Rapport is described by Lexico.com as ‘a close and harmonious relationship in which the people or groups concerned understand each other's feelings or ideas and communicate well’ and it’s widely accepted that good rapport with your client is important to the outcomes of therapy.
We often build relationships with people by exchanging stories – about ourselves, our families and our lives. But in therapy the information is flowing in pretty much one direction from the client to you and, as a therapist, the responsibility for building a good level of rapport will fall mostly on you.
How important is rapport to therapy outcomes?
I have seen the odd post on social media from therapists who believe that rapport really isn’t important. As long as they have the skills to help a client, they argue, they don’t need a relationship with them. However,
- Strupp (2001) [1] said that the outcome of psychotherapy is influenced more by the personal characteristics of the therapist and the positive feelings that arise in the client than by the type of intervention.
- Eysenck (1952) [1] went further, claiming that any improvements were ‘spontaneous remission’ and that ‘the efficacy of psychotherapy had not been demonstrated’.
- The APA’s Society of Clinical Psychology found that ‘the therapy relationship makes substantial and consistent contributions to psychotherapy outcome, independent of the specific type of treatment … [and] accounts for why clients improve (or fail to improve) at least as much as the particular treatment method’. [2]
- Ackerman and Hilsenroth discovered that ‘Therapist's personal attributes such as being rigid, uncertain, critical, distant, tense, and distracted were found to contribute negatively to the alliance. Moreover, therapist techniques such as over structuring the therapy, inappropriate self-disclosure, unyielding use of transference interpretation, and inappropriate use of silence were also found to contribute negatively to the alliance.’ [3]
So if rapport is that important, what can you do to help build that trust and move forward with your client?
How to build rapport with therapy clients
- Write up session notes straight after each appointment. Read through them before each appointment to remind yourself of what you talked about last time, any feedback the client gave you, and what tasks (if any) you asked them to complete before this meeting. (For our advice on how to keep notes – see THIS LINK)
- If the chance arises, remember something personal that’s not necessarily connected to the therapy. Greeting them by asking how a child’s birthday party went, or asking about a hobby, shows you recognise them as an individual as well as a client.
- Use active listening and non-judgmental responses when your client is telling their story.
- Pay attention to the client’s non-verbal cues as well as their words, including silences.
- Give positive feedback whenever you can, without going over the top.
- Be professional – be friendly but professional from the first contact, which is often your website, an email or social media message. Reply to texts, emails and answerphone messages promptly.
- Empower the client by involving them in their therapy; check that your therapy plan feels good to them, that you have understood their goals correctly and that they understand what you are trying to achieve in each session. Ask for feedback.
- Have a restful therapy space where the client can feel safe. If you work from home, ensure the space is uncluttered by children’s toys, dog or cat beds and the like before they arrive.
- When it’s necessary to challenge the client (for example about an unhelpful or self-limiting belief) do so gently and respectfully.
- Allow the client to feel unrushed; yes, you have just an hour (or whatever time slot you allow) but clock-watching or looking at your watch will unsettle your client and put them under pressure.
----------------------------------------------------------------------------
Author: Debbie Waller is an experienced hypnotherapist and hypnotherapy trainer. She is the author of Their Worlds, Your Words and has co-written the Hypnotherapy Handbook, both of which are available from Amazon. Find out more about Debbie's services on
Yorkshire Hypnotherapy Training - multi accredited hypnotherapy practitioner training, taster days and foundation levels.
CPD Expert - accredited CPD and other therapy training (online and workshops options), expert and qualified hypnotherapy supervision
[1] cited in Ardito RB, Rabellino D. Therapeutic alliance and outcome of psychotherapy: historical excursus, measurements, and prospects for research. Front Psychol. 2011;2:270. Published 2011 Oct 18. doi:10.3389/fpsyg.2011.00270
[2] Firestone, L. (2020). The Importance of the Relationship in Therapy. [online] Psychology Today. Available at: https://www.psychologytoday.com/gb/blog/compassion-matters/201612/the-importance-the-relationship-in-therapy [Accessed 19 Feb. 2020][3] Ackerman, S. J., & Hilsenroth, M. J. (2001). A review of therapist characteristics and techniques negatively impacting the therapeutic alliance. Psychotherapy: Theory, Research, Practice, Training, 38(2), 171–185. https://doi.org/10.1037/0033-3204.38.2.171
Comments
Post a Comment