must produce a positive, open, and trustworthy environment from the outset.
Carl Rogers, the founder of Person-Centered Therapy (PCT), coined the concept of “Core Conditions.” He first discussed these conditions in the 1950s, which should provide the perfect platform from which healthy therapy can begin.
Rogers argues that there cannot be a workable therapeutic relationship without these three core conditions. It is down to the counselor to ensure these parameters are met from session to session.
The first of these conditions is empathy – the ability to understand other people’s feelings, thoughts, and perspectives. A reliable therapist can feel and demonstrate empathy from the outset of therapy through active listening and careful questioning.
Secondly, Rogers defines congruence as equally important. Congruence simply measures how “real” and “genuine” a therapist is. Are they acting out of genuine concern and care for a client, or are they doing so purely to tick a box or earn a living?
Rogers argues that congruence is critical for clients to start building trust. This often manifests as a feeling of warmth and value. A client that feels congruence with a therapist will start to talk with greater self-esteem and feel less threatened by judgment. Without congruence, they may not share any details or concerns – which will defeat the object of the exercise!
Finally, Rogers suggests the last core condition is unconditional positive regard or UPR. UPR shows care and support with complete acceptance and without bias.
UPR, on behalf of a counselor, means offering care and guidance that purely benefits the client. It also scratches an itch that many people feel regarding a need for approval. A counselor offering gentle advice and positively questioning a client, showing genuine interest, and supporting them unconditionally, helps them to gain confidence and self-worth.
With UPR, clients feel they no longer need to “prove” themselves to a counselor and can therefore open up.
Working together, these three conditions can create an open playing field through which a healthy therapeutic relationship can develop.
Is it always easy to build therapeutic relationships?
While simple in principle, therapeutic relationship building can be taxing depending on the people involved in counseling conversations. Each person will have different needs, come from different backgrounds, and may be experiencing different traumas.
As such, counselors need to develop a standard code of practice if they wish to get better at building therapeutic relationships for positive results.
You’ll typically learn about the basic facets of the therapeutic relationship during education, for example, when studying for a masters school counseling online. Educational bodies, such as St. Bonaventure University, provide flexible and comprehensive modules where therapists in training can practice their core conditions and learn how to work with different types of personalities.
Ultimately, building positive relationships in counseling takes time and practice. Adopting UPR and showing empathy (while demonstrating congruence) will lay the groundwork for open discussion.
This perhaps will not account for some challenges that arise in session – such as clients potentially reacting negatively to advice. However, counselors can still use the lessons learned from these exercises to react to future challenges with confidence.
What are some of the major barriers to positive results through therapeutic relationships?
Providing a counselor follows the principles they learn during education and practices without bias (and with a genuine interest in helping people), it is likely clients will be highly receptive. Some people may have traumas or psychological problems that make them less receptive to help; however, laying down simple groundwork is vital.
That said, it is all too easy to produce negative results from counseling if parties ignore the core conditions, or if clients feel their counselors are not presenting these conditions openly enough.
Other barriers to building positive results through therapeutic relationships may not be the fault of either party in the conversation. For example, there may be language barriers that prevent open discussion between therapists and clients. Moreover, a client may have attachment issues or a lack of boundaries when building relationships.
This also applies to counselors. In rare cases, counselors may have boundary issues that result in them pursuing personal relationships with clients, which is both unprofessional and highly detrimental to positive progress.
There is also a risk that a client may project or transfer onto a counselor – for example, they may see similarities with their counselor and another authority figure in their lives and thus potentially confuse the two.
These are all hypothetical barriers, of course – and the best way to overcome them, and to continue producing positive outcomes, is for the counselor to provide a healthy, professional, and open groundwork upon which discussions can take place.
Why therapeutic relationships go beyond counseling practice
While the relationships built between counselors and clients are likely to be some of the closest you will experience in healthcare, the concept of the healthy therapeutic relationship applies just as importantly elsewhere in medicine and treatment.
For example, mental health nurses using holistic care practices must develop a deep understanding of how their patients feel. Therefore, it is likely they, too, will follow a system similar to Rogers’s Core Conditions.
Crucially, no clients will be receptive to receiving help and guidance if they do not feel valued, safe, or confident to do so. It is down to the healthcare provider, in this case, the counselor, to create this scenario and atmosphere.
Of course, there will always be work for clients to do during counseling sessions, too. They will need to be open to receiving feedback and avoid being obstructive on purpose. Some people may find this difficult to manage, but it is for their greater benefit.
The more positive and open a relationship between a therapist and client is, the more positive and long-lasting the results can be for those receiving care. This means keeping within professional relationship boundaries and ensuring clients can always feel safe to “open up” without judgment or prejudice.
