What to Know About Therapeutic Rapport

Therapeutic rapport is an essential part of a healthy therapist-client relationship, leaving the client feeling safe and respected so that therapy can be successful.

What Exactly Is Therapeutic Rapport?

Therapeutic rapport refers to the empathic (caring) and shared understanding of issues between a therapist and a client. It implies a team approach to management of these issues in contrast to an adversarial approach.

With good therapeutic rapport, a client feels his therapist "has his back" in a way the allows him to face difficult-to-face problems. Likewise, the therapist in a setting with good therapeutic rapport feels respected in a way which allows her to speak clearly and freely.

Importance of Developing Therapeutic Rapport

The goal of developing a good rapport is to improve your chances for a successful outcome, along with developing mutual trust and respect, to foster an environment in which you, the client, feel safe.  

To develop a good rapport, your therapist must, among other things, demonstrate empathy and understanding. Therapeutic rapport is a cornerstone of some forms of psychotherapy, including cognitive-behavioral therapy, which is common in phobia treatment.

Case Conceptualization

In order to develop a therapeutic rapport, you need to feel confident that your therapist is an expert who is developing a treatment plan designed to meet the needs of your specific case.

How will you know if your therapist is taking the time to conceptualize your case? 

• From your very first session, she should assess the difficulties you currently have. She will help you create a problem list and begin to prioritize that with you. 
• During the first few sessions, your therapist should outline her treatment plan for you and ask if it's acceptable to you. She should revisit the plan in future sessions and consult with you about necessary modifications. 

• Your treatment plan should include goals and benchmarks, so it's easier to self-report and assess your own progress.

Your Therapist Should Be Genuine

Genuineness is one of the ways your therapist can develop a healthy rapport with you. When she is genuine, it allows you to see her as a human being, not just a mental health professional. If you see her as being genuine, you are more likely to positively receive critical feedback about your progress.

Some of the ways the therapist can demonstrate genuineness is to:

• Provide supportive nonverbal cues, including eye contact and nodding in agreement.
• Give feedback in the moment, rather than in a later session.
• Encourage you to be active and feel empowered in regards to your treatment plan.

Your Therapist Should Ask You for Feedback

Although you are there for your therapist's expert advice, you are also the client. Asking you for feedback is another way your therapist can develop a good rapport with you and indicates she sees you as an active participant in the healing process, so be honest. Asking a client for feedback:

• Shows your therapist cares about what you think and values your input.
• Gives you space to bring up anything that's bothering you about your treatment and individual sessions. If you sense that your therapist is genuine, you will also realize that therapists are human and aren't perfect. Keep in mind that everyone is different, and what works in a treatment plan for one person may not work for you. One of the ways in which your therapist can recognize your uniqueness is by providing feedback about anything that doesn't seem to be working for you as an individual.

• Encourages teamwork between the two of you.
• Allows your therapist to repair any damage to your therapeutic relationship, whether it's real or perceived.

Therapeutic Rapport With Parents

When your child is in therapy, his therapist should develop a good rapport with the parents or guardian as well.

Anxiety disorders, such as social phobia, agoraphobia, and specific phobia, are highly treatable and the most frequently diagnosed class of mental health issues in adolescents and children. Phobia is most commonly treated with cognitive behavior therapy techniques, which emphasize the import of the healthy therapeutic relationship for a successful outcome.

Therapeutic Rapport in Online and Telehealth Therapy

With the advent of online and telephone options for therapy, the importance of therapeutic rapport is just as important, but more difficult to develop and assess. We know from history, that typed messages (think Facebook misunderstandings) and communications on the phone are more difficult to interpret since neither the client nor the therapist can visualize important body language clues. Keep this in mind if you are considering distance therapy and ask a potential therapist how she works with this issue.

When You Lack Therapeutic Rapport With Your Therapist

Just as there are some painters who may a better job painting your house, there are some therapists that do a better job of establishing rapport. Yet, based on the definition of rapport, this effort is two-sided, and requires effort on the part of both the therapist and the client.

That said, personality can play a large role in developing rapport with your therapist. Even if a therapist is very compassionate and a client is very motivated to address her mental health issues, there are times when personalities simply don't mix. If you find yourself in this category, don't fret. It doesn't mean that you chose a bad therapist or that you have failed in your attempt to get help. There are many good therapists out there, and just as you may need to interview a few home decorators to see which one matches your personality best, you may need to talk to more than one therapist before you find the one who can best help you work through and cope with any mental health issues.

_Sources:

_{Bachelor, A., Clients' and Therapists' Views of the Therapeutic Alliance: Similarities, Differences and Relationship to Therapy Outcome. Clinical Psychology and Psychotherapy. 2013. 20(2):118-35.}

_{Holdsworth, E., Bowen, E., Brown, S., and D. Howat. Client Engagement in Psychotherapeutic Treatment and Association with Client Characteristics, Therapist Characteristics, and Treatment Factors. Clinical Psychology Revew. 2014. 34(5):428-50.}

_{Nissen-Lie, J., Havik, O., Hogeland, P., Ronnestad, M., and J. Monsen. Patient and Therapist Perspectives on Alliance Development: Therapists' Practice Experiences as Predictors. Clinical Psychology and Psychotherapy. 2015. 22(4):317-27.}