Harvard Mental Health Letter

The therapeutic relationship: What patients want

Two studies in a journal exploring the theory and practice of psychotherapy show that therapists and their patients or clients don't always agree on what makes for a good working relationship.

In the first study, 40 psychotherapy patients ranging in age from 18 to 62 described "critical incidents" that they thought helped establish a strong therapeutic relationship and promote successful psychotherapy. The interviewers requested specifics — something either the patient or the therapist did or said, something they did together, or something else that happened in connection with the therapeutic sessions. Patients were asked why and how the critical incident helped to form or strengthen the relationship.

Using tapes of the interviews, the researchers divided the responses into 25 categories. Examples:

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