“The establishment of a therapeutic alliance can be a daunting task, even for those therapists who are generally successful.”
For some time now, it has been well-understood that the alliance between the therapist and the client plays a significant role in predicting successful therapeutic outcomes. A strong alliance is predictive of successfully achieving positive results. Conversely, a poor alliance leads to increased dropouts and more missed sessions. At the risk of stating the obvious: missing therapeutic sessions and dropping out of therapy are not optimal strategies for successful outcomes.
Although a therapist’s individual characteristics are essential for establishing a strong therapeutic alliance with a client, attempts to understand the alliance are focused on the client and the client’s perception. Of course, this makes sense given that the perception of a therapeutic alliance, or lack thereof, begins and ends with the client–it is, at the end of the day, how the client feels.
The role of the therapist is to reach out to the client and engage in activities that will create and strengthen a bond between them. However, it is only the client who knows whether that outreach has been successful or not. A smiling client does not necessarily translate into a trusting client. Without trust resulting from a strong therapeutic alliance, work toward achieving the client’s therapeutic goals will be compromised. How can you tell if your attempts to build this rapport are working?
The establishment of a therapeutic alliance can be a daunting task, even for those therapists who are generally successful in creating rapport with their clients. After all, each client is unique and, thus, all clients won’t respond the same to all therapist alliance-building behaviors. Most therapists adjust their strategies for creating a therapeutic alliance if needed. The trick is knowing if such adjustments are necessary, and then, if the adjustments are working.
The therapist, then, needs some insight into the client’s perceptions of their relationship in order to determine if they are using the right approach. In an ideal universe, the therapist could simply ask the client. Unfortunately, clients’ perceptions are more complex. Luckily, it isn’t necessary to use complex tools to solve the problem of understanding clients’ perceptions and gauging the strength of the Therapeutic Alliance. Therapists can gain insight into their client’s perceptions using MyOutcomes.
The Session Rating Scale (SRS) is a conceptually simple, easy-to-use, tool that measures the client’s perception of the Therapeutic Alliance. One of the powerful tools offered by MyOutcomes, the SRS takes seconds to administer at the end of each session and informs the therapist of the strength of the Therapeutic Alliance and whether the alliance is deteriorating or improving. The insight provided by the SRS enables the therapist to identify any challenges and to make adjustments accordingly.
The key to strong Therapeutic Alliances lies within therapists’ ability to engender one, but doing so is much more of an art than a science. Luckily for them, MyOutcomes gives therapists insight into clients’ perceptions, using methods approved by the National Registry of Evidence-Based Programs and Practices (NREPP). This information can then be used to see if techniques deployed to improve the Therapeutic Alliance are working or not.
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