Therapeutic Alliance: What It Is, How It Influences Therapy And How It Is Created
The professional’s knowledge and the patient’s desire to improve and make an effort are aspects that influence the success of psychotherapy. However, in therapy this is not everything, since the relationship between the psychologist and the patient takes on a very great weight when it comes to inducing improvement in the patient.
The therapeutic alliance is the interpersonal bond that exists between the patient and the therapist.a relationship based on trust, acceptance and understanding that makes it easier for those who go to see a psychologist to expose their inner world with the hope that the professional will help them without judging them.
The way in which this link is established is crucial for the patient to improve, which is why it has been a highly researched aspect in recent years and there is great interest in doing everything possible to establish solid therapeutic alliances. Let’s find out in more detail what it consists of.
The therapeutic alliance is the meeting point between the patient and the therapist, a unique bond that is established within the therapy. On this bond will be based the trust and understanding necessary to address the process of change that the patient has begun by resorting to therapy in the first place.
The therapeutic alliance is extremely important, especially in psychotherapy. Although in other relationships between patient and therapist (for example, doctor, physiotherapist, surgeon…) the therapeutic alliance is a very important component, the value it acquires in the relationship between patient and psychologist is crucial, so much so that it determines success. of psychotherapy. If the patient does not have a good relationship with his psychologist, does not feel that “feeling” or trust with his psychotherapist, the therapy can drag a significant burden that will hinder the patient’s recovery and improvement.
Psychologists do not work with disorders, but with people who suffer from a problem or pathology that requires specialized intervention. Treatment or therapy cannot be conceived apart from the establishment of an interpersonal relationship between the patient and the psychologist. The meeting between the professional and the patient makes these two people become significant elements for each other, and not mere strangers or instruments to achieve objectives. The therapeutic alliance is so important that it predicts the success of therapy.
For a good therapeutic alliance to establish, It is necessary that both the therapist and the patient make an effort towards the therapy, combining their experience and knowledge. They must be able to adopt different points of view, understand and accept them, as well as be predisposed to change. The patient must make an effort to change, but it is essential that the psychologist also leaves his or her comfort zone if necessary and understands the person to whom he is doing psychotherapy.
A meeting point between two people in psychotherapy
The therapeutic alliance begins to be established from the moment the patient establishes contact with the therapist.. From the moment of meeting between these two people, we try to ensure that the therapy becomes a climate of trust, closeness, in which the patient feels comfortable and feels that he is in a safe environment, where he can open up to expose his feelings. fears and needs without fearing being judged.
It is essential to understand that in therapy the psychologist does not judge, but rather accepts. Psychotherapists are not people in charge of solving the patient’s problems or telling them what to do, but rather they help them see for themselves what is most appropriate for their life. The aim is to get the patient to open their eyes and understand what their potential and capacity is to induce change in their life.
The therapist is not a friend, but a person who offers support. It accompanies the patient on their long and turbulent exploratory journey, helping them identify those resources that are within their reach but that, due to different psychological barriers such as lack of self-esteem or a locus of control that is too externalized, they do not use.
The therapeutic alliance is the meeting point between two minds, two universes. Two very different people coincide in time and space in a therapeutic context, a place where it does not matter who or why. The psychologist is in charge of offering help to the patient, discovering what is bothering the person who has come to her help and analyzing what can help them overcome their problem.
But for this to happen, it is necessary that the patient see your therapist as that person with the ability to pick you up when you are going to break down and trust them.
Components of the therapeutic alliance
As we said, the therapeutic alliance is a very important aspect of psychotherapy. Being such a unique and important link between patient and therapist, this connection has been studied in numerous investigations. However, it should be said that the serious scientific approach to this link is relatively recent, with Lambert being one of the first to investigate it in 1992. According to him and his research, This therapeutic alliance is a variable capable of predicting up to 30% of the success of the therapy..
