Fostering A Positive Therapist-Patient Relationship

When you were just learning how to become a therapist, one of the first things you learn is to foster a positive therapy relationship with your clients. The relationship between therapist and patient is incredibly important; a good therapist patient relationship is key to a patient getting better, while a poor therapeutic relationship can be harmful to a patient's mental health.

But what exactly does a good therapist patient relationship look like? How do you foster a good therapist and patient relationship? In this guide, we’ll explore the answers to these questions to help you identify the traits of a positive therapeutic relationship or therapeutic alliance and make improvements in how you relate to your clients during in person or online therapy session to help you improve chances of a positive therapeutic outcome.

What Are the Signs of a Good Therapist Patient Relationship?

In order for patients to get the most out of therapy, it’s important for them to find a therapist they can trust and form a healthy relationship with. If you want to ensure that your relationships with your patients stay on the right track, here are nine signs of a healthy therapist and patient relationship that you should look out for:

1.   You Create a Safe Space

A safe space is a place where your clients can feel relaxed, open, and able to express themselves. You should make it clear from day one that patients are free to share their thoughts and feelings—that what goes on in your sessions stays in your sessions. Providing a safe space where patients can be open and honest is essential for healing, and it helps to build a positive bond between you and your clients.  

2.   You Share a Mutual Trust and Respect

Trust and respect are crucial for any relationship to thrive, but it’s especially important in therapy. Patients can spend many hours a week working through tough issues with their therapists, so it’s vital that they trust and respect them. The first step is for patients to feel completely comfortable and able to be vulnerable in front of their therapists without feeling judged. It also helps if therapists have an open and empathetic attitude so patients can feel understood. If there isn’t mutual trust and respect, patients may not have positive experiences during the therapy session and could eventually become less engaged or refuse to continue treatment altogether.

3.   You Agree on the Goals of Therapy

While it’s important for you and your patient to have mutual respect for each other, it’s more important to have agreement on the goals for therapy. This is critical because it helps ensure that therapy will be effective and successful.

How can you tell if you agree on therapy goals? Asking therapy questions during intake and discussing them before treatment begins is a good way to gauge where everyone stands; you should also check-in throughout treatment to see if your patients feel they’re on course and making progress—this will also help foster a better connection and deeper trust between you.

4.   You Made Decisions Together

Making decisions together is vital for several reasons. For one, it helps ensure that patients are informed about their treatment options and how they will fit into their lives. When it comes to therapeutic approaches, if a patient really understands what’s on offer, he or she is more likely to see which approach might work best for them.

This can create a suitable environment for counselling where they feel free to be honest with their therapists—and that honesty is critical in creating mutual trust between patient and therapist. Additionally, not only does decision making together help develop trust but it also allows therapists to share some of their power with patients and instill confidence in them.

5.   You Can Share Your Honest Responses – Even if They’re Negative

Patients want to feel listened to, validated, and understood by their therapists. They also want to be able to speak honestly about their feelings, even if they’re negative. Honest communication is key for building a strong therapist client relationship and results in patients feeling comfortable enough to share their deepest thoughts and fears. That comfort level—and trust—takes time to develop and it’s important for both parties to express themselves openly throughout that process.

Patients may hesitate if they believe sharing honest thoughts or discussing issues will result in judgment or criticism from their therapist, leading them down an emotionally dangerous path. A therapist who listens intently and gives thoughtful feedback builds trust, which can make all other sessions go smoother.

6.   You Can Talk Openly about the Therapist-Patient Relationship

Sometimes, patients have difficulty in talking about their problems with their therapists because they are afraid that their therapists will think less of them. This fear needs to be dispelled. A healthy relationship can only work if there is an open line of communication between both parties.

However, many therapists believe that it is not appropriate to talk about their relationships with patients as they do not want to become too close to them and possibly lose objectivity. Patients also tend to avoid discussing such issues because they fear conflict and rejection. Discussing these issues would help both parties understand each other better and make open lines of communication possible.

7.   You Can Resolve Any Issues that Come Up in the Therapist-Patient Relationship

With any patient relationship, there are bound to be issues that come up. Sometimes they're minor, and other times they can cause major problems. The real question is: How do you fix things? Patients need to know that resolving problems in their relationship with their therapist will only make them stronger. If something isn't working between you and a patient, you should be able to address and resolve the issue—that is a sure sign that you’re in a good therapist client relationship.

How To Foster A Good Working Therapist-Patient Relationship

A good therapy relationship doesn’t just happen by accident—you have to actively promote it through your actions. Here are a few tips on how to foster positive bonds with your clients.

  • Listen to Your Patients Carefully: A good therapist is present and really listens; that’s what helps you develop trust, which is important in psychotherapy. You may find your mind wandering off from time to time—it’s only natural. But to let your clients know that they matter and their problems are important, you need to be an active listener.  

  • Ask Relevant Questions: A good therapist will ask relevant questions that show they're listening, draw out information, and clarify topics to better help patients understand their situation. When you’re able to elicit insights from your patients in this way, it helps to build and even stronger bond of trust between you and deepen your client therapist relationship.

  • Use I Statements, Not You Statements: Using “I statements” puts the focus on the patient, allowing them to reflect on their thoughts, feelings, and experiences without feeling judged. If therapists used “you statements” instead of “I statements” it could suggest that there is something wrong with the patient. Rather than attacking someone who is already suffering, therapists should use language that builds confidence and encourages healing.

  • Try Different Tactics If the First Doesn’t Work: Not every patient will respond the same way to a certain therapeutic approach. If you’ve already tried one tactic but your patient doesn’t seem to be making much progress, put the patient’s needs first and be willing to try something new.

  • Communicate Openly and Often: Maintaining communication with your patients is crucial to forging a strong relationship. It allows you to check in frequently, learn about how they’re doing, and evaluate their progress. It also shows your patients that you care about them on a personal level and aren’t just focused on pushing them through their problems as quickly as possible so that you can see more clients.

  • Manage Your Emotions: The relationship you have with your patients is paramount to a successful therapy session. Therapy is all about emotion, so it’s important for therapists to manage their emotions—and learn how not to project them onto their patients. The best way for therapists to do that? By setting healthy boundaries and acknowledging their personal baggage and biases.

  • Recognize that Relationships Build Over Time: When people come to therapy, they often want a quick fix, like a pill or an easy set of steps. But as a therapist, you know it’s unwise to hope for too much too soon. The same principle applies to building a good therapist-patient relationship. It might be helpful to remind yourself that building a strong therapeutic bond takes time. Be patient with yourself and your client during sessions; most likely you will get closer as time goes on.

  • If All Else Fails, Recommend They See a Different Therapist: This may be tough to admit, but there will be times when you and your patient simply aren’t well-suited to one another. If you’ve tried to build a bond but haven’t had any success, don’t hesitate to refer them to a different therapist. If you’re not sure who to send them to, they can use a matching service like Advekit to find another therapist in the area.


Despite the fact that therapy can often be emotionally difficult, it’s critical to have good therapist-patient relationships for your patients to truly benefit from treatment. Your job as the therapist is to help your patients discover and resolve issues that are holding them back in their life, but you will only succeed if they feel comfortable enough to talk openly with you about the things that matter most to them. If you want to create the right atmosphere in your sessions, take steps to foster a strong therapist-patient relationship.