The Therapeutic Alliance

The Therapeutic Alliance

According to Michel, Jobes and American Psychological Association (2011), therapeutic alliance denotes the relationship between a healthcare practitioner and a patient. The helping alliance describes the engagement between the two parties and the beneficial change that a patient reaps. The working alliance forms the most fundamental part when kick starting a psychotherapy serssion. In light of previous studies, the interaction and trust between the client and therapist best predicts treatment outcome.

Question 2

I subscribe to the fact that engagement between a clinician and a therapist entirely contributes the outcome efficiency. Numerous studies prove that a purposeful collaborative alliance between a clinician and a patient is directly linked to positive therapeutic progress and outcome. Michel, Jobes and American Psychological Association (2011) argue that therapists should focus on alliance cultivation for better results. The power of the working alliance has a direct relationship with end results. Previous research on the topic shows that therapeutic alliances start right when a patient makes a call to book the first session with a physician. The interaction through communication creates a first impression that lasts until the end of therapeutic engagement (Muran & Barbe, 2010). The effect and outcome is merely not reliant on skills and competence of a physician. A positive outcome require understanding and empathy from the therapist. Displaying a high degree of warmness during interactions builds a friendly alliance ultimately realizing positive results. Contrary, rigid therapists who fail to give a listening ear, experience strained relationship with a client leading to negative results (Muran & Barbe, 2010). Inappropriate self-disclosure and insensitivity characterize weak and unhelpful client-clinician relationships. A client having a therapeutic session with a clinician who insensitively hold silence, is overly structured and exercises intense interpretation creates a hostile environment resulting to an undesirable outcome.


As Muran and Barbe (2010) argue a continuous and authentic working alliance amounts to a successful therapy. The effectiveness of any alliance depends on the prevailing atmosphere between a client and the clinician. Relationships characterized by empathy, genuineness and positive unconditional client regard instils satisfaction to a client and makes a patient yearn to have similar repeat sessions. A clinician who fails to understand a client feelings imparts a negative impression within the patient consequently scoring a low outcome (Safran & Muran, 2000). Prosperous relationships calls for openness and honesty from the therapist. Physicians must show positive regard and avoid enacting any conditions of worth. Disregard of a patients’ values puts an ongoing therapeutic alliance in jeopardy. The behavior demonstrated by a clinician is critical to the outcome of the therapy. The relationship nature is the most fundamental art of any therapy. The effectiveness of all therapies exudes from aspects such as focusing on emotions and a patient’s feelings (Safran & Muran, 2000).

Failure to hold a patient as an equal partner during interactions is a show of demeaning the client resulting to negative transference. For an individual to trust the physician, the clinician must examine incidences of mistrust and review client goals and ultimate expectations. A clinician must inculcate a high condition of worth to make a patient feel valued unconditionally. During interactions a physician must work to dispense feelings of anger and hurt to realize a fruitful working alliance (Safran & Muran, 2000). A clinician-client relationship where a physician displays warmth, acceptance, empathy and ability to comprehend a client feelings achieves a therapy’s set goals achieving mutual satisfaction. The outcome of a therapeutic alliance depends on trust and emotional closeness between involved parties. The client and the therapist must formulate expectations regarding change of behavior. The two should reach a concurrence on methods to employ to realize set goals.


As Safran and Muran (2000) argue a strong bond in the relationship is a necessity to realize set targets. A fruitful therapeutic alliance is mutually founded between the two party’s shared goals, tasks and cultivated bond. Realizing a rewarding outcome require therapist to increase rapport with clients by displaying interest, showing active engagement and embracing the patients intentions. Quality of a therapeutic alliance is directly related to the outcome of the engagement. An efficacious connection between a therapist and a patient strengthens the alliance facilitating realizations of stipulated expectations. Current research on topic explains that therapists and clients must prioritize on building the relationship to foster good results (Safran & Muran, 2000). An amiable therapist client engagement is a core foundation for a profitable therapy. To foster a safe and a trustworthy relationship parties must honestly and openly discuss issues.

