It turns out that one of the most healing factors of therapy is the relationship I have with my therapist. She knows when to be a sympathetic ear, when to challenge me, and accepts who I am.
I’m free to be open and vulnerable in a safe, nonjudgmental space. As a result, this reparative relationship allows me to grow, heal, and stick with the therapy process.
According to the American Psychological Association, 20 percent of clients will drop out of therapy before completing treatment. Considering how daunting developing a solid therapeutic relationship can be, this statistic isn’t surprising. But in my experience, it’s proven to be worth the discomfort — but that’s because I’ve had a great experience. This, experts say, is crucial.
“The therapeutic relationship is proven time and time again to be the determining factor in a client’s success with therapy,” says Maelisa Hall, a psychologist in Irvine, California.
So, how do you know if your therapy relationship is beneficial? Here are six questions to ask yourself, and what experts advise, to help you know whether your therapy relationship is working or if it’s time to move on.
This may seem obvious, but it’s much easier to build a relationship with a person you genuinely like.
“One thing [clients] deserve is to be with someone that they like, because it’s hard work to be in therapy,” says Janet Zinn, a New York-based psychologist. “You might not like everything about them, but do you like them enough that you feel like you can get something from them?”
This relationship is most often an optional one. In the same way you choose friends or partners, you want to feel connected to your therapist.
Therapy requires delving into uncomfortable, difficult, and vulnerable aspects of our lives. In a good therapeutic relationship, you’ll feel comfortable doing this, which is part of the healing process.
“One thing is to feel safe, to feel like you’re really heard, you’re cared about, whatever you say will be taken seriously and listened to,” says Sherry Amatenstein, author of “How Does That Make You Feel?” and a New York-based therapist. “You learn that it’s OK just to show up and be you.”
This goes both ways between a therapist and their clients. While clients won’t know everything about the personal life of their clinician, a therapist should bring their true self to the relationship.
“The more that both the therapist and the client can be themselves and can be authentic, the more there can be a connection,” says Zinn. “[This] creates a foundation of trust.”
By its nature, therapy is a bounded relationship. It’s a business, because you hire a professional for a service, but it’s also a very personal relationship. This dynamic requires strong boundaries, which facilitate safety in any relationship.
Therapists must also hold boundaries in the relationship, including a code of ethics. This includes not having a relationship with clients outside of the therapy room and deciding how much of their personal lives to share in sessions.
Therapists and clients work together on other boundaries, including keeping predictable appointment times and payment expectations, as well as managing the time while in session, and when it’s acceptable to contact a clinician outside of the therapy room.
Occasional discomfort in therapy is a sign of growth as you learn to challenge old ways of thinking. There should be a balance between challenge and comfort.
To challenge clients, some therapists rely on their intuition and cues from clients as to when to push. Other therapists collaborate with clients to determine what pace is most comfortable.
“Therapists will often ask their clients for feedback about how therapy is going, what they’re ready for, and what they feel they need more of,” says Hall. “If you feel your therapist is pushing too much or too little, bring up the subject. If you’re not even sure what the right balance is, bring that up too.”
Feeling anger toward a therapist may seem counterintuitive, but it’s actually normal and crucial to a good relationship with your therapist.
“One of the most important things that can happen in therapy is that there’s room for the client to be upset with their therapist,” says Zinn. “To honestly communicate their anger or disappointment with a therapist, and the therapist to be able to hear it and take responsibility, is a relationship in which there can be healing.”
Many people have trouble appropriately expressing anger and asserting themselves in relationships, not just in therapy. Therapy can be a laboratory for testing what it feels like to express anger, set healthy limits, and ask for what you need. A therapist who supports this process will likely cultivate a meaningful relationship with their clients.
There are many types of therapy, from cognitive behavioral therapy to psychoanalysis, dialectical behavioral therapy, exposure therapy, art therapy, and many others. Most therapists will specialize in one or a few of these therapeutic techniques, but they may not all be right for you.
This might take research, and even trial and error.
“I would encourage potential clients to do a little research on the various therapeutic theories and even techniques,” says Margery Boucher, a Texas-based psychologist. “They can then do an over the phone consultation with most therapists or clinicians, and ask questions about their specific therapeutic interventions and style of therapy.”
To have the best chance for a good relationship right away, ask potential therapists both practical and personal questions. Hall suggests asking:
1. What’s your availability during the day and evening?
2. What are your fees, and do you accept insurance?
3. How long do you typically work with clients?
4. What do you enjoy about being a therapist?
5. How do you think you’ll be able to help me?
“I would encourage clients to trust their intuition in working with a therapist,” adds Boucher. “I find that generally within the first session both client and therapist know if it’s a good clinical match.”
Like therapy itself, it may take you time to find the right therapist for you. It’s taken me 10 therapists to find a healthy relationship, one that allows for growth and the safety to be vulnerable.
Cycling through so many therapists was a frustrating process, but once I found the right relationship, I knew. As a result, today I’m making true progress toward healing, which is after all, the ultimate goal of therapy.
Renée Fabian is a Los Angeles-based journalist who covers mental health, music, the arts, and more. Her work has been published in VICE, The Fix, Wear Your Voice, The Establishment, Ravishly, The Daily Dot, and The Week, among others. You can check out the rest of her work via her website and follow her on Twitter.