“It is the relationship that heals.”

As Irvin Yalom, an esteemed psychiatrist so eloquently put, a positive therapeutic alliance is essential to the patient’s outcome in therapy.

There may be many reasons for the relationship to be healing. It may foster belief in the patient that there are other people that truly understands their problem and cares for them. Strong relationships may also enable the trust needed to try out the recommendations provided by the therapist. Or genuine and empathetic interactions are just naturally healing in and of itself.

Regardless, the fact of the matter is that building a positive rapport is important. Below, I discuss different ways that a therapist can develop a positive relationship with their patients.

Show that you care

Patients often believe that you are their to simply collect a paycheck. Or they may think that you have so many patients, there is no way you care that much about them.

And it’s your job to show them otherwise.

In showing care, it’s really the little things that count. Sometimes, even checking in for their thoughts during session or saying that you’ve been thinking about them outside of the session can have a positive impact. Like most people, patients find a lot of meaning in the little acts.

In terms of specific skills, the use of accurate empathy can be very helpful to show that you really understand this person’s feelings because you are attending well to what they are saying.

Show you understand the problem

Before showing competence in dealing with a patient’s problem, you must show that you understand the problem itself.

Active listening strategies, such as reflections and summaries, can be a great way to showcase to the patient that you understand their problems well. You’ll know you have hit the jackpot when you hear the patient say something along the lines of “that’s exactly it!”.

Be open and transparent

Although you are the expert in the room in terms of psychology and mental health, you are not expected to be the expert in everything.

It’s okay to say I don’t know. And that you will get back to them to make sure you’re giving them the most helpful up-to-date information. And it’s okay to have feelings – positive and negative about a person or a situation.

Patients are smart enough to know when you are hiding something or pretending to know something you don’t. And they will appreciate your honesty.

If you have a dilemma, share it with them and get their thoughts on the matter. This is beneficial to help the patient take more responsibility for the therapy and takes pressure off you to be the person to have to solve every problem.

Be collaborative

If you are the expert in the psychological matters, the patient is the expert of themselves and their own psychological world.

Therefore, it’s important to work together in pursuit of goals in therapy. Look to check-in and ask for the patient’s feedback, bringing them in when discussing possible solutions rather than just assigning them to the patient.

Questions such as: “what do you think about this?”, “does this fit right for you?”, and “how do you feel therapy is going between us?” can be helpful to show collaboration and that you place importance in what the patient is thinking.

Demonstrate genuine positive regard

You probably won’t enjoy working with every patient you meet throughout your career.

However, I have never met a patient without a single quality that I could appreciate – whether it’s their diligence towards their work, their curiosity in experimenting with different skills, or their resilience in the face of their suffering and harsh life experiences.

In some cases, it’s also helpful to understand where behaviours that you see in a negative light come from. For example, some patients may come in with a lot of distrust and anger; however, you may come to an appreciation that this anger may have protected this person from a lot of pain in the past. This understanding of the patient’s struggles and problem-solving may allow for greater appreciation of the person themselves.  

Show appropriate humour

Sometimes, a few light-hearted jokes done appropriately can be very helpful to add some levity and diffuse potentially distressing situations.

Of course, it’s important to be judicious in your application of humour – being considerate of the patient and your relationship with them.

Be non-judgmental

One final way that can be helpful to build rapport is through taking a non-judgmental approach. To be able to see the person as they are without personal bias and prejudice.

Mindfulness practice can be a useful tool to be consciously aware of our own thoughts and feelings and be able to let them go. By doing so, we can take a beginner’s mind to a patient’s problems and work with them in a unique and personalized manner.

Best wishes,

P