The Importance of a Strong Therapeutic Alliance in Treatment

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Psychotherapy is a central element of substance abuse treatment and addiction recovery. However, contrary to popular belief, reaping the benefits of psychotherapy involves more than merely attending therapy sessions. For therapy to be effective, there must be a strong therapeutic alliance between the client and the therapist. Simply put, the therapeutic alliance is the bond – including collaborative strategies – shared between the client and therapist.

A strong therapeutic alliance is known to predict positive treatment outcomes for clients. This is independent of the type of therapeutic approach used in the treatment or the client's diagnosis. Many clients seeking addiction recovery may wonder what the therapeutic alliance entails. They may also wonder how they can work to build a valuable alliance with their therapist in treatment. Clients can feel confident in learning about and fostering a strong therapeutic alliance at Pathways Recovery Center.

What Is a Therapeutic Alliance?

Some clients participate in treatment expecting to receive direct advice from a therapist. In some cases, clients may need direct advice. However, the most effective forms of therapy are a collaboration between the client and the therapist.

It is important to know what a therapeutic alliance entails. An article in the journal Focus: The Journal of Lifelong Learning in Psychiatry explains:

Although scholars may differ in how the alliance is conceptualized, most theoretical definitions of the alliance have three themes in common: the collaborative nature of the relationship, the affective bond between patient and therapist, and the patient’s and therapist’s ability to agree on treatment goals and tasks

A therapeutic alliance is not created by the efforts of a client or the efforts of a therapist alone. Rather, both the therapist and the client must be open and willing to form a bond over the course of treatment.

Mutual Relationship

Forming a personal relationship is often the first step in nurturing a therapeutic alliance. This is because “any agreement on goals and tasks requires the patient to believe in the therapist’s ability to help him/her and the therapist, in turn, must be confident in the patient’s resources," according to Frontiers in Psychology.

Self-Awareness and Advocacy

To be an active member of the therapeutic alliance, clients should examine what strategies are working or not working throughout their recovery. In other words, clients must advocate for their own well-being. To do this, they must develop self-awareness of what works for them. Of course, this is in addition to honoring advice and guidance from a therapist.

Individualized Treatment

The effectiveness of the therapeutic alliance was recognized alongside the rise of individualized treatment approaches. Individualized treatment for substance use disorder (SUD) involves more than addressing a diagnosis or associated symptoms. Rather, these approaches allow treatment facilities to tailor treatment interventions and modalities to fit a client's needs and goals.

When individualized treatment is utilized in tandem with a favorable therapeutic alliance, a client can feel empowered, validated, and supported throughout every stage of their healing journey.

Predictors of a Strong Therapeutic Alliance

An article in the journal World Psychiatry sheds light on predictors of a strong therapeutic alliance. The first element addresses a client's childhood attachment style. Clients with secure styles of attachment may be at an advantage in forming a high-quality therapeutic alliance.

Another predictor of alliance quality is the character and behavior of the therapist. The aforementioned journal article explains, “Therapist attributes such as confidence, warmth, patience, and flexibility have been shown to be positively associated with the development of high-quality therapeutic alliances.” When a therapist exhibits natural attributes of comfort and compassion, it can strengthen the quality of the therapeutic alliance with a client.

Ruptures in the Therapeutic Alliance

Additionally, the journal article offers recommendations that are important for forming a constructive therapeutic alliance. These recommendations are specifically about navigating ruptures. Unrepaired ruptures can predict weak therapeutic alliances and poor treatment outcomes.

Some recommendations for navigating ruptures include:

  • Being open to criticism
  • Validating the client's negative experiences
  • Accepting responsibility for mistakes and empathetic failures

How Pathways Fosters Therapeutic Alliance

Every treatment facility navigates a therapeutic alliance in its own way. At Pathways Recovery Center, our primary purpose is to provide the best addiction treatment and recovery experience possible. We build our therapeutic alliances on many elements, such as prioritizing a safe and comfortable environment conducive to recovery. Our staff members can provide the empathy, compassion, and understanding that clients need to heal because we each have the personal experience of addiction.

Additionally, we cap our therapy sessions and treatment programs, keeping only a small number of clients at a time. This ensures that each client can receive not only the intensive care that they need but also the time to form a worthwhile bond with their therapist, other staff members, and peers in recovery.

Participating in treatment at Pathways will require clients to deeply reflect on the person they are as well as the person they want to become. We utilize the biopsychosocial model and assessments to help clients identify unique components and factors in their life that have affected their well-being thus far. Additionally, we understand that discussing certain topics, such as trauma, is never easy. Therefore, prioritizing strong therapeutic alliances in our programs can ensure that clients feel safe, supported, validated, and understood throughout their entire treatment and recovery journeys.

A therapeutic alliance is a personal relationship that is formed between a client and therapist in treatment. In addiction recovery, a strong therapeutic alliance can predict positive treatment and recovery outcomes. Fostering a strong therapeutic alliance requires a client to remain open about their needs throughout treatment. It also involves active empathy and understanding shown by a therapist. At Pathways Recovery Center, we value a strong therapeutic alliance between all of our clients and staff. We understand that healing from addiction requires clients to discuss challenging topics like trauma. Therefore, we are passionate about providing a comfortable and empathetic environment where they can overcome issues from their past. To learn more, call us today at (888) 771-0966.

Clinically reviewed by 

Moses Nasser
Dr. Moses Nasser, a double board-certified physician in Family Medicine and Addiction Medicine, with expertise in holistic healing, addiction medicine, and psychiatric care, holds an X-waiver to prescribe buprenorphine and has extensive experience in mindfulness-based customer service and medication-assisted treatment.

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