Have you heard of the term ‘Therapeutic Alliance”? This term refers to the relationship between client and any mental health professional. The ‘alliance’ refers to the reciprocal nature of therapy. That is, the client and the therapist must work together as a team if they wish to achieve the clients desired outcomes. Both the client and the professional have shared duties and responsibility to ensure an efficacious outcome is achieved.
The professionals responsibilities;
Competence: The professional must be competent if they are to be effective. If a professional is concerned that they cannot meet their clients therapeutic needs, they must take responsibility to inform their client of such and provide the client referrals to professionals who can meet the clients needs.
Education and knowledge: The professional must have also undertaken training and education relevant to the needs of their clients. This means engaging in continued professional development. It is also the professionals responsibility to stay on top of relevant and emerging mental health research and practices.
Professional boundaries: When interacting with vulnerable clients, the professional is always in a position of power and trust. The professional is responsible for minimising the negative impacts of this power imbalance by not engaging in actions or activities which can potentially exploit their clients. The professional must have clear professional boundaries between themselves and their clients.
Non-judgemental and non-biased: The professional is responsible for keeping their personal opinions, values and belief systems out of the therapeutic space. The professional must also be mindful of their inherent biases and cultural or societal stereotypes. It is never appropriate for a professional to demean, degrade or in any way ridicule their client or their clients way of being, thinking or living.
Booking sessions: The client is responsible for finding and maintaining the motivation to book sessions. It is not up to the professional to chase clients around begging them to book sessions. This brings us to the next point.
Attending sessions: Not just physically attending but attending mentally. It is up to the client to actively engage in their treatment process and complete any assigned tasks or homework.
Personal boundaries: Clients also have a responsibility to maintain and communicate their boundaries to the professional. This may seem intimidating but it is vital. The client has every right to request that the professional act in a manner which preserves and protects their personal boundaries.
Respecting the process: Their is a big difference between a client asking questions about the therapeutic process and a client proactively and or manipulatively undermining the process for whatever reasons.
Creating a safe place: Both the professional and the client deserve a safe space in which to work. Abuse, yelling, shouting, etc, is not appropriate and should not be tolerated. Neither party should feel intimated or vulnerable. Likewise, the professional must manage waiting rooms making sure that they minimise any potential conflict between clients.
Open and honest communication: The client and the professional need to be honest with each other if they are to work effectively as a team. Neither party should be afraid of speaking up and communicating a need.
Setting goals: The professional sets goals for the client and the client sets goals for themselves. The key is to set clear, harmonious and realistic goals which both parties understand and agree upon.
Working towards positive outcomes: The goal of therapy is to achieve a state of well-being not currently experienced by the client. Through teamwork and all of the previously mentioned points, the professional and the client can ensure that they are moving forward towards healing and recovery and not moving backwards through re-traumatising or arrested development.
This is by no means an exhaustive list of all that makes up the therapeutic alliance. Research has shown that it is the quality of the relationship between the professional and the client can determine the outcome of mental health treatment. If there is little to no trust, rapport or reciprocity between the client and the professional, progress and recovery will be difficult to achieve. The client must feel comfortable with the professional if they are to open up and disclose their innermost thoughts and vulnerabilities.