The Psychotherapy Relationship

The bottom line for successful therapy is the bond that exists between the therapist and the client. This is not left to chance, but is something that a therapist can consciously create by honoring and affirming each client for who they are — not just for their potential or who they can become.

Ideally, a client can feel understood and appreciated by the therapist on a moment–to-moment basis in the therapy process. Creating a safe relationship is crucial, since it takes courage for clients to bring forth parts of themselves that they don’t usually express in the normal course of their lives.

A Collaborative, Respectful Attitude

Another part of what makes therapy “safe” is for the therapist to maintain a collaborative, non-authoritarian, respectful attitude. If clients feel strongly that they know what is best for them, their views should be honored. I believe that therapists should answer reasonable questions from clients and be open to giving specific feedback.

I also believe that therapists should be willing to give an overview at any point in the therapy, describing how they feel the process is going and how the process will help meet the client’s goals.  Part of a collaborative relationship also involves soliciting feedback from clients as to whether, and/or how, a session was helpful.  

A Therapy Relationship that is Genuine and Alive

Much of the power of the therapy relationship comes from its “aliveness” — the ability of the client and therapist to respond genuinely and spontaneously in the moment, to be able to be expressive and laugh together as well as entertaining deep feelings.    

The therapist should be flexible enough to be fully present with the client as he or she experiences joy, pain, humor, sadness, excitement, etc. Yet, to do this effectively, the therapist must also be able to set appropriate boundaries, as necessary — and to stay grounded and constructive in the face of fear, anger, anxiety, despair and other difficult emotions that a client may experience.

When the therapist navigates this process successfully, a genuine relationship can evolve and strengthen. Research has shown that, aside from inherent client strengths, the quality of the psychotherapy relationship is the most powerful factor in predicting successful therapy outcomes — much more so than any technique or the orientation or education of the therapist.

To ask questions or set up an appointment, call 212-439-5102 or contact me by email at

180 East 79th Street, Suite 1A
New York, NY 10075

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"The client's view of the relationship [with the therapist] is the 'trump card' in therapy outcome... Clients who rate the relationship highly are very likely to be successful in achieving their goals. Despite how chronic, intractable or 'impossible' a case may appear, if the client's view of the relationship is favorable, change is more likely to occur."


From The Heart and Soul of Change: What Works in Therapy by Mark Hubble, Barry Duncan and Scott Miller. (A book that summarizes 40 years of outcome research to point the way to what really matters in the therapist's day-to-day work.)