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Making Therapy Successful: Building a Good Relationship with Your Therapist

Making Therapy Successful: Building a Good Relationship with Your Therapist

The last article in the "Making Therapy Successful" series explored how to set goals for therapy. By thinking about what you want to change in your life and shaping your aspirations into concrete goals, you can give yourself a boost in the beginning of therapy. When you begin with focus and intention, you can proceed with confidence and trust the therapeutic process as it unfolds.

The next steps in making therapy successful are tracking your progress on your goals and building a good relationship with your therapist. While these may seem like separate steps, they are part of the same process. To build a good relationship, you'll need to engage in the work of therapy both inside and outside of the therapy office. Therapy is an active process and even the best therapists can't help people who don't engage. It takes effort and courage to do the emotional work of therapy, and therapists respect and connect with clients who do.

1. Understand the nature of the therapeutic relationship.

The first step in building a good relationship with your therapist is understanding the relationship you're trying to build. A therapist is a professional, but one whose work requires getting to know you more intimately than most other professionals. A therapist can't work well with clients who are too guarded or passive. Like doctors, therapists diagnose clients and recommend treatments, but unlike doctors, they can't simply prescribe medication or a procedure and give you a set of directions to follow. Therapy only works when you collaborate fully and are emotionally engaged.

However, therapists can't get too close—they must maintain professional boundaries to be successful. For therapy to work, you need to share as much as possible while your therapist shares little. By keeping the right distance and setting aside personal agendas, therapists create an accepting atmosphere that gives clients the space they need to work through their issues. Unlike friends, good therapists only sparingly relate experiences from their own lives, so don't expect to learn too many personal details about your therapist. Instead, expect them to listen, to help you notice important thoughts and feelings, and to nudge you toward your own insights. Think of a therapist as a guide whose job is to help you navigate your own mind.

2. Communicate openly and be honest. Don't hold anything back!

For therapy to be successful, you have to be honest. You don't have to tell your therapist every secret you've ever kept, but you do need to share everything relevant to the themes you're exploring and the goals you're trying to achieve. For example, if your goal is to improve your mood, but you neglect to tell your therapist something you do that makes you feel depressed because it's embarrassing, you're limiting how much they can help you.

One of the most important elements of the therapeutic relationship is trust. Good therapists create a safe space for their clients to speak openly without fear of judgment or rejection. While no therapist is perfect, most therapists aren't interested in judging you in the way your friends and neighbors might. Therapists share two important motives: they want to help people feel better and are curious about how people's minds work. They are listening for clues to the nature of your problems and their solutions, and the more material you give them, the more successful they'll be in helping you piece those clues together.

One of the ways to deepen any relationship is to be honest when something is bothering you and to risk controversy to resolve problems. As with a friend, you don't have to tell your therapist every little thing they do that irks you or that you don't understand, but you do need to bring up major concerns. If you feel frustrated or stuck or like therapy isn't working, let them know. This will give both of you the chance to address the issue and deepen your relationship.

3. Make your goals clear to your therapist and work together to track them.

In the past, therapists expected to work with each client for years. The process of free association that they used could take a long time to spark transformative insights. Some modern therapists still use these traditional methods, but most who do amend them to be more focused and mix them with other approaches. Therapeutic styles like cognitive behavioral therapy (CBT) are even more precise for targeting specific symptoms.

Regardless of your therapeutic goals, the method your therapist uses, or your time frame for therapy, you'll get better results when you track your progress. While experienced therapists are usually comfortable with ambiguity and the slow process of working through stuck places and blocks, all therapists like knowing how their clients are doing outside of the therapy room. Don't be shy about telling your therapist what's working and what isn't. Remind your therapist of your goals and work together to track your progress.

Putting an action or treatment plan together is as simple as defining one or more long-term goals and figuring out milestones that will show you that you're on your way. For example, if you want to change a habit, you can work with your therapist to figure out what triggers it and try new, small changes every week based on what you learn from tracking your patterns.

4. Do your homework. Therapy isn't just what happens in your therapist's office.

What you do outside of the therapy office is essential to making progress and building a strong relationship with your therapist. Just like school, you can't successfully "graduate" from therapy without doing homework. The more you show your therapist that you're motivated and willing to work for change outside the office, the more dynamic your time together each week will be.

Some therapists use methods like CBT that involve literal homework assignments. They may give you tracking pages to take home and fill out or exercises to do in certain situations where you experience emotional triggers. They may ask you to assign numbers or ratings to the thoughts or feelings you experience. But you can still do homework and use it to track your progress even when you and your therapist use a less concrete approach.

Many traditional therapeutic styles use dream analysis and require you to record your dreams. Just about any form of therapy benefits from journaling. In many cases, though, you can do your homework without even picking up a pen. Did you and your therapist notice a pattern in your behavior? Talk about something you can do differently the next time you're in a similar situation and practice what you discussed at home or work. Come back and tell your therapist how it went. As you work together this way, you'll deepen your connection and make progress on your goals.

5. Be prepared to deal with strong feelings and unexpected reactions.

If you stumbled into a therapy conference, you might hear therapists using mysterious words like "projection" and "transference." But you don't have to pull out a psychology textbook or attend an academic lecture to understand the dynamics of the therapeutic relationship.

The idea behind these terms is that as you get closer to your therapist, you start to do with them what you do in other relationships: make assumptions about them and how they feel about you based on your experiences in past relationships. The closer you get to your therapist, the more intense these reactions will become.

You'll know that this is happening when you suddenly shout, "You don't respect me! You're just like everyone else!" or go home and seethe over what you assume your therapist was thinking when he raised his eyebrow or she looked out the window: "He thinks I'm a freak," or "she's bored with me already." It makes you feel like you felt when you were 10. It hurts.

Many therapeutic relationships fracture when people start having these intense reactions. But these reactions are signs that therapy is working and can help you get to deep places in yourself. If you hold on and work with them, you can have major breakthroughs. Follow these feelings back to their origin and you can gain insights that will help you dismantle the personal narratives that are holding you back.

As you achieve your first therapeutic goals, you may find you have deeper work you want to do. But at some point, it will be time to move on. The next installment of "Making Therapy Successful" will explore when it's time to quit therapy.

If you haven't been able to make therapy work for you yet, try using the search features on OpenCounseling or BetterHelp (a sponsor) to find affordable local or online therapy. An amazing relationship with a therapist may only be a click away.

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Stephanie Hairston, MSW
Posted on 07/07/2019 by Stephanie Hairston, MSW

Stephanie Hairston is a freelance mental health writer who spent several years in the field of adult mental health before transitioning to professional writing and editing. As a masters-level clinical social worker, she provided group and individual therapy, crisis intervention services, and psychological assessments. She has also worked as a technical writer for a medical software company and as an editor for a company that appeals denials of insurance coverage for behavioral health treatment. As a writer, she is motivated by the same desire to help others that brought her into the field of social work and believes that knowledge is one of the most essential recovery tools. She strongly believes in the mission of OpenCounseling and in making therapy accessible for everyone.