Its weight is greater than that of the techniques used by the therapist, the theoretical model from which it is based or the patient’s own expectations of change regarding psychotherapy. In fact, in Lambert’s own studies, the therapeutic alliance is the most determining factor in the success of therapy, being only surpassed by extratherapeutic factors, that is, m variables that are not within the psychologist’s control, which are not usually controllable. and that its influence on the process may be greater.
Three basic components can be identified that make up the therapeutic alliance.
The relationship established with the patient
As one might expect, a fundamental component of the therapeutic alliance is the relationship established with the patient. This is established by what the American psychologist Carl Rogers describes as the unconditional acceptance of the patient.
It can also be understood as unconditional positive acceptance, in which the psychotherapist has an attitude of absolute respect and acceptance of the patient’s experiences, experiences, feelings and opinions.
Degree of agreement on the objectives to be achieved between patient and therapist
A fundamental task in psychotherapy is that The therapist helps the patient define the objectives that they want to achieve throughout the psychotherapy. In addition, it is intended to reach an agreement with him to achieve them.
Degree of agreement with the means or tasks to achieve such objectives
Before starting the therapeutic process, It is essential that the psychologist explains to the patient what techniques he is going to use and what he intends to achieve with them.. If the patient has any doubts, the beginning of therapy is the perfect time to answer them since, once these doubts are clarified, the patient’s involvement in the therapy will be greater.
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How do you achieve a good therapeutic alliance?
At this point we can understand the importance of the therapeutic alliance. As we have mentioned, it is a factor that increases the chances of success of the therapy, since it makes the patient feel more comfortable sharing their inner world and sees the psychologist as the person qualified to help them get their life back on track and gain psychological and emotional well-being. .
Given this, the time has come to know how to achieve a good therapeutic alliance. The steps that we will see below can be of great help to psychologists interested in improve the relationship with your patients and increase the success of the treatments applied to them. Some of them may seem very obvious for the professional career of every psychologist, but it must be said that psychologists are still people and sometimes we forget to take these steps into account.
1. Use active listening
Every psychologist must apply active listening when he is with his patients. It’s about listening to him without judging him, being aware of everything he says. It is essential, because if we want him to open up completely, it is necessary that he trust us, that he know that, whatever he says, we are not going to stop listening to him.
Furthermore, it is often the case that patients need to listen to themselves, give voice to their thoughts and understand them. Therefore, as psychologists, we should not be afraid to quote the patient literally, since this will help them see that we are listening to them and will help them analyze their own words.
Related article: “Active listening: the key to communicating with others”
2. Be empathetic
Another fundamental aspect in all psychotherapy, but it is worth remembering: using empathy. We must not only listen to the patient, but we must also put ourselves in their shoesunderstand what he feels and show him that we understand him.
This does not mean that we feel compassion or pity for him or her, but that we understand how he or she feels. Telling them how we would feel, not what we would do, in their same situation can help because it generates trust. When the psychologist shows empathy towards the patient, the latter does not see the former as a cold stranger with the role of professional, but as a person who truly understands him and whom he can trust.
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3. Adapt to each patient
Another fundamental aspect of all psychotherapy that significantly influences the therapeutic alliance. Each person is a world, with a way of perceiving reality, give your opinion about it and relate very varied from individual to individual. His way of explaining things is also different, using his own language. As psychologists we must adapt to them, a gesture that helps the patient feel understood.
4. Explain how the therapy will develop
A good way to establish the therapeutic alliance is be transparent with the patient about what will happen with the therapy. It is about reducing the patient’s uncertainty regarding how he is doing, in the sense that he knows if progress is being made.
It is important to explain to the patient that, if it occurs, there is a problem or dysfunctional process, but that this may be more common than they think and that it is normal for them to feel frustrated by it. It is pertinent to explain how we are going to work on his problem and mark the objectives that we intend to achieve with him to reach a consensus, making him see that he is a participant in the improvement process.
5. Be honest about the development of the therapy
We must be sincere and not convey false hopes for a quick recovery. The psychologist must also be honest with himself and with the patient, accepting that there are things he does not know and offering, if necessary, to seek information or to refer if it exceeds his skills and knowledge.
