The therapeutic relationship is considered a cornerstone of psychotherapy, and research has shown it as one of the most reliable predictors of positive outcomes across the course of treatment. The therapeutic relationship is unique because it is both highly personal and a professional agreement. The clear framework provided by the therapist, both through practice policies and during therapy sessions, creates a container for the personal and often deeply intimate material that might be shared. Within that container are several factors that can make or break the quality of the therapeutic relationship and, in turn, impact the overall outcome of your time spent in therapy. Some of these factors include:

Communication and rapport between you and the therapist
Bi-directional engagement and collaboration
Qualities of the therapist that are present in the therapy room
A therapeutic approach that matches your needs and presenting issues
Clear and collaborative treatment goals agreed upon by both client and therapist
Your own motivation, engagement, and readiness for change

A few additional themes have emerged from the numerous research studies done on aspects of the therapeutic alliance, or healing relationship. It is considered:

A measure of the mutual engagement between therapist and client
A foundation for supporting therapeutic growth and successes
More important than the treatment modality or approach

Indicators of a Good Therapeutic Relationship

Any sort of relationship or connection with another person, even of a professional nature, is going to have its own unique qualities. Because of the number of variables at play, there is no clearly-defined checklist that ensures a good therapeutic relationship. However, there are several common themes that have emerged from various research studies and related information available on this topic.

Emotional Safety

In particular, and especially when there’s a history of trauma, therapy might be the first setting where certain experiences, thoughts, or emotions are shared out loud in the presence of another. If one is carrying relational trauma or attachment wounds, therapy might also be one of the few places where one can experience a trusting relationship that does not replicate the past interactional patterns that have caused such deep impacts to begin with. Therapy can also be a place to explore, experiment, and practice new ways of being—without fear of judgement or reaction from your therapist—before taking those new skills and applying them to your life.

Trusting Yourself

Although it is possible to know right away that your therapist is a good fit for you, keep in mind that it could just as easily take several sessions to get a clear sense of this. Trust develops over time, and the first session or two might flow differently from the way a session will once established. Again, the more trauma you have experienced, the more likely it is that you will feel a bit guarded while watching for signs that it’s truly safe to share. When authentic trust and rapport has developed, you might then experience the therapeutic relationship as a place where you:

Feel deeply heard and listened to
Can trust that whatever is shared will not be met with judgement or reaction
Fully believe that it’s okay to show up exactly as you are, without needing to be a certain way, and without having to rehearse or plan what to say
Feel safe to try new ways of communicating or relating to another
Can feel that your therapist has your best interests in mind, even when they give you the space to find your own clarity and answers from within

The Space Between Client and Therapist

Other indicators of a good therapeutic relationship might be noticeable through the interactions between you and your therapist, such as:

How you connect, engage, and communicate with each other
Having the space to bring in whatever most needs support from week to week, even while trusting that your therapist will guide the overall direction therapy is taking
Feeling an overall sense of collaboration and partnership
Having a shared understanding of your goals, which have been tailored to your individual needs and characteristics, including your various identities and cultural background

Even with awareness of the many indicators to watch for in a therapeutic relationship, it also sometimes comes down to noticing and trusting how you feel. You might call it an intuitive sense, where listening in to how you feel inside provides an internal yes or no.

Qualities in a Therapist

“A healing relationship is like a couple’s therapist for both sides of the self: the self that wants to change, grow or heal—and the part of the self that wants to stay the same, the part that is afraid of, or unable to change. A therapist’s role is to hold both of these realities—to not take sides, but rather to support both sides by creating an environment in which both sides can grow and integrate.” —Gretchen Schmelzer

There are additional qualities in a therapist that act as important factors in the healing process. Various sources on this include trauma-informed care guidelines, the National Institutes of Health (NIH), the IFS Institute trainings, and related research on the qualities that clients desire in a therapist.

Responsiveness, flexibility, and ability to repair ruptures are commonly mentioned in resources on this topic. Responsiveness includes not just active listening, presence, and engagement from the therapist, but also being attuned to the unique individual that sits before them. For example, a client might need a more tailored approach or different pacing to therapy based on their background and unique circumstances. This flexibility also includes openness to feedback and a willingness to incorporate that into treatment. Ruptures in the therapeutic relationship might happen if there is a disagreement, a misinterpretation between client and therapist, or the client has a distrust of the therapeutic process itself. Relational healing can arise from those moments after a rupture if a therapist has the ability to repair by staying present without reacting, and by listening to the impact it had on the client.

Trauma-informed care guidelines mention four key elements: safety, space, containment, and choice. Oftentimes, being afforded choice and autonomy in itself creates a sense of emotional safety, particularly since traumatic experience carry feelings of helplessness or being trapped. Additionally, NIH suggests qualities to look for in a therapist are someone who is consistent, patient, and hopeful, and puts the client first without offering their own agenda or advice. Consistency, once again, supports the development of emotional safety in a therapeutic relationship. Consistency is similar to predictability—meaning you start to gain a sense for how your therapist might respond or support you—and predictability is often said to equal trust. These core qualities are of utmost importance, particularly for anyone who has experiences of trauma.

The 5 Ps of Self

IFS Institute provides experiential training to therapists that include the 5 Ps of therapist Self energy that are present in the therapeutic process. As part of this experiential training, therapists often do their own personal work. This commitment to healing and growth within themselves creates the space and presence needed to be fully with their clients in the therapy room. The qualities of therapist Self energy are:

Presence

Patience

Persistence

Perspective

Playfulness

Seven Qualities Most Desired in a Therapist

One research study by Ward and Morgan (2017) stands out above the others because, unlike other similar studies, this one asked the clients themselves about the qualities they most desire in a therapist. The findings speak volumes:

Compassionate
Competent
Accessible
Helpful
Listens
Open-minded
Respectful

Making the Most of a Consultation Call

Most therapists will offer a free consultation call in support of finding a good therapeutic fit. Even in this short amount of time—often 15 or 20 minutes—it is possible to get an intial sense of how it might be to work with someone.

How do I find a good therapeutic fit?

Questions you might ask yourself:

What do I hope to get out of therapy?
What is impacting me the most?
What have I already tried to help resolve this?
What would be a great outcome for me?

Questions you might ask the therapist:

What is your training, background, and approach?
Do you tailor your approach to the individual?
Do you have experience in working with these challenges or pain points?
Are you trauma-informed?
What is a typical session like?

During and after the consultation, you might notice:

Do I feel a connection is possible with this therapist?
Can I see myself feeling at ease with them once trust has developed?
Did they seem warm, friendly? Authentic?
Did I feel heard as I shared a bit about what is bringing me to therapy?
Did I feel a sense of hope and possibility for change?

Taking the Next Step

You deserve support and the possibility of greater fulfillment, connection, and joy. Reach out to schedule a free 15-minute consultation with Alicia.

Finding a Good Fit: Reflections on the Therapeutic Relationship