If you’ve never had therapy before, you may well be unfamiliar with the term ‘therapeutic alliance’ (also referred to as therapeutic relationship). This refers to how you and your therapist connect, behave and engage with each other; it’s the bond that’s formed in your sessions.
Different therapeutic approaches will place different levels of importance on this alliance (for DBT it is considered to be absolutely crucial, for other approaches, less so). However, all therapists would agree that a positive therapeutic alliance is a core aspect of therapy and without it, progress will be more difficult to achieve.
Think about the last time you had a conversation with someone about something difficult, or something personal. Was it with a stranger you bumped into, or was it with a close friend/family member? Probably the latter, correct?
This is because we tend to find it easier to open up to people we have built trusting relationships with. In therapy, there also needs to be a good level of trust and respect. For many of us, even talking to those we’ve known for a long time about certain topics can be a challenge, so the therapeutic relationship is a unique one.
If you’re talking to your therapist and you’re finding that it’s just not really clicking, you’re going to find it much harder to be honest and vulnerable. If you feel that they aren’t really understanding you, you may be more reluctant to put your faith in their ideas.
If this is the case does it mean that your therapist is not up to scratch? Not necessarily, it’s a bit more complex than that. No matter how similar their training may or may not have been, therapists are still humans. They each have their own personality and individual communication style. There can be times when, unfortunately, it’s just not the right fit.
Speaking to our Clinical Director Dr Annemarie O’Connor earlier this year about the challenges of being a therapist, this topic came up. “I tend to be quite fast-paced, quite direct, but I appreciate that’s not for everyone. As a therapist you always want to help everyone that comes to see you, but part of the job is knowing that you’re not always the best option for every individual. Sometimes you need to be willing to encourage them to try someone else.”
If you find that you’re not completely on the same page after the first 15 minutes, we’re not suggesting you immediately start thinking about other options. Ultimately, it comes down to if you feel that you are progressing. If weeks have gone by and you’re not noticing any difference in yourself, raise it with your therapist.
You don’t have to do this in the session, you can send them an email outlining why you’re dissatisfied. It may be that the between session homework you’re doing isn’t working for you or there is something under the surface which needs to be discussed. Even if it relates to the therapist’s approach, some things can be tweaked with feedback.
However, if that conversation is had and you’re still not sure about the therapeutic alliance, it may be time to look elsewhere.
There can be completely understandable concerns around switching therapists. If you have invested a certain amount of time into working with someone, you might feel that changing to a new therapist would be like ‘starting all over again’. You may even feel slightly awkward in deciding to stop further treatment from someone that seems nice and is trying to help you - perhaps they just need more time?
There are no easy answers to these questions, but try to remember that you come first. In fact, this is an area where you MUST come first. Trust your instincts and if you’re not seeing your therapeutic alliance improve, consider moving on - your therapist will understand.
At HelloSelf, we pride ourselves on connecting you to a therapist suited to what you need, but in the event that you want to try someone else, we make it as easy as we can. We will listen to your feedback on why the previous therapist wasn’t quite right for you and find you another specialist suitable for your needs.
With HelloSelf offering online therapy, you are more likely to find someone that you can form a strong therapeutic alliance with as you are able to speak to therapists from all over the country, not just whoever is available in your nearby area. Whilst it may seem harder to create that alliance online, evidence suggests that you can form just as strong a bond in virtual therapy as you can in face-to-face.
Your therapist doesn’t have to be your best friend, but you do need to feel comfortable talking to them. If you’ve tried therapy before and you didn’t make the progress you wanted to, try not to think that therapy ‘doesn’t work’ for you.
We’ve written a few blogs recently (here, here, here, here and here) that explain different therapeutic approaches and how they can work for different conditions and/or personalities.
But a change in approach may not be required. Finding the right therapist may be all that you need, and we can certainly help with that.