A collaborative relationship requires a positive perception for both clinician and the patient. As Safran and Muran (2000) observe the two must work as a team. Parties must take active roles for a fruitful outcome. A good rapport in a therapeutic relationship supports feedback system for both parties to make informed choices and decisions.

Cooperation during sessions in a therapeutic alliance accomplishes productive results. Prevailing relationship is powerful and acts as an agent of behavior change. Exploring negatives in a therapeutic relationship creates a sour environment and may contribute to premature termination of a session (Safran & Muran, 2000). Quality of prevailing relationship is an ingredient that determines outcome of an engagement.


Collaborative client relationships has myriad characteristics. The elements are core to success of the engagement. The features form the foundation of the relationship.


Therapist-client genuineness

Previous studies emphasize on importance of the clinician and the patient expressing concern authentically to foster cooperative relationship. As Muran and Barber (2010) expound, genuineness cultivates value of honesty and trustworthiness strengthening therapeutic relationships. Expression of real thoughts, feelings and problems in a working client relationship interaction calls for both parties to be true to one another. Collaboration is cultivated through trust and positive altitude enhanced by authenticity of both parties.

According to Safran and Muran (2000), genuiness serve as the heart of every true client relationships. The virtue is expressed through openness. A comfortable environment created by the element enable patients express feelings freely. Clients become comfortable in sharing with a therapist, ultimately deepening relationship. The feature prompts a fearsome and fearless exchange between parties in a therapeutic relationship.


Manifestation of empathy in client relationships nurtures collaboration consequently reducing level of potential conflict in an alliance (Safran & Muran, 2000). The element is essential in improving relationships and eliminating feelings of racism, sexism and other forms of sensitive aspects. Furthermore, the feature cultivates cooperation by making parties in a working alliance more open-minded about pertinent issues.  Empathetic client interactions build relationships, stimulate self-exploration, provide support and help clinicians focus attention on the client. The virtue enhances manifestation of respect and ultimately tight working relationship. Empathy enable clinicians recognize and relate to patients feelings. Clients is such engagements experience satisfying relationships. Empathetic physicians easily identify with a client experience and understand raised problems effectively. As Safran and Muran (2000) note, empathy is a key element in establishing collaborative client relationships. Clinicians exercising the feature understand issues from a client perspective facilitating accurate crafting of solutions. The cooperation creates an environment that propels the therapy in a productive direction (Safran & Muran, 2000). Clients in such a relationship comply more because of the feeling that a physician is sensitive about needs.

Trust and confidentiality

The elements enable clients have the willingness to share problems, concerns and issues considered private. The element gives clients assurance of safety in disclosing secret problems.  A therapeutic alliance lacking trust makes clients reluctant in giving information. The aspect provide reassurance and make the individual comfortable during therapies (Safran & Muran, 2000).

Positive regard

According to Muran and Barber (2010), different clients have different needs therefore demanding positive regard from a therapist. The phenomenon creates awareness and enable clinicians effectively monitor needs ultimately cultivating a collaborative atmosphere. It is an important aspect in providing support and encouragement in client relationships. Moreover, the established environment enhances improvement of a patient’s condition. Positive regard is important in preventing termination of therapy sessions and fostering effectiveness of results. Developing the perception helps get rid of barriers to successful therapeutic outcome. The coordination promotes creation of shared goals and counters possible resistance and separation during sessions.
            The element is essential for creation of cooperative client relationships. Humour in alliances stimulates a client’s mood and state of mind. It serves as a therapeutic experience and allows a patient feel more in control of the prevailing situation. The amusement impacts a client feelings and thoughts, biochemistry and behavior (Muran & Barber, 2010).


Michel, K., Jobes, D. A., & American Psychological Association. (2011). Building a therapeutic alliance with the suicidal patient. Washington, DC: American Psychological Association.

Muran, J. C., & Barber, J. P. (2010). The therapeutic alliance: An evidence-based guide to practice. New York: Guilford Press.

Safran, J. D., & Muran, J. C. (2000). Negotiating the therapeutic alliance: A relational treatment guide. New York: Guilford Press.


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