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The relationship between therapist and client.

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At the heart of therapy is the therapeutic relationship.  The key to the success of counselling is the way that the client and the therapist interact and relate to one another.  It is so important for clients to feel heard supported, and for them to know that their therapist thinks about them and holds them in mind.  In therapy the relationship is where the real therapy takes place.

Therapists need to be highly trained, and they need to have great insight.  However it isn’t enough, just to listen, interpret, reflect or understand.  Beyond this there needs to be analysis, support, guidance, and still there needs to be more.  Theory enables therapists to be well grounded and for them to be trained in different areas.  But theory and therapeutic skills will only ever be enough for basic counselling to take place.

The real changes take place, when you look at and explore the therapeutic relationship.

  

So much of what happens between a therapist and their client is subtle and can go unsaid or unexplored.  It is vital that any therapist recognises the importance of the impact that they can have on their client.  It may be something that they say, or do, or how they react to certain things.  It is imperative that therapists constantly evaluate the relationship that they have with their client, in order for the therapy to progress and move forward.  Therapeutic boundaries need to be maintained and respected, and if these are ever crossed, it can be extremely damaging to the therapy.  Clients can feel very confused if a therapist steps out of their role for example, and begins to act like a friend.  A chance encounter out in the street, can, as another example, cause clients to feel unsettled and ungrounded.  All of these things must be looked at and explored within the therapeutic space.  Questions such as the following need to be answered –

  • How do clients feel when their therapist goes on holiday?
  • What is it like for a client if their therapist is unwell and has to cancel a session?
  • What would it bring up for a client if they saw another client as they arrived for therapy?
  • How do clients feel if a therapist is late for any reason?
  • What happens if a therapist discloses a lot about themselves in the counselling room?
  • How would a client feel if something interrupted their session?
  • What is it like for a client if a therapist looks or appears different one day?
  • What happens when a therapist gets married or has a baby? How do clients feel about this?

These are just some of the examples of things that can impact on the therapeutic relationship.  They are some of the very basic examples.  Often therapists will explore these areas with clients, but sometimes there are more subtle areas that can get missed.  It could be for example that something about the therapist or the therapeutic environment brings up something for the client about their past.  Furniture could trigger a memory.  Or it could be that something the therapist does or says, takes the client back to something that was very difficult for them in their history.  It is imperative that a good therapist looks for the signs and signals of this, and explores it with their client.

There are various different fields of psychotherapy and they all have different approaches.  These range from the therapist being seen as a total blank screen, to the therapist being more humanistic and open in the counselling room.  Whatever a therapists approach, they will focus on what is best for their client, and ensure that they respond in an appropriate way.  The key to the success of the therapy is the relationship that is formed.

A good therapeutic relationship will have firm boundaries.  Clients will know where they stand and what to expect.  It will be consistent and firm, yet warm, kind and supportive.  A strong therapeutic relationship will enable a client to express all kinds of emotions in the therapy room, ranging form anger to distress.  It will be able to tolerate all of these, and to survive them.  The key to such a relationship is trust, and this takes time to develop.  Clients need to feel safe, and able to depend on their therapist.  At the same time their therapist will encourage them to take steps forward and to eventually be able to move away from the therapist and on with their lives in a more grounded and manageable way.  Working on the therapeutic relationship is vital and needs to be ongoing.  A good therapist will constantly be reflecting on this and evaluating it, so that progress can be made in the therapy room.