How the therapeutic alliance ensures that change happens for clients

During the journey of life most everyone will experience the undulations between “up days” and “down days”. Many of the therapy sessions in psychologists’ offices are with clients who don’t have a mental health diagnosis because they are the “worried-well” – those who experience everyday stress, everyday sadness, everyday worry and everyday relational tension. The worried well want to change their lives.

Contrary to popular psychology, believing that just the right psychological theory, intervention and technique will act like a health-care “magic pill” that can make one’s worries suddenly disappear is mistaken. Most of the therapeutic change that happens during counselling is due to the 3 Rs of the therapeutic alliance: rapport, relationship and resources. Rapport is about the connection the client and therapist feel for each other. Relationship is about the constructive cognitive and emotional exchanges and trust that a client and therapist build up over time. Resources are about how the therapist helps the client to activate their existing emotions, thoughts and behaviours in service to the healthy change they seek in their day-to-day lives.

Scientific research shows that the therapeutic alliance comes about quicker and feels deeper if three things are perpetually and mindfully present in the relationship and dialogue between a psychologist and a client: 1.) a strong bond, 2.) clearly defined goals and 3.) a mutual agreement on the therapeutic methods to be employed. The most effective way to initiate and foster the alliance and change process is to establish with a client right from the outset that their therapeutic “hero’s journey” is going to be one that relies on the rapport we establish/sustain (BOND), the relationship we build/maintain (GOALS) and the resources we engage/employ (METHODS). Such a co-creative therapeutic process will take time and practice; it will be ill-defined and uncertain; and, at times, it may feel vulnerable, but by courageously and whole-heartedly engaging in the work of counselling the changes the client has been seeking will eventually become them